Caring for Your Mental Health in the NICU

October 31, 2023
Photo by Emily Ingalls Photography

by Lexi Losch, MA, LPC, NCC

Having a baby in the NICU can be a stressful time for the entire family. You may be experiencing many ups and downs as you navigate this new life. You may feel helpless because you can’t help your baby more and guilt because of blame turned inward. Perhaps you’re feeling overwhelmed; you’re juggling a return to work, caring for other children, transportation or finances. You may feel sad if you are unable to bring your baby home as planned. You may also feel happy because your baby is making progress and overcoming challenges. You may weave back and forth between all these feelings and more, such as fear, anxiety and grief. These feelings and experiences can affect your ability to function and care for your baby.

Because of this common whirlwind of feelings, NICU mothers are at a higher risk for developing a perinatal mood and anxiety disorder (PMAD).  Mothers of preterm babies are 40% more likely to develop postpartum depression and those with neonates in the NICU have a 28-70% risk of postpartum depression. There is also an increased risk for post-traumatic stress disorder (PTSD). With these increased risks for a PMAD, NICU mothers can quickly become engulfed in things that they feel they can control to help mitigate this new territory of unexpected hormones, moods, feelings and needs. Taking care of yourself during this time may seem like something that should be on the back burner, something that you can attend to once you’ve completed the rest of the day’s tasks. However, in order to continue taking care of your baby, you must take care of yourself. You cannot pour from an empty cup.

Caring for your mental health in the NICU

Caring for your mental health does not have to feel overwhelming. It does not have to be a grand gesture if you don’t want it to be. Here are some gentle suggestions:

Rest whenever possible

During this time, it may feel impossible to get any rest at all! Between visiting the hospital, possibly working, breastfeeding on a tight schedule, pumping, and hands-on time, it’s difficult to find any time to sleep. However, sleep and depression are tightly wound and can affect each other. Perhaps you can allow another family member or friend to help with cleaning pump parts, cleaning the house or caring for any other children in your home so you can take a nap.

Talk to someone

If you’re feeling overwhelmed, the last thing you want to think about is scheduling another appointment. However, making space to speak with a NICU social worker or a licensed professional counselor can help you process your birth story, have a safe space to discuss what you’re needing and how you’re coping. If you are unable to leave the house, perhaps there are practitioners who do home visits or online support groups that can help normalize what you’re feeling and support you along the way. Don’t hesitate to reach out to friends and let them know what you need as well.

Maintain routines

Whether that routine is becoming involved with your baby’s care in the NICU (feeding, kangaroo care, etc.) or creating routines at home, routines are commonly known to help reduce levels of anxiety and create a sense of purpose.

Adequate nutrition and hydration

It’s already 4 p.m. and you haven’t eaten a single thing today! Planning nutritious meals can feel exhausting and time-consuming. Perhaps this is the time for a Care Calendar, or a meal train set up for you and your family. It’s okay to be specific in your dietary needs. Good nutrition and comforting foods can help you feel more connected to your support system and can boost your energy levels.


If you’re able to find a few minutes a day, you can start a journal of your baby’s NICU journey along with your lived experience. This can be an outlet for your emotions and needs if you aren’t able to get that met in a timely manner with a professional or friend. Journaling is also a great conductor for developing clarity, insight and sometimes resolution.

Engage in a hobby

Do you enjoy listening to music? Perhaps you can play your favorite music on the way to the hospital to invoke warm and inviting feelings. Do you love exercise? If you’ve been cleared by your OB/GYN and/or your health professional to exercise, try fitting in a few minutes of gentle walking, perhaps even around the hospital grounds. This is a great way to take a break and still be on-site.

When to seek professional help

You may try these suggestions or some of your own and come to the realization that it isn’t enough. When is it time to seek professional help? Symptoms may include:

  • Constant worry
  • Feelings of fear
  • Constant anger and irritation
  • Physical symptoms such as shortness of breath, chest pain, dizziness, etc.
  • Feelings of isolation
  • Intrusive Thoughts/Obsessions
  • Lack of interest in the baby
  • Crying/sadness
  • Hypervigilance
  • Avoidance
  • Exhaustion
  • Panic attacks
  • Loss of appetite or eating too much

This list is not exhaustive, and a combination of different symptoms may signal a mood disorder. These are all common symptoms of PMADs, and we want you to know that you aren’t alone. While these feelings can be isolating and overwhelming, it’s important for you to be able to recognize them so you can seek treatment when necessary. This list can also be used by partners, family, and friends who may be able to help you seek treatment if necessary. A mental health professional can provide screening options to help you better understand your emotions, physical changes, and needs. It’s important to allow a practitioner to interpret the screening, as they can share the results in a caring and normalizing safe space.

Caring for your mental health while your baby is in the NICU can feel insurmountable, but it doesn’t have to be. It’s okay to ask for help. It’s okay to ask for support. It’s okay to not “do it all.” Be honest with yourself, your doctors and your baby’s doctors and nurses about how you’re doing. You may be paralyzed from waves of emotions and concern for your baby, but you are absolutely worthy of taking the time you need to care for your mental health.

If you’re looking for support, here are a few ways you can get help:

  • Request a peer mentor. Would you like to talk to another parent who has been where you are now? Hand to Hold can match you with a trained NICU graduate peer mentor at any stage of your journey.
  • Postpartum Support International (PSI) has additional postpartum resources local to your state or area. There are also PSI Coordinators for different areas that can assist with helping you narrow your search for either a group or individual professional counselor.
  • Postpartum Health Alliance is a membership organization of diverse and dedicated health care and resource providers, working together to raise awareness of PMADs.

About the author

Lexi Losch Hand to Hold

Lexi Losch, MA, LPC, NCC, is a therapist that lives in Pflugerville, TX, with her husband and three children. She holds a Bachelor’s in Psychology and a Master’s in Higher Education from the University of Miami. Lexi recently completed a Master’s in Professional Counseling, as she realized after her own experience with perinatal mood disorders, that there weren’t enough resources and mental health clinicians of color dedicated to supporting the transition into motherhood and beyond.