Maternal Mental Health and How Therapy, Community, and Ketamine Can Help

Mother’s Day is approaching, and maternal mental health has been heavy on my mind lately. Heavy because of how unsupported so many postpartum mothers still are in our current healthcare system. Heavy because effective treatment for postpartum depression is still inaccessible for far too many women. But alongside that grief, I also feel a deep sense of drive—a commitment to continuing to improve this corner of mental health care in every way I can.

My relationship to postpartum depression isn’t just professional. It’s deeply personal.

I felt wonderful during pregnancy. Grounded. Connected. Emotionally steady. So when postpartum depression hit me—while I was still in the delivery room—I was completely blindsided.

For weeks afterward, the safest place in the world felt like sitting alone in my closet. Intrusive thoughts about running away from my life looped through my mind constantly. I had the kind of insomnia that happens when you’re so sleep deprived your nervous system can no longer settle into sleep at all. I battled mastitis alongside a wave of strange psychosomatic symptoms throughout my body. I didn’t feel connected to my life, my body, or even my baby in the way I thought I was supposed to.

What’s striking to me looking back is how invisible it all was.

No helping professional caught it initially. No one really saw the severity of what was happening until my daughter’s six-week pediatric appointment, when her pediatrician handed me a PHQ-9 depression screener. A few minutes later, he returned to the room with visible concern and asked, “Are you okay? I’m concerned about these depression scores.”

And I immediately minimized it.

“I’m a therapist,” I told him. “I’m okay. I’m just hyperaware of my thinking and moods.”

Even though I dismissed him completely, I still think back on his expression with gratitude. Something in him recognized that I was not okay, even when I couldn’t fully admit it myself.

At eight weeks postpartum, I attempted to return to work part-time. I remember sitting in a DBT training at the corrections facility where I worked, trying unsuccessfully to hide tears streaming down my face through nearly the entire training. One of the therapists there—a mentor of mine—quietly said to me, “You know you don’t have to come back yet. You can take more time for yourself.”

So I did.

That season became a strange patchwork of survival, healing attempts, and tiny moments of being witnessed by the right people at the right time.

When persistent somatic discomfort in my lower body continued despite repeated visits to doctors who offered medications and guesses but no relief, I reached out to a friend steeped in shamanic healing traditions. He came over and facilitated a shamanic toning session with me. During the session, I heard an incredibly high-pitched tone internally, and he said, “Sing it. You just have to trust yourself.”

What came out of me felt impossible—some sound I didn’t know I could make—and afterward, the physical symptoms disappeared.

I can’t explain that experience scientifically. I only know it helped.

It was another friend—a male prescriber—who helped me finally begin sleeping again. A temporary medication changed everything. Sleep changed everything.

Still, even though the acute and more frightening aspects of the depression lifted within a couple of months, I would say it took nearly two years before I truly felt reconnected to myself again. Postpartum depression is often discussed as though it’s a brief hormonal episode, but for many women, the aftermath is much longer and more existential than that. There can be grief. Identity loss. Numbness. Disconnection from your own aliveness.

And this is where the women in my life carried me home.

An experienced female psychedelic therapist helped me process the trauma surrounding childbirth and reconnect to the beauty of that day—the beauty that had been buried beneath shock and emotional shutdown. My friends, my yoga community, and my own therapist helped me slowly rebuild trust in myself and my body. The community of mothers surrounding me has been an important factor in helping me to come to be most proud of the aspect of my identity that is “mother.”

I think often about the different roles men and women played in my healing. The men in my life helped stabilize me when I was shattered. The women helped me reassemble myself afterward. There’s something deeply meaningful in that dynamic that I still reflect on.

Professionally, one of the most meaningful clinical trials I’ve worked on so far has been a study involving a psilocybin-like compound for postpartum depression. The mothers I sat with in that study often experienced profound emotional breakthroughs and rapid symptom improvement following treatment. Many described reconnecting to themselves, their emotions, and their babies in ways that had previously felt inaccessible. For many, the psychedelic experience felt like a doorway to their healing journey that would continue well after the study. 

The results were incredibly promising and deeply moving to witness.

And yet, like so many emerging treatments in mental health, this therapy is still largely inaccessible outside of research settings. Again, I feel that same mixture of grief and hope when I think about it—the heartbreak of knowing how many mothers are suffering right now without adequate support, alongside the hope that meaningful change is coming.

So what actually helps?

There is no one-size-fits-all answer, but there are several things I wish every postpartum mother knew.

First: mindfulness matters deeply. The intrusive thoughts, depressive spirals, and anxiety associated with postpartum depression can become terrifying largely because of how convincing they feel. Mindfulness practices—particularly Vipassana-style meditation—can help create space between you and your thoughts. Not suppressing them. Not fixing them. Simply learning to observe them without fully identifying with them. That shift alone can be life-changing. I often recommend the Waking Up app as an accessible introduction to this kind of practice.

Second: sleep is not optional. Sleep deprivation destabilizes every aspect of mental health, and postpartum women are often expected to survive profound nervous system depletion while functioning normally. If you are struggling, receiving support with nighttime care is not weakness. Using medication to sleep when appropriate is not weakness. Protecting your nervous system matters.

Third: ketamine-assisted therapy deserves more attention in postpartum mental health care. I often wish I had known about it during my own postpartum experience. Ketamine works on the glutamate system and can rapidly reduce depression symptoms and suicidality. Neurologically, it appears to decrease rigid patterns of fear and negative thinking while increasing cognitive flexibility and emotional openness. For many people, it creates enough breathing room to begin healing. There are also ways to receive ketamine safely while breastfeeding under appropriate medical guidance due to its relatively short half-life.

And finally: we need to expand our understanding of healing.

Our current postpartum care system in the United States is profoundly inadequate. Many women receive one brief postpartum check-up and are otherwise expected to navigate one of the largest psychological, hormonal, relational, and existential transitions of their lives essentially alone.

So sometimes healing comes through conventional treatment. Sometimes through medication. Sometimes through meditation. Sometimes through ceremony, movement, bodywork, community, spiritual practice, or unconventional modalities that reconnect women to themselves in ways our medical system does not yet fully understand.

Try what genuinely calls to you.

And if you are a therapist, healthcare provider, partner, family member, or support person reading this: education and involvement matter immensely. Postpartum depression rarely exists in isolation. Mothers need people around them who know what to look for, who can recognize when someone is disappearing beneath the surface of “functioning,” and who are willing to step in with practical and emotional support before things become critical.

Because maternal mental health isn’t a niche issue. It shapes families, relationships, children, and entire communities.

And mothers deserve far more care than we are currently giving them.

If this resonated with you, I would love the opportunity to discuss how we can use Ketamine therapy to assist in your postpartum recovery.