Is this Postpartum Anxiety? An Exploration of What it is, Who Experiences it, and Why it Isn’t Talked About More

When you become a parent, you may expect – thank you, in part, to the “Our hearts are full,” “We have never experienced a love like this,” and “We never imagined we could love a person this much” social media posts – that the journey into motherhood is one marked only by exploding hearts, overwhelming love, and incomprehensible bliss. Postpartum anxiety is often not part of the perfectly curated posts and conversations about how beautiful the baby is and how blessed you are to now have “mom” as one of your titles. 

Before becoming a mom myself, I remember hearing about Postpartum Depression, Postpartum Anxiety, and the “Baby Blues” and thinking, ‘How could anyone be sad after having a baby? Babies are amazing, a miracle!’ The ignorance, I know. However, I think this is reflective of a lot of people’s thoughts and mindset about the postpartum experience. This may be where there is a lot of misunderstanding around the postpartum experience originates, in general, and specifically around what postpartum anxiety is and what causes it. Postpartum anxiety is a condition some moms develop after having or adopting  a baby that is marked by irrational fears that go well beyond the natural concerns parents have for their children's health and well-being.

How Many Moms Experience Postpartum Anxiety?

Part of the reason discussions about postpartum anxiety don’t enter our social media feeds and coffee-date conversations is because moms tend to feel shame for feeling anything but overwhelming love for their baby in the weeks and months following the birth. For this reason, I think it’s important to note that experiencing postpartum anxiety, depression, or the baby blues is not at all in opposition to the love you feel for your baby.  It is not an indication that you are not “thankful enough” for your baby, and it doesn’t mean anything is wrong with you.

Research actually suggests that about 1 in 5 moms experience postpartum anxiety, but that the numbers are likely higher due to the fact that people don’t always feel comfortable talking about or admitting these feelings. The postnatal care for women after having a baby isn’t always conducive to discussing these feelings either (As a mom in the postpartum period myself, I filled out the maternal mental health screeners at my baby’s pediatrician’s office and once at my six week appointment after having him. This form, in my experience, doesn’t always get talked about or even addressed, resulting in it feeling like an ancillary part of care rather than a primary focus of the postpartum experience).

Is it Postpartum Anxiety or Normal New Parent Worry?

It can be hard to know if the thoughts, emotions, and behaviors you may be coping with are truly postpartum anxiety or if they’re a normal part of adjusting to life as a new parent. In those initial weeks and months as a new parent, or as a parent again to another baby, it is normal to feel some worry. There are a few key distinguishing factors that can help you figure out if what you are experiencing is normal or if it may be postpartum anxiety.

Two primary characteristics of postpartum anxiety that distinguish it from normal new parent worry are:

• The worry or anxiety is far more intense than typical new parent worrying.
• The worries are more persistent and typically not based on any real problem or threat.

When I had my daughter, I thought -- for months after she was born -- that she had a variety of health conditions due to the lines at the bottom of her feet, the persistent mucus and congestion she had, and even the shape of and fold underneath her eyes. Despite the newborn screening and other tests confirming she didn’t have the conditions I feared she had, I would obsessively examine her and google these conditions. I convinced myself that the team of doctors who examined her in the hospital and her pediatrician (who she had seen a handful of times at this point) had missed the markers of the  conditions in question. 

Postpartum Anxiety Can be All-Consuming

This and a variety of other fears about my daughter’s health and wellbeing consumed me, kept me up at night, and prevented me from taking her anywhere except to her doctor appointments for the first several months of her life. Because I had suffered loss and had fertility struggles leading up to having my daughter, I felt confused and embarrassed that I was not enjoying the newborn phase as much as Instagram, other people, and my own idealized vision of motherhood indicated that I should.

As a result, I didn’t seek out help as soon as or in the way I wish I would have, and I didn’t end up taking the anti-anxiety medication I was prescribed when I was diagnosed with PPA (Note: The use of medication is, of course, a personal and individual decision that everyone has to assess for themselves and with their health care professional). I had this mentality that I just needed to “power through it,” despite the fact that most aspects of my life had been severely disrupted.

Some of the other PPA symptoms to look out for:

In addition to the two primary markers of postpartum anxiety, there are a variety of mental, emotional, and physical symptoms that may also point to PPA:

• A persistent feeling of being on edge, like something is about to go terribly wrong
• Dread or a sense or fear of danger
• Excessive, all-consuming worry about the baby’s health, development or safety
• Racing thoughts that you feel you can’t control
• An overwhelming sense of burden, stress and concern about the ability to be a good parent
• A persistent case of the jitters or a constant agitated feeling
• Insomnia or trouble falling or staying asleep, even though you’re exhausted
• Changes in heart rate and breathing, including elevated heartbeat, rapid breathing, and/or chest pain, especially if the anxiety takes the form of panic attacks
• Nausea
• Dizziness
• Shaking
• Chills and/or hot flashes

What Causes Postpartum Anxiety? And Who’s at Risk?

