Here are some things to consider and tips on getting support as you manage your mental health and wellbeing during this important time.

Unique considerations for Black parents

It’s important to recognize how the following stressors can impact your recovery and mental health:

• Not feeling seen or heard. You may encounter providers who do not take your concerns seriously, such as dismissing or minimizing your symptoms, pain or discomfort. This lack of care can potentially overlook risks affecting your postpartum recovery, mental health,  and overall health.
• Health disparities. Black people suffer from higher rates of morbidity and mortality due to bias, discrimination, and racism in the healthcare system. This can lead to fear, anxiety, distrust and avoidance of the medical system.
• Managing cultural expectations around strength and resilience. Struggling to keep up with the expectations of the “strong black woman” and “black girl magic” can often contribute to anxiety and stress. The pressure to be strong and resilient can discourage some people from asking for help, including during the postpartum period.
• Navigating work matters. Worrying about facing discrimination at work for taking maternity leave or being able to pump at work can add to your stress.
• Access to care. The lack of access to a provider who can understand your cultural needs can create stress and the feeling of not receiving adequate care.

Ways to get valuable support

• Advocate for yourself. Ask questions and seek out second and third opinions, if needed, to meet your healthcare needs. Feeling validated and receiving respectful and proper care is your right.
• It truly does take a village. Don’t be afraid to ask for help from your family and friends. They may be able to provide you with resources and support for you and your family. You are not alone in this journey!
• Seek culturally competent providers. These are healthcare professionals who are sensitive to and respectful of the cultural, racial, and ethnic backgrounds of their patients. Finding a provider who is Black, practices respectful care and helps you feel more comfortable and understood during your postpartum journey can make a big difference in your postpartum care.
• Make self-care a priority. Caring for yourself is as important as caring for everyone else. A good first step is attending your postpartum care appointments to ensure you confidently manage your postpartum recovery. During this time, your provider should address your mental health needs as well.
• Join local and/or online support groups for black parents. Sometimes, gathering and engaging with others in the same place as you can make a difference.

Understanding the signs of postpartum depression (PPD) 

1 in 8 women will experience PPD, and the condition is underdiagnosed in Black women and birthing people. It’s important to be aware of the signs. Are you feeling sad, hopeless, anxious, or worried more often than not? Do you have thoughts of harming yourself or the baby? These are common PPD symptoms. Other signs of PPD include changes in eating habits, losing sleep, and having a hard time bonding with the baby. If you are experiencing these, it’s important to seek help and contact your healthcare provider right away. Read more about PPD.

Reviewed by the Ovia Health Clinical Team

Read on

Why it’s important to track your mood postpartum

Sources:

• Centers for Disease Control and Prevention. “Symptoms of Depression Among Women.” CDC. May 15, 2024 https://www.cdc.gov/reproductive-health/depression/index.html
• Black Mamas Matter Alliance. “Black Maternal Mental Health Factsheet.” BMMA. https://blackmamasmatter.org/wp-content/uploads/2022/08/Factsheet-Black-Maternal-Mental-Health.pdf
• Maternal Mental Health Leadership Alliance. “Black Maternal Mental Health: the Data, the Barriers, and Organizations to Support.” MMHLA. February 1, 2024. https://www.mmhla.org/articles/black-maternal-mental-health-the-data-the-barriers-and-organizations-to-support

For many new parents, the reality of the first few weeks looks different than they had expected. Even if you have an older sibling(s) at home, adding another child to the mix likely comes with unanticipated challenges. It is normal to feel a multitude of emotions after delivery: joy, relief, gratitude, and excitement are common, but worry, fatigue, and sadness are too. Giving birth and becoming a parent is emotionally-taxing and having conflicting emotions during postpartum is normal. Most new moms will experience some negative feelings or mood swings after giving birth. These feelings are commonly referred to as the “baby blues,” and lessen after a few weeks.

Postpartum depression (PPD) is not the same as the baby blues. PPD affects 15% of women, can start any time after childbirth, and typically begin after 1-3 weeks. If you think you might be experiencing symptoms of postpartum depression, anxiety, OCD, or PTSD, reach out to your healthcare provider or call the hotline at Postpartum Support International. You can also visit the PSI Directory for help finding a provider who specializes in perinatal mood disorders. More resources here. The emotional changes of PPD affect both new mothers and their partners.

Common issues

Lack of sleep

A newborn doesn’t usually sleep through the night until they are at least three months old. Frequent night-feedings and soothings may be essential for baby, but they can be a difficult adjustment for new parents.

