top of page

Johns Hopkins Medicine

Baby Blues and Postpartum Depression: Mood Disorders and Pregnancy

Women's Health Managing Mood and Stress Women's Health Conditions Living with Depression

Bringing a baby home can be one of the most joyful times in a woman’s life, but for many, the experience isn’t always so rosy. Lauren Osborne, M.D, former assistant director of the Johns Hopkins Center for Women's Reproductive Mental Health and Lindsay R. Standeven, M.D. explain what women need to know about baby blues, postpartum depression and postpartum psychosis.

The Baby Blues

In fact, most new moms will get the baby blues. These are hormonal changes that can cause anxiety, crying and restlessness that goes away within the first two weeks after giving birth. Also called postpartum blues, the baby blues are actually a mild — and temporary — form of depression that goes away once hormones level out.

Almost every new mother — up to 85 percent of them — will experience the postpartum blues. You may feel happy one minute and overwhelmed and crying the next. 

“No mother is happy all the time,” says Osborne. “It’s normal to be frustrated and even need to put the baby down sometimes.”

Postpartum Depression

For others, bad feelings after giving birth become more than a mild case of the blues. As many as one in five new moms have postpartum depression, a more serious, but highly treatable, condition. 

Standeven says that both mother and baby can be affected by postpartum depression. “Postpartum depression is the most common complication of pregnancy,” she says. “Untreated depression and anxiety in pregnancy is associated with preterm delivery, higher startle reflex in babies, gestational diabetes and more.”

It can also be life-threatening. Standeven says postpartum depression is a factor in 20% of all maternal deaths, according to data in countries that track the incidence of the problem. 

Who Is at Risk for Postpartum Depression?

Postpartum depression symptoms may be more likely ― or more severe ― in some individuals. These are some factors:

History of anxiety or mood disorders. Those with bipolar disorders, depression or anxiety are 30% to 35% more likely to have postpartum depression. Likewise, mothers who have had depression symptoms after previous pregnancies are apt to have them again.

Family history. Those who have family members who have suffered with postpartum mood disorders are more likely to experience them also.

Genetics. Researchers at the Johns Hopkins Women’s Mood Disorders Center identified epigenetic biomarkers — differences in the activity of certain genes — that may predict who’s most likely at risk for postpartum depression.

Postpartum Depression Symptoms

The signs and symptoms of postpartum depression include:

  • Anxiety

  • Sadness

  • Anger and irritability

  • Difficulty sleeping

  • Intrusive thoughts (which may include thoughts of harming the baby)

If symptoms are severe or last for more than two weeks, a new mom should be concerned about a postpartum mood disorder, such as postpartum depression. Women who had anxiety or depression before giving birth are at higher risk.

“People tend to think of depression as sadness, but that’s not always the case,” Osborne says. “Particularly in the postpartum period, there’s a lot of anxiety and irritability, plus lack of sleep, which is a huge risk factor for postpartum depression.” 

And while it’s not necessarily a symptom of depression to be sleeping poorly with a newborn, it can make postpartum depression symptoms worse. 

How Long Does Postpartum Depression Last?  

Without treatment, postpartum depression symptoms can hang on for months, even years. In one study, 25% of participants were still experiencing depression three years after the birth of their babies. That’s just one more reason why prompt assessment and treatment are recommended.


The Transition To Motherhood Has A Name: Matrescence. So Why Don't We Talk About It?

The concept of "matrescence" is helping moms feel seen. Here's what to know about this phase of life — and how to navigate it.
By Kelsey Borresen
Jan 19, 2023, 06:32 PM EST
The word matrescence sounds a lot like adolescence, and that’s not a coincidence. Like adolescence, matrescence — the developmental process of becoming a mother — is a time of transition in nearly every facet of a woman’s life. It changes her physically, hormonally, psychologically, socially, even politically and spiritually.

While adolescence is its own field of study and is well-established in the public consciousness, matrescence is not. But it should be, says reproductive psychologist Aurélie Athan, a research professor at Teacher’s College, Columbia University.
Anthropologist Dana Raphael originally coined the term matrescence in the 1970s; Athan revived it in 2008 and applied it to mental health to give “patience and time and support” to adults transitioning into parenthood, she told HuffPost.

As a psychologist, Athan was interested in how becoming a mother transforms a person’s identity.

“It’s about how I think about myself with my body changing, with my relationships changing: my friends, the peers that I hang out with, my relationship with my significant other, loved ones and family members,” she said.

“But then [it’s] also thinking about myself in the larger world: How do I feel about political systems and social justice? I might awaken to those things now too. And even larger questions like spiritual and religious questions about the sort of origins of all things. So it’s a pretty profound change — and it’s a worldview change at the end of the day.”

Mothers go through the developmental passage of matrescence whether they give birth or welcome a child via adoption or surrogacy. The acute stage typically lasts several years, but the “learning and maturation and growth then takes the rest of the lifetime to do,” Athan said.

An Antidote To ‘Bounce Back’ Culture

Rather than honoring the transformation that has taken place, the cultural conversation around new motherhood, at least in the United States, has too often focused on “bouncing back.” When are you going back to work? When are you going to fit into your jeans again? When are you going to return to the person you were before you had the baby?

