Postpartum Depression vs. Postpartum Anxiety

Reviewed by Dr. Sanam Shamtobi, PhD, PMH-C

The short answer: Postpartum depression tends to pull you down: heaviness, numbness, guilt, and losing interest in things you loved. Postpartum anxiety winds you up: racing thoughts, constant worry, and a body that will not settle. Many mothers experience both at once, and both respond well to treatment.

Different Experiences, Both Real

Postpartum depression and postpartum anxiety are separate conditions that happen to share a postpartum context and sometimes co-occur - which is part of why they get conflated. But they feel different, and the distinction matters for getting the right treatment.

Postpartum Depression

Postpartum depression tends to feel heavy and slow. The dominant experience is often sadness, numbness, or a persistent sense of emptiness. Mothers with postpartum depression frequently describe feeling disconnected from their baby, losing interest in things they used to care about, or feeling like they are going through the motions without really being present.

Postpartum Anxiety

Postpartum anxiety tends to feel fast and relentless. The dominant experience is worry - a constant hum of what-if thinking, a body that stays tense and on alert, and a mind that races through worst-case scenarios even when everything is objectively fine. Physical symptoms are common: tight chest, trouble sleeping, restlessness that does not respond to reassurance.

Why They Frequently Co-Occur

Research suggests that postpartum depression and postpartum anxiety overlap in roughly half of cases. A mother can be simultaneously depleted and numb and terrified - and often is. This is one of the reasons a thorough assessment by a perinatal specialist matters: treatment approaches differ depending on which condition is driving the picture, or how they are interacting.

The Bottom Line

If your postpartum experience feels more like sadness and disconnection, postpartum depression is the more likely primary diagnosis. If it feels more like fear and relentless worry you cannot turn off, postpartum anxiety is more likely. If it feels like both - that is common, and treatable.

What the Research Shows

Postpartum Support International reports that 1 in 5 women experience depression or anxiety during the perinatal period. The American College of Obstetricians and Gynecologists adds that nearly 1 in 5 adults has an anxiety disorder, including those who are pregnant or postpartum.

The same National Institutes of Health trial found that only 9% of women who received CBT-based talk therapy had moderate to severe anxiety six weeks after childbirth, compared to 27% of those who did not.

From Dr. Shamtobi

Dr. Shamtobi often explains postpartum anxiety as an old survival system working overtime, not a personal failing.

"This is your oldest brain that was developed when you were like a cave person. It's wired to keep you alive. It's not wired to have you thrive." (as shared on the We Shine Well podcast)

Frequently Asked Questions

Can you have postpartum depression and anxiety at the same time?

Yes, and it is common. Many mothers feel exhausted and flat while their mind races with worry. A therapist trained in perinatal mental health can untangle which symptoms are driving the others and treat both together. Read more about postpartum anxiety.

What does postpartum anxiety feel like?

Racing thoughts you cannot turn off, checking on the baby again and again, dread without a clear reason, and physical symptoms like a pounding heart or trouble sleeping even when the baby sleeps. It is your alarm system stuck in the on position.

Which one do I have?

You do not need to figure that out alone, and you do not need the right label before asking for help. A perinatal specialist can assess both in one conversation. Reach out and we will help you make sense of it.

At The Mother Hood, we offer specialized postpartum mood and anxiety therapy in Los Angeles and across California via telehealth. If you're ready to talk, reach out to schedule a consultation.

Related reading: Compare next: postpartum OCD vs. postpartum anxiety · prenatal vs. postpartum depression.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. If you are experiencing a mental health emergency, please call 988 (Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or contact the Postpartum Support International Helpline at 1-800-944-4773. Always consult with a qualified healthcare provider about your specific situation.