Parental anxiety

Many new parents experience concern about their new baby. Caring for a newborn, who depends on you entirely, is something that you can never fully prepare for. In the first few weeks it’s easy to feel like you aren’t doing everything right or to worry about the baby’s safety. While you’ll likely never completely stop worrying about your little one, the worry of the first few weeks should dissipate as you and your little one settle into a routine.

Changes in relationships

Despite their small size, babies make a huge impact. Having a newborn can affect new parents’ relationships with family, friends, and each other. New parents usually have less time and energy for socializing or maintaining their love life. This can heighten mood swings and cause some negative feelings.

Bodily changes

Your body goes through an enormous change to carry and birth a child. Many women struggle to feel like themselves throughout these changes, but be gentle on yourself, recovery takes time. You’ve brought a whole new person into the world!

New parents have to make a lot of adjustments in a short amount of time. Give yourself and your partner grace, especially during the first few weeks postpartum. It is normal to cycle through a range of moods while adjusting to parenthood.

What you can do

If you have a support system, accept help

Letting a family member, friend, or caregiver babysit for a night or two so you can get a full night of sleep can improve your mood and help alleviate symptoms of separation anxiety. Friends or family can also help with other necessities, like cleaning or cooking dinner. Give yourself one less thing to worry about.

Practice open communication

Sometimes just talking through your feelings can begin to help you feel better. Talking with your partner or another support person can strengthen your relationship and lead to more long-term solutions.

Build a community

Connect with other new parents. They’re likely going through many of the same feelings and experiences. And they’ll understand your schedule constraints in ways your other friends may not.

Speak with a professional

If you are concerned about postpartum depression or anxiety, seek help. Visit the PSI provider directory to find someone near you with expertise in these conditions. Help is available. There is hope.

Reviewed by the Ovia Health Clinical Team

Sources

• Postpartum Depression: FAQs.” American College of Obstetricians and Gynecologists (ACOG). ACOG. November 2019. https://www.acog.org/womens-health/faqs/postpartum-depression.
• Publishing, Harvard Health. “Beyond the ‘Baby Blues.’” Harvard Health Publishing. Harvard Medical School. September 2011. www.health.harvard.edu/newsletter_article/beyond-the-baby-blues.
• “Postpartum Depression: Types, Symptoms, Treatment & Prevention.” Cleveland Clinic. Cleveland Clinic. January 2018. my.clevelandclinic.org/health/diseases/9312-postpartum-depression.

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Did you remember to put the milk in the fridge? How are you supposed to get through hundreds and hundreds of emails? Did you forget to switch the laundry? Is the baby sleeping enough? Too much?

Returning to work after having a baby can be stressful, exhausting, and anxiety-inducing. One minute, you’re holding your newborn, and the next, you’re sitting in an open office trying to tackle a dozen overdue projects, listening to your coworkers rant about all of the work you missed.

The days, weeks, and months following birth bring a dozen different emotions, which people may experience in various ranges and frequencies. Because your body is undergoing hormonal changes, it’s normal to feel a little sad or overwhelmed after having a baby, but how do you know if it’s just the “baby blues” or if it’s something more serious?

The early days of the baby blues

For first-time parents whose lives have been upturned, the early days can feel more overwhelming, exhausting, and emotional than expected. The “baby blues” can affect you in the days following birth all the way up to the first few weeks of postpartum.

Postpartum, part of the perinatal stage (the period after one gives birth), is considered an adjustment period, and you are bound to experience a wide range of physical symptoms — perineum soreness, afterbirth pains, post c-section soreness, vaginal discharge or vaginal bleeding, breast pain, swelling. You may experience mental changes as well, which could include symptoms of the “baby blues,” like:

• Sudden mood swings
• Loss of appetite
• Irritability
• Restlessness
• Sadness
• Weepiness
• Loneliness
• Anxiety

It can be frustrating dealing with these symptoms, especially when the world around you is telling you to enjoy those early newborn days, but know that this is normal.

“The ‘baby blues’ are considered normal and do not generally require more than understanding, patience, sleep, and self care,” says Amanda Tinkelman, M.D., psychiatrist at Brooklyn Minds who specializes in perinatal psychiatry.

Only if these symptoms persist after two or three weeks should you be concerned. If that happens, you may need to speak with a mental health professional who can help you determine if the problem is more serious.

Perinatal mood and anxiety disorders

The perinatal period generally occurs from the time of conception to the end of the first year of the baby’s life. Many experience a variety of symptoms during this time, due to stress, fatigue, and hormone fluctuations, and it can be hard to know if you’re simply dealing with exhaustion and “baby blues” or if you’re suffering from a perinatal mood disorder.

