Postpartum Anxiety Symptoms: Getting Support

Becoming a mom, whether for the first time or the third, is a journey filled with complex emotions. While many expect pure joy, the reality can be far more nuanced, with many women experiencing intense anxiety that extends beyond typical new parent concerns. Often overshadowed by discussions of postpartum depression, postpartum anxiety can also affect countless new mothers—sometimes even before the baby arrives.

This guide explores postpartum anxiety: what it is, how postpartum anxiety differs from “normal” worry or the “baby blues,” its potential causes, and most importantly, the effective treatments and support available. Kellie Nichelson, MSW, LCSW, an Employee Assistance Program therapist at Franciscan Health, shares tips on postpartum anxiety.

What Is Postpartum Anxiety?

Postpartum anxiety is named after the timeframe immediately following delivery or becoming a parent, but the condition can begin much earlier in the pregnancy.

“One of the things that maybe is misleading is that it's called ‘postpartum,’ but this is something that can be something that can start happening even while a woman is pregnant,” said Nichelson. “They can start experiencing some of this ‘baby blues’ even during pregnancy. Questioning if they're going to be a good mom, even, two or three weeks after finding out that they're pregnant. And that really does have a lot to do with the kind of rapid hormonal changes that start to occur within the body.”

The condition is marked by irrational fears that go well beyond the natural concerns parents have for their children's health and well-being. For example, you might have unfounded, repetitive thoughts that someone or something is going to harm you or your baby.

What sets postpartum anxiety apart from normal worry is the severity of its symptoms.

How Are Baby Blues Different From Postpartum Anxiety?

“Baby blues is going to be something that a pretty big majority of women experience,” Nichelson said. “This period overall, may be some tearfulness, may be some experiences of like mood lability. A little bit of ups and downs, maybe more reactivity to things that maybe normally wouldn't have a woman reacting a certain way. Mental and physical exhaustion, things like that.”

If around two weeks after delivery, a mother continues to have concerning symptoms, is having increased severity of symptoms, or develops significant mood fluctuations, there is the possibility that she has a mood disorder.

“If we get to past that two weeks and these are persisting, that's where recommended to continue to talk to your OBGYN or even your family doctor,” Nichelson said. “If you have a therapist or a psychiatrist, talking to them and letting them know, ‘It's been about two weeks, I am still not getting back to feeling like myself. What is going on?’ And talking to them.”

What Are Postpartum Anxiety Symptoms?

Postpartum anxiety shares some symptoms in common with postpartum depression, including:

• Irritability

• Issues with relaxing

• Trouble falling or staying asleep.

Other common postpartum anxiety symptoms include:

• Shortness of breath

• Heart palpitations or increased heart rate

• Restlessness

• Nausea and decreased appetite

• Racing or irrational thoughts, particularly fearful ones

• Poor focus

• Social avoidance

• Control issues

• Overly cautious behavior

It's also not uncommon for postpartum anxiety to manifest as a type of anxiety disorder known as obsessive compulsive disorder (OCD), according to the U.S. National Institute of Mental Health.

What Causes Postpartum Anxiety?

The causes and risk factors for postpartum anxiety are varied and may include:

• Shifts in hormones, which decrease in women after pregnancy and make it more difficult to manage stress

• Added life stressors, such as difficulty breastfeeding or issues during pregnancy and delivery

• Being overwhelmed due to the responsibilities of caring for a newborn

• A lack of sleep, which is common for new parents

• Certain health conditions, such as a history of eating disorders, anxiety or depression. “If they already have kind of pre-existing mental health struggles, whether that be depression, anxiety, bipolar disorder, or just naturally have kind of a more low mood in general, they may be more predisposed to this,” Nichelson said. “The biggest thing is we notice a shift in hormones, therefore a shift in mood kind of right off the bat.”

• Life events that increase your risk for developing anxiety, such as a previous miscarriage or loss of a child

• Lifestyle factors, such as caring for multiple children at once or having a child with health issues

“If there's a lot of external stress in your life, if you're going home to inadequate supports, if you are going home to a lot of external stress in your home life, in your work life, in your personal life in general, that increases your risks as well,” Nichelson said.

How Are Postpartum Anxiety Symptoms Treated?

Luckily, there is help for postpartum anxiety. Treatments for postpartum anxiety include:

Therapy

Cognitive behavioral therapy is used to treat different types of anxiety, including postpartum anxiety and OCD.

A psychologist or counselor helps you identify your thoughts, emotions and behaviors, and helps you work to change them.

Medication for postpartum anxiety

Postpartum anxiety medications can be prescribed by your doctor to help you manage and improve the physical, behavioral and emotional symptoms of the condition. These include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Mirtazapine, an antidepressant.

“I think a lot of moms are fearful of is the use of medication, especially with potentially breastfeeding, potentially having kind of hormonal re-regulation, coming back from having an influx of hormones, coming back to a normal level of hormones,” Nichelson said. “But medication is still one of the #1 helping tools for treating postpartum depression, anxiety, and even psychosis.”

Social support for postpartum anxiety

Whether a formal postpartum support group online or in person or joining other new moms in activities such as stroller walks, having support of others going through the postpartum period can help you realize you’re not alone.

“There are specific support groups that are exclusively created for moms with postpartum depression, moms with postpartum anxiety,” Nichelson said. “The knowledge of, ‘OK, I am not alone in this. this is not a unique experience.’ It's more so having that camaraderie around me and having that support network of like-minded individuals and moms who can relate and be a shoulder to either cry on or just complain to some extent and say, ‘I am exhausted, I'm overwhelmed, I'm stressed.’”

Other lifestyle tips

Other suggestions to help you ease your symptoms include:

• Cuddle your child to release mood-enhancing oxytocin

• Include workouts that incorporate calming breathwork, such as yoga

• Wean your child from breastfeeding slowly to help keep hormone levels from shifting too quickly

• Do everything you can to get more sleep

When To Seek Help For Postpartum Anxiety

“It took nine months to get you here, and you don't have to do this alone. No one is expecting you to do this alone, and that's why, you have all of these different support networks and support options,” Nichelson said. “If there comes a point where those emotions might become too much for you to feel like you can handle, that's why there's several resources that exist, where you can get assistance in coping with those emotions.

“You don't have to cope alone. You are not meant to cope alone, if you need assistance in doing so, that's also not to be demonized. You're allowed to do that. You are a human being as well. You didn't just become a mom and lose your identity as a human as well.”

If you're wondering if you may have postpartum anxiety, you can start by taking this short anxiety quiz from Anxiety.org.