Are You at Risk for Postpartum Depression? A Therapist Weighs In


If anyone understands the seriousness of postpartum depression, it’s therapist Debbie Alexander, Psy.D. Having counseled many in her practice who have gone through it, she also suffered from postpartum depression herself 25 years ago — so she knows it’s not to be taken lightly. “We’re not talking the baby blues,” says Alexander. “We’re talking about the experience of severe, debilitating depression.”

Postpartum depression (PPD) is far more common than you might think. If you’re pregnant, your chances of experiencing it are as high as 10%, according to one CDC study. And while postpartum depression is rare, the risks of non-treatment are serious — including harming one’s baby and suicide.

So if you’re pregnant, or even if you’ve already had the baby and think you might be experiencing postpartum depression symptoms, it’s crucial to educate yourself and get support if you need it. Here’s what you should know about both the risks and symptoms, according to Alexander. Should you decide you need help, Orange County Health Psychologists can pair you with a compassionate postpartum depression therapist.

Risks of postpartum depression

One thing that can put you at greater risk for postpartum depression is if you’ve suffered from depression in the past, and/or are feeling depressed during this pregnancy. Past depression, Alexander says, has a “priming effect” that can make it more likely you will experience it again.

If you have difficulty in your marriage or partnership — meaning you have a lack of support from your partner during pregnancy or after the baby is born — this can also put you at risk. For example, your partner may be absent or causing you distress.

Also, having multiple children (two or more before this pregnancy) also increases your risk for postpartum depression. It’s not entirely known why having two or more children (called multiparity) is associated with postpartum depression, although we could infer that the stress of having young children while pregnant can be overwhelming.

In addition, studies have shown that pregnancy complications and difficult births can add another level of stress as the new mother recovers, increasing the risk for PPD.

Finally, if your own mother has passed away, this is a surprising risk factor for postpartum depression. According to Alexander, being pregnant and giving birth can trigger the grief you may feel over your mother’s passing. Stressful aspects of being a new mother may be a poignant reminder that you no longer have your mother’s support. “All of a sudden it shines a light on what’s missing in your life in that really important moment,” says Alexander.

Keep in mind this is not an exhaustive list of risk factors for postpartum depression, but can give you an idea of some factors to watch out for.

Signs of postpartum depression after your baby is born

Aside from risk factors, you may notice symptoms of postpartum depression once your baby is born. For instance, you may continue to feel depressed after the first two weeks. You also may feel like you’re not bonding with your baby. “I remember for myself, I felt kind of disconnected from my baby,” says Alexander. “I could hear her crying and I’d give her the bottle, but I didn’t have that emotional connection.”

Other postpartum depression symptoms you might experience include:

● Crying

● Withdrawing from your family and friends

● Hopelessness

● Restlessness

● Feelings of guilt or shame

● Sleeping too much or too little

● Eating too much or too little

● Fatigue

● Anger or extreme irritability

● Loss of interest in activities you previously enjoyed

● Lack of concentration

● Panic attacks or anxiety

● Thoughts of suicide or harming your child

What to do if you’re at risk or have symptoms

A smart thing to do if you think you’re at risk for postpartum depression, says Alexander, is to make sure you have support set up in advance. Think about anyone in your life who’d be willing to help once the baby’s born — family members, friends, etc. — and let them know you need support as soon as you can.

Right after she was diagnosed with postpartum depression, Alexander says she reached out for help and was met with a wonderful support network. “After I was honest and said … I’m not okay, I’m really struggling, the troops came in. I had people bringing in food. I had a friend come and sleep on the couch one night so I could get a good night’s sleep for a change. But if we don’t tell them, how will they know?”

Finding someone to talk to about how you’re feeling is also very important. People who you trust, such as a church leader, family member, or even members of a postpartum depression support group, can be useful outlets at this time.

You also may want to talk to your obstetrician if something doesn’t feel right, letting them know of any postpartum risks you think you may have. Your doctor can then refer you to a skilled postpartum depression therapist if necessary.

How a postpartum depression therapist can help

Even if you just think you’re at risk, seeing a therapist for postpartum depression — such as a provider at Orange County Health Psychologists — can help. Things like self-care might be hard to prioritize without outside support. You may also not notice subtle changes in your mood that a therapist might detect.

Because guilt is also very common with those suffering from postpartum depression, a therapist can provide a safe place for you to express those feelings. They’ll also coordinate with your medical doctor about any medication you might need.

Finally, Alexander cautions that while talking to your medical doctor is a good idea if you suspect postpartum depression, that doctor still may need to consult with a therapist — something she experienced first-hand as a patient.

“My doctor didn’t understand that sometimes postpartum depression doesn’t kick in right away,” she said. “For me, it started three months after my baby was born, and he didn’t know that was a possibility … he had no idea that’s what this was. So it’s about educating the medical providers about the dangers and giving them a point of contact.”

Reach out to Orange County Health Psychologists

If you feel like you may be suffering from postpartum depression or are at risk and need a therapist, we can help. Contact Orange County Health Psychologists at 949.528.6300 or email us at to be matched with a provider.

—Written by Ekua Hagan for Orange County Health Psychologists

About Debbie Alexander, Psy.D.

Debbie Alexander, Psy.D.

Debbie Alexander is a licensed clinical psychologist who specializes in women’s health (postpartum depression, infertility, miscarriage, menopause, surrogacy, female sexual dysfunction, and survivors of abuse). In addition, she has extensive experience assisting adolescents and young adults process and heal from traumatic events. Dr Alexander currently accepts Medicare and welcomes new patients for in-person or telehealth appointments.

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949-478-0201Alexander@stage.ochealthpsych.netCA License # PSY32684