Tinkelman explains that if you have been experiencing “baby blues” for more than two weeks, you have an inability to enjoy things, and/or if you have any thoughts of harming yourself or the baby, then you may be experiencing a more serious mental health condition. 

Here are some of the most common perinatal mood and anxiety disorders that can occur during the perinatal period:

Postpartum anxiety disorder

Worry is a natural aspect of parenthood, but constant worry can be a sign of an anxiety disorder. If you’re experiencing dread or fear that something’s going to happen to your baby; or sleep disruption (without being woken up by those newborn cries); or fatigue, sweating, heart palpitations, shakiness, nausea, or hyperventilation, you could be experiencing postpartum anxiety.

Postpartum obsessive compulsive disorder (OCD)

If you suffer from OCD, pregnancy and postpartum can trigger your symptoms. Postpartum OCD, specifically, can involve many obsessive thoughts, like imagining your baby being harmed or injured. This can lead people to obsessively check on the baby during the night or avoid the baby for fear of something happening.

Postpartum panic disorder

This is a more specific disorder, as part of postpartum anxiety disorder, that shares similar symptoms. However, the major difference is that those experiencing postpartum panic disorder may have symptoms of severely anxious thoughts and/or panic attacks. If your thoughts or anxieties prevent you from functioning, you may be experiencing postpartum panic disorder.

Postpartum depression

The most commonly talked about perinatal disorder, postpartum depression can affect you mentally and physically, and it can cause many symptoms, including but not limited to: memory problems, sleep problems, feelings of guilt or worthlessness, loss of interest in everyday activities, feeling disconnected from your baby, having no energy, persistent crying, eating too much or too little, withdrawal from family or friends, having thoughts of injuring yourself, etc.

Postpartum psychosis

This is a very severe disorder that can carry symptoms that resemble symptoms of manic depressive disorder or a bipolar disorder. You may experience erratic, unusual behavior, disorientation, suicidal thoughts, delusional beliefs, auditory hallucinations, or violent thoughts.

If the “baby blues” won’t go away or if you think you’re experiencing one of the perinatal mood disorders listed above, then it’s important to seek help. Postpartum psychosis, though rare, is a life-threatening disorder that requires immediate medical attention.

Returning to work while experiencing a perinatal mood or anxiety disorders

When you’re a new parent, work is likely the last thing on your mind, but parental leave only lasts for so long. Returning to work can be anxiety-inducing. What will you wear? What will your coworkers say? Will you make it through a full day? How will you pump? What if you start crying out of nowhere?

It will take time to adjust to your new normal, so expect some discomfort and some nerves in this transition back to work. Since your “normal” has changed, it’s important to sit down with your manager to discuss your return. Set clear expectations. Make sure you agree on a timeline. Make sure you discuss work breaks. See if you can work from home once a week or half days on occasion, or leave an hour early.

Being a parent isn’t easy, especially in the months following birth, so take proper care of yourself and pay attention to your mental health. If you’re feeling extremely anxious or if you’re experiencing panic attacks at work, you should speak with a mental health professional.

“Baby blues” happen to most postpartum people, and “even with ‘baby blues,’ one can generally still feel happiness or joy,” Tinkelman says. Only if those symptoms continue or if you experience more serious symptoms should you be concerned.

Why does postpartum depression develop?

There is no one single cause of postpartum depression (PPD) – rather, it could be due to a number of different factors.

• Hormones: They say that pregnancy is a rollercoaster, and when it comes to hormones, that’s absolutely true. After the massive drop in the hormones estrogen and progesterone that happens after childbirth, it’s very common to notice fatigue and sadness, as well as other bodily effects that can contribute to postpartum depression.
• Life changes: So you’ve dealt with pregnancy and the changes it brings, but bringing a baby home presents a whole new set of challenges. It can take some time getting used to all of the change and new responsibilities in life, and if you feel overwhelmed from time-to-time, you can consider yourself part of the majority. However, when “occasionally overwhelmed” turns into “definitely depressed,” it’s time to talk to your healthcare provider.

Other possible contributing factors include sleeping problems and sleep deprivation, nervousness about caring for a newborn, and stress about work. It’s important to note that postpartum depression is clinically different than regular depression. Although those with PPD likely also notice the regular symptoms of depression like anxiety, sadness, and social withdrawal, postpartum depression is generally only diagnosed as such when the depression symptoms come in conjunction with, or are a result of, hormonal, physical, emotional, and lifestyle changes due to childbirth and motherhood. However, postpartum depression is more common in those with a history of depression or mental illness.

