After my first baby, I struggled with what I now know was undiagnosed postpartum anxiety.
At the time, though, I didn’t really see it that way. A lot of the things I was doing just felt like me being a good mom.
I remember feeling like I had to sleep facing my son. I couldn’t turn my back toward him, even if I would’ve been way more comfortable. Mind you, he was literally sleeping in the same room as me. I remember feeling like I couldn’t fall asleep until I knew he was asleep, even if he was quiet and perfectly content. And I remember not being able to sleep when my husband had him, even though I knew he was completely safe and in good hands.
It went on and off for about 10 months, and the sleep deprivation just compounded everything.
Then I had my second baby, and the experience was honestly night and day.
He slept so much better, and that, combined with a little second-time-mom confidence, showed me how fun and joyful having a baby could actually feel when I wasn’t constantly running on empty.
That experience is a huge part of why I care so much about talking about sleep and maternal mental health.
If you’re struggling right now, you are not failing. You are not a bad mom. And you are not broken.
That’s why I’m so grateful to have Dr. Emily Guarnotta here to talk about how sleep deprivation can affect your mental health, what might be a sign of something more, and when it may be time to reach out for support.
Mallory
Can sleep deprivation actually affect your mental health, or am I just not coping well?
Sleep deprivation can absolutely affect your mental health. Sleep is important for managing stress, emotion regulation, and focus. When you’re consistently getting less and less sleep, even the most resilient person will notice effects on their mood, attention and concentration, and patience. If you’re feeling off, it’s your brain telling you that you’re running on empty.
Why do I feel so much more anxious, emotional, or overwhelmed than normal?
When you’re short on sleep, the part of your brain that detects threats becomes more reactive. At the same time, the part of your brain that helps you remain calm and think things through becomes weaker. Your stress hormones also remain elevated when you’re not getting enough sleep. This means that minor annoyances can feel bigger than they actually are. You might also notice yourself more sad, anxious, or prone to tears than usual. This is a real biological response.
Is it normal to feel angry, resentful, or unlike myself when I'm exhausted?
Yes, it is very common to feel agitated, irritable, and not like yourself when you’re sleep deprived. You also might notice yourself more short or prone to anger with other people around you. Many parents feel very guilty about this too. This is because exhaustion lowers your frustration tolerance, allowing for irritability and resentment to build, even toward the people you love most. Feeling this way doesn’t make you a bad person. It’s a sign that things are off biologically.
How can I tell the difference between "baby blues" and something like postpartum anxiety or depression?
The baby blues are a temporary state that nearly 80% of new mothers experience within the first few weeks of giving birth. They usually begin within a few days of birth and go away on their own within about two weeks. Many women report waves of sadness, anxiety, and irritability during this time. These feelings tend to come and go, are mild, and don’t interfere with her functioning.
If symptoms last longer than two weeks, get worse over time, or make it hard to function, it may be postpartum depression or anxiety. Signs of postpartum depression include low mood, hopelessness, lack of enjoyment, and difficulty bonding. Signs of postpartum anxiety include constant worry, racing thoughts, panic, and difficulty sleeping. These conditions affect around one in five new mothers and can occur at any time within the first year of giving birth, not always right after.
Other mental health conditions that can occur in the postpartum period include perinatal OCD, post-traumatic stress disorder (PTSD), and postpartum psychosis. Signs of perinatal OCD include unwanted intrusive thoughts that are very distressing to the new mother, often about her baby’s well-being. In an effort to cope with the thoughts, she engages in compulsions, or repetitive behaviors that temporarily alleviate anxiety. However, the anxiety returns again, and she finds herself in a vicious cycle. PTSD during the postpartum period is a response to trauma, often after a traumatic birth. Postpartum psychosis affects around one to two in every 1,000 births. This condition is very serious and involves a loss of touch with reality. The new mother may see or hear things that are not there and have delusions, which are fixed beliefs that are false. Postpartum psychosis carries a risk of suicide and infanticide, so emergency medical attention is needed. When women receive prompt treatment, they make a full recovery.
All of the perinatal mental health conditions mentioned are treatable. Women who get the help that they need and deserve almost always recover and go on to live healthy, happy lives.
What can I do to support my mental health when getting more sleep isn't realistically an option right now?
When you can’t control how much sleep you’re getting, focus on the small things that protect your energy. For example, try to take rest whenever you can, even if it’s just closing your eyes for 20 minutes. Accept help with meals, chores, or night feedings. Get outside, drink water, eat regularly, and incorporate gentle movement. Most importantly, tell someone you trust about how you’re really doing. Connection is one of the best protections.
When should I ask for help, and who should I reach out to?
It’s a good idea to reach out for help if your feelings have lasted for more than two weeks, are getting worse, or are getting in the way of caring for yourself or your baby. Get help right away if you have thoughts of harming yourself or your baby, or feel disconnected from reality. You can reach out to your OB, midwife, psychiatrist, or a therapist that specializes in perinatal mental health. In the U.S. you can also call or text the National Maternal Mental Health Hotline at 1-833-852-6262 any time, day or night.
Recognizing that you need help and asking for it is one of the most courageous things you can do. The sooner you get the help that you need and deserve, the sooner you will feel like yourself again.
Meet Dr. Emily Guarnotta
Dr. Emily Guarnotta is a licensed clinical psychologist and certified perinatal mental health specialist. She is the co-founder of Phoenix Health, an online therapy practice that specializes in treating maternal mental health conditions and supporting families experiencing infertility and pregnancy loss. As a mother herself, Dr. Emily understands the challenges that motherhood can bring and is passionate about supporting parents through every step of their journey.
