Postpartum anxiety is excessive worry or fear that can occur after giving birth. While it’s normal for new mothers to experience some anxiety, approximately 10-15% develop more severe symptoms that meet the criteria for a true anxiety disorder. This debilitating condition is similar to general anxiety disorder but revolves specifically around the transition to parenthood.
Postpartum anxiety has many of the same symptoms as general anxiety but manifests in the context of caring for a new baby. These can include:
- Physical symptoms like panic attacks, heart palpitations, nausea, dizziness, and insomnia
- Emotional symptoms such as dread, irrational fears, feeling overwhelmed, and inability to relax
- Behavioural symptoms like avoidance, obsessive worrying, and compulsive habits
Postpartum anxiety differs from postpartum depression primarily in that it centers around anxiety instead of depressive thoughts. However, many women experience both conditions simultaneously.
| Postpartum Anxiety | Postpartum Depression |
|---|---|
| Excessive worrying | Sadness, crying spells |
| Feeling panicked | Hopelessness, guilt |
| Obsessive fearful thoughts | Withdrawal, lack of interest |
If you think you may be suffering from postpartum anxiety, reaching out to your doctor and getting the help you need is important. You don’t have to handle this alone.
Symptoms and Triggers
Postpartum anxiety has both emotional and physical symptoms. These symptoms are your body’s way of reacting to the constant state of worry and fear.
Physical Symptoms
Physical manifestations of postpartum anxiety include:
- Insomnia – Unable to sleep even when the baby is sleeping
- Racing heart or heart palpitations
- Shortness of breath or hyperventilation
- Nausea and stomach pain
- Dizziness
- Fatigue – Exhaustion from lack of sleep
- Muscle tension
- Appetite changes – Lack of appetite or overeating
For some women, the anxiety also causes full-blown panic attacks involving sweating, trembling, nausea, jitteriness, and an overwhelming sense of doom.
Emotional Symptoms
Postpartum anxiety also causes a wide range of emotional symptoms:
- Feeling panicked, on edge, or like something terrible is going to happen
- A constant state of worry – Obsessing over fears all day and night
- Inability to relax or calm down
- Dread about the future
- Irritability and quickness to anger
- Feeling overwhelmed, fearful, or like you’ve “lost control”
- Irrational fears – Usually revolving around the baby’s safety
Some women also develop obsessive-compulsive disorder (OCD) with repetitive thoughts about harming the baby.
Behavioural Symptoms
The emotional turmoil of postpartum anxiety can cause behavioural changes as well:
- Avoidance of people, places, activities
- Refusing to let others care for the baby
- Compulsive checking – Obsessively checking on the baby
- Seeking constant reassurance that everything is okay
- Controlling behaviour – Micromanaging parenting duties
- Obsessive Research – Excessively researching perceived threats
Causes and Risk Factors
There is no single cause of postpartum anxiety, but potential triggers include:
- Hormone changes – The post-delivery drop in estrogen, progesterone, oxytocin, etc.
- Sleep deprivation – Lack of sleep caring for a newborn
- High levels of stress
- Traumatic birth experience
- Preexisting anxiety disorders
| Risk Factor | Example |
|---|---|
| Personal history | Previous anxiety, OCD, panic disorder |
| Family history | Blood relatives with anxiety disorders |
| Pregnancy factors | Complications, preterm birth, NICU stay |
| Environmental factors | Lack of support system, caring for multiples |
Seeking an accurate diagnosis is critical to finding the right treatment plan for your postpartum anxiety. Don’t hesitate to speak to your doctor.
Impact of Postpartum Anxiety on the Family
While postpartum anxiety primarily affects the mother, it can also significantly impact others in the family. Understanding these potential effects can help families provide support.
Impact on the partner
- Partners often feel confused, concerned, and helpless, seeing their loved one struggle with postpartum anxiety.
- Taking on extra household duties while providing emotional support leads to fatigue and burnout.
- The intimacy and connection in the relationship can suffer.
- Postpartum anxiety support groups and couples counselling can help partners manage these challenges.
Impact on the child
- The mother’s constant worry and inability to relax may impair bonding with the infant.
- OCD behaviours, like compulsively checking on the baby, can disrupt the child’s sleep and development.
- As the child grows up, they are at higher risk for developing an anxiety disorder.
- Having another trusted caregiver help meet the child’s needs can offset these effects.
Impact on older siblings
- Older siblings may feel jealous, ignored, or resentful of the new baby, causing stress.
- The anxious behaviours, anger outbursts, and family tension can be confusing or frightening.
- Setting aside one-on-one time, explaining anxiety in kid terms, and involving them in self-care activities creates reassurance.
Ways families can help
- Listen without judgment and offer reassurance. Don’t minimize feelings.
- Give mom space when needed. Watch the baby to allow time for self-care.
- Don’t insist she “get over it” – acknowledge anxiety is real and outside help is needed.
