Postpartum Anxiety: What You Should Know

Almost 80% of new mothers will experience the “baby blues,” or postpartum blues, after giving birth—feelings of sadness, fatigue, or general moodiness in the first few weeks after giving birth. 

Postpartum hormone changes and other factors can also lead to the development of postpartum anxiety or postpartum depression.

Postpartum depression (PPD) gets talked about more, but postpartum anxiety is every bit as important to understand.

In this article, I’ll explore what postpartum anxiety is, its symptoms, and how to tell the difference between postpartum anxiety and PPD.

We’ll also discuss causes, diagnosis, and treatments.

And I’ll tell you how a medical provider can help.

Having a new baby may (or is expected) be an exciting time, but if you find that you feel overwhelmed with anxiety, you do not have to figure it out on your own. 

What is Postpartum Anxiety?

Postpartum anxiety happens when a person experiences overwhelming anxious thoughts in the weeks after giving birth.

These thoughts are often worries about their abilities as a parent, the way others will judge them, and the potential long-term consequences of their perceived parenting abilities on their child’s development.

The anxiety can feel severe, and may interfere with the ability to focus on everyday tasks.

Postpartum anxiety can start shortly after having your baby, or the symptoms may not begin for several months after the baby is born.

While postpartum depression is screened for at most 6-week follow-up appointments with OBGYNs, anxiety is not always discussed.

It is estimated that between 11-21% of pregnant and postpartum people may experience an anxiety condition.

Other research finds that as many as 75% of postpartum people who experience anxiety may also have symptoms of depression.

Symptoms

Anxiety affects everyone differently.

People who have postpartum anxiety may have overwhelming thoughts that feel all-consuming, frightening, and irrational.

But even if a person can recognize that the thoughts seem to be irrational or not grounded in reality, the feelings are so intense that the person is not able to put them out of their mind or reason them away.

Postpartum anxiety may cause common types of anxious thoughts, such as:

• Worrying constantly about the baby
• Having new or consistent thoughts or fears about their own health
• Fears of something bad happening to their partner, other children, or other loved ones
• Feelings of blame or excessive guilt if anything does not go as expected
• Obsessions and fears
• A constant sense that something bad is about to happen

Postpartum anxiety can also cause other physical symptoms that may include:

• Rapid heartbeat
• Tense muscles
• Headaches
• Sleeping problems
• Fatigue
• Restlessness
• Poor concentration
• Problems bonding with their baby

Postpartum anxiety could also have negative impacts on the infant, especially if the parent remains untreated or unaware of their symptoms .

Postpartum depression vs. anxiety

Postpartum depression and postpartum anxiety may have some overlapping symptoms.

They can also coexist.

With postpartum depression, there are feelings of overwhelming sadness, and a person may be more likely to cry.

With postpartum anxiety, the feelings are more centered around worrying or fears, and a person may be more likely to feel restless or edgy.

Causes

Bringing a new baby into the world may certainly cause worry.

But postpartum anxiety is different from the expected concerns and adjustment of adding a new person to the family.

While there is not a single cause for postpartum anxiety, some contributing factors could include:

• Hormone changes associated with pregnancy and birth
• A personal history of anxiety
• A family history of anxiety or other mental health conditions
• A history of disordered eating
• Previous miscarriage or stillbirth
• Previous death of an infant or child
• History of premenstrual dysphoric disorder (PMDD) or severe PMS
• Traumatic birth or complications with the infant

Diagnosis

Unlike other types of anxiety, there is not a specific set of diagnostic criteria for postpartum anxiety.

Some healthcare providers may give you a questionnaire that includes questions about anxiety.

But if you are not asked about it, do not feel shame or discomfort about bringing up your thoughts, fears, or worries to your healthcare provider.

An open conversation about how you are feeling can help them prescribe the right treatment to help you find relief.

Treatments

Postpartum anxiety treatments are similar to those used for other anxiety conditions.

• Psychotherapy with a mental health professional: This may help to diffuse the burden of being alone with your anxious thoughts. A therapist may use approaches like cognitive behavioral therapy (CBT) to help teach you ways to change thought patterns associated with anxiety.
• Stress management: This can be challenging when you are a new parent, or even if this is not your first baby. Finding time to care for yourself or take steps to address your anxiety and stress can feel impossible, but may have significant benefits for reducing your symptoms. Whether it is allowing yourself to take a nap or do something for enjoyment, or practicing yoga or going for a walk after your OBGYN has cleared you for resuming physical activity, taking steps to care for yourself is essential.
• Deep breathing and meditation: These techniques can help take the focus off of your anxiety and bring you back into the present moment. Even if you do not have time to learn breathing routines, just breathing in slowly and exhaling for the same number of seconds can help put your body in touch with the part of the nervous system that helps reduce stress.

If your symptoms do not respond to therapy and lifestyle treatments, antidepressant or anti-anxiety medications are available.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are two classes of antidepressants that may be used in treating postpartum anxiety.

Benzodiazepines like alprazolam (Xanax) can be prescribed for acute anxiety, though it is not designed to be used long-term, and may be habit-forming.

If a postpartum person is breastfeeding, a healthcare provider will take this into consideration when prescribing a medication.

Paroxetine (Paxil) and sertraline (Zoloft) are two antidepressants that, compared to other types, were less likely to pass through breast milk into infants in highly measurable amounts.

Prevention

It is not possible to prevent postpartum anxiety, but you can take steps to ensure that there is a care plan in place if you do notice signs developing.

• If you have a history of anxiety, see a therapist during your pregnancy and after giving birth, even if you do not feel anxious. Being proactive is an important part of recognizing when symptoms start, if they do happen.
• If you are prescribed antidepressants or other medications during pregnancy or postpartum, take them as directed.
• Have a plan in place to be able to care for yourself after giving birth. It is easy to focus efforts on setting up the baby’s room and getting everything ready for them, but make plans for your own recovery and well-being, too. Have caregivers help with the baby so you can take naps, or find ways to integrate care into other aspects of life, like planning meals ahead or having your partner take on more of your previous responsibilities.

When to Talk to a Medical Professional

While nearly all parents may experience some level of anxiety, if you find that anxious thoughts or worry are starting to be present all the time, reach out to a medical provider.

Even if you think what you are feeling is normal, ask a healthcare provider if there are things you should be mindful of, or if you can address or manage the anxiety.

If you find that it becomes hard to take care of yourself or your baby, or you feel like your symptoms start to worsen, reach out to a medical provider.

If you ever have thoughts of harming yourself or your infant, seek immediate medical care.

It is scary to tell someone that you had thoughts of harm, but these thoughts are caused by chemical imbalances in your brain, not because you desire to think them.

By reaching out for help at the first sign, you can get treatment that will prevent serious effects and restore your quality of life faster.

How K Health Can Help

Want mental health support?

K Health offers anxiety medication for the right candidates.

Get connected to care in minutes.

K Therapy offers free smart chats, which are dynamic, pre-written conversations designed by experts that cover a number of common mental health topics such as depression, anxiety, stress, relationships, and more. Access them for free by downloading the K Therapy app.

Online therapists are also available in select states for individualized care.

Connect with a licensed mental health therapist for unlimited asynchronous text-based therapy. Therapists respond Monday through Friday between 9am-5pm, within 24-hours.