What You Need to Know About Postpartum Anxiety

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A mom of three described overwhelming anxiety that spiked at night following her second baby. She knew it would be difficult to have two babies just eighteen months apart. She prepared as much as she could. She asked her mom to help out one day a week. She hired a nanny to come in another day. She tried her best to nap when the kids napped. She let the dishes go and didn’t think twice about the piles of laundry or the dirty shirt she wore three days in a row. What she didn’t count on were the late night panic attacks. 

She didn’t know that the overwhelming worries that kept her up night after night, long after the little ones were asleep in their cribs, had a name. She didn’t know about postpartum anxiety.

Postpartum anxiety is one of many mood disorders that can occur following pregnancy, and is often considered “silent” or “hidden” because it tends to go undiagnosed. Without adequate information, many postpartum mothers simply don’t recognize their symptoms as significant enough to reach out for help.

Postpartum Support International, an organization that raises awareness about postpartum mental health and provides support for postpartum moms, estimates that 10% of postpartum women develop anxiety.

Symptoms of postpartum anxiety:

Some worry is healthy. Anxiety is a natural response to wanting to protect your baby from harm. When healthy levels of anxiety occur, moms learn to dismiss intrusive thoughts. When worries become irrational and feel impossible to dismiss, on the other hand, anxiety reaches a maladaptive level.

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Anxiety can include any number of symptoms, so it’s important for postpartum women to tune in to changes in emotions and behaviors. There are a few symptoms to watch for:

  • Feeling that something bad is going to happen to the baby
  • Constant worry
  • Racing thoughts
  • Intrusive thoughts
  • Changes in sleep patterns (not related to the newborn sleep/wake schedule)
  • Changes in eating patterns
  • Difficulty sitting still
  • Physical symptoms, including dizziness, nausea, or hot flashes
  • Women who experience postpartum anxiety can also experience panic attacks. Moms might experience shortness of breath, racing heart, dizziness, chest pain, and tingling in the extremities during a panic attack.

Risk factors for postpartum anxiety:

While any new mom can develop postpartum anxiety, certain factors can increase the risk. Women with a family history of anxiety or previous experience with anxiety, depression, certain symptoms of PMS, or OCD have an increased risk for postpartum anxiety.

Women who experienced miscarriage or stillbirth are also more susceptible to postpartum anxiety.

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Postpartum Obsessive Compulsive Disorder (OCD) is another form of postpartum anxiety that tends to fly under the radar, but can feel very scary for moms.

Symptoms of postpartum OCD:

Postpartum OCD is characterized by repetitive and intrusive images and thoughts that are frightening to the mother and feel as if they appear from out of nowhere. Watch for these symptoms of postpartum OCD:

  • Obsessions (intrusive thoughts) that include persistent, repetitive thoughts and images about the baby. The obsessions are very upsetting to the mother.
  • Compulsions – the mother might do certain things over and over again to reduce the obsessions. Compulsions can include checking, cleaning, counting, and other repetitive behaviors.
  • Fear of being left alone with the infant
  • Hypervigilance about protecting the infant
  • Feeling frightened by the obsessions

Risk factors for postpartum OCD:

Risk factors include a family history of anxiety or OCD and/or personal experience with anxiety or OCD.

How to get help:

You might be afraid to seek help or think that your symptoms will go away with time. Left untreated, postpartum anxiety and/or OCD can impact your ability to bond with your baby and make it difficult to care for your baby. Self-care, including mental health treatment, is critical during motherhood.

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Both postpartum anxiety and postpartum OCD are treatable. Once you’ve identified the symptoms, the first step is to ask your primary care physician or your ob-gyn for a referral to a psychologist with expertise in Cognitive Behavioral Therapy (CBT). CBT can help you change your thought patterns and establish adaptive coping strategies.

Other techniques include: Exercise, mindfulness, deep breathing, progressive muscle relaxation, meditation, and increasing your support network. Reaching out to friends and family is a great first step toward building a positive support system to help you through this difficult time.

Disclaimer: Information in this article does not replace an evaluation from a licensed mental health practitioner. If you are experiencing symptoms of anxiety or OCD following the birth of your child, call your doctor for immediate assistance.

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What You Need to Know About Postpartum Anxiety

Katie Hurley, LCSW is a Child and Adolescent Psychotherapist and writer in Los Angeles, CA. She is the author of "No More Mean Girls: The Secret to Raising Strong, Confident, and Compassionate Girls" and "The Happy Kid Handbook: How to Raise Joyful Children in a Stressful World". She earned her BA in Psychology and Women's Studies from Boston College and her MSW from the University of Pennsylvania. She divides her time between her family, her private practice and her writing. Passionate about he ... More

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