Something Doesn’t Feel Right: A Guide to Postpartum Mental Health
Updated: 5 days ago
HOLISTIK JOURNAL · SEPTEMBER 2026
MATERNAL MENTAL HEALTH · CLINICAL EDUCATION
Everyone asks about the baby.
Is the baby sleeping?
How often is she eating?
Is he gaining weight?
How much did she weigh?
And somewhere between feeding schedules, pediatrician appointments, visitors, photographs and trying to remember the last time anyone slept, there is another person whose body and life have changed dramatically.
The mother.
The Lindsay Clancy case has brought renewed public attention to postpartum mental health and serious postpartum psychiatric disorders.
A necessary boundary
This article will not attempt to interpret Lindsay Clancy’s mental state, diagnosis, actions or legal responsibility.
Those questions belong to the court and to the qualified professionals directly involved in her case.
But the conversation surrounding it raises a much broader question — one that matters far beyond any single family or headline:
How well do we recognize maternal mental-health concerns before they become severe?
We should not need a tragedy before we become curious about a mother’s mental health.
“I’m tired” can mean a lot of things after having a baby
Of course you’re tired.
You have a newborn.
Of course you’re emotional.
Your body has been through something enormous.
Of course you’re overwhelmed.
Your life may have changed almost overnight.
Sometimes all of that is true.
The first days and weeks after birth can be physically exhausting, emotionally intense and profoundly disorienting without there being a psychiatric disorder.
The baby blues are common and can include tearfulness, worry, irritability, anxiety and feeling overwhelmed. They usually improve within a few days to about two weeks.
But sometimes symptoms persist.
Sometimes they intensify.
And sometimes a mother knows, even if she cannot explain exactly why:
This feels like more than being tired.
The problem is that “you’re a new mom” can become an explanation for almost anything.
And sometimes it explains too much.
Postpartum depression doesn’t always look like crying
Depression can look like sadness.
But it can also look like irritability, numbness, guilt or disconnection.
It can look like not enjoying things anymore.
Struggling to make simple decisions.
Feeling as though everyone else understands motherhood and somehow you missed the instructions.
It can look like going through the motions of caring for a baby while privately wondering where the person you used to be went.
Perinatal depression can begin during pregnancy or after childbirth. It can affect mood, energy, concentration, sleep, appetite, functioning and the ability to experience pleasure.
Some people experience profound hopelessness or thoughts of death, self-harm or suicide.
A mother doesn’t have to look devastated every minute of the day for her symptoms to deserve attention.
And she doesn’t have to wait until she cannot function at all before asking for help.
Sometimes it looks more like anxiety
A mother may love her baby intensely and still spend much of the day afraid.
She checks whether the baby is breathing.
Then checks again.
She doesn’t want anyone else driving with the baby.
Her mind rehearses everything that could go wrong.
She cannot relax when someone else is holding the baby.
The baby finally sleeps.
She doesn’t.
Everyone keeps telling her:
Enjoy this. It goes so fast.
She would love to.
Her mind won’t stop scanning for danger.
Perinatal anxiety disorders are also part of the maternal mental-health picture.
The New Jersey Department of Health recognizes conditions including perinatal anxiety, panic disorder, postpartum obsessive-compulsive disorder, postpartum post-traumatic stress disorder, depression and postpartum psychosis among the mental-health concerns that may occur during the perinatal period.
Sometimes the symptom a mother notices first isn’t sadness.
It’s the feeling that she can never completely exhale.
And sometimes it looks like anger
This part doesn’t get talked about nearly enough.
The baby cries and something inside you feels like it might explode.
Your partner asks one harmless question and you snap.
Everyone needs something from you.
Someone touches you and you want to scream.
Then the anger passes.
And guilt takes its place.
Why am I so angry?
What kind of mother gets this irritated with her own baby?
People sometimes use the phrase “postpartum rage” to describe intense anger or irritability during the postpartum period.
It is not a standalone psychiatric diagnosis.
But the experience should not simply be dismissed.
Irritability and anger can occur alongside depression, anxiety and other maternal mental-health concerns.
Trauma, relationship stress, physical recovery, lack of sleep and the relentless demands of caring for a baby can matter too.
The useful question isn’t:
Am I a terrible mother because I’m angry?
It’s:
What is happening underneath this anger — and how much is it affecting me?
Then there are the thoughts mothers are terrified to say out loud
Imagine standing at the top of the stairs holding your baby.
A disturbing image flashes through your mind.
What if I dropped him?
You’re horrified.
So horrified that you start avoiding the stairs.
Or you’re bathing your baby when an image of something terrible happening suddenly enters your mind.
You don’t want it.
The thought itself frightens you.
And then another fear arrives:
Why would my brain even think that?
Followed by an even scarier one:
If I tell someone, will they think I’m dangerous?
