Should I Work During Intensive Outpatient Treatment?
August 25, 2026
Note: Anchor respects and welcomes all gender identities and acknowledges that people who don't identify as "women" can also become pregnant and experience perinatal mood and anxiety disorders. Because the vast majority of research on postpartum people in the workplace uses female terms, for the sake of this article, we use terms like "woman" and "mother."
The question of when and whether to return to work during the postpartum period is fraught with emotional, psychological, and financial implications. Despite research suggesting that "access to paid maternity leave is associated with a reduced likelihood of developing adverse mental health outcomes,"¹ the United States remains one of seven countries without a federally mandated paid maternity leave plan, meaning many women are left with no personal income while recovering from birth. If not working means no income, for some women, going back to work is not even a question. They have to do it. However, if that new mom is suffering from perinatal mood and anxiety disorders, the question of work becomes more complicated. For people receiving intensive outpatient treatment in programs like Anchor's, it's important to examine if work is therapeutic or a barrier to recovery.
Symptom Severity
During a PMAD, skills needed for work like concentration, communication, and alertness can become impaired.
Perinatal mood and anxiety disorder (PMAD) symptoms occur on a spectrum ranging from mild to severe. During a PMAD, skills needed for work like concentration, communication, and alertness can become impaired. When someone is experiencing intense, daily symptoms, they may be so debilitated that a return to work is not possible. One postpartum depression survivor explained her outlook on a return to work as beyond her capacity. "I truly thought I would never be able to go back to work. I thought I'd broken my brain by having a baby, and that I would have to quit my job," she said.
People experiencing severe PMAD symptoms should focus on healing through specialized therapy, support groups, and medication.
While there is no one way that people experience PMADs, in general, severe symptoms might look like this:
persistent depression or hopelessness
uncontrollable worry that dominates a large part of the day
involuntary bouts of crying
profound exhaustion that limits basic functioning
avoidance that interferes with self-care or caring for baby
inability to separate from baby or fear of others caring for baby
People with symptoms at this level should focus on healing—through a mix of specialized therapy, support groups, and medication—until their symptoms decrease to a more manageable level. As symptoms improve, those recovering from PMADs still need to consider if work will be an added strain that could exacerbate symptoms and set back recovery, as there are several workplace stressors to consider:
Workplace Stressors
arranging childcare
infant feeding challenges
pumping and milk storage at work
ongoing sleep disturbances and sleep loss²
work-life balance
If adding work back into the mix will do more harm than good, women should prioritize their mental health.
Total Leave and Partial Leave
Caring for a new baby, healing from birth, functioning on minimal sleep, and navigating a new identity as a parent all while working is no easy feat. If a mental health condition like postpartum depression, anxiety, or OCD is added to the equation, even if the person wants to return to work, they may not be currently capable of fulfilling their job duties. With this in mind, when finances and support systems permit, some IOP clients may benefit from taking total leave for the duration of treatment. If returning to work is a necessity or an immediate goal, total leave for the first half of treatment and then a gradual approach where work is integrated back into their routine can be a viable option.
When Not Working Is Not Feasible
We understand that the ability to not return to work is a privilege, and for some women, it simply isn't financially feasible to not work postpartum. Additionally, low job security may make postpartum people feel like they need to return to work quickly. For these women, steps can still be made to protect their mental health and recovery:
Option A: Create Work-Therapy Boundaries
IOPs like Anchor meet on a set schedule. For Anchor, that schedule is three days a week, for three hours at a time. IOP participants who need to work can build a work schedule around the intensive outpatient program, enabling clear boundaries between work days and treatment days.
Option B: Request Accommodations
Another option is to request accommodations at work for the duration of treatment with the goal of making the workload less stressful. In fact, legislation like the Pregnant Workers Fairness Act of 2023, which requires employers to make reasonable accommodations for employees based on any pregnancy or childbirth-related condition, and the PUMP for Nursing Mothers Act which includes protections for certain breastfeeding employees, make some accommodations legally mandated² though it's important to note that legislation is not always enforced or applied consistently.
