How to Tell if You’re Experiencing Postpartum Anxiety

I vividly remember the mental anguish of taking my then-3-month-old son to a pediatric cardiologist after learning from his pediatrician that he had a heart murmur. Although heart murmurs are very common in babies and small children—affecting about 75 percent of newborns—and often go away on their own, I feared the worst. I spent days Googling and ruminating, and was a complete mess during the appointment. Of course, it didn’t help that holding a wiggly baby still while he’s getting an ultrasound is close to impossible. He cried because he was hungry and uncomfortable, and I cried because it was all too much. We both cried because we just wanted to get out of there.

Crying was a common theme those couple of weeks, and even though the ultrasound results were normal, I only really calmed down when the doctor said his murmur was no longer detectable—which was a couple years later. It was hard to think about anything else at the time, and my anxiety spilled into worrying about other areas of his health. I checked on him constantly while he was sleeping, even if it was in the stroller, where I could see him. I freaked out when his growth chart didn’t follow the expected trajectory: He was a big newborn, but was slow to gain weight in the first few months. Feeding issues, 45-minute sleep stretches and chiropractor appointments were all sources of worry.

When my son was 9 months old—and most sleep and feeding issues were thankfully behind us—I finally had the chance to reflect on those messy few months. After experiencing generalized anxiety my entire life, it was pretty clear that I had postpartum anxiety, a condition that affects between 11 and 21 percent of new moms in the US. I started prioritizing treatment that’s helped me in the past, such as tapping into my support system and practicing yoga, and I slowly started to climb out of it. If you’re experiencing postpartum anxiety, it may feel like you’ll never get through it—but you’re far from alone, and you will.

“The postpartum period can be an amazing, magical and beautiful time, and it can be a challenging and unsettling experience,” says Laila Rubin, LCSW, a clinical social worker and mental health therapist in Atlanta. “This transformation, also referred to as matrescence, marks a pivotal time in a new mother’s life, with biological, hormonal, emotional, relational and lifestyle changes.”

Ahead, learn what causes postpartum anxiety, how to identify the most common symptoms—and how to feel better, soon.

What Is Postpartum Anxiety?

“Postpartum anxiety is exaggerated or excessive worry that impacts your quality of life and daily functioning” during the postpartum period, says Rubin.

According to Cleveland Clinic, postpartum anxiety can start right after birth or at some point during baby’s infanthood. The condition can also begin as pregnancy anxiety. “Parents [often] think about their own mortality and what will happen,” adds Renée Goff, PsyD, PMH-C, a licensed clinical psychologist and owner of Orchid Wellness & Mentoring in Cincinnati, Ohio. “‘If something happens to me, what will happen to my baby, or who will take care of my baby?’”

What Causes Postpartum Anxiety?

The causes of postpartum anxiety vary from person to person and can be physiological, psychological and environmental, explains Katie Raskin, LPC, HHC, CCH, a psychotherapist and intuitive eating counselor in Atlanta. Here are a few potential causes and risk factors that can contribute to postpartum anxiety:

• Hormonal changes. The sharp decrease in hormones after birth can significantly impact mood and stress levels, says Raskin.
• Postpartum stress. It may seem obvious, but the stress of postpartum healing—and new-baby sleep deprivation—can play a number on your mood levels, says Raskin. Relationship changes that occur after baby’s birth can play a role too, notes Rubin.
• A history of generalized anxiety disorder. Goff shares that most of her clients who have postpartum anxiety have experienced anxiety in the past. “Often they’ll tell me they feel like they’ve always had a baseline anxiety in their life … but once they had baby, it was more difficult to manage,” she says.
• Family history of depression or anxiety. If anxiety runs in the family, you might be more susceptible to it, says Raskin.
• Previous loss. If you’ve experienced pregnancy loss, the loss of a child—or if you have a child who has a health condition—it could exacerbate postpartum anxiety, says Rubin.

Postpartum Anxiety Symptoms

Symptoms of postpartum anxiety can be both psychological and physical, and can include, according to Raskin:

• Excessive worry, especially about your or baby’s health
• Difficulty controlling your worry
• Restlessness and irritability
• Difficulty falling and staying asleep
• Shortness of breath
• Muscle tension
• Dizziness
• Heart palpitations

Generalized postpartum anxiety is the most common type of postpartum anxiety, says Raskin. But there’s also panic disorder, which includes having frequent panic attacks and/or fearing having them. “Panic attacks are episodes of intense fear or discomfort, shortness of breath, dizziness, chest pain, rapid heartbeat, numbness or tingling sensations in the limbs,” she says, and include excessive fear over losing control or even dying. Another type of postpartum anxiety disorder is postpartum OCD, or obsessive-compulsive disorder, says Raskin. It’s characterized by obsessive and intrusive thoughts, often related to baby’s well-being.

Goff describes what it can feel like to experience postpartum anxiety: You might start “having racing thoughts, feeling on edge or that things aren’t right so you can’t relax,” she says. “There are also changes in sleep, and this is tough because with the newborn, you don’t sleep much anyway. And then it changes appetite.”

