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Counseling Specialty Areas: Pregnancy & Postpartum

Prenatal Depression is a distinct disorder that can greatly impact the mother during pregnancy, and if left untreated, can transition into Postpartum Depression; Prenatal Depression may feel difficult to discuss, but it is typical, treatable, and you do not have to suffer silently.

Prenatal Depression
Therapy for Anxiety/Depression during Pregnancy | Austin/Cedar Park,TX

When most of us think of mental health and pregnancy, the first term that comes to mind is Postpartum Depression (PPD). However, the medical field is now seeing Prenatal Depression as a distinct but related illness. Together, Postpartum Depression and Prenatal Depression are collectively referred to as “Perinatal Depression”.

The distinction is important and dealing with Prenatal Depression involves addressing a unique set of challenges that are complicated by the misperception that we only need to be mindful of a mother’s mental health state after her child is born. 

Bringing a human being into this world is one of the biggest responsibilities you can have. For some, pregnancy is an exhilarating experience. But for some of us it’s exhilaration mixed with self-doubt, second thoughts and even depression. What’s happening to my body? Am I ready for this? I came from a dysfunctional family, how on earth will I be able to break the cycle of dysfunction? Is my partner ready for this? How will my relationships change after the baby arrives? What about my career?

For those who already have children, you may be wondering how arrival of the new baby will affect the family dynamics. You may wonder if you could ever possibly love another baby as much as you love your other child/children. These are all completely normal questions to ask yourself. However, if you find yourself focusing on the “what ifs” more than the joy and excitement of bringing home your bundle of joy, you may suffer from prenatal depression or prenatal anxiety. 

Asking any of these questions or having these concerns is not, in itself, an indication of Prenatal Depression. However, if these thoughts have become persistent (on a daily basis for several days at a time) or are starting to affect your mood by making you feel more agitated or irritable, it is a good idea to speak to a counselor.

You probably have your own preconceived notions of what pregnancy “should feel like”, either from what you have read, seen, or even experienced firsthand with a previous pregnancy. As with childbirth and motherhood, there are societal expectations and pressures on women to feel a certain way about being pregnant. You may assume that you will feel better as you progress through trimesters, or that the constant stream of worries is just your nature as a mother-to-be.

The fact is: There is no one way to experience pregnancy any more than there is one way to experience motherhood. Everyone experiences pregnancy in a different way and how you feel can even vary from one pregnancy to the next.

These expectations, pressures and hard-wired notions often lead to feelings of shame and fear of opening up. What is important is that you know these feelings are not indicative of you as a mother, and that counseling can help.

As with other forms of depression, counseling plays a critical role in helping a mother talk through her feelings and experiences, develop coping skills and promote self-care that can decrease symptoms and allow mothers-to-be to truly enjoy and prepare for a new baby. Book an appointment today to see how you can relieve some of the pressure to make room for the excitement and joy that come with a new child. 

While better understood and more widely discussed than before, Postpartum Depression is still largely underestimated and underdiagnosed; PPD is highly treatable, the key is to engage a mental health professional, and it is never too late to seek help. 

Postpartum Depression
Postpartum Depression therapy in Austin/Cedar Park, TX

The postpartum period can be tricky. Society tells us it’s all bliss from the minute you lay eyes on your baby, that you feel a strong bond right away, breastfeeding is completely natural and easy (I mean, women have been doing it for centuries right?), that caring for baby is intuitive and you just know what their cries mean from infancy on, sleep when the baby sleeps and whatever “baby blues” you may experience are entirely cancelled out by the pure joy of motherhood.

But, what about the rest of us who didn’t get the hang of motherhood right away? If you’re feeling exhausted, depressed, anxious, experiencing feelings of regret, feeling numb, having intrusive thoughts about something bad happening to you or your baby, struggling to feel any joy at all or feeling anguish about whether to return to work then you may be suffering from postpartum depression or postpartum anxiety.

We certainly know more about PPD than we did a generation ago but is still easy for new mothers to underestimate or underreport their symptoms, which means that there are a lot of mothers who need help. For example, we now know that PPD can start anywhere from 2 weeks after giving birth up to one-year post-partum.

When trying to differentiate between “baby blues” and Postpartum Depression, there are two critical areas to consider:

  • Severity – With Postpartum Depression, the feelings are extreme and impact your ability to care for yourself and your child. The magnitude of the emotion feels insurmountable and contributes to feeling hopeless or overwhelmed.

  • Duration – Symptoms of Postpartum Depression last for several weeks and can increase if left untreated.


Postpartum Depression is highly treatable, and what works varies from mother to mother.  At A Path Forward, I am affiliated with the National Perinatal Association and take an evidence-based approach to determine the right treatment plan for each client.

Postpartum Depression is not caused by any one thing, nor is it brought on by something a mother does or does not do. It does require professional help to diagnose and treat, so if you are trying to work through powerful feelings after giving birth, make an appointment to talk through your concerns and how we can make you the best mother you can be.

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