Pregnancy and postpartum are times of tremendous physical and emotional change and transformation. Feelings of anxiety and sadness are common during these life changes, and it can be hard to distinguish whether they are just a normal part of the adjustment or an actual mental health problem. The thing is, when these feelings start to interfere with daily life, it’s crucial to seek appropriate support. Recognizing when it’s time to transition to a higher level of care can be life-changing—not only for the person experiencing the symptoms but also for their family.

Sadly, our society sometimes propagates the idea that mothers have to suffer to fulfill the role of caretaker of their children. In my career, I have met so many women who say, “looking back, I realize that I was actually experiencing postpartum depression, and I wish I had asked for help. I thought this was my new normal as a mom.” The truth is, it is not normal to feel like life is a daily struggle. Here are the signs of postpartum anxiety and depression below so you know when it’s time to reach out.

Common Symptoms of Perinatal Depression and Anxiety

Mild to moderate anxiety or depression during pregnancy and postpartum often includes symptoms such as:

Frequent worry or intrusive thoughts
Irritability or anger
Difficulty sleeping, even when the baby is sleeping
Changes in appetite
Low energy or motivation
Feelings of guilt or worthlessness

These symptoms can often be managed with outpatient therapy, support groups, lifestyle changes, and, when needed, medication prescribed by a healthcare provider. However, when these strategies aren’t enough, it may be time to seek a higher level of care.

Signs That Indicate a Higher Level of Care May Be Needed

A higher level of care—such as intensive outpatient programs (IOPs), partial hospitalization programs (PHPs), or even inpatient treatment—should be considered when:

1. Symptoms Interfere with Daily Functioning

You struggle to complete basic tasks, such as bathing, feeding yourself, or caring for your baby.
You feel paralyzed by anxiety or overwhelmed by sadness, making it difficult to get out of bed.

2. Persistent or Worsening Symptoms Despite Current Treatment

If you’ve been in therapy or on medication and haven’t seen improvement after several weeks.
Symptoms such as panic attacks, uncontrollable crying, or extreme irritability become more frequent.

3. Loss of Interest or Detachment

Feeling emotionally detached from your baby or loved ones.
Loss of joy in activities that used to bring pleasure, which can signal deeper depression.

4. Intense or Intrusive Thoughts

Experiencing recurrent thoughts of self-harm or harm to your baby, even if you don’t intend to act on them.
Thoughts that feel intrusive and distressing, such as obsessive fears about your baby’s safety.

5. Suicidal Ideation or Thoughts of Harming Others

If you have thoughts of ending your life or harming others, it’s essential to seek immediate help. This is a clear sign that a higher level of care is required to make sure you are safe.

What Are Higher Levels of Care?

If any of the above signs resonate, there ARE options for help. These include:

Intensive Outpatient Programs (IOPs)

These programs offer several hours of structured therapy multiple times a week, allowing you to receive intensive support while still living at home.

Partial Hospitalization Programs (PHPs)

PHPs are more intensive than IOPs, typically requiring attendance five days a week. They provide therapy, psychiatric care, and support in a structured environment but do not require an overnight stay.

Inpatient or Residential Treatment

Inpatient programs offer 24-hour care in a hospital or residential setting. This level of care is reserved for severe cases, especially when there is a risk of harm to oneself or others.

Seeking Help Is a Sign of Strength

It’s important to remember that needing a higher level of care is not a reflection of weakness or failure. Perinatal and postpartum depression and anxiety are medical conditions that require appropriate treatment, just like any other health issue. Seeking a higher level of care ensures that you’re giving yourself the best chance at recovery and providing a strong foundation for your family’s well-being.

Perinatal and postpartum anxiety and depression have the tricky ability to plant ideas in your mind that aren’t true - things like “maybe I am just not meant be a mom,” or “my family would be better off without me.” Please know that these things AREN’T TRUE, and are simply signs of the mental health disorder talking. With professional help, you CAN feel better.

Resources for Immediate Help

National Suicide Prevention Lifeline: 988
Postpartum Support International (PSI) Helpline: 1-800-944-4773

No one should have to navigate perinatal mental health challenges alone. Be kind to yourself. With the right support, healing is possible.

When to Seek a Higher Level of Care for Depression or Anxiety in Pregnancy or Postpartum