Kendra Williams is a motherhood coach and content creator who frequently talks about matrescence on her social media platforms. She told HuffPost that she first remembers hearing the word in early 2021 when her kids were 2 and 3 and she was still feeling “somewhat disoriented about who [she] was.”

“The word made me feel so seen and helped make sense of what was going on in my own life outside of parenting,” Williams said. “Back then, it was my shifting career goals, my relationship with my parents and my marriage.”

Williams wishes she had learned about matrescence prior to having kids, she said — then, perhaps, she would have known she wasn’t supposed to be the same person before and after.

“‘Bounce back’ culture is alive and well when it comes to women’s postpartum bodies but I think a lot of us also walk into motherhood with an unconscious expectation that everything else in our life should bounce back too,” Williams said. “That’s just not the case. And while it can sound like a bad thing at first, it’s simultaneously an amazing opportunity for growth and healing.”

Normalizing — Rather Than Pathologizing — The Ups And Downs Of Becoming A Mom

Reproductive psychiatrist Alexandra Sacks wrote in a 2019 Psychology Today blog about matrescence that new mothers frequently call her asking if they have postpartum depression because they’re feeling exhausted, bored, resentful or just not enjoying every minute of the motherhood experience as they thought they would.

“Though they may not meet diagnostic criteria for this condition, postpartum depression seems to be the most familiar term they have on hand to frame their distress,” Sacks, who helped popularize the term matrescence, wrote in the piece.

These uncomfortable feelings are a normal part of matrescence; they don’t always need to be pathologized. Reproductive psychiatrist Sarah Oreck described the transition to motherhood as “wonderful and challenging — even unpleasant.”

“Unfortunately, our culture has been invested in the myths around the bliss and martyrdom that surrounds pregnancy and the postpartum period,” she told HuffPost. “Which is likely the reason this term [matrescence] has not become more popular earlier.”

“In a world with so many stressors and a lack of support for new parents, especially mothers, I see a great deal of suffering during the transition to motherhood when ideals of perfection can’t be reached,” Oreck added. “It’s important to normalize the bumps that come during matrescence, and to also differentiate these symptoms from more severe perinatal mood and anxiety disorders.”
Athan said she, too, wants to normalize the conflicting emotions that accompany the motherhood experience. It’s not this feeling or that one — it’s this feeling and that one, often at the same time.

“Mothers will say how I’m both exhausted and exhilarated. I am both depleted, but also learning new wellsprings of patience within me that I didn’t know that I have,” Athan said. “This is the language of growth. And I don’t think that a lot of women know it because we sort of split things a lot.”

Re-Centering The Woman In Motherhood

So much of the modern motherhood discourse is about how to be a better parent and raise a happy, healthy kid. Those are important pursuits, but they put all of the energy and attention on the child. Matrescence turns some of that focus back on the mother.

Re-centering the woman in the motherhood conversation “feels like a breath of fresh air,” Williams said.

“I believe matrescence is focused on the woman and the act of mothering is focused on the child,” she said. “In a world so focused on parenting styles, Pinterest-perfect nurseries and child development, it’s easy for the woman to be overlooked. Matrescence is about the evolving woman who is navigating motherhood.”

“Our culture has been invested in the myths around the bliss and martyrdom that surrounds pregnancy and the postpartum period.”


This may be one of the reasons matrescence has been slow to catch on: Culturally and academically, we’ve been much more interested in the child’s development than the parent’s.

“There’s always another theory on how to improve your parenting style and raise a child better and improve child outcomes,” Athan said. “So the empathic thrust has been largely on children — we understand that they’re the vulnerable other in the dyad. There hasn’t been as much curiosity on adult development.”

Sexism in scientific research may have also played a role in matrescence not getting the attention it deserves. Historically, researchers and their subjects were men, so many of the biological and psychological models we have are based on male bodies and brains.

The tides have been turning though. More and more women and mothers have entered academia, bringing with them “the techniques and tools and theories to narrate their [own] experience,” Athan said.

In recent years, the matrescence movement has picked up momentum thanks to social media, where moms are introducing each other to the term and having honest conversations about the many changes, joys and struggles of this phase of life.

“Social media as a sort of new wave of how public health information gets out the


Miranda at Postpartum U



  • it can affect anyone! Supposedly 1/7 experience it - PROBABLY MORE LIKE 1/3 (especially after COVID)

  • WE HAVE CONTROL WHEN CAN ADDRESS THE ROOT CAUSE! NOT JUST: hormones **Commonality DOES NOT = NORMALCY - just cause many have it - doesn't make it NORMAL!! **we need SLEEP, NUTRIENTS & SUPPORT - can you detoxify your body - toxins stay in your system when you're stressed?


  • Emotional & mental health should be normalized!! Sometimes counseling is necessary - we've come a long way understanding trauma (traumas stored in our bloodlines). WE CARRY THE EXPECTATION THAT WE NEED TO DO IT ALONE.

