What Every Parent Should Know About Postpartum Anxiety
As a new parent, it’s expected that you’ll worry. But if your worry or anxious thinking gets to the point where it’s affecting your everyday life, you may have postpartum anxiety.
Postpartum anxiety (PPA) can occur anytime between giving birth and your baby’s first birthday. It can be described as an anxious feeling that can be overwhelming or difficult to control. Michelle DiBlasi, D.O., a psychiatrist at Tufts Medical Center in Boston, describes it as being “worried all the time, then starting to have physical symptoms like trouble sleeping even when the baby is sleeping, nausea, chest palpitations, or muscle tension.”
Postpartum anxiety is more common than you may think, with some studies finding that the condition can affect anywhere from 15% to 20% of birthing people in the first year after giving birth. Left untreated, it can lead to negative impacts on both a parent and baby’s health. Here’s how to spot postpartum anxiety and tips on seeking treatment.
The Difference Between Anxious Feelings and an Anxiety Disorder
“Some anxiety around pregnancy, birth, and parenting is normal, as this period marks a significant change in someone’s life,” says Nicole Pacheco, M.D., a clinical instructor of psychiatry for the Columbia's Women's Mental Health Program in New York City.
To be diagnosed as PPA, it must cause a notable level of distress and/or affect your ability to function. “In postpartum anxiety, the anxiety presents as uncontrollable, highly elevated levels of worry that causes functional impairment such as difficulty at work or in maintaining relationships with others,” says Pacheco.
Postpartum anxiety is considered a perinatal mood and anxiety disorder (PMAD), one of a group of mental health concerns that can occur during pregnancy up to one year after giving birth. Others include postpartum depression (PPD), postpartum obsessive compulsive disorder (OCD), and postpartum psychosis.
Postpartum Anxiety Symptoms to Watch Out For
With postpartum anxiety, worry or anxious thoughts can spiral out of control. It’s common for those thoughts to be about the pregnancy, the baby’s health and development, or labor and delivery—but they can be about anything.
The anxiety is sometimes accompanied by physical symptoms such as:
- Shortness of breath
- Heart palpitations
- Behavioral changes such as avoiding stressful situations or acting overly cautious or watchful
- Being tense or feeling overwhelmed
- Inability to relax
- Trouble sleeping
- Nausea or other stomach issues
“Some people may not actually recognize the signs themselves,” says Jillian Amodio, a social worker in Annapolis, Maryland, and founder of Moms For Mental Health, an online support group. They may be so consumed by anxiety that they’re not able to recognize that something isn't right, she says.
So, another sign of postpartum anxiety could be another person commenting that you’re worrying or stressing a lot.
“If you experience symptoms where it’s hard to function that last for longer than two weeks— even if it's mild— at that point, it's time to contact your physician,” says Anjie Li, M.D., an ob-gyn at Women’s Care Medical Group at Stanford Medicine Children’s Health in California.
Postpartum Anxiety vs. Postpartum Depression
You may have heard of postpartum depression and wonder how these two conditions are different. Many of the signs of PPA overlap with PPD and someone can have both.
“Postpartum depression is distinct from postpartum anxiety, and is characterized by persistent low mood, low energy, poor motivation, impaired concentration, and changes in sleep and/or appetite,” says Pacheco. “In more severe cases, thoughts of self-harm or suicide may be present [in PPD].”
People who experience with PPD can have an overwhelming sense of hopelessness, guilt, shame, or a lack of interest in the baby, says Venus Kennedy, a licensed therapist and owner of Charlotte Women's Counseling in North Carolina. They may cry a lot and not be interested in things that usually bring them joy.
People with PPA, on the other hand, tend to have an overfocus of the baby. They may worry if the baby is breathing, eating enough, sleeping well, and other similar concerns, says Kennedy.
For help with any mental health concern during or after pregnancy, talk to a provider with experience in postpartum mental health care. You can search for one in the Postpartum Support International directory.
What Causes Postpartum Anxiety?
“One of the things that we think causes postpartum anxiety is hormonal fluctuations after pregnancy,” says Li. “There’s a huge change in estrogen and progesterone levels.”
While birthing parents of all backgrounds can develop postpartum anxiety, there are certain risk factors that may make a person more prone. “The strongest risk factor is the presence of a prior anxiety or depressive disorder,” says Pacheco.
Other risk factors include history of negative childhood experiences, lack of support, and family history of psychiatric illnesses. External stressors like the pandemic, an illness, or a death in the family can also increase one’s chances of developing PPA. People who’ve experienced pregnancy loss or trouble conceiving may be more likely to have anxiety during late pregnancy.
What to Do About Postpartum Anxiety
If you experience symptoms of postpartum anxiety, or if a friend or family member says that your worrying seems out of control, reach out to your doctor or a mental health provider. They may be able to prescribe treatment or refer you to a specialist for help.
Treatment for postpartum anxiety often includes a mix of therapy, medication, self-care, and seeking support.
Psychotherapy can help people with PPA tremendously, says Kennedy. A therapist can help both you and the people in your life understand postpartum anxiety. They can help you create a plan for getting the support and care you need.
A therapist is someone you can see for regular mental health support. They can help you feel less anxious in the way that’s right for you. That could mean helping you to work through your feelings, to understand any trauma or triggers you’ve experienced, to empower you for parenthood, or to work on self-compassion.
Doctors often prescribe antidepressant medications called SSRIs (selective serotonin reuptake inhibitors), like Prozac or Zoloft, for postpartum anxiety. These work by increasing the levels of serotonin in the brain. This is a chemical thought to help with emotions, mood, and sleep.
Healthy Lifestyle Strategies
It’s important to find healthy ways to relieve stress and relax, says DiBlasi. This could include mindfulness activities like meditation.
Movement is another effective way to help manage symptoms of anxiety. If you had complications during pregnancy or childbirth, talk to your doctor about when you can start exercising. According to the American College of Obstetricians and Gynecologists, most birthing people who had a vaginal delivery and a healthy pregnancy can start exercising as soon as they feel ready. If you had a c-section or complications, you may have to heal first.
It may feel tough to find time for exercise but even taking a short walk while your partner or a friend stays home with the baby may help greatly. It’s also important to eat a nutritious, balanced diet to help support your mental and physical health.
Amodio stresses the importance of having people in your life who can help you emotionally. That can mean joining a support group for parents. You can search Postpartum Support International for in-person and online support groups.
It can also help if you have other trusted friends or loved ones you can talk to about your feelings.
Support can also come in the form of physical help, so you feel less overwhelmed with your responsibilities as a parent. You can ask people in your life to care for the baby or help you around your home. You may even consider hiring a postpartum doula, in-home helper, or cleaning service to relieve some stress.
The most important thing is that you reach out any time you think you can use some support. Your doctor may be a good person to start with. This can be your ob-gyn, general practitioner, or mental healthcare provider, says Li.
“Some people fear getting help for a variety of reasons,” says Amodio. “This includes fear of repercussions, shame, guilt, and stigma.” But PPA is treatable and nothing to be ashamed of. With the right treatment and self-care, you can get back to feeling like yourself.
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