If you believe you may have symptoms of postpartum depression, you should contact your healthcare provider immediately. There are a number of different ways doctors treat PPD, but no matter which one your healthcare provider thinks is best, it’s much easier to get through when you have help. Approximately 10 to 15% of new moms develop PPD, so you’re far from alone if you do. Just know that help is available, and with your baby here, the future is bright.

Sources

• Mayo Clinic Staff. “Postpartum depression.” Mayo Clinic. Mayo Clinic, August 11 2015. Web.
• “Postpartum Depression.” MedlinePlus. U.S. National Library of Medicine, February 27 2017. Web.
• “Postpartum Depression Facts.” National Institute of Mental Health. National Institutes of Health. Web.

With so many new changes in your life, just what’s normal? 

For many new parents, it’s totally normal to experience what are called the “baby blues” shortly after a baby is born, which can last for a few days or even a few weeks. This period can include mood swings, anxiety, sadness, irritability, and crying. It can also include feeling overwhelmed, having trouble sleeping, reduced concentration, appetite problems, and trouble sleeping. These feelings and symptoms are totally normal and will likely soon pass. But if they stick around, you might have postpartum depression (PPD). PPD actually shares a lot of similarities with the baby blues, but it lasts longer and the symptoms can be more intense.

When does postpartum depression occur?

Much like the baby blues, often PPD symptoms will develop within the first few weeks of giving birth, hence the “postpartum” in the name. However, it’s also very common for PPD to develop later too, anytime within the first year or so after you deliver.

Is postpartum depression different than regular depression?

It’s important to note that PPD is clinically different than regular depression. Although those with PPD may notice some of the same symptoms of regular depression— like anxiety, sadness, and social withdrawal— PPD is generally only diagnosed as such when these depressive symptoms come in conjunction with or are a result of the hormonal, physical, emotional, and lifestyle changes that accompany childbirth and parenthood. However, PPD is more common in those with a history of depression or mental illness. 

Why does postpartum depression develop?

There is no one single cause of PPD, and it could be due to a number of different factors. Your hormones fluctuate immensely before, during, and after pregnancy, so that could play a role. Following the massive drop in the hormones estrogen and progesterone that occurs after childbirth, it’s very common to notice fatigue and sadness. And there are other major life changes to deal with on top of the changes to your body. Bringing a baby home presents a whole new set of challenges and responsibilities that can certainly cause stress. Contributing factors can include sleeping problems and sleep deprivation, nervousness about caring for a newborn, and stress about work.

How can you recognize postpartum depression?

Symptoms of PPD are more intense and longer lasting than the baby blues. These symptoms can include:

• Depressed mood or severe mood swings
• Excessive crying
• Intense irritability and anger
• Severe anxiety and panic attacks
• Appetite changes – loss of appetite or eating more than usual
• Sleep troubles – inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Diminished ability to think clearly, concentrate or make decisions
• Difficulty bonding with your baby
• Withdrawing from family and friends
• Reduced interest and pleasure in activities you used to enjoy
• Feelings of worthlessness, shame, guilt, or inadequacy
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

It’s also worth noting that some of these symptoms overlap with symptoms of other postpartum mood disorders, including postpartum anxiety disorders (which might cause excessive worry, trouble sleeping, panic attacks, hyperventilation, or repeatedly imagining scary things happening to one’s baby) or postpartum psychosis (which might cause confusion or disorientation, paranoia, hallucinations, delusions, sleep disturbances, obsessive thoughts about one’s baby, or thoughts of harming oneself or one’s baby).

If you’re experiencing these feelings and symptoms, when should you seek help? 

It can certainly take some time to adjust to all of these new changes in your life, and if you feel overwhelmed from time-to-time, that’s entirely normal. If you’re not sure if what you’re experiencing is still just baby blues or may be PPD, you should talk to your provider if symptoms:

• have been around for more than two weeks
• are getting worse
• are making it hard for you to care for your baby
• are making it hard for you to complete everyday tasks
• include thoughts of harming yourself or your baby

If you believe that what you’re experiencing might be PPD or another postpartum mood disorder, if you’re having a hard time and it’s impacting your day-to-day life, or even if you’re just wondering if what you’re feeling and experiencing is normal, then you should contact your healthcare provider immediately. There are a number of different ways that healthcare providers can treat PPD, but no matter which one your own provider thinks is best, it’s much easier to get through these challenges when you have help.

And if at any point you have thoughts of harming yourself or your baby, you should seek immediate help from a loved one to take care of your baby and contact 911 or your local emergency assistance number. 

Dealing with the prospect of postpartum depression can feel scary, but you have nothing to be ashamed of. And you’re not alone; we’ve found that 32% of new moms develop PPD. Help is available, and you deserve to get the help you need. 

