How to Know When New Parent Worries Are Postpartum Anxiety (and When to Get Help)

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Having a newborn can be a joyful experience, but many parents also feel overwhelmed by their new role and responsibilities. Feeling this way is a totally normal reaction to caring for a new baby - especially in the first couple of weeks.

But sometimes, worry and anxiety can start to take center stage. When this happens, it's possible that you may have a postpartum anxiety disorder.

Here, we'll look at what postpartum anxiety can feel like, how it's treated, and how to get help.

What is postpartum anxiety disorder?

A postpartum anxiety disorder is any mental health condition that causes anxiety in the period after birth. Postpartum anxiety can lead to physical and mental health issues. It may also make you feel less confident about your parenting abilities, disrupt your daily life and routine, and impact personal relationships.

Is postpartum anxiety disorder common?

Postpartum anxiety is very common. It can happen at any time within the first 12 months following childbirth and is reported to affect about 1 in 5 new parents. But postpartum anxiety may be even more common than this. It's not always easy for parents to talk about these feelings, and your healthcare team won't always ask about it.

What causes postpartum anxiety?

Researchers aren't sure exactly what causes postpartum anxiety. Some factors that experts think might be tied to postpartum anxiety include:

• Low levels of social support

• Use of labor-inducing medications

• C-section or assisted vaginal delivery (like forceps or vacuum)

• Poor relationship adjustment between the new parents and with the baby

• Anxiety before pregnancy

• Hormone changes

• Stressful life circumstances

• Health of the birthing parent or baby

What are the symptoms of postpartum anxiety?

When you have postpartum anxiety, you might feel worried a lot - to the point where it gets in the way of your everyday life. These worries are usually related to your baby, but they can extend to many other aspects of your life as a new parent. This might include feeling anxious about:

• Nursing

• Feeding

• Social interactions

• Returning to work or school

• Parenting abilities and whether or not you're a good parent.

In addition to nonstop, disruptive worries, you might have other feelings like:

• Tension

• Frustration

• Guilt or self-blame

• Fear of being left alone with baby

Postpartum anxiety can also cause physical symptoms, including:

• Trouble sleeping

• Heart palpitations

• Body aches

• Fatigue

• Numbness and tingling

A person with postpartum anxiety may show certain behaviors like:

• Being controlling of situations

• Being cautious about situations that aren't dangerous because they cause concern

• Avoiding people, activities, or places that cause anxiety

• Repeatedly checking and rechecking things

What are the different types of postpartum anxiety disorders?

There are many different types of anxiety disorders. Let's discuss the three most common postpartum anxiety disorders.

Postpartum generalized anxiety disorder (GAD)

Postpartum generalized anxiety disorder (GAD) is characterized by excessive worrying that lasts at least 6 months. It might feel like:

• Restlessness

• Constant worry

• Fear about the future

• Fatigue

• Tension

• Poor concentration and/or poor sleep

GAD is common in the first 6 months after delivery and might affect as many as 1 in 10 after childbirth.

Postpartum panic disorder (PD)

Postpartum panic disorder (PD) is a condition involving recurring panic attacks. The risk of postpartum PD is higher in people who've had a history of panic disorders before having a baby. It occurs in about 1 in 30 people in the first couple of months after childbirth.

Symptoms of PD include:

• Shortness of breath

• Heart palpitations

• Chest pain

• Dizziness

• Fear of dying

• Sweating

• Trembling

Some new parents with postpartum PD might feel like they can't leave their homes because they're anxious about having a panic attack in public.

Postpartum social anxiety disorder

Social anxiety disorder is an extreme fear of being watched and judged by others. People with social anxiety disorder may avoid certain places and situations due to their anxiety about what might happen. Social anxiety disorder affects about 1 in 15 new parents after childbirth.

Other mental health conditions linked to postpartum anxiety

Other mental health conditions can be linked to postpartum anxiety. It can happen alongside related conditions, including:

• Postpartum depression

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

Postpartum depression (PPD)

PPD is a condition that causes feelings of sadness and emptiness, lasting for at least 2 weeks.

Other symptoms include:

• Lack of interest in your normal activities

• Sleep problems

• Guilt

• Poor concentration

• Appetite changes

• Low energy

• Thoughts about death or suicide

PPD can also cause severe anxiety and even panic attacks. It's possible to have both PPD and postpartum anxiety disorder at the same time. There's evidence that 2 out of every 3 people with PPD also have an anxiety disorder.

Postpartum obsessive-compulsive disorder (OCD)

OCD is a condition where you have obsessive thoughts, compulsive behaviors, or both. In the postpartum period, this could include what are known as intrusive thoughts - excessive thoughts about the safety and health of your baby and engaging in rituals and behaviors to keep your baby safe. People with OCD often know these obsessions are "illogical," but feel temporary relief from performing certain behaviors or rituals again and again.