- Make lifestyle adjustments to reduce stress and anxiety triggers.
Family support and professional treatment can reduce the impacts of postpartum anxiety.
Getting Diagnosed
Getting an accurate diagnosis is an essential first step in treating postpartum anxiety. Your doctor can help determine if your symptoms are a normal response to new parenthood or part of a more severe anxiety disorder.
- Inform your doctor about your physical, emotional, and behavioural symptoms. Be honest about the severity so they can make an informed diagnosis.
- Some screening tools can be used to evaluate your symptoms:
- The Edinburgh Postnatal Depression Scale contains questions about anxiety.
- Your doctor may also have you fill out a generalized anxiety disorder questionnaire.
- Discuss how long you’ve had symptoms and any events that trigger your anxiety, like breastfeeding issues or baby milestones.
- Note how your anxiety impacts daily functioning- can you sleep, bond with your baby, and concentrate at work?
- Explain any personal or family history of anxiety, OCD, depression, or other mental health conditions.
Your doctor can help differentiate between average new parent worrying and postpartum anxiety disorder:
| Normal Worrying | Postpartum Anxiety Disorder |
|---|---|
| Periodic worrying about the baby’s health | Constant, obsessive worrying, even when the baby is healthy |
| Some trouble sleeping | Severe insomnia most nights |
| Occasional feelings of being overwhelmed | Daily panic attacks or inability to cope |
Don’t downplay your symptoms. Be clear about the severity of your anxiety and how much it is interfering with your life. With an accurate diagnosis, you and your doctor can develop the right treatment plan for you.
Treatment Options
The good news is that postpartum anxiety is highly treatable through a multifaceted approach, including lifestyle changes, therapy, medication, and support systems. Treatment plans are tailored to each woman’s specific symptoms and situation.
Lifestyle Changes and Self-Care
Making certain lifestyle adjustments can help manage milder cases of postpartum anxiety:
- Sleep – Make sleep a priority by napping when the baby naps, going to bed early and accepting help from others for night feedings. Proper rest helps stabilize emotions.
- Exercise – Do some form of exercise daily, even just a walk around the block. Exercise naturally reduces anxiety.
- Diet – Eat a balanced diet with lean protein, complex carbs, and omega-3s to stabilize blood sugar and mood. Stay hydrated.
- Relaxation techniques – Try deep breathing, meditation, yoga, or progressive muscle relaxation to activate the parasympathetic nervous system.
- Social support – Spend time with supportive loved ones who can provide perspective. Voice your feelings.
- Ask for and accept help from family and friends with household duties. Don’t isolate.
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Therapy and Counselling
Seeing a therapist can be very beneficial for developing coping skills and working through anxiety triggers. Types of talk therapy that help with postpartum anxiety include:
- Cognitive behavioural therapy (CBT) – Identifies distorted thought patterns and replaces them with more realistic perspectives.
- Acceptance and commitment therapy (ACT) – Focuses on accepting difficult thoughts and feelings rather than trying to control them.
- Interpersonal therapy – Examines relationship and social factors contributing to anxiety.
- Postpartum counselling – Counsellors specialize in the emotions, stresses, and adjustments surrounding new parenthood.
Medication
If symptoms are severe and interfering with daily life, medication may be prescribed in addition to therapy.
- SSRIs – Selective serotonin reuptake inhibitors like Zoloft, Prozac, and Lexapro are commonly used. They increase serotonin levels.
- SNRIs – Serotonin-norepinephrine reuptake inhibitors like Cymbalta and Effexor are another option.
- Benzodiazepines – Anti-anxiety drugs like Klonopin, Ativan, and Xanax temporarily relieve acute symptoms—risk of dependence.
Always weigh the pros and cons if you are breastfeeding. Discuss all medication decisions with your doctor.
Breastfeeding Considerations
Some medications are considered compatible with breastfeeding. Your doctor can help determine the best options.
| Drug Class | Example Drugs | Safety with Breastfeeding |
|---|---|---|
| SSRIs | Sertraline, Paroxetine | Generally considered safe |
| SNRIs | Duloxetine, Venlafaxine | Use with caution |
| Benzodiazepines | Lorazepam, Clonazepam | Use with caution; short-term |
In many cases, the benefits of medication outweigh the potential risks. Work closely with your doctor and lactation consultant when making decisions.
Seeking a combination of lifestyle changes, therapy, social support, and medication as needed can help you manage postpartum anxiety and restore the enjoyment of new motherhood.
Managing and Coping Day-to-Day
Living with postpartum anxiety can be challenging, but there are strategies you can use to help manage symptoms and cope daily:
Build your support system
- Ask your partner, family, and friends for help around the house so you can focus on your mental health.
- Confide in loved ones about what you are feeling.
- Connect with other new moms experiencing postpartum anxiety through support groups.
Make time for self-care
- Take brief breaks while your baby naps to engage in a hobby, meditate, or go outside.