Ability and Space to Practice Skills Outside of Treatment
As part of Anchor's IOP, we teach techniques that new parents can use to better cope with PMAD symptoms, including distress tolerance skills, mindfulness practices, and strategies to manage intrusive thoughts. Treatment isn't confined to the time a person is in treatment sessions. Just like with any newly learned task, IOP participants need to practice these skills, and they need to be able to do so in their home environment in real-life situations away from therapy. If returning to work impedes this practice, it may make it more difficult to get the full benefit of treatment. For people who do need to work during treatment, they will want to consciously carve out time to practice these skills.
Summary of Options to Consider for Working During Intensive Outpatient Treatment
Employment during intensive outpatient treatment should be evaluated according to symptom severity, functional impairment, financial implications, workplace stressors, and the individual's capacity to participate meaningfully in treatment. There is no "yes" or "no" answer to the question "Should I Work During Intensive Outpatient Treatment?" It's a decision that should be made between your family, treatment team, and workplace based on an honest assessment of how work is affecting symptoms, sleep, treatment participation, and ability to practice skills between sessions. The important part to keep in mind is that multiple workable options exist:
Total leave for duration of treatment
Total leave for the first half of treatment and then support integrating work back in
Avoiding work on treatment days
Workplace accommodations to make workload less intense
Anchor Can Assist with Leave Requests
For those considering Anchor's IOP, we can assist with work decisions in a few ways. Our admissions and clinical teams can help a person assess whether working will help or harm their recovery. We can then provide employers with the clinical documentation they require to approve a work leave request.
Final Thoughts
Ultimately, the question isn't simply whether someone can work while receiving treatment. It's whether working during treatment leaves enough time, energy, and emotional capacity to participate meaningfully in treatment and practice skills outside of it. Regardless of the approach taken, any work-leave plan should be revisited throughout treatment to assess if the plan continues to feel helpful or whether adjustments need to be made. Upon return to work "some women report improved self-esteem and work-family balance, while others experience rising stress and declining wellbeing as they navigate competing demands."³ So, as with so many parts of motherhood, it's an individual choice based on your needs, and you don't need to figure it out alone.
If you are suffering from any of the symptoms addressed in this blog or other symptoms of perinatal mood and anxiety disorders, please reach out today.
References
¹ McCardel, Rachel E., et al. "Examining the Relationship between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review." Maternal and Child Health Journal, vol. 26, no. 9, 2022, pp. 1917-1943. ProQuest, https://login.proxy055.nclive.org/login?url=https://www.proquest.com/scholarly-journals/examining-relationship-between-return-work-after/docview/2701324950/se-2, doi:https://doi.org/10.1007/s10995-022-03489-0.
²Schneider, Kimberly T., et al. "Workplace Discrimination Against Pregnant and Postpartum Employees: Links to Well-being." International Journal of Environmental Research and Public Health, vol. 22, no. 8, 2025, pp. 1160. ProQuest, https://login.proxy055.nclive.org/login?url=https://www.proquest.com/scholarly-journals/workplace-discrimination-against-pregnant/docview/3244039452/se-2, doi:https://doi.org/10.3390/ijerph22081160.
³ Darmaillacq, C., Seryer, S., Alleaume, D., Ahmadi, S., Remy, E., Barbosa, S., Davidovic, L., van der Waerden, J., & Wendland, J. (2026). Occupational exposures and maternal mental health across the perinatal period: A systematic review. Best Practice & Research Clinical Obstetrics & Gynaecology, 107, 102750. https://doi.org/10.1016/j.bpobgyn.2026.102750
Written by Bridget Bell
Bridget Bell is Anchor Perinatal Wellness’s Digital Marketing Associate. She is also a survivor of postpartum depression, anxiety, and OCD as well as a maternal mental health advocate. Her debut book of poetry All That We Ask of You Is to Always Be Happy (CavanKerry Press) is about perinatal mental health.
Reviewed by Roxanne Rosenberg, Clinical Director of Anchor Perinatal Wellness, LCMHC, PMH-C
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