Sources

• “Postpartum Depression.” MedlinePlus. U.S. National Library of Medicine. Retrieved July 25 2017. https://medlineplus.gov/postpartumdepression.html.
• Mayo Clinic Staff. “Postpartum depression.” Mayo Clinic. Mayo Foundation for Medical Education and Research, August 11 2015. Retrieved July 25 2017. http://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/causes/con-20029130.
• “Perinatal Mood and Anxiety Disorders.” UNC School of Medicine. Center for Women’s Mood Disorders. Retrieved June 28 2019. https://www.med.unc.edu/psych/wmd/mood-disorders/perinatal/#md_postpartum_anx. 

Signs of anxiety

It’s important to know the signs of anxiety, which can include:

• constant worry
• feeling that something bad is going to happen
• racing thoughts
• sleep and appetite disturbances
• inability to sit still
• worrying so much that it is taking a toll on your personal or professional life
• physical symptoms like dizziness, hot flashes, and nausea

Signs of a more serious anxiety disorder can manifest physically as well, with symptoms including muscle tension, heart palpitations, dizziness, hot flashes, or nausea.

Risk factors for postpartum anxiety

It’s also important to understand some of the risk factors that can put new parents at higher risk of developing anxiety:

• previous diagnosis of an anxiety disorder
• anxiety during most recent or past pregnancy
• previous pregnancy loss or fertility struggles
• pregnancy complications
• stress in personal or professional life

Treatment can help

Anxiety is a treatable condition, so seeking out help from a mental health professional and getting treatment can help. And if you know you could be at a higher risk of anxiety postpartum, there are some important things you can do now. It can be very helpful to keep a close eye on your moods and your mental health. You should also speak honestly with your healthcare provider and/or mental health provider about how you’re feeling and managing as you move along your parenting journey. Further safety measures that can be taken if you have a history of anxiety include sticking to established treatment routines, like regularly adhering to medication regimens, and keeping up with talk-therapy appointments; tracking moods; sticking to healthy eating and regular sleep routines; seeking out support groups; and reaching out to a support system. Remember, if you experience postpartum anxiety you’re not alone, and it is possible to feel better — you deserve it.

Sources

• Mayo Clinic Staff. “Coping and support.” MayoClinic. Mayo Foundation for Medical Education and Research, Sep 25 2014. Web.
• Mayo Clinic Staff. “Treatments and Drugs.” MayoClinic. Mayo Foundation for Medical Education and Research, Sep 25 2014. Web.
• Melinda Smith, Lawrence Robinson, Jeanne Segal. “Anxiety Disorders and Anxiety Attacks.” HelpGuide. Helpguide.org, Sep 2016. Web.
• “Anxiety Disorders.” NIH. US Department of Health and Human Services, Mar 2016. Web.

Anxiety disorders and the postpartum period

New moms who have had mental health problems in the past, including depression, bipolar disorder, or an anxiety disorder, have a higher risk of experiencing postpartum depression symptoms within the first year after giving birth. Postpartum depression, often referred to as PPD, isn’t the only mood disorder postpartum women face, though. Postpartum anxiety symptoms are estimated to be about as common as postpartum depression, and is probably caused by the same combination of hormonal changes and added stressors that can contribute to PPD.

Postpartum depression and postpartum anxiety are both treatable conditions. Parents who experience persistent symptoms of depression or anxiety, especially if these symptoms start to interfere with self-care or baby care, should seek help from a medical professional as soon as possible.

Parenting with an anxiety disorder

One thing to keep in mind when parenting with an anxiety disorder is that parents dealing with anxiety have an extra challenge to cope with, and may find themselves feeling overwhelmed or short on patience more often than they might otherwise. This is understandable, but it’s also something to keep in mind when responding emotionally. Another thing to remember is that, while parents can feel like their own needs should be pushed to the side in favor of their children’s needs, parents with anxiety who seek treatment, and who carefully stick to a treatment plan, are taking care of their children’s needs as much as they’re taking care of their own.

Parenting is a task which offers a range of new worries for every new parent, whether they’re dealing with an anxiety disorder or not. When worries and concerns start to feel overwhelming, external resources like a healthcare provider, parent or other family member, or a partner can be great for checking in, to try to help set the level for worry about a concern.

