What is postpartum anxiety? How do I get help?

Do you feel like you’re constantly worrying after giving birth? Are you struggling to shake off anxious thoughts, even if they don’t make sense? If this sounds like you, you may be experiencing postpartum anxiety.   Although postpartum anxiety isn’t an official diagnosis, it’s a very real phenomenon that many new mothers experience. In fact, research shows it may affect up to 21% of new moms.  

So, if you’re a new mom struggling with intense postpartum anxiety, you aren’t alone. Read on to learn about the symptoms of postpartum anxiety and how to treat it.

What does postpartum anxiety look like?

Postpartum anxiety can look similar to generalized anxiety disorder. However, the overwhelming anxiety typically centers around the new baby. For example, your fears may revolve around:

• Leaving your baby alone with someone else, even your partner

• Someone hurting your baby

• Something bad happening to your baby if you leave the house

• The baby falling ill or having a medical emergency

Like non-postpartum anxiety disorders, symptoms are often emotional, behavioral, and physical. Here are some examples of symptoms you may experience when you have an anxiety disorder:    

Emotional:

• Experiencing irrational or very unlikely fears

• Excessive worry

• Trouble concentrating

• Irritability

• Hypervigilance

• Trouble relaxing

• Seemingly uncontrollable racing thoughts  
  

Behavioral:

• Exercising extreme caution

• Avoiding people or scenarios that could potentially cause harm

• Constant checking (such as checking if the baby is breathing while asleep)

• Acting controlling

Physical:

• Nausea or other GI symptoms

• Decreased appetite

• Racing heart

• Trouble sleeping

• Shortness of breath

• Tense muscles

• Restlessness  

Some new moms with anxiety might also develop postpartum onset panic disorder, having panic attacks on top of the general anxiety and worry. Panic attacks can come on suddenly and be super frightening due to physical symptoms such as shortness of breath, chest pain, heart palpitations, and numbness. You might feel like you’re losing control, going “crazy,” or having a major medical emergency.  

Are intrusive thoughts part of postpartum anxiety?

Intrusive thoughts can be a part of postpartum anxiety, but they’re more common with postpartum obsessive-compulsive disorder (OCD), which is not an official diagnosis but more so a subtype of OCD These thoughts are unwanted and distressing. Often, they seemingly come out of nowhere and can be very anxiety-inducing. Intrusive thoughts do not mean these are things you want to occur. They are actually the exact opposite of what you want to occur, and they are not in line with your true values at all.

The intrusive thoughts and obsessions related to postpartum OCD can be extremely distressing. Due to the disturbing and often taboo subject matter, you may be afraid to tell anyone about your thoughts. However, it’s important to speak to a mental health professional if you’re experiencing this so you can get relief.  

Some signs of postpartum OCD include:

• Intrusive thoughts about harming the baby or someone else harming the baby

• Intrusive sexual thoughts about the baby

• Fear of losing control and acting out the intrusive thoughts  

• Performing compulsions or repetitive behaviors to negate the anxiety surrounding the obsessions  

• Avoiding scenarios that are related to intrusive thoughts (such as bathing them if you have sexual intrusive thoughts, or holding them if you have intrusive thoughts about dropping or harming them)  

• Fear of telling anybody about the thoughts, thinking the baby will be taken away

• Excessive checking (such as checking if the baby is breathing, bathing them more often than necessary, or asking for reassurance from a partner or doctor)  

OCD can interfere with your bonding with the baby or taking care of the baby––which is why it’s so important to seek help. Mental health professionals understand the nature of disturbing intrusive thoughts—they aren’t there to pass judgment but get you the help and treatment you need.  

How long does anxiety last after giving birth?

The duration of your postpartum anxiety depends on your individual situation, such as pre-existing anxiety, co-occurring disorders, and whether you seek treatment or not.  

Technically, the postpartum period is considered 6-8 eight weeks after giving birth. In some cases, it can take 12 weeks for hormones and the body to return to a neutral baseline. Pregnancy and birth result in major changes to the body, which can contribute to mood and other mental health symptoms, but everyone is different.

However, that doesn’t mean anxiety is guaranteed to go away after eight to 12 weeks. If you don’t seek treatment and you fall into ongoing patterns of anxiety, it can stick around for months into the perinatal period, which is often defined as the first year after giving birth.  

Can you have postpartum anxiety and depression?

You can absolutely have postpartum anxiety and postpartum depression (PPD) at the same time. In fact, it’s quite common.

It’s important to understand that postpartum depression is different from the “baby blues,” especially in severity and duration of symptoms. However, PPD may be more common than you think, affecting one in seven new moms.  

 Postpartum depression symptoms include:  

• Ongoing sadness

• Loss of interest in activities you used to enjoy

• Trouble bonding with the baby

• Hopelessness

• Worthlessness

• Irritability

• Trouble sleeping

• Low self-esteem

• Suicidal thoughts

• Trouble concentrating

• Fatigue

PPD is treatable. Usually, a combination of talk therapy and medication is the most effective treatment. Doctors may prescribe antidepressants like selective serotonin reuptake inhibitors (SSRIs) to relieve symptoms. There’s also a newer medication on the market, Zurzuvae, the first FDA-approved oral medication for PDD.

Another potential concern for new mothers is postpartum psychosis, which is much less common than postpartum depression, but it is a psychiatric emergency. This is characterized by hallucinations, delusions, and paranoia. For both the mother's and baby’s safety, quick treatment is necessary.

Postpartum anxiety treatment: When to get help

You don’t have to go through postpartum anxiety alone. Seeking professional treatment can make a huge difference in your symptoms, helping you to enjoy motherhood and bonding time with your baby.  

If your anxiety lasts for more than a few weeks and it’s interfering with your ability to function, take care of your baby, and bond with your baby, it’s time to get help. Therapy and medications can relieve your symptoms. Talk therapy, such as cognitive behavioral therapy (CBT), is a modality that can teach you how to manage anxious thoughts, replacing negative thought patterns with more healthy ones, improving your overall wellness.  

Additionally, medications like antidepressants can aid in reducing symptoms. A type of antidepressant called SSRIs (selective serotonin reuptake inhibitors) is a common first-line treatment for anxiety. SNRIs (serotonin-norepinephrine reuptake inhibitors) may also be prescribed. However, it’s important to weigh the pros and cons of these medications since some may pass into breast milk if you’re breastfeeding. A medical professional can help you weigh the benefits and risks.  

If you’re looking for a psychiatrist to diagnose you and present you with treatment options, consider Talkiatry.  

We’re a national psychiatry practice that treats a wide variety of mental health conditions, including women’s health concerns like postpartum anxiety, depression, and OCD. We provide virtual, in-network services so you can get the care you need from the comfort of your home. To get started, complete our free online assessment to get matched with a psychiatrist.  

FAQs

Is postpartum anxiety in the DSM-5?

No, postpartum anxiety in the DSM-5. This means it is not an official diagnosis. However, it is a common, troubling phenomenon affecting new moms.  

What’s the difference between postpartum anxiety and worrying?

It’s certainly normal for new parents to worry about their baby’s health and safety. However, postpartum anxiety is much more pervasive, all-consuming, and difficult to control. It may also interfere with you taking care of the baby or bonding with the baby –which is why seeking treatment is so important to get you back on track.

Will I get anxiety after giving birth?

Experiencing anxiety after birth is not a guarantee. You may have a higher risk if you have a history of anxiety or a pre-existing anxiety disorder.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.