Postpartum Depression: The Awareness Is There. So Is the Shame.
"You are not alone." That's how the World Health Organization opened a recent post on perinatal mental health — followed by a figure worth sitting with: 1 in 5 women experience a mental health condition during pregnancy or in the year after birth. Not rare. Not unusual. One in five. And yet, for something this common, it remains one of the hardest things a mother can say out loud.
We asked Olivia Rosa Izzo, a UK-trained psychotherapist at The Psychiatry & Therapy Centre in Dubai, to help us understand why. Her answer, in short: awareness has genuinely grown. Shame hasn't gone anywhere.
What is postpartum depression, really, and how is it different from the "baby blues"?
The baby blues are common — somewhere between half and four-fifths of new mothers experience them, Olivia says. They usually appear around the third to fifth day after birth: tearfulness, mood swings, irritability, feeling overwhelmed. Crucially, they settle on their own within about two weeks and don't stop a mother functioning.
Postpartum depression persists. It lasts weeks or months rather than days, it can begin at any point in the first year rather than only right after birth, and it genuinely affects a mother's ability to function. "It tends to involve persistent low mood, loss of pleasure or interest, disturbed sleep and appetite, difficulty concentrating, heavy guilt, and often significant anxiety," Olivia explains. "Many mothers describe feeling numb or disconnected from their baby, and then blame themselves for that disconnection. That self-blame is one of the most painful features of the condition — and it's also one of the clearest signs we're dealing with an illness rather than a personal failing. It's a genuine clinical condition, and it responds to clinical care."
Why does postpartum depression still carry so much shame, even now?
"Depression is still treated in many cultures as a weakness of character rather than a health condition," Olivia explains. "Add the expectation that new motherhood should be the happiest time of a woman's life, and a struggling mother has to admit not just to being unwell, but to feeling the 'wrong' thing about her own baby. That's a very difficult thing to say out loud."
It also isn't just emotional. In the days after delivery, oestrogen and progesterone drop steeply, thyroid function can shift, iron is often depleted, and sleep is severely disrupted — all of it affecting the brain systems that regulate mood, alongside the psychological and social factors at play. "None of that is a character flaw," Olivia says. "But depression is an illness that argues in its own favour, and it will make you believe every word of it."
"A great deal of good work is being done by clinicians across the UAE to spread that message, but the fear of asking for help is still there," she adds. "Mothers worry about being a burden, about having let their family down, about being judged as a bad mother. I want to be very direct about this: none of that is true. Getting support is the best thing you can do for yourself and for your baby."
✦ Misconceptions Worth Retiring
A mother doesn't love her baby. Depression flattens emotion across the board — the flatness distresses her precisely because she does love her baby.
It only follows a difficult birth. It happens after straightforward births, longed-for babies, and second or third children too.
It will pass if you push through it. The baby blues might. Postpartum depression generally doesn't, and shouldn't be left untreated.
It only affects mothers. Partners can develop it too, and rates rise significantly when the mother is unwell.
What are the signs people tend to dismiss or explain away?
The most common one Olivia hears: "I only feel this way because I'm not sleeping." Her question back is simple — when the baby is asleep and you have the chance to sleep too, can you? A mother who's simply exhausted will drop off in minutes. One who lies awake wired or ruminating is telling us something more is going on.
Other signs that get missed: irritability and anger rather than sadness (we expect depression to look tearful, and often it looks like rage), anxiety and constant catastrophic checking on the baby's safety, feeling numb or detached "as though watching yourself parent from behind glass," losing interest in everything outside the baby — or in the baby too, withdrawing from friends and family and letting messages go unanswered, and physical symptoms with no clear cause. Easiest of all to miss is over-functioning: the mother who appears immaculately organised and is holding herself to an impossible standard because slowing down feels unbearable. "The rough guide I give families is duration and function," Olivia says. "If it's gone on beyond two weeks, and if it's affecting how she's managing day to day, it's worth a conversation with a professional."
Is there anything about the UAE specifically that makes this harder to talk about?
The UAE is home to people from more than 200 nationalities — one of the things that makes it such a rich place to live, Olivia notes, but it also means every culture in the room carries its own norms about pregnancy, birth, and what a good mother looks like. "When a woman is surrounded by friends, family and practitioners from very different backgrounds, she often receives a real volume of advice," she says.