Sources

• Michael G. Gottschalk. “Genetics of generalized anxiety disorder and related traits.” Dialogues in Clinical Neuroscience. 19(2): 159-168. June 2017. Retrieved 21 June 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573560/.
• C.-L. Dennis, K Falah-Hassani, H.K. Brown, S.N. Vigod. “Identifying women at risk for sustained postpartum anxiety.” Journal of Affective Disorders. 213: 131-137. 15 April 2017. Retrieved 21 June 2018. https://www.jad-journal.com/article/S0165-0327(16)32042-0/pdf.
• Golda S. Ginsburg, et al. “Preventing onset of anxiety disorders in offspring of anxious parents: a randomized controlled trial of a family-based intervention.” The American Journal of Psychiatry. 172(12). 25 September 2015. Retrieved 21 June 2018. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.14091178.
• Brigit Katz. “How to avoid passing anxiety on to your kids.” Child Mind Institute. Child Mind Institute Inc. Retrieved June 21 2018. https://childmind.org/article/how-to-avoid-passing-anxiety-on-to-your-kids/.
• Mayo Clinic Staff. “Postpartum depression.” Mayo Clinic. Mayo Clinic, 11 August 2015. Retrieved June 21 2018. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617.
• I. Shlomi Plachek, L. Huller Harari, M. Baum, R.D. Strous. “Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression, and postpartum PTSD.” The Israel Journal of Psychiatry and Related Sciences. 51(2): 128-34. 2014. Retrieved 21 June 2018. https://www.ncbi.nlm.nih.gov/pubmed/25372562.
• “Understanding anxiety.” Anxiety and Depression Association of America. ADAA. Retrieved June 21 2018. https://adaa.org/understanding-anxiety.

Figure out what type of mental health provider you’d like to work with

Because of differences in education and training, different mental health specialists have different areas they focus on, so you should work with someone based on your individual needs. It’s really just a matter of trying to figure out who could be the best choice for you.  

• Specialists who can provide therapy and counseling include clinical psychologists, clinical social workers, marriage and family therapists, mental health counselors, licensed professional counselors, certified alcohol and drug abuse counselors, pastoral counselors, school psychologists, and more. Some psychiatrists also provide therapy, though this isn’t common.
• Specialists who can prescribe medication are psychiatrists and psychiatric mental health nurse practitioners; in a few states and territories, psychologists can also prescribe medication. 

Mental health treatment may or may not include medication. Some people do really well just working with a therapist, and some people do better with a combination of therapy and medication. You’ll need to work with a provider to figure out what will be most beneficial for you.  

If you’re at a loss and really not sure what sort of a provider would be best for you, you can always ask your regular healthcare provider for guidance — your primary care provider, OB/GYN, midwife, or whoever you feel most comfortable starting the conversation with. It’s important to speak with them honestly, but if you don’t feel like they give you especially helpful feedback, know that it’s not your fault — these sort of care providers simply aren’t mental health specialists. That’s why it’s so important that you move beyond your regular healthcare provider and work with a mental health professional who can provide you with specialized care.

Check with your health insurance 

A big factor in the provider you choose to see might be the healthcare coverage you have. Reaching out to your insurer can help you get a clear understanding of the care available to you. 

If you have insurance, check with your insurance to see what sort of mental health care treatment is covered under your plan.

Many insurers have an online directory that you can search through to find a list of healthcare providers in your area who are covered. Most insurers also have a special mental or behavioral health phone line that you can call for screening, which will help connect you with a provider in your insurance network who could be a good fit.

Because your mental health coverage might be different from one location or provider to the next, it can be helpful to look into these details right from the get-go. If you have a preferred specialist in mind, call that provider’s office to ask directly about what kinds of insurance they take and the cost of services. And if they’re not accepting new patients, you can always ask them for a referral to another practitioner in your area. 

If you don’t have insurance, you still have options

Many providers — including training institutes or government-funded community health centers (FQHCs) — offer low-fee or sliding-scale services that can make getting treatment possible even without insurance, so this doesn’t need to stop you from getting the help you need. If you’re in school, school counselors and student health centers can also be a great place to get started.

Some search tools you can use

• The National Institute of Mental Health provides a number of links to resources with searchable provider directories. 
• The Substance Abuse and Mental Health Services Administration provides a searchable behavioral health provider directory. 
• The American Psychiatric Association has a “psychiatrist finder” tool.
• Psychology Today has a tool to search for therapists, psychiatrists, support groups, and/or treatment centers.
• For pregnancy and postpartum support, Postpartum Support International has a helpline, a database of local resources, and a directory of perinatal mental health specialists.
• You can also visit your state or county’s government website and search for the health services department.

When you can expect to speak with a provider

It’s not unusual for a provider to take a little while to respond, so it often helps to reach out to several providers to start.

Once you do hear back and decide to move forward with a particular provider, know that it may also take a little while to be seen for your first appointment. But once you are, you can then expect to speak with your provider weekly or every other week — some sort of a rhythm that works for you both. 

