This week, we’re honored to feature a post from Robin Secrist of Inner Healing Charleston, a psychiatric nurse practitioner with deep experience supporting moms through every phase of their mental health journey. Robin’s message is one we hope every new mom hears: there is no “right” way to feel after having a baby, and you are never alone.
Postpartum mood and anxiety disorders often go unrecognized and untreated. New mothers may feel intense pressure to experience certain emotions—joy, gratitude, fulfillment—and when their reality doesn’t align with those expectations, whether imposed by themselves or others, feelings of guilt and shame can emerge. In truth, it is completely normal to feel a wide range of emotions during the postpartum period.
Many factors can contribute to feeling down, tearful, anxious, or irritable. Hormonal shifts, disrupted sleep, a difficult labor and delivery, financial stress, and limited support are among the most common contributors. Additionally, the reality of daily life with a newborn often does not align with expectations. Baby’s behavior, sleep and feeding patterns, and the development of predictable routines can differ markedly from one home to the next. When media about early motherhood portrays only easy experiences and joyful images, perceived unmet cultural expectations can negatively affect a mother’s mood and mental health.
Worrying about a baby’s safety is common, and occasional negative intrusive thoughts can be part of that normative experience. These thoughts can range from vague fears of being an unfit mother to being convinced that a harmless rash is the sign of a serious illness. Some women even have occasional fears that they might hurt their baby. Persistent intrusive thoughts that cause distress signal a need for professional help.
Attachment and bonding can also be affected by untreated mental health issues. Feeling distant, overly controlling, or hesitant about physical contact with the baby may reflect underlying struggles. These are not reasons for shame or guilt; they are signs that additional support may be necessary.
Though sometimes difficult to talk about, it’s also important to acknowledge that suicide is the leading cause of death among mothers in the first year postpartum. Unfortunately, many mothers fear that seeking help for mood or anxiety concerns will cause others—whether professionals, family, or friends—to judge them as unfit or worry that their baby could be taken away. In reality, seeking help is reassuring to professionals. It demonstrates strength, self-awareness, and a commitment to caring not only for oneself, but also for one’s child. Help is available, and no mother needs to suffer in silence.
At times, mental health professionals may recommend medication to treat postpartum mood and anxiety disorders. Research shows that while there is no single “safest” or “best” medication during pregnancy or postpartum, many medications can be used safely, including while breastfeeding. In most cases, the benefits of treating maternal mental health far outweigh the minimal risks to the baby. In fact, untreated postpartum depression has been shown to increase risk of behavioral and cognitive problems for children later in life.
For women who have been diagnosed in the past with conditions such as PTSD, depression or bipolar disorder, ADHD, and eating disorders, it is very important to have close mental health support and monitoring during pregnancy and postpartum. These conditions can be addressed safely with medication and complementary treatments like psychotherapy. As with postpartum depression, untreated pre-existing mental health conditions can lead to negative long-term outcomes for both mothers and children.
While medications can be effective, they are not suitable for everyone. Depression, anxious depression, and OCD can also be treated with non-invasive interventions such as transcranial magnetic stimulation (TMS). TMS is a safe and effective option for women who have not responded well to medications, or for those who prefer an alternative to medications. Psychotherapy, lifestyle modifications, and bright light therapy are additional helpful approaches.
Community support is critical to mental well-being throughout the postpartum period. Building a support network may feel overwhelming—especially while dealing with depression or anxiety—but it is essential. Postpartum Support Charleston is an excellent starting point for finding resources and connection.
There is no one-size-fits-all approach to treating postpartum mental health concerns. What matters most is that mothers receive care in a collaborative, nonjudgmental environment, and are provided with education about the common struggles of the postpartum period and the risks and benefits of various options for treating postpartum mood and anxiety disorders. Mental health professionals should be intentional in focusing not just on the baby or physical recovery, but on the lived experience of the mother herself, an aspect that too often gets overlooked in routine medical care.
Postpartum Support Charleston offers a trusted list of professionals who advocate for mothers in this critically important time. Seeking help or information doesn’t mean something is wrong—it simply means you are doing something brave and loving, both for yourself and your baby.
About the Author:
Robin Secrist, RN, MSN, PMHNP-BC is an advanced practice nurse specializing in psychiatric care and therapy. With over a decade of experience in both inpatient and outpatient settings, Robin is passionate about trauma-informed, culturally responsive care. She currently provides medication management and therapy services, with a focus on collaborative care for women and families in the perinatal period.