Worry is an inevitable part of parenthood. Every parent frets, wonders, and has concerns about their children. We want to provide the best for them. We want to keep them safe. It is not unusual or uncommon for parents to worry, especially in the postpartum phase, when hormones are balancing and we’re adjusting to raising a new baby.
Sometimes it can seem like all we do is worry. Is the baby too hot or too cold? Do they need more to eat? Is their diaper wet? Will my breast milk come in? Is this the right amount of bleeding? Did I make the right medical decisions? Having a baby comes with a lot of big decisions and unknowns, regardless of if it’s your first or your tenth!
At what point are the worry, stress, and anxiety unhealthy? Postpartum Depression (PPD) is the most well known mental health struggle after a baby is born. There is a lesser-known disorder known as Postpartum Anxiety (PPA). Thousands of mothers may experience PPA and it is not always identified or diagnosed. Often it occurs alongside PPD, but not always. PPA is when worry, stress, and anxiety become unhealthy.
What is Postpartum Anxiety?
Postpartum anxiety is persistent irrational fear or over-exaggerated worry. This is why it can be difficult to diagnose and identify PPA. All parents succumb to these types of thoughts. The key in diagnosis is in the excessive, exaggerated, uncontrollable, and/or irrational manifestations of the anxiety.
Fears and worries may be over something unusual, irrational, highly unlikely, or even impossible. Normal parental worry involves thoughts that dissipate in time. A normal level of worry also involves thoughts the parent is able to talk themselves out of. In cases of postpartum anxiety, these thoughts persist, get worse, or become all-consuming.
Mothers might go to great lengths to avoid her anxiety becoming real. An example would be overwrapping a baby in blankets out of fear they’ll become cold. Then not being concerned when it causes the baby to overheat. Sometimes mothers don’t sleep out of fear of SIDS or will walk everywhere out of fear the baby will be injured in their car seat. Another common manifestation of PPA is not allowing any visitors out of fear that the baby will become gravely ill
Other times PPA involves anxious persistent thoughts, fight or flight responses within the body, or panic attacks. Behaviors may be more subtle or not even noticeable at all. Just as with PPD, it can be difficult to gauge as an outside observer if someone is struggling.
Symptoms may begin during pregnancy and remain after birth or develop after birth. Women who have a history of anxiety are much more likely to experience PPA. Those with a family history of anxiety or depression are also at an increased risk.
It can be just as debilitating as depression and can influence life in many ways. The exhaustion of recovering from birth and raising a newborn often amplifies postpartum anxiety as sleep deprivation and wild hormones take over.
Postpartum Anxiety Symptoms
Knowing the difference between normal parental awareness and thoughts vs PPA can be difficult. If you, or a loved one, seem to be experiencing anything concerning please reach out for help.
It is expected that about 85% of women will have “baby blues.” Many of the symptoms on this list will occur with baby blues. The main difference is that baby blues occur within the first six weeks postpartum, lasts a short period of time, and is able to be controlled. Baby blues do not usually persist or progress into PPA or PPD, it will usually go away on its own.
Some of the most common PPA symptoms:
- Panic attacks
- Racing thoughts
- Foggy thinking
- Unusual or uncontrollable anger
- Thoughts that keep sleep from coming
- Obsessive-compulsive behaviors
- Social isolation
- An overwhelming sense of dread
- An overwhelming sense of burden about being a parent
- Frequent worry about death or injury in oneself, family, or baby
- Excessive worry about the development of the baby
- Uncontrollable fret about the growth of the baby
- A constant need for reassurance from outside sources
- Inability to sleep even when exhausted
- Weight loss
- Changes in heart rate
- Rapid breathing
- Trembling/ shaking
In severe cases, a mother may end up hurting her child in an effort to prevent anything bad from happening to them. Other times, a child may end up neglected because the mother is so afraid she will hurt her child or is ill-equipped to be a parent.
Often PPA symptoms start out small and escalate over time. What may first seem like something minor can change into a major concern as the days progress. Your feelings, worries, and concerns are always valid. Anytime you’re unsure please make sure to talk with your healthcare provider, midwife, doula, or reach out to us for guidance. It’s always better to err on the side of caution.
These symptoms often develop within the first few weeks postpartum. For some mothers, these symptoms begin during pregnancy and intensify after birth. Symptoms can, however, develop weeks or months postpartum. If left untreated, these symptoms can linger months or even years into the child’s life. If any of these symptoms persist for longer than two weeks, it is time to get outside help.
Anxiety may also present when hormones shift again upon weaning. This should be taken as seriously as postpartum anxiety.
PPA Treatment Options
Treatment is possible and effective, especially when begun early on. Counseling is a good first stop. Often having someone to talk to can be helpful. Adjusting to a new baby is difficult and a trusted guide can help with that adjustment. Counselors can also help provide techniques for relaxation, calming the mind, and refocusing during a panic attack.
Rest is often one of the most healing and helpful things for a woman with PPA. Babies are exhausting and keep us busy. Taking time to rest is often helpful for calming the nervous system to bring peace. Sitting down in the counselor’s office for an hour a week brings about not only a chance to talk but a chance to rest and feel like an adult again for a while!
Other complementary treatment options include:
- Diet changes
- Herbal or homeopathic remedies
- Bach flower essence therapy
- Exercise and lifestyle changes
- Increase in sleep
- Community support
- Support group
- Mindfulness training
- Fresh air
- Sunshine or vitamin D supplementation
Community support and support groups are helpful as well. Mother’s groups and PPA specific groups are found throughout the country and online. Help from friends or neighbors is often needed. These helpers can fold laundry, cook meals, or help with chores while the mother rests or breastfeeds.
Our church communities are a great place to ask for help. In our society, we don’t always ask for the help we need, but there are people in your church who would love to come help. Grandma’s and older women in the church are often the first to volunteer. An older woman may also provide a source of mentorship and support you didn’t even know you needed.
Enlisting help from a postpartum doula is another option alongside counseling. These are individuals who are trained to help after the birth of a baby. They can help with household tasks, infant care, appointments, medication, and other needs. These doulas also have the tools to manage postpartum anxiety. Available for overnight or during the day, a postpartum doula can provide peace of mind and a helping hand in many ways.
In some cases, hospitalization may become necessary. This is rare but does occur. Never hesitate to reach out for help anytime you have concerns about yourself or a loved one.
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