  • THESE DON'T OFTEN ADDRESS THE ROOT CAUSE! SSRI'S target seratonin: depression is not a seratonin deficiency. PREGNANCY DOES NOT CAUSE CHEMICAL IMBALANCE. We can tell by the inflammatory markers in your body!

  • INFLAMATION: e.g. tooth pain, c-section, healing from an event...these can be depression predictors! Depression is symptom of body not getting what it needs to survive. ROOT CAUSES OF INFLAMATION: 1) external support, 2) nervous system care 3) sleep, 4) nourishment Counseling can help in the moment (not only option).

3) PPD ONLY HAPPENS RIGHT AFTER BIRTH - "symptoms in 1st 6 weeks" some say..."maybe one year...?" WRONG! Can be YEARS!

  • 3 mo. mark is common w/ breast milk changes

  • 2 yr mark: brain changes are finishing after biological chemical neurotransmitter changes can take 2+ years! 

  • Weaning depression happens too! 



  • Biological changes are supposed to happen - they work in our favor! When they're not supported, we have a system of inbalance & dysregulation + THAT'S PPD! 

  • THE MAMA THREAD METHOD: What supports do we need for our HORMONAL (biological normal) changes?? If we understood Postpartum physiological postpartum experience the way it's meant to be, there would be a huge hormonal fluctuation supported by community care and support and words of affirmation and people telling us we're doing a great job and lots of SLEEP & NOURISHMENT!!! Help feeling good and tellin you that you're doing a great job! You're able to process the birth and use your coping skills to process the birth! THIS WILL REGULATE THE HORMONES. 

  • Hormones are responders - to nervous system, to gut (can't process food bc struggling)...sending warning signs to brain which triggers NERVOUS SYSTEM - immune system struggles as a result too!! 



  • SHE SAYS: "IT'S NOT OKAY THAT YOU'RE NOT OKAY..." Yes, for moments, but not long term! You deserve better! 

  • Myth: "PPD means you're an unfit mom" - I have psychosis...need to be away from baby...WRONG - studies show mom heals better w/baby around. 

***She says it's a medical condition but it's NOT... :| 


PPD MAKES YOU FEEL ALONE - you know that stats and that others feel it but we still feel alone in our experience. IT'S NOT TRUE - WE'RE ALL IN IT TOGETHER BC WE'RE FEELING THIS BC WE'RE NOT GETTING THE SUPPORT WE NEED.

There are 4 sections here - take best from each.

Perinatal mental health disorders like postpartum depression are the #1 complications of childbirth.




Having mom friends who relate to your situation before and after childbirth can change EVERYTHING. Believe me, I know.


What causes PMADs to develop during pregnancy and postpartum?
While there usually doesn't appear to be a single direct cause linked to perinatal mood and anxiety disorders (and every women is different), several factors are thought to play a role, including:Trusted SourceAmerican College of Obstetricians and GynecologistsPostpartum DepressionSee All Sources
-one possibility of many: Life changes, such as isolation, illness, job loss, money trouble, moving to a new city, or a lack of support from a partner, family or friends
Ask for help. Setting up a support network before you really need it can help you avoid feeling overwhelmed and exhausted after giving birth. Friends and family may be available to help do the dishes, burp and change the baby, and cook dinner, giving you the opportunity to put your feet up and take a break.


Forbes - Motherly’s 6th Annual State of Motherhood Report reveals an increase in the percentage of moms who have sought mental health therapy in the past year, to 46% from 43% in 2022. Untreated maternal mental health disorders are estimated to cost the U.S. $14.2 billion annually....But companies that invest in mental health programs see an average return on investment of $4 for every $1 spent, according to the National Safety Council.

EXCELLENT: Assoc. of American Medical Colleges DC 20001 (5/23)“The fact that such a common, treatable medical condition is harming so many women and their families and is causing so many preventable deaths means this is a crisis,” says Wendy Davis, PhD, executive director of the nonprofit Postpartum Support International (PSI), which provides resources and services to families and health care professionals.

BAD: Perinatal mental health (PMH) conditions are the leading cause of U.S. maternal mortality, responsible for 23% of such deaths. Rates among Black and Native American patients are even higher.

What’s more, 75% of people with PMH issues never get treatment.

GOOD: “The chance to talk with other moms who are having similar experiences can be extremely validating, extremely powerful.” Khatiya Moon, MD, Northwell Health



BAD: 1in 5 women will suffer from a perinatal mental health disorder like postpartum depression.Perinatal anxiety and depression are the most common complications of childbirth, impacting up to 1 in 5. , yet they are not universally screened for, nor treated.more stats:

GOOD: The good news is that risk for both depression and anxiety can be reduced and sometimes prevented, and with treatment women can recover.



Nearly half of working mothers surveyed have been diagnosed with anxiety or depression. Here’s what can help

bad: A recent poll found that 42% of working mothers surveyed were diagnosed with anxiety and/or depression in 2022.

good:Walton ALSO INVITES working moms to build out a support system

Did you know? 1 in 5 Moms and 1 in 10 Dads suffer from postpartum depression

bottom of page