Unwanted intrusive thoughts can occur during the perinatal period, including with anxiety and obsessive-compulsive symptoms.
And this distinction matters enormously:
A frightening thought is not automatically an intention.
A clinician assessing an intrusive thought needs more than the content of the thought.
Is it unwanted?
Does it cause distress?
Is there an urge or intent to act?
Is reality testing intact?
What else is happening?
Those distinctions matter.
A mother shouldn’t have to diagnose herself from a Google search.
But she should be able to tell a qualified professional what is actually happening in her mind.
Intrusive thoughts and postpartum psychosis are not the same thing
Public conversations sometimes collapse them together.
They shouldn’t.
A mother experiencing an unwanted intrusive thought may recognize it as disturbing, frightening and completely inconsistent with what she wants.
Psychosis is different.
Postpartum psychosis is a rare and serious psychiatric condition.
It can involve hallucinations, delusions, paranoia, severe confusion, disorganization and manic symptoms.
It requires immediate medical and psychiatric attention.
This isn’t simply “really bad postpartum depression.”
And having an intrusive thought does not, by itself, mean someone is experiencing psychosis.
That distinction may be one of the most important things we can teach mothers.
Because if every frightening postpartum thought is treated as evidence that a woman is dangerous, some mothers may become even more afraid to tell anyone what they are experiencing.
And silence makes good assessment harder.
Bipolar disorder belongs in this conversation too
Postpartum mental health isn’t limited to depression and anxiety.
Bipolar disorder deserves particular attention during pregnancy and postpartum, including because of its relationship to postpartum psychosis.
Current ACOG guidance recommends screening for bipolar disorder before beginning medication treatment for depression or anxiety when bipolar screening has not already been completed.
When bipolar disorder is suspected, further psychiatric assessment is important.
That doesn’t mean every dramatic change in mood after childbirth is bipolar disorder.
It means psychiatric history matters.
Personal history matters.
Family history can matter.
And changes in sleep, energy, thinking, behavior and mood need to be understood together rather than interpreted from one symptom in isolation.
This is one reason significant postpartum changes in mood, thinking or behavior deserve an actual clinical assessment — not a diagnosis assembled from individual symptoms online.
“But she seems fine.”
Someone can get dressed.
Answer texts.
Feed a baby.
Go to an appointment.
Laugh at something.
Post a photograph.
And still be struggling significantly.
But the opposite matters too.
Looking tired, overwhelmed, irritable or unlike yourself after having a baby does not establish that someone has a psychiatric disorder.
Observable functioning gives us information.
It doesn’t give us a diagnosis.
So perhaps the better question isn’t:
Does she look sick enough?
It’s:
Has something meaningfully changed — and does she need more support or an evaluation?
When should I actually reach out for help?
You don’t need to wait for a crisis.
And you don’t need to know which diagnosis fits before you call someone.
Consider talking with your OB-GYN, midwife, primary-care provider or a qualified mental-health professional when symptoms are persistent, worsening or interfering with your ability to function.
That may include:
sadness, anxiety, anger or emotional numbness that feels increasingly difficult to manage;
feeling persistently unlike yourself;
anxiety consuming significant parts of the day;
difficulty sleeping even when you have a realistic opportunity to sleep;
intrusive thoughts causing significant distress;
withdrawing from people or activities;
difficulty functioning or caring for yourself;
persistent hopelessness or guilt;
people close to you noticing concerning changes; or
the simple but persistent feeling that something isn’t right.
You don’t have to know whether what you’re experiencing is depression, anxiety, OCD, trauma or something else before you ask for an assessment.
That’s what assessment is for.
You do not have to prove that you’re sick enough to ask someone to take a closer look.
And then there are symptoms that should not wait
This is a different category.
Hallucinations.
Delusions.
Severe confusion.
Paranoia.
Mania.
Significant loss of contact with reality.
Suicidal intent.
Intent to harm someone else.
Immediate inability to maintain safety.
These are not symptoms to save for an appointment next week.
Postpartum psychosis is a psychiatric emergency and requires immediate medical attention.
If postpartum psychosis is suspected, call 911 or go to the nearest emergency department.
For suicide, self-harm or another mental-health crisis, call or text 988.
If you are unsure how urgent something is, it is appropriate to seek professional help rather than trying to determine the level of risk on your own.
Getting help doesn’t always mean the same thing
This is the part that can get lost when we talk about serious symptoms:
Maternal mental-health conditions are treatable.
Getting help may begin with an OB-GYN, midwife or primary-care provider.
It may mean psychotherapy.
It may mean psychiatric evaluation.
Medication may be appropriate for some people after an individualized discussion of benefits, risks and circumstances.
Some mothers benefit from support groups and other community supports alongside professional treatment.
Severe psychiatric illness may require urgent or inpatient psychiatric care.
The right treatment depends on the person.
The important part is that recognizing a symptom isn’t the end of the story.