Postpartum post-traumatic stress disorder (PTSD)

PTSD is a mental health condition that can occur following a scary or life-threatening event. This could include a complicated or dangerous birthing experience, extreme pain, or a feeling that you lost control.

PTSD can cause upsetting memories or flashbacks, nightmares, and/or avoidance of certain situations. In postpartum PTSD, this can also show up as:

• Guilt

• Anxiety

• Depression

• Trouble with nursing

• Difficulties bonding with your new baby

Who is at risk for postpartum anxiety?

Anyone can have postpartum anxiety. But people who had an anxiety disorder before or during their pregnancy are at higher risk. As many as 1 in 3 women with anxiety during pregnancy experience some type of postpartum anxiety.

Other risk factors for postpartum anxiety include:

• Stressful events during pregnancy or childbirth

• Younger age of the parent

• Personal experiences of trauma in childhood

• Previous unwanted pregnancies

How long does postpartum anxiety last?

It's hard to say how long postpartum anxiety lasts. Postpartum anxiety disorders can begin at any time within the first year of your baby's birth. But the duration of symptoms can vary. Recovery depends on many different things, including:

• The severity of your symptoms

• How long it took for you to get help

• Whether your treatment has been helpful

• Your history of anxiety or depression

• Your home life, relationships, and support network

• Your overall physical and mental health

• Your baby's health

But take heart: Postpartum anxiety is common and treatable. Getting help is the first step.

When to get help for postpartum anxiety

Some anxiety in the postpartum phase is normal - especially within the first 1 to 2 weeks (when it's called the baby blues). After all, worrying about your new baby and your role as parent is part of what helps keep your baby safe.

But if your worries seem excessive, are affecting your mood, or are getting in the way of your everyday life and relationships, it may be time to get professional help. If you're unsure, it's always better to ask.

Getting treatment for postpartum anxiety

Natural methods, therapy, and medications can all help with postpartum anxiety. Some anxiety disorders have their own unique treatments, too.

Natural treatments

There are some natural methods that may help ease postpartum anxiety, such as:

• Skin-to-skin contact and plenty of cuddles

• Music therapy

• Massage from a partner

Other steps that may improve overall postpartum mental health include:

• Be prepared: Parenting training during pregnancy and the support of a trained professional during pregnancy and beyond seems to lessen postpartum anxiety.

• Build a support group: Spending time with other new parents allows you to share fears and validate your experiences. If you don't have a network or haven't found one that's right for you, keep trying. Just having one new parent friend can help you feel less alone.

• Add in physical movement: Even light physical activity can help improve your mood. Whether you join a new parent yoga group or go for a walk alone with your baby, try to get some form of physical movement every day. This will also help you sleep and may provide opportunities to meet other new parents and bond with your baby.

• Sleep: Although this is challenging with a newborn, getting longer stretches of sleep can help you feel less anxious. Ask for help to sneak in a daytime nap or get an early night when possible. Lowering caffeine intake might also help you sleep for longer stretches.

• Ask for help: It may not come naturally, but it's OK to accept and ask for help. Practice saying "yes" and be specific about what help you need. Maybe have someone take your baby for a walk so you can nap, or get a hot meal delivered. Or, ask a trusted friend to sit with your baby while you shower. Whatever it is that you need, asking for help is important for your mental health. Remember, you need to care for yourself first before you can care for your baby.

Talk therapy

Cognitive behavioral therapy (CBT) can directly help with anxiety and mood. It's often short-term, with improvement typically seen in 12 to 16 sessions. CBT can help you learn to identify and confront negative thoughts, avoid triggers, and learn new ways of coping. It teaches you to think and react differently to situations that might cause more anxiety. CBT may also involve individual counseling and/or couples therapy with a partner. To lower your anxiety, your therapist might encourage you to:

• Schedule activities

• Exercise

• Socialize

• Get out of the house

CBT might also include joining a support group.

Anti-anxiety medications

Selective serotonin reuptake inhibitors (SSRIs), like fluoxetine or sertraline, are commonly used to treat various mental health conditions, including anxiety disorders, depression, and OCD. These medications take up to a month to start working, so your prescriber might also suggest a short course of benzodiazepines (like lorazepam or ativan). Benzodiazepines can help with anxiety and sleep. But they should only be taken short term.

Is it safe to take anti-anxiety medication if I'm breastfeeding my baby?

Yes - if you need it. Although anti-anxiety medications can make their way into your milk, it's usually in very small amounts. Experts agree that the benefits of nursing seem to outweigh the small risk of taking these medications. Plus, there's evidence that untreated anxiety can also have an impact on your child. This is why SSRIs and benzodiazepines are generally considered safe for most parents to take, even while nursing.

If you're nursing and considering medication, talk to a healthcare professional. They can help you fully understand the risks and benefits, so that you can make a decision that's right for you and your family.

Frequently asked questions

If you or someone you know is having thoughts of suicide, you're not alone and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 or text "HOME" to 741-741 to reach the Crisis Text Line.

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