Having a baby ushers in a million different emotions—both positive and negative. While a mama may be overjoyed with her growing family, she may also experience trouble sleeping, sudden tears, or mood swings. Thankfully, these “baby blues” don’t last long: after a few weeks, hormones level out, sleep and showers happen more frequently, and things go back to normal. 

But for some mothers, those negative emotions don’t go away. Instead, they linger, fester and evolve into serious mood disorders that transform new motherhood from a challenge into a nightmare. 

Two of these disorders are postpartum depression (PPD) and its lesser-known cousin, postpartum anxiety (PPA). PPD may feel like baby blues at first, but persists long past a week or two. A mama with PPD may feel isolated, overwhelmed and hopeless; she might withdraw from family and friends, or have difficulty making decisions or doing things she once enjoyed

Conversely, a mother struggling with PPA may seem like she’s always on red-alert. Her thoughts will race constantly, fixated on panic and disaster, and she’ll live in a constant state of dread. Both PPA and PPD can include physical symptoms, like nausea, fatigue and panic attacks, and both disorders interfere with a mama’s ability to take care of herself or her baby. 

If a friend or family member is struggling with PPD or PPA, it can be difficult to know how to help. If you feel moved to say something to them, be sure to come from a place of love, understanding and support, rather than from fear, confusion or control. Here are some phrases to try—and some to avoid. 

What to say to a mama struggling with PPD or PPA

“I know you’re going through a lot. How can I help?”

What not to say: “Just hang in there!”

If you’ve never experienced a postpartum mood disorder like PPD or PPA, you may not know how to reach out to someone who’s going through it. It’s tempting to throw out a familiar platitude, something well-meaning and positive but ultimately hollow. “Not only can hollow and empty platitudes prevent a struggling mother from feeling heard and seen, but they can actually trigger deeper feelings of guilt and shame,” says Sarah Pool, MA, LPC, NBCC, a counselor who works with parents and women in the postpartum period.

It’s far more meaningful to ask an open-ended question and listen actively to the response. Try not to project what kind of help you would want in this situation, or what you wish the person would say in return. Just listen, then make a plan to help. Most importantly, follow through. 

“Would you be open to talking to a doctor?”

What not to say: “My friend had PPD/PPA and she said yoga/meditation/gratitude lists fixed everything!”

PPD and PPA are both diagnosable health conditions that can be medically treated. It’s important that mamas know this, because it means that they can get professional help.

Rather than throw out anecdotal evidence for miracle cures, encourage your loved one to see a doctor. If they’re open to it, you can even go a step further and offer to help make them an appointment, drive them there, or treat them to lunch afterward. PPD and PPA make it difficult to seek help, so if you’re able to, do what you can to ease the burden.

“Even with the increase in awareness of mental health struggles, a stigma still very much exists around struggles with depression and/or anxiety, and even greater stigma if you are struggling with PPD/PPA,” says Pool.

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“This isn’t your fault.”

What not to say: “If you had made better choices during your pregnancy, you wouldn’t be dealing with this.”

Any new mama can experience PPD or PPA. It can develop after the birth of any child, not just the first. There are certain factors that can raise the risk of these disorders, such as a history of mental illness, recent stressful experiences, or relationship difficulties.

“There is a growing body of evidence to support that isolation and loneliness are major risk factors for women suffering from anxiety and depression, but specifically those struggling with PPD and PPA,” adds Pool.

If someone has PPD or PPA, they in no way caused it or brought it upon themselves. If your loved one is feeling guilty, telling them it isn’t their fault reminds them that they did nothing wrong.

“I’m here for you. You’re important to me.”

What not to say: “I promise that everything will be OK.”

Unfortunately, it’s impossible to guarantee that your mama friend’s struggles will end when we say so. “We often think the best way to help a struggling friend is to try and fix their problems or band-aid their wounds, but in reality just listening and holding the space for their pain can be more helpful and powerful than anything you could ever say,” says Pool.

Promising that everything will turn out for the best may make them feel invalidated or frustrated. Instead, the best thing you can do is remind them of their inherent worth and of your presence in their life. Taking care of a new baby can feel lonely; PPD and PPA make that isolation even worse. Make sure your friend knows you’re in her corner. 

“I’ll check in with you again tomorrow morning.”

What not to say: “Fine. I’ll leave you alone.”

Everyone has bad days. Someone suffering from PPD or PPA may be having quite a few of them. If you reach out to your loved one and they lash out, give you the cold shoulder, or otherwise react negatively, it can be tempting to stop trying. However, just because they hurt your feelings doesn’t mean they don’t still deserve help, love and support. Let them know you’ll reach out again later, and at a specific time. It gives both of you time to cool off and lets them know that you’re not giving up on them. 

A note from Motherly

In the early weeks and months, new mothers need lots of support both physically and emotionally, notes Pool. “It’s critical that we try not to fall into problem-solving or cheerleading mode. Often in our attempts to make things better or brighter, we might invalidate their feelings, which can actually trigger more feelings of guilt and shame. New moms who are struggling need an advocate—and people who can show up to help without having to ask.” 

Lastly, regardless of the severity, it is always best to encourage a suffering mother to seek support and assistance from a medical professional, Pool suggests.