NICU Parent Mental Health: Stress, Anxiety, and Where to Get Help

You’re not alone

Having a baby in the NICU is stressful, and March of Dimes notes that the stress can go on for weeks and months. The AAP lists fear, anger, guilt, a sense of loss, and powerlessness as common parent reactions in the NICU. Many parents feel a few of these at once.

Research backs this up. A 2022 review of 56 studies, covering 6,036 parents of babies in neonatal units, found that up to one month after birth, about 42% of parents had anxiety and about 40% had post-traumatic stress symptoms. Those rates fell over the first year but stayed higher than in perinatal women in general. Post-traumatic stress symptoms were still found in about 27% of parents more than a year after birth. The authors recommended routine screening so parents can get help early.

March of Dimes also says postpartum depression is more common in people who have or have had a baby in the NICU. Postpartum Support International (PSI) lists having a baby in the NICU as a risk factor for perinatal PTSD.

The feelings don’t always end at discharge. For our family, the hardest stretch came after Maverick came home from the NICU and then caught RSV, which meant months more in the hospital and the PICU. You can read our story.

Baby blues, depression, and anxiety

Baby blues

The National Institute of Mental Health (NIMH) describes the baby blues as mild, short-lasting mood changes that often show up in the first two weeks after birth. They usually go away on their own.

Postpartum depression

Postpartum depression is more intense and lasts longer than the baby blues. It usually doesn’t get better without treatment. CDC research found that about 1 in 8 women with a recent live birth reported symptoms of postpartum depression. NIMH lists symptoms such as:

• A sad, anxious, or “empty” mood that doesn’t go away
• Feeling hopeless, guilty, worthless, irritable, or restless
• Losing interest in things you used to enjoy
• Tiredness, trouble concentrating, and changes in sleep or appetite
• Trouble bonding with your baby, or doubting you can care for them
• Thoughts of death, suicide, or harming yourself or your baby

March of Dimes says to tell your healthcare provider if sad feelings last longer than 2 weeks. NIMH is clear that perinatal depression is not the mother’s fault. It’s treatable with therapy, medication, or both.

Anxiety, intrusive thoughts, and trauma

Depression isn’t the only possibility. PSI describes perinatal anxiety as constant worry, racing thoughts, and a feeling that something bad might happen, and says it often occurs together with depression. PSI also describes perinatal OCD, with repetitive, unwanted, intrusive thoughts, often about the baby’s safety. Perinatal PTSD can follow a traumatic pregnancy, delivery, or postpartum experience, including a baby going to the NICU.

These are sometimes grouped together as perinatal mood and anxiety disorders. As PSI puts it, you do not need a diagnosis to reach out for help.

Dads and partners are affected too

The 2022 review above included both mothers and fathers. PSI says perinatal mental health conditions also affect dads and partners, and cites studies showing that 1 in 10 dads experiences postpartum depression. March of Dimes notes that you and your partner may cope with NICU stress differently, and that either of you may develop more serious conditions like depression or anxiety.

Partners are also often the first to notice when something is wrong. NIMH says spouses, partners, family members, and friends may be the first to recognize signs of depression in a new mother. They can help by encouraging her to talk to a provider, going to appointments with her, and taking on everyday tasks.

Ways to cope

These ideas come from March of Dimes and the AAP:

• Keep a simple daily routine. March of Dimes suggests a daily routine as one way to take care of yourself.
• Take breaks from the NICU. Finding healthy ways to step away for a while is part of taking care of yourself, not a sign you care any less.
• Talk it out. Talk with a friend, your partner, or a counselor. Writing in a journal helps some parents too.
• Connect with other NICU families. Ask whether your hospital has “graduate” NICU parents who volunteer to talk with families.
• Ask the NICU team for support. Ask your baby’s nurse whether the hospital has a support group, social worker, chaplain, or someone else who supports parents’ emotional needs. Our guide to the NICU and questions to ask the NICU team can help.
• Go easy on yourself. March of Dimes puts it simply: you’re doing the best you can.
• Let people help. Friends often want to do something useful. Send them our guide on how to help a friend with a baby in the NICU.

When to get help right away

Call or text 988, or call 911, if you or your partner:

• Has thoughts of suicide, of harming yourself, or of harming your baby
• Sees or hears things that aren’t there, has beliefs that aren’t true, or seems confused. NIMH says these can be signs of postpartum psychosis, a psychiatric emergency

You can also go to the nearest emergency room. If someone you love is in crisis, the CDC advises not to leave them alone.

For feelings that are hard but not an emergency, the CDC suggests talking with your healthcare provider and asking for a referral to a mental health professional.

Free, confidential support

National Maternal Mental Health Hotline

Call or text 1-833-TLC-MAMA (1-833-852-6262), 24/7. This national hotline from the federal Health Resources and Services Administration (HRSA) supports pregnant and new parents. In an emergency, call or text 988 or call 911.

988 Suicide & Crisis Lifeline

Call or text 988, or chat at 988lifeline.org. It’s free, confidential, and available 24/7. According to the Idaho Department of Health and Welfare, calls from a 208 area code are routed to the Idaho Crisis and Suicide Prevention Hotline. The department also lists 24/7 behavioral health crisis centers for adults across Idaho.

Postpartum Support International

Call or text the PSI HelpLine at 1-800-944-4773 (text en español: 971-203-7773). It isn’t a crisis line. You leave a confidential message, and a trained volunteer calls or texts you back. PSI also runs free online support groups, including a NICU Postpartum Parents group for parents of babies currently or formerly in the NICU, and a Dad Support Group.

Idaho has its own chapter, PSI Idaho (PSI-ID), which works to increase awareness, education, prevention, and treatment of perinatal mental health issues across the state.

Hand to Hold

Hand to Hold is a national nonprofit for NICU families before, during, and after a NICU stay. It offers support groups, peer mentors who have been through the NICU, counseling, bereavement support, and podcasts for NICU parents.

Your hospital’s social worker

Ask your baby’s nurse how to reach the hospital social worker or other staff who support parents. St. Luke’s lists parent support lines, social work, and spiritual care for its Treasure Valley NICUs. Those numbers are on our Treasure Valley NICU resources page.

Getting ready to bring your baby home? See our discharge checklist. Make sure there’s a line on it for you, too.