The mental health crisis hidden behind motherhood

The birth of a baby is usually accompanied by celebration and expectations of happiness. Mothers are often told they should feel grateful, fulfilled and immediately connected to their newborn. Postpartum depression can bring anxiety, guilt, emotional disconnection and feelings of inadequacy. In rarer cases, postpartum psychosis can cause hallucinations, delusions and a loss of contact with reality. These experiences can be difficult to acknowledge because childbirth is overwhelmingly framed as a happy event. Psychologist Joelle Yaghi explains that mothers may struggle to understand why they do not feel the way they believe they should.

When depression does not look like depression

Postpartum depression does not always resemble conventional depression. Alongside sadness and exhaustion, it can appear as severe anxiety, constant overwhelm, intrusive thoughts and intense self-blame. A mother may continue caring for her baby and completing daily responsibilities while experiencing significant distress internally. “Postpartum depression often gets masked by the social expectations surrounding birth,” Yaghi explains. Following a major loss or crisis, society generally allows people to grieve or withdraw. Childbirth, however, is viewed as joyous, and mothers are frequently expected to show “instant gratitude, joy and natural competence.” That expectation exists while a woman may be recovering physically, experiencing hormonal changes, severely sleep deprived and adapting to an entirely new lifestyle. Instead of recognizing their distress as symptoms of a treatable condition, mothers may interpret it as evidence that they are failing.

Why does it happen?

There is no single reason someone develops postpartum depression or psychosis. Yaghi describes vulnerability as a combination of biological, psychological and environmental factors. A history of anxiety or mood disorders can increase vulnerability, alongside a difficult or traumatic pregnancy or birth, hormonal changes following delivery and insufficient emotional or practical support. However, these conditions can affect anyone. “Postpartum depression and psychosis can affect any mother, regardless of her background, preparation, or how much she wanted the pregnancy,” Yaghi says. Wanting a child does not prevent someone from developing a mental health condition after giving birth. Experiencing one does not determine how much she loves her baby or reflect her strength or character.

Depression and psychosis are not the same

Although postpartum depression and postpartum psychosis are often discussed together, they are distinct conditions. With postpartum depression, a mother remains in contact with reality. She may experience persistent sadness or anxiety, irritability, fatigue, feelings of worthlessness and difficulty bonding or coping. Postpartum psychosis is a rare psychiatric emergency involving a break from reality. It often develops rapidly during the first weeks after birth and may involve hallucinations, delusions, severe paranoia, confusion or erratic behavior. A major warning sign is a change in the mother's perception of reality. Thoughts of harming herself or her baby also require immediate attention. Yaghi says complete insomnia accompanied by unusually high energy or extreme restlessness can also signal something more serious. A mother experiencing psychosis may not recognize that her thoughts or perceptions are unusual. Postpartum psychosis therefore requires immediate psychiatric evaluation and treatment.

Motherhood, relationships and identity

Postpartum mental health struggles can affect almost every major relationship in a woman's life. A mother may feel disconnected from her newborn, frightened of being left alone with the baby or overwhelmed by intrusive thoughts. Difficulty bonding can produce guilt, which may create further emotional distance. For mothers with older children, limited energy or an inability to be as present as before can create additional guilt. Relationships with partners can also become strained through stress, emotional withdrawal and miscommunication. Partners may feel helpless or misunderstand symptoms as personal rejection. The experience can also dramatically affect a mother's identity. A woman who has previously had children may wonder, “I've done this before, why can't I handle it now?” According to Yaghi, the gap between the mother a woman expected herself to be and the reality of her internal experience can create grief over a lost sense of identity and control.

The pressure to love every second

Motherhood is often romanticized in ways that leave little room for contradictory emotions. Women are expected to be exhausted but grateful, overwhelmed but fulfilled and frightened but naturally capable. Yaghi describes the idea of “instant motherly bliss” as a cultural myth reinforced across generations. Older generations of women were often expected to endure difficulties involving children, marriage and domestic life privately. Maintaining the appearance of a functioning family could take priority over openly discussing what was happening inside it. A mother experiencing distress today may therefore fear that admitting she is struggling will make her appear weak, ungrateful or incapable. The result can be silence at precisely the moment when support is most needed.

The Lebanese context

In Lebanon, these expectations intersect with broader attitudes surrounding mental health and family privacy. Yaghi explains that psychological distress may be easier for society to understand when there is an obvious external cause, such as war, displacement, grief or economic instability. Childbirth does not fit that narrative. Because having a baby is culturally celebrated, distress afterward may instead be dismissed as tiredness, moodiness or a lack of faith or resilience. Comparisons to previous generations who “suffered in silence” can further discourage women from seeking help. Postpartum psychosis faces an even greater taboo. Paranoia, hallucinations or severe confusion may be hidden because families fear judgment or attributed to spiritual explanations rather than immediately recognized as requiring medical attention. This can delay treatment for a condition in which timely intervention is particularly important.

Making space for mothers to struggle

A woman can love her baby and feel disconnected. She can desperately want motherhood and still experience depression. She can have family support and still become ill. Postpartum depression and postpartum psychosis are treatable conditions, not evidence of maternal failure. Recognizing them requires allowing women to describe motherhood as it actually feels rather than how they have been told it should feel. Families can help by listening without judgment, taking changes in behavior seriously and encouraging professional support rather than minimizing distress. For Yaghi, changing the conversation means replacing generational silence with empathy, open dialogue and access to healthcare. Childbirth can be joyful while the postpartum period can still be psychologically difficult. Those realities do not cancel each other out. The question should not be how much mothers can endure, but how quickly they can receive the help they need.