It can be the beginning of getting better.
Partners and families don’t need to diagnose. They do need to notice.
Maternal mental health cannot rest entirely on the mother recognizing what is happening.
Sometimes she knows.
Sometimes she isn’t sure.
Sometimes she knows something is wrong but is frightened by what might happen if she says it out loud.
The people around her don’t need to become amateur psychiatrists.
They can notice change.
You haven’t seemed like yourself lately.
You haven’t been sleeping even when I take the baby.
You seem scared most of the day.
I’m concerned about what you just told me.
And then:
Can we call someone together?
That is very different from:
You’re acting crazy.
Or:
Every new mom feels like this.
Or:
You just need to sleep.
You don’t have to diagnose someone to take her suffering seriously.
Screening matters. What happens after the screening matters more.
We have gotten better at asking mothers mental-health questions.
That’s progress.
But a screening questionnaire isn’t treatment.
Current perinatal mental-health guidance recommends screening for depression and anxiety during pregnancy and postpartum using validated screening tools.
But screening should happen within systems that can also provide or connect people with appropriate assessment, diagnosis, treatment, monitoring and follow-up when needed.
Because a mother can answer honestly and still leave wondering:
Who do I call?
Does anyone specialize in this?
Will they take my insurance?
How quickly can they see me?
What do I tell my partner?
What if I’m afraid to say everything?
Asking “Are you okay?” matters. Knowing what to do when the answer is “no” matters even more.
If you’re in New Jersey and something doesn’t feel right
You don’t need to understand the entire maternal mental-health system before asking for help.
Start with someone who can help assess what you’re experiencing:
Your OB-GYN.
Your midwife.
Your primary-care provider.
Your therapist.
A psychiatrist.
Or another qualified mental-health professional.
National Maternal Mental Health Hotline
Pregnant and postpartum mothers — as well as partners and family members — can contact the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).
It provides free, confidential support 24 hours a day, 7 days a week.
Professional counselors can listen, provide information, connect callers with community resources and help identify additional care when needed.
New Jersey Family Health Line
New Jersey mothers can call the NJ Family Health Line at 1-800-328-3838, Monday through Friday from 8 a.m. to 6 p.m.
The line provides information and connections to health and family resources, including resources related to postpartum depression and maternal mental health.
If you need crisis support now
For suicide, self-harm or another mental-health crisis, call or text 988.
If postpartum psychosis is suspected, there is immediate danger, or there is a medical emergency, call 911 or go to the nearest emergency department.
The National Maternal Mental Health Hotline can provide support and connection to resources, but it does not replace emergency evaluation when immediate safety is at risk.
The conversation needs to be bigger than one case
The Lindsay Clancy case may be one reason maternal mental health is receiving renewed public attention.
But this conversation cannot begin and end with one woman, one family or one courtroom.
And it shouldn’t require tragedy to make us interested.
The mothers who deserve our attention are also:
The mother crying quietly in the shower.
The mother checking the baby’s breathing again.
The mother who loves her baby but misses herself.
The mother furious at everyone and ashamed five minutes later.
The mother frightened by a thought she never wanted.
The mother who keeps saying she’s fine because everyone around her seems to be handling motherhood better.
The mother whose partner knows something has changed but keeps hoping another night of sleep will fix it.
The mother who answered the screening questions honestly and is still wondering what happens next.
They deserve our attention before their suffering becomes dramatic enough for everyone else to notice.
Postpartum depression is not postpartum psychosis.
Anxiety is not psychosis.
Intrusive thoughts are not automatically intent.
Anger is not automatically dangerousness.
And none of these experiences should be reduced to whether someone is a “good mother.”
The better questions are more useful:
What changed?
How long has it been happening?
How much is she suffering?
How is she functioning?
What is she experiencing that nobody else can see?
Does she need help?
Does she need help now?
A mother should not have to become unrecognizable before someone asks whether she needs help.
Maybe that’s the conversation worth carrying forward after the headlines disappear.
Not whether every difficult postpartum experience is an illness.
Not whether motherhood is supposed to be hard.
And not whether strangers can determine someone’s diagnosis from the outside.
But whether we’re creating enough room for a mother to say:
Something doesn’t feel right.
And whether, when she does, someone actually listens.
Written and clinically reviewed by Silvia Almeida, LCSWFounder & Clinical Director, Holistik Therapy
Last fact-checked: September 8, 2026
Official & clinical sources
This article provides general educational information and is not intended to diagnose a mental-health condition, assess an individual’s risk or replace individualized medical or mental-health care. Symptoms and circumstances vary. Concerns about postpartum mental health should be discussed with an appropriate healthcare professional. Urgent safety concerns require immediate evaluation.
Looking for mental-health support?
If you’re seeking private therapy in New Jersey, Holistik Therapy can help determine whether one of our clinicians may be an appropriate fit based on your needs and current availability.
Comments