Postpartum Emotional Challenges: Can You Cope Without Medication or Therapy?

In this article we will address some serious practical questions that often arise regarding postpartum challenges.

1. Can I learn to cope on my own?
The very fact that you're asking whether you can manage on your own already indicates healthy coping strength. Your desire to overcome this challenge by yourself activates your inner resources, engages your motivation, and pushes you in the direction of healing.

To answer the question directly, there is definitely a possibility that you will find your own path to cope. If you have emotional support from a mother, spouse, friend, sister, or anyone who truly listens and understands your feelings, you have a good chance of managing on your own. If the emotional challenges gradually decrease, it’s a sign you’re on the right path.

2. Will it go away by itself?
As with any emotional challenge, two key factors must be considered: the duration of the symptoms and the intensity of the difficulty.

Let’s compare it to a physical illness. When the first symptoms appear- such as a runny nose, a cough, or a headache- you don’t rush to the doctor. You assess how intense the symptoms are and how long they last. If, after several days, symptoms worsen, fever spikes, and the cough deepens, you realize it’s not going to pass on its own, and then you seek help.

The same applies to emotional distress. In the first week or even the first month, it’s normal to wait before seeking treatment. For example, with PTSD, someone who has witnessed a traumatic event (like a bombing) will likely experience nightmares for a few weeks, which is a normal reaction. According to clinical guidelines, treatment isn’t recommended until a month has passed. Initially, we allow the person’s natural coping mechanisms to kick in.

If the symptoms worsen or persist over time, we then conclude that it’s unlikely to go away on its own. This same logic applies to postpartum symptoms: if the situation doesn’t improve and continues to intensify, it’s time to seek help.

I would add a third factor here- the distress of the family including the baby, other children, and the spouse. Their pain should also be considered alongside the mother’s experience.

3. Will it come back with the next birth?
Statistically, there is a higher likelihood of postpartum symptoms recurring if a woman experienced them in a previous birth. The brain tends to associate events. If anxiety was stored in the “birth folder,” so to speak, it’s likely to appear again during the next birth.

The exception is if the emotional difficulty was treated effectively, in which case, the chances of recurrence are greatly reduced.

4. Is treatment necessary?
After answering the previous three questions, the answer becomes clear. If the emotional distress persists over time and causes significant suffering for the woman or her family, it is advisable to consult a professional about the need for treatment.

From my many years of experience as a CBT therapist, I can share that there are several helpful forms of treatment:

1. Emotional support

2. Reflexology, which soothes both body and mind

3. CBT therapy- focused, practical therapy that often brings amazing results in a short amount of time

4. Dynamic psychotherapy

5. Psychiatric consultation (when needed)

5. Will medication be necessary?
When a woman seeks professional advice and expresses a desire to try non-medicated therapy first, that choice is always respected, so long as her condition allows. No one is forced to take medication. I’ve seen women in complex emotional states who were highly motivated to avoid medication, and they succeeded.

In general, I believe that 50% of the success of treatment depends on the person’s level of motivation. If you’re determined to recover without medication, go for it.

May G-d bring light and joy to all homes, especially to mothers during the special and sensitive postpartum period, and guide us always to serve Him with joy and a full heart.

Batsheva Adler is a certified CBT emotional therapist.