# Therapy for postnatal depression: when to seek help, what therapy is like and how to choose > Everyone tells you to enjoy it, and all you want to do is cry. How to tell if it is postnatal depression, when to ask for help and what effective therapy is like, including from home. *https://mypsicotest.com/en/blog/therapy-for-postnatal-depression/ · Published: 2026-10-16 · 10 min read · MyPsicoTest team* It is four in the afternoon, the baby has finally fallen asleep on your chest and you are staring out of the window, not wanting to do anything. Everyone tells you to enjoy it, that it goes so fast. All you can think about is that you do not feel what you are supposed to feel, and that nobody can know. Postnatal depression, also called postpartum depression, is common, it is not your fault and it can be treated. If you are thinking about **therapy for postnatal depression**, this guide explains how to tell it apart from the baby blues, when it is worth asking for help, which treatment works, what therapy is like from the inside, whether it works online with a baby at home, what role your partner plays and how to choose a professional. ## Baby blues or postnatal depression: when to ask for help Feeling down, anxious or irritable for a few days after giving birth is very common. The [NHS](https://www.nhs.uk/mental-health/conditions/postnatal-depression/) calls it the **baby blues** and explains that it usually passes within two weeks of the birth. If it carries on, gets worse or you are struggling to cope, it is important to get help. **Postnatal depression** can begin during pregnancy, soon after the birth or at any point in the first year. A meta-analysis by Wang and colleagues, covering 565 studies from 80 countries and regions, found it in 17.2% of mothers, with lower rates in higher-income countries. According to the NHS, its symptoms include: - Low mood, and finding it hard to enjoy anything. - Feeling hopeless, or that you cannot cope. - Guilt, or feeling worthless or like a bad mother. - Fear, anxiety or constant worry. - Restlessness or irritability. - Trouble sleeping, even when you have the chance to rest. - Problems concentrating or making decisions. - Difficult feelings towards your baby, or trouble bonding. - Thoughts of suicide or of harming yourself or your baby. The NHS encourages you to get help even if you only have some of these signs. It also acknowledges that you may be scared your baby will be taken away if you say how you are feeling, and makes clear that this very rarely happens: the health team's job is to support you in caring for your baby. The UK's NICE guideline suggests that, in the early weeks after the birth, professionals ask whether during the past month you have often been bothered by feeling down, depressed or hopeless, and by having little interest or pleasure in doing things. If either sounds familiar, mention it to your midwife, your GP or a psychologist. You may be asked to fill in a questionnaire. The best known is the **Edinburgh Postnatal Depression Scale**, which has ten questions and takes about five minutes; NICE mentions it alongside the PHQ-9 as a way of monitoring symptoms. If you want to get your bearings first, the [Depression Test](https://mypsicotest.com/en/depression-test/) is based on the PHQ-9: it has 12 questions about the last two weeks and breaks your result down into mood and motivation; sleep, energy and appetite; and thoughts and concentration. Intrusive images of something happening to the baby are very common after giving birth and do not put the baby at risk; we explain why in [Intrusive thoughts: what they are, why they appear and when to worry](https://mypsicotest.com/en/blog/intrusive-thoughts/). And two situations that cannot wait. If thoughts of harming yourself appear, call the **024 line** in Spain (free, confidential, around the clock), **112**, or your local emergency number. And if in the first few weeks you suddenly notice confusion, suspicions or strange ideas, seeing or hearing things that are not there, or a high mood that is unlike you, the NHS explains that it may be **postpartum psychosis**. It affects around 1 in 1,000 mothers and should be treated as a medical emergency: get help that same day, at A&E or by calling 112. ## Which treatment works for postnatal depression NICE's guideline on mental health in pregnancy and after birth suggests self-help guided by a professional for mild to moderate depression. For moderate or severe depression, it suggests a high-intensity psychological therapy such as **cognitive behavioural therapy**; medication if the woman prefers it, does not want therapy or therapy has not worked; or both together if neither has been enough on its own. It also says women should not be kept waiting: assessment within two weeks of referral, and therapy within a month of that first assessment. A [meta-analysis by Cuijpers and colleagues](https://pubmed.ncbi.nlm.nih.gov/37310303/) pooled 43 studies with more than 6,200 participants and concluded that psychological therapies for perinatal depression are probably effective, with an effect that held at six to twelve months. The authors urge caution because the studies differ a lot from one another. Another review, by Sockol, looked at **interpersonal therapy** and found that it reduced depression and anxiety and improved relationship quality and social support. We explain what therapy for depression is like in general in [Therapy for depression: when to see a psychologist, what works and how to choose](https://mypsicotest.com/en/blog/therapy-for-depression/). ### What therapy for postnatal depression is like from the inside Every process is different, but it usually covers these points: 1. **An honest look at how you are:** your mood, your sleep, the support you have, whether you have had depression before and whether there are thoughts of harming yourself. 2. **Taking guilt out of the picture.** Postnatal depression is a health problem, not a failure as a mother. 3. **Getting back small things that give you some air.** The NHS suggests regular exercise, even a short walk each day, and setting aside time for things you enjoy, even small ones. 4. **Questioning the demands you place on yourself.** Ideas such as "a good mother enjoys every moment" or "I should be able to cope with everything" weigh heavily, and therapy works on them. 5. **Sharing the load.** Asking for help with shopping, housework or looking after the baby, and sleeping and resting as much as you can, are part of recovery, not a luxury. 6. **Looking after the bond with your baby.