It can be easy to conflate physical symptoms of postpartum anxiety with symptoms of other health conditions, notes Goff—and as someone who has experienced health anxiety, I can attest to that. It’s important to remember that anxiety can be highly physical, and that it can exacerbate certain conditions like GI issues. If you’re not sure where your symptoms are coming from, Goff suggests thinking about your past health history and taking note of any patterns. Then, it’s always a good idea to get checked out by a medical doctor. “But if the doctors come back and say everything looks good, then you can think it’s probably anxiety-related,” she says.

Physical symptoms tied to anxiety show up differently in different people. When I was in the worst of my postpartum anxiety, I would often feel dizzy and nauseous. For Christine Carpenter, a mom of two in upstate New York, anxiety shows up in her hands. “I get adrenaline rushes down to my fingertips,” she shares. “I also always notice my shortness of breath, or my heart pounding. Or I’ll feel like I could choke because my throat is kind of closed up.”

Postpartum Anxiety vs Postpartum Depression

It’s important to note that there’s a lot of overlap in symptoms between postpartum anxiety and postpartum depression, says Raskin, and that these can occur together. “What I usually see is that for some, anxiety symptoms are more predominant and for others depressive symptoms are,” she says. “I also often see it oscillate like a pendulum back and forth between anxiety and depression.”

If you have postpartum depression, you may experience excessive sadness, frequent crying or feel like you can’t take care of yourself or baby, says Cleveland Clinic. “You may have trouble finding joy in your baby or feel like you aren’t capable of being a parent,” says Cleveland Clinic. Postpartum anxiety, on the other hand, is characterized by excessive worrying, as well as panic and overwhelm, rather than sadness. However, symptoms like disrupted sleep and heart palpitations can overlap.

No matter what you’re feeling, it’s important to discuss your symptoms with your healthcare provider.

Postpartum Anxiety Treatment

There are many options for postpartum anxiety treatment, and the type that’s right for you depends on the severity of your condition, says Rubin. Treatment options include:

• Talk therapy. In therapy, the most effective treatments for postpartum anxiety focus on teaching coping skills to manage fears and worry, says Rubin. Treatment modalities include cognitive behavioral therapy (CBT) and mindfulness-based therapy. “My therapist worked with me on learning to trust myself and normalizing the feelings I had,” says Carpenter. “Without breaking confidentiality, she would tell me stories about other women she’d worked with over the years and what they were experiencing. And I felt less alone.”
• Medication. Moderate to severe cases are usually treated with both therapy and medication, most often the class of antidepressants and anti-anxiety drugs known as selective serotonin reuptake inhibitors (SSRIs), says Rubin. SSRIs are generally considered safe to use during pregnancy and while breastfeeding.

For milder cases of postpartum anxiety, there are several holistic approaches to treatment, adds Rubin:

• Prioritize sleep. “Since sleep deprivation can be a significant factor, having a plan to maximize sleep or rest can be helpful in reducing the intensity of the worries,” she says.
• Eat a balanced diet and move. Drinking enough water, eating balanced and nourishing meals and snacks, and moving your body can help release some of your anxious tension.
• Slow it down. Deep breathing, meditation, mindfulness or slowing down can support a more regulated nervous system, as can relaxation exercises, aromatherapy, fresh air and outdoor time.
• Create a routine. “Some parents benefit from creating a routine, as a little structure can help create a sense of control,” she adds.

With the right kind of treatment and the support of family members and friends, a mom or new parent who’s dealing with postpartum anxiety will get better in time, so they can find new ways of enjoying their baby and the experience of being a parent, says Rubin. “It’s extremely important to acknowledge how you feel; reach out to your support system; talk to your partner, friends, family, physician or a therapist,” she says.

“There’s been days where I’ve just been home and I’ve said, ‘I’m so anxious I could crawl out of my skin,’” shares Carpenter. “I’ve called my mother and said that to her, and she’s like, ‘I’ll be right over. Let me get in the car.’ And just having somebody there to witness the experience and support you through it makes a big difference.”

How Long Does Postpartum Anxiety Last?

It’s difficult to predict how long postpartum anxiety symptoms will last because recovery depends on many factors, says Rubin. These factors include:

• The severity of symptoms
• How long it took to get help and whether treatment was helpful
• Whether you’ve had anxiety or depression in the past
• Your home life, relationships and support network
• Your overall physical and mental health
• Baby’s health

Factors that may minimize the amount of time you suffer from postpartum anxiety include, according to Rubin:

• Recognizing the symptoms and getting help early
• Regular self-care practices
• Engaging in therapy or support groups
• Consulting with your doctor about medication options
• Developing a personal support system that may include a partner, friends or parents

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

The Truth About Postpartum Depression

What You Need to Know About Postpartum OCD

How Moms-to-Be Can Manage Pregnancy Anxiety