One final thing to keep in mind when working closely with a therapist: not every therapist will be a good fit for you. Therapists know this, and they want to be sure that their clients’ needs are being met. So if you start working with a provider who doesn’t feel like a good fit, don’t get discouraged. If you’re comfortable, ask them for a recommendation for another therapist or keep looking on your own. There is a provider out there who’s a good fit for you. 

What you should know about telemedicine

Many mental health care providers are now offering telehealth options, where you can speak with a practitioner over the phone or via video chat. Studies suggest that talk therapy through telemedical channels can be as effective as talk therapy in person. This means you can start working with a mental health professional now to get the support you need, even if you can’t leave home.

What to do if you need help right now 

For more short-term or emergency situations, helplines and emergency phone lines are available to provide support at any time, like: 

• The National Suicide Prevention Lifeline (988 or online chat)
• The Disaster Distress Helpline (1-800-985-5990)
• The Crisis Textline (text HOME to 741741)
• 9-1-1

Reach out for immediate help if you need it. 

Start your search today 

It’s entirely normal to need mental health support at some point in your life. We hope that you’ll commit to starting your search for a mental health provider today so that you can be one step closer to getting the support that you need — you deserve it.

Reviewed by the Ovia Health Clinical Team.

Sources

• Lisa Gillespie. “Even with coverage expansion, access to mental health services poses challenges.” Kaiser Health News. Henry J. Kaiser Family Foundation, December 2018. Retrieved March 27, 2020. https://khn.org/news/even-with-coverage-expansion-access-to-mental-health-services-poses-challenges/.
• Helen Jack, Alan Stein, Charles R. Newton, Karen J. Hofman. “Expanding access to mental health care: a missing ingredient.” The Lancet. 2(4): e183-184. April 2014. Retrieved March 27, 2020. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70029-4/fulltext.
• Amy Novotny. “A new emphasis on telehealth.” American Psychological Association. 42(6): 40. June 2011. Retrieved March 27, 2020. http://www.apa.org/monitor/2011/06/telehealth.aspx.
• APA Coronavirus Resources.” American Psychiatric Association. American Psychiatric Association. Retrieved March 27, 2020. https://www.psychiatry.org/psychiatrists/covid-19-coronavirus.
• “Help for mental illness.” National Institute of Mental Health. U.S. Department of Health and Human Services. Retrieved March 27, 2020. https://www.nimh.nih.gov/health/find-help/index.shtml. 
• “Types of Mental Health Professionals.” Mental Health America. Mental Health America. Retrieved March 27, 2020. https://www.mhanational.org/types-mental-health-professionals. 

Jen Jabaily-Blackburn Contributing writer

This story begins in Horseytown. Or, rather, on Horseytown, the road-map rug in my daughter’s room, named by the town’s intrepid founder.

Part of being a parent is recognizing which wish-fulfillment impulses won’t harm your children. Am I going to push my child who loves to sing toward the performing arts to compensate for my unfulfilled dreams of a life on the stage? Uh, no. Am I going to get her the road-map rug I always wanted but never had? Hell yes. 

I chose one for her that felt calm and green. Horseytown is a little town — ’90s-child high five if your next impulse is to sing “it’s a quiet village” — apple-treed, pavement-laced with only a few cars and trucks, a few buildings, a peaceful, unpopulated soccer field its centerpiece. 

Where are the horses? one might ask. Simple. We are the horses. Or, no, horse princesses, my daughter insists. Neighing, galloping horse princesses. So much for calm.

And, so, we were playing horse princess when the thing happened, inciting incident of so many self-care narratives: my daughter bounced her baby carrot of a fingerlet into my abdomen, saying, “Your tummy is squishy.” She said it neutrally, factually, because for her there is no other way to say it.

Except this isn’t a story about my body, not primarily. My big body — big before pregnancy, big after — is a fact, not a failure of willpower. 

But even knowing what I need doesn’t make getting it easy.

So much postpartum self-care urges us to claim time for ourselves — and it’s usually implied that that time should be used for “bouncing back,” for reclaiming the bodies we had before we had children, as though that’s entirely possible. 

Time, in relation to the postpartum body, we’re told, is merely misallocated. What tasks can be reassigned or let go? Do you have a free hour? That’s an hour that could be spent in the gym. Everywhere the words what’s your excuse?

My excuse: there are only so many hours in a day, and so few of them belong only to me. With limited time and energy available, I can prioritize my body or my mind. I choose and have always chosen my mind.