** Struggling to connect with them is one more symptom, not something that defines you as a mother, and with treatment the bond can come back. Interpersonal therapy focuses on the change of role that becoming a mother brings, on your relationships and on the support you have. And if the birth was traumatic and has left you with significant post-traumatic stress symptoms, NICE recommends trauma-focused therapy, such as trauma-focused CBT or EMDR, and advises against single sessions focused on reliving the trauma. ### What about medication? NICE points out that in pregnancy and after birth the threshold for using psychiatric medication is higher, because the balance of benefits and risks changes, and asks professionals to discuss this with the mother before starting any treatment, together with what psychological therapy could offer her. When an antidepressant is needed, the NHS explains that many are safe to take while breastfeeding: tell your doctor if you are breastfeeding and they will prescribe one that suits you. Medication is decided by a doctor, not a psychologist. ## How long therapy for postnatal depression takes The NHS explains that postnatal depression usually gets better within three to six months, although it sometimes lasts much longer, and that it is more likely to get better with treatment. How long therapy takes depends on how severe the symptoms are, the support you have and whether there are other problems, such as anxiety or a traumatic birth. What is clear is that it is not worth waiting for it to pass on its own: that is why NICE asks for therapy to start within a month of assessment. ## Does online therapy for postnatal depression work? Yes. A meta-analysis by Lau and colleagues, with 8 trials and more than 1,500 mothers in six countries, found that internet-based CBT with support from a therapist improved stress, anxiety and depressive symptoms after giving birth. ![Mother holding her baby during a video call on a laptop, as in an online therapy session for postnatal depression from home](https://mypsicotest.com/assets/img/blog-terapia-online-depresion-posparto-1200.webp) With a newborn, **online therapy** solves the hardest part: you do not have to leave the house, find someone to look after the baby or plan trips around feeds. You can join during a nap, with the baby in your arms if need be, or while your partner looks after them. If you have never had therapy by video call, [Online psychologist: how to choose well and what to expect from video-call therapy](https://mypsicotest.com/en/blog/online-psychologist-how-to-choose/) may help. ## Postnatal depression affects partners too The NHS points out that fathers and partners can also have depression after a baby is born. A [meta-analysis by Paulson and Bazemore](https://pubmed.ncbi.nlm.nih.gov/20483973/), with 43 studies and more than 28,000 participants, found it in around 10% of fathers during pregnancy and the first year, with higher rates between three and six months after the birth, and a moderate link between fathers' and mothers' depression. Sharing the nights and the chores, talking about how each of you is doing and asking for help early protects you both. Sometimes it also helps for your partner to join a session. ## How to choose a psychologist for postnatal depression These checks help you get it right: - **Registration as a health professional.** This comes first. - **Experience in perinatal mental health**, meaning pregnancy and the first year after birth. - **An evidence-based approach**, such as cognitive behavioural therapy or interpersonal therapy. - **Flexibility:** online sessions, appointment times that fit around feeds and the option of having your baby with you. - **A space without judgement**, where you can say out loud that you are not enjoying motherhood without feeling like a bad mother. - **Coordination with your midwife, your GP or a psychiatrist**, especially if you take medication or are breastfeeding. - **Experience with trauma**, if the birth was traumatic. ## A psychologist for postnatal depression At MyPsicoTest we recommend [Xènia Capel Salcedo](https://psicologaigualada.es/en/therapist-psychologist-igualada/), a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. She sees clients in Igualada and Sant Sadurní d'Anoia and also through [online therapy](https://psicologaigualada.es/en/online-therapy-online-therapist/), and on her blog she has written an article about postpartum depression. In it she explains that therapy focuses on processing emotions, managing guilt, working on expectations about motherhood and strengthening the bond with the baby, and that the online format is especially suitable after birth because it saves you travelling with a baby. In another article, on online therapy for women, she writes about perinatal anxiety and the importance of normalising ambivalence: you can love a child deeply and still find motherhood exhausting. She works from an integrative, evidence-based approach: on her website she explains that she uses tools from cognitive behavioural therapy, EMDR, systemic therapy and person-centred therapy. Sessions are available in English, Spanish or Catalan, and the first contact is a free, no-commitment information consultation. She herself points out that in a serious crisis or psychiatric emergency, immediate in-person care is what is needed. ## Frequently asked questions ### What is the difference between the baby blues and postnatal depression? The baby blues are a few days of sadness, anxiety or irritability after the birth that usually pass within the first two weeks. Postnatal depression lasts longer, is more intense and makes daily life harder. It can begin in pregnancy or at any point in the first year. ### When should I see a psychologist for postnatal depression? If the low mood has not lifted after two weeks, is getting worse or you are struggling to cope. The NHS encourages you to get help even if you only have some of the signs. If thoughts of harming yourself appear, call the 024 line in Spain, 112 or your local emergency number. ### Which therapy works for postnatal depression? Cognitive behavioural therapy and interpersonal therapy are the most studied. A meta-analysis of 43 studies concluded that psychological therapies are probably effective and that their effect holds at six to twelve months. ### Can I take antidepressants while breastfeeding? The NHS explains that many antidepressants are safe to take while breastfeeding. Tell your doctor so they can choose a suitable one. NICE also asks for a conversation beforehand about what psychological therapy could offer. ### Does online therapy work for postnatal depression? Yes. A meta-analysis of 8 trials found that internet-based cognitive behavioural therapy with support from a therapist improved depression, anxiety and stress after giving birth, and it saves you leaving the house with the baby. ### Can fathers get postnatal depression? Yes. A meta-analysis found depression in around 10% of fathers during pregnancy and the first year, with more cases between three and six months after the birth. ### How long does postnatal depression last? According to the NHS, it usually gets better within three to six months, although it sometimes lasts much longer. It is more likely to get better with treatment, so it is not worth waiting for it to pass on its own.