The bigger factor is distance. A large proportion of mothers here are giving birth thousands of miles from their own mother and relatives, sometimes with a partner working long hours, sometimes without a single person nearby who's known them longer than a couple of years. "The traditional postpartum support structures that exist in most cultures simply aren't available to them," Olivia says. There's also a practical point that cuts both ways: many families here have domestic help, and while that support is valuable, it can mean the practical tasks get covered while a mother's emotional state goes entirely unnoticed. "From the outside, everything looks managed."
What would you say to a mother who suspects something is wrong but is afraid to say it out loud?
"I would say that the fear you're feeling about saying it is itself part of what you're unwell with, and it's not a reliable guide to what will happen when you do," Olivia says.
"Saying it out loud once, to one person, is usually the hardest and most significant step. It doesn't have to be a doctor — a partner, a sibling, a friend, whoever feels safest. Things tend to start improving from the point at which one other person knows."
When it comes to professional support, she encourages looking for a clinician you feel you can be honest with — someone whose values and understanding fit with yours, particularly around culture, faith, and family. "Feeling properly understood is a substantial part of what makes therapy work, and if the first person you see isn't the right fit, you're entitled to try someone else. You don't need to have your symptoms organised or your case prepared. 'I don't feel like myself and I don't know why' is an entirely sufficient way to begin."
What role can partners and family actually play?
"What I most want partners and family to understand is the scale of what a woman is carrying after birth," Olivia says. "She's recovering physically from a major event, managing significant hormonal change, and holding the constant mental load of another person's survival. If you're tired, she's many times more so." What helps is mostly practical.
✦ What Helps, According to Olivia
Take the baby out so she can sleep — and protect that block of sleep as a fixed arrangement, not an occasional favour.
Do the task without asking what needs doing. Being asked is itself another decision she has to make.
Bring food, and keep visiting, especially after the first few weeks, once everyone else has stopped.
Ask directly, more than once, and be willing to sit with an honest answer without trying to fix it or talk her out of it.
Avoid comparing her experience to your own, or to anyone else's — every birth and postpartum experience is individual.
If she agrees to seek help, offer to make the call and go with her.
Where should someone in the UAE actually start?
Treatment usually involves up to three professionals working together, Olivia explains. A GP or obstetrician is a sensible first port of call — they'll listen to what's been happening and screen for depression or other post-birth medical issues. A psychiatrist carries out a full diagnostic assessment, distinguishes postpartum depression from other conditions, and prescribes and monitors medication where indicated, including guidance on options compatible with breastfeeding. A psychotherapist or psychologist provides the talking therapy — cognitive behavioural therapy, interpersonal therapy (which has a strong evidence base in the postpartum period), or attachment-focused parent-infant work, depending on what's presenting.
"For mild to moderate presentations, therapy alone may be preferable. For moderate to severe presentations, the combination of therapy and medication has the strongest evidence," she says. In the UAE, the route in is relatively straightforward: raise it at the six-week postnatal check, speak to a GP, or approach a licensed mental health clinic directly, as most don't require a referral. Many insurance policies here include mental health cover, so it's worth checking your plan.
What would you want every new mother in the UAE to know?
"That you're not alone in this, and that the number of women around you who've been through something similar is far higher than you'd ever guess from how everyone appears," Olivia says.
"That recovery is the norm, not the exception. With appropriate treatment, most women recover fully, and the earlier you reach out, the shorter and more straightforward that process tends to be. That bonding isn't something you either get right in the first week or lose forever — attachment develops over months and years, and it's remarkably repairable. Mothers who felt nothing at all in the early weeks go on to form deep and secure relationships with their children. Depression is not a verdict on the relationship you'll have with your child."
"That asking for help is an act of care towards your baby, not a failure of it. My door is always open to new mums, or to any mum who just needs somewhere to talk."
Our thanks to Olivia Rosa Izzo for the care she brought to these answers. If any of this sounds familiar, her door — like WHO's message — carries the same starting point: you are not alone, and prompt support can make a real difference.
Olivia Rosa Izzo is a UK-trained Psychotherapist (MSc) at The Psychiatry & Therapy Centre in Dubai, specialising in child and adolescent mental health, neurodiversity, and creative therapeutic approaches. She has worked across the NHS and CAMHS in the UK, in private practice, and as the sole psychotherapist within an autism, ADHD, and additional-needs school. A trauma-informed practitioner and mental health advocate, she has presented at conferences across the UAE and appeared on Dubai One.
This article reflects Olivia Rosa Izzo's professional experience and perspective as a psychotherapist, and is for general information only. It is not a diagnostic tool and should not replace personalised medical or psychological advice. If you are concerned about your own mental health or someone else's, please speak to a GP, obstetrician, or licensed mental health professional.