There is not one single cause of PPA, but there are several factors that may contribute to an increase in chance that you will develop it, including:

• Sleep deprivation - The sleep deprivation during this time can have a significant impact on all aspects of your health as a new parent.
• Stress - The added stress of caring for a new person who is 100% dependent on you to keep him or her alive can be overwhelming at first 
• Hormonal Shifts - Some moms experience a greater impact on overall mood and levels of anxiety from the swing in hormone levels
• Relationship Shifts - Romantic relationships, family connections, and friendships can all feel different following the birth of a baby. These sometimes drastic and sudden changes can be disorienting and can contribute to increased levels of anxiety. 
• Societal pressure - The pressure for moms to experience, talk, and post about motherhood in a certain way can be a lot while adjusting to such significant physical, hormonal, emotional changes. 
• Personality type — Moms who are “type A,” very sensitive, or easily worried may be more likely to suffer from postpartum anxiety
• Mental Health History - having a history of anxiety and/or panic attacks can increase your likelihood of experiencing PPA
• Family History- having a personal or family history of mood disorders
• Infertility or Previous Pregnancy of Infant Loss Trauma - A previous miscarriage or stillbirth can be a risk factor for PPA
• Baby’s Health - Having a premature baby or a baby with health issues
• High Risk Pregnancy or Delivery - Having a high-risk pregnancy, trauma during pregnant, or having complications during delivery can cause already-heightened anxiety levels to turn into PPA

I think I have Postpartum Anxiety. What Do I Do Now?

Some anxiety after having a baby is normal, especially in the first couple of weeks (when it is called the “baby blues”), but if your anxiety is disrupting your day-to-day, if it is not subsiding after a couple of weeks, and/or if you are experiencing some of the above symptoms or risk factors, it is best to seek help.

 If you think you may have postpartum anxiety, or if you are pregnant and you think you are at an increased risk for experiencing postpartum anxiety, it is important that you connect with your healthcare provider – your OB/GYN, midwife, doula, your baby’s pediatrician, your primary care physician, or your therapist or mental health care provider if you already have one. The healthcare provider you reach out to can help connect you with other professionals, if needed, so that you can receive the care, attention, and resources you need to overcome PPA.

Treatment Options for PPA

Talk therapy, cognitive behavioral therapy, and getting connected to resources that can help lessen the mental, physical, and emotional load of having a newborn can help mild to moderate cases of PPA. More severe cases may warrant anti-anxiety medication in addition to these things to help alleviate the PPA symptoms. Your healthcare provider can talk through the options that are best for you and your individual postpartum experience. And while not everyone has the luxury of support from family and friends after having a baby, this kind of support can also be helpful in lightening the load of becoming a new mom. The companionship and connection to other adults during this time can be instrumental, too,  in alleviating some of the symptoms of PPA.

Postpartum Anxiety Doesn’t Have to Rule Your Early Parenthood Experience

The new motherhood narrative often revolves around experiencing inexplicable love, joy, and life transformation. And while these things can be and often are true for many people, postpartum anxiety and postpartum depression are also often very real parts of this journey that parents may experience with shame and in silence. Acknowledging postpartum anxiety is recognizing that parenthood, particularly the entrance into parenthood, is a multifaceted experience marked by conflicting emotions – none of which negate the love you feel for your child or your worthiness or value as a parent. 

If you are experiencing PPA, know that this does not have to define your postpartum and early parenthood experience. While postpartum anxiety can be isolating and overwhelming, remember that recognizing your need for help is nothing to feel shame about and is actually a sign of notable strength. And on the other side of PPA, there is hope for finding more joy in the early months and years of motherhood. There are people and resources available to help address and ease your symptoms and move you toward and support you on a (much-deserved and judgment-free) journey of healing.

By: Erika Muller, Assistant for Wildflower Therapy LLC

All images via Unsplash

How Can Wildflower Therapy in Philadelphia, PA Help You?

If you’re looking for someone to come alongside you to help you unpack and approach the the complex set of emotions you may experience during the various stages of motherhood, our therapists in Pennsylvania are honored to help!  In fact, you can get to know a little bit more about them here and book a free consultation here.

Other Mental Health Services Provided by Wildflower Therapy, Philadelphia, PA

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We offer services for eating disorder therapy, services for anxiety, and depression, and have practitioners who specialize in perinatal mental health , maternal mental health, therapy for college students and athletes. As well as LGBTQIA+ Affirming Therapy. As you can see, we have something to offer just about anyone in our Philadelphia, PA office. Reaching out is often the most difficult step you can take to improve your mental health. We look forward to partnering with you on this journey!