I need time alone. The most important tools I have for understanding the world are headspace, quiet, and time. Intellectually, I knew that taking care of another person would mean I’d have less of these resources, but I had no idea how much less. A poet, I barely wrote. A reader, I rarely read. And reading and writing weren’t luxuries. They were necessities. 

But even knowing what I need doesn’t make getting it easy. 

When you have a young child, making space for thought feels like an elaborate side hustle. It pays in quiet and can’t be observed easily by others. Losing baby weight is often an obvious marker for how many others approach self-care, an occasion for an awkward high five. Feeling like I might have figured out how to approach a poem I’ve been stuck on doesn’t necessarily translate to anyone else. Very few people want to high five me for that.

I wish I could say that I am diligent about asking for space and time, or that I use the time well when I have the windfall of a miraculously free hour. Sometimes I’m just too tired to do anything but play puzzle games on the phone when I know I could be writing or reading but I need time to just exist. Sometimes I don’t know how to ask for what I need because the asking feels almost petty when put in words: Can I go read at the cafe where no one’s crying? Would it be ok if I went to the museum for an hour? Can I go walk the trail by the river? Alone? Sometimes I need to muster courage to ask my husband if I can take a break from being on parent duty because I know he understands; the last holdout in giving me permission to relax is always, without fail, me.

While I’m at work and my horse princess is at daycare, sometimes I am able to carve out that sort of time, find a bit of that needed space.

One of the great joys of my job on a college campus is knowing that I have a small, beautiful art museum visible from my office window, a greenhouse behind my building, a quiet poetry reading room right down the hall. There’s a footpath by the Mill River that I can walk along after lunch. (There is, of course, a huge amount of luck and privilege that allows me to access spaces like these: I have a full hour at lunchtime to enjoy them, no one has ever made me feel unwelcome or misplaced in them, and I can access them on the cheap or for free.) Public libraries and parks are full of spaces to decompress and dream too. Even if museums charge entry to galleries, many have quiet free courtyards and atriums open to the public. 

And my favorite recently rediscovered time-hack: my dad used to get us amped up for going to the carwash by saying, semi-ironically, “kids, we’re going on vacation!” I get it now; for five glorious minutes, the conveyor belt and the soapbots would handle everything. Vacation, indeed.

Finding that sort of time and space at home is another story.

In theory, I have a dedicated writing room, but it comes with a couple of glaring catches: currently, it’s full of boxes containing the whole of my childhood, the survivors of my parents’ move from my girlhood home — photos, letters, warping plastic tchotchkes, stickers, terrifyingly and yet, irresistibly, an envelope labeled “baby teeth” — there’s no comfortable place for me to sit, and the room has no door. 

Even if there was a door to close, I have a three-year-old. I can’t exactly throw her a Baby-Sitters Club and tell her to knock herself out. 

My conditions for writing are not ideal, in or out of the house. So most of my poetry these days is written in the cloud, a browser window open while I work to catch ideas, an app on my phone in a café at lunchtime. The phone’s portable and less fragile than a laptop, and it’s always with me. And here’s how I find time and space to write at home — and, in fact, how I am writing this right now: screen time. 

It’s not ideal. It’s usually a compromise. It’s often a hustle.

I’d love to give my child the freedom to play independently away from the screen, but we’re still at the age of crayon on walls and all manner of spills, which I might be able to accept as the price of exploration — it’s also the age of chokeables and outlets and dread of accidentally open stairs. I don’t have the time or inclination to feel shamed by using the TV as a distraction. She engages and asks me questions about what she sees and I try to answer them and then get back to work. I’m not fully here nor there, and that’s how it has to be right now. I’m in the cloud. 

So much of finding what we need postpartum is like this. It’s not ideal. It’s usually a compromise. It’s often a hustle. And it’s always complicated, like so many other parts of being a parent.

Sometimes I wonder if my child’s boisterous extroversion is a phase, or if it’s just her — I can try to teach her calm, but I can’t make her approach the world in a way that I recognize. My wild toddler may turn out to be an extroverted child and adult. She can take an 8’ x 5’ rectangle of carpeting and populate it with Horseytown’s commotion and noise. When I am with her, I am a guest of the horse princess and, so, I neigh along. I hope she will understand one day that I can stand in the same imaginary village and need to find peace there: the soccer field with no one on it, red truck going nowhere fast, an apple tree unbothered by wind.

About the author

Jen Jabaily-Blackburn has been making unconventional lullaby choices since winter 2015. A poet, her work has twice been selected for Best New Poets (2014 & 2016) and has appeared widely in journals and magazines, most recently Rattle, The Common and Massachusetts Review. She lives in the Pioneer Valley of Western Massachusetts with her husband and daughter.