- Say no to nonessential obligations and avoid overscheduling.
- Squeeze in small acts of self-care like taking a bubble bath, getting a massage, or reading an uplifting book.
Practice relaxation techniques
- Try square breathing, progressive muscle relaxation, or mindful meditation for 10-15 minutes daily.
- Use apps like Calm, Headspace, or Insight Timer for guided relaxation.
- Listen to relaxing music or nature sounds. Diffuse calming essential oils.
Stay active
- Get outside for a short walk every day to relieve stress.
- Do prenatal yoga videos at home.
- Dance with your baby or put on upbeat music for a mood boost.
Avoid anxiety triggers
- Limit time spent reading scary articles or statistics.
- Be mindful of how certain friends or family members increase your anxiety.
- Avoid too much caffeine, which can worsen anxiety symptoms.
Keep perspective
- Set small, manageable goals each day so you don’t get overwhelmed.
- Celebrate little parenting victories. Write down things you are grateful for.
- Remind yourself this is temporary – you will feel better with professional help.
Caring for yourself needs to be a priority. This will allow you to be your best parent while coping with postpartum anxiety.
Seeking Counselling/Therapy
Seeing a therapist or counsellor specializing in postpartum mental health issues can help you recover from postpartum anxiety. Here are some tips for pursuing counselling:
- Ask your doctor for a referral to a perinatal mental health specialist.
- Look for therapists with training in cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), and interpersonal therapy to treat anxiety.
- Inquire about telehealth options for convenience—many therapists now counsel clients remotely via phone or video chat.
- At your first appointment, clearly explain your symptoms and how postpartum anxiety negatively impacts your life.
- Be prepared to discuss your birth experience, relationship dynamics, support system, and any past trauma that could be triggering anxiety.
- Commit to weekly sessions and any “homework” exercises to reinforce skills outside sessions.
- If you don’t feel comfortable with a therapist after a few visits, don’t hesitate to look for someone else. The therapist-client fit is critical.
- If cost is an obstacle, ask therapists if they offer sliding scale fees or payment plans.
Quotes/Stories from Real Mothers
“After my second baby, the obsessive worrying started. I would lay awake picturing horrible scenarios happening to my babies. I stopped sleeping. When I did drift off, I would wake up in a panic to check that they were still breathing.” ~ Jessica, 32, Ontario
“The anxiety made me constantly nauseous. My heart would race every time the phone rang, because I thought it was bad news about my child. When driving, I was convinced I had run someone over. The months after childbirth were scarier than the actual labor.” ~ Marie, 28, British Columbia
Take the First Step
Therapy can be life-changing, but taking that first step can be intimidating. Remember, it’s okay to ask for help. You deserve to prioritize your mental health and well-being. So make that appointment – your future self will thank you.
Frequently Asked Questions (FAQs)
There is no set timeline - each woman's experience is different. Many women fully recover within 6-12 months with proper treatment, like therapy and medication. However, symptoms can persist for longer without adequate support. Don't lose hope - continue communicating with your doctor to adjust your treatment plan.
Yes, partners of any gender can develop anxiety around the transition to parenthood. Adjusting to dramatic lifestyle changes, financial stress, lack of sleep, and new responsibilities can trigger excessive worrying in partners just as much as birth parents. Their anxiety may even begin during pregnancy.
If underlying risk factors are still present, it's possible to experience postpartum anxiety again after subsequent pregnancies/births. Stay in touch with your doctor and therapist so if symptoms recur, you can get ahead of them faster. Some prevention strategies include minimizing stress, planning for more support post-delivery, and managing anxiety disorders during pregnancy.
You can best listen without judgment, validate their feelings, offer practical support like childcare or meals, gently encourage professional help, and be patient on bad days. Don't try to "fix" their anxiety. Refrain from sharing scary stories or statistics that could worsen worries. Instead, remind them this is treatable.
If you have risk factors like a history of anxiety, discuss prevention with your doctor prenatally. Identify your support system in advance. Please read up on PPA symptoms so you can recognize them quickly. Have a therapist lined up. Practice self-care and stress management skills during pregnancy.
- Contact your doctor immediately to explore medication options, dosage changes, or new therapies.
- Consider intensive treatment like day programs or residential treatment centers.
- Have a loved one stay with you to monitor symptoms and provide support.
- If you ever feel suicidal, call emergency services or the Talk Suicide Canada at1.833.456.4566 (Available 24/7/365)
Don't wait. Worsening anxiety warrants an immediate response to keep you and your baby safe.
Left untreated, postpartum anxiety poses many risks:
- Chronic anxiety or development of other mental illnesses
- Impaired mother-child bonding and developmental delays for baby
- Loss of relationships/social isolation
- Substance abuse as a coping mechanism
- Suicidal ideation in severe cases
Intervening early with appropriate treatment can help avoid these adverse outcomes. Your health matters - seek help.
Pareen Sehat MC, RCC
Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.
