After the birth of her second daughter, mom of two Caitlin Devan, 33, of Clover, South Carolina, was diagnosed with postpartum anxiety (PPA). “I never felt sad, depressed, alone,” Devan explains. “It was more the worry, always worrying thinking that the worst could happen and wondering how to prepare for it.”
“Postpartum anxiety is more common than many think,” says licensed professional counselor Kristy Christopher-Holloway, who has a doctorate in education, “but postpartum depression is often heard of most, or even used interchangeably.”
While postpartum depression (PPD) is more widely discussed — in part, thanks to celebrities like Chrissy Teigen and Serena Williams opening up about their struggles with it — what many people don’t realize is that PPA is just as, if not more, prevalent among new moms. Indeed, up to 25% of women in the U.S. develop a perinatal mood or anxiety disorder (PMAD). While stats vary across sources, research out of the University of British Columbia found that nearly 17% of new moms are diagnosed with postpartum anxiety.
When baby No. 2 was 5 months old, Devan says she found herself feeling paranoid. “I’d think, ‘What happens if we get into a car accident?’ Or ‘If I don’t do this the right way, then something bad will happen,’” she says. “I was so happy; that’s why it felt like this hit me out of the blue.”
So what the most common signs of postpartum anxiety? And if you are suffering, what are some ways to cope with it? We asked our experts to explain.
What is postpartum anxiety?
According to Megan Ellow, a licensed clinical social worker at Nest Counseling & Wellness, a private practice that focuses on perinatal mental health, moms can tell the difference between normal new mom stress and PPA by noting if their anxiety is standing in the way of everyday activities.
“All new moms worry and have some anxieties,” Ellow says. “But when the anxiety starts to interfere with your day-to-day functioning, that’s a problem. When you can’t sleep, even when the baby is sleeping, when you can’t take your baby outside for fear of germs, when you can’t bathe your baby for fear of drowning, it’s time to get some help. I usually tell moms who are wondering if they should get some help for their anxiety that if they are worried enough to wonder about it, they probably do need some support.”
“All new moms worry and have some anxieties. But when the anxiety starts to interfere with your day-to-day functioning, that’s a problem.”
—Megan Ellow, licensed clinical social worker
What are common postpartum anxiety symptoms?
In general, postpartum anxiety symptoms include:
- Constant worry.
- Feeling that something bad is going to happen.
- Racing thoughts.
- Disturbances of sleep and appetite.
- Inability to sit still.
- Physical symptoms like dizziness, hot flashes and nausea.
A family history or personal history of anxiety disorders or thyroid imbalance may put moms at higher risk for PPA, according to Postpartum Support International (PSI). In addition, women with a history of trauma — physical, sexual or emotional abuse, times when they felt their life was in danger, traumatic pregnancy/birth, etc. — may also experience increased anxiety, says Dr. Christy Duan, a physician providing clinical care to perinatal women in the Ambulatory Perinatal Psychiatry Clinic at Northwell Health’s Zucker Hillside Hospital in New York.
How long does postpartum anxiety last?
“People think that PPA usually occurs within the first six weeks, which is not always the case,” Christopher-Holloway says. “It is important to recognize that PPA can affect any mother and can manifest up to two years after giving birth.”
“It is important to recognize that [postpartum anxiety] can affect any mother and can manifest up to two years after giving birth.”
—Kristy Christopher-Holloway, licensed professional counselor
What experts recommend if you’re suffering with postpartum anxiety
1. Open up one-on-one.
For Devan, leaning on friends, especially other new moms, was particularly helpful.
“Reach out to anyone who has been in the same shoes, and just say, ‘You know what’s weird, I’ve been feeling like this… Is that normal? I’m thinking about talking to my doctor,’” she says. “I think the faster you can get help, the better off you’ll be.”
2. Find a trained healthcare provider.
Experts agree it’s imperative that women who suspect they may be suffering from PPA seek out the care of a mental healthcare provider who is trained specifically in perinatal mood disorders. The PSI website offers resources for finding a local provider.
PPA patients can benefit from psychotherapy — either individual or group therapy or both, notes Dr. Mayra Mendez, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California.
“Treatment modalities such as Cognitive Behavioral Therapy, mindfulness-based therapy models, stress management and medication evaluation are effective options for treating anxiety,” she says. “The most effective anxiety treatments focus on teaching coping skills to manage fears and worry and promote shifting of negative thinking patterns.”
3. Seek social support.
“Motherhood is a huge life transition and peer support is key,” Ellow says. “Finding other mothers who can understand and empathize with the highs and lows of motherhood can help women feel understood.”
Christopher-Holloway agrees that talking to other moms, especially in a group setting, can be beneficial for a woman coping with PPA.
“If a mom is able to use social media without it creating further anxiety, I usually suggest joining some type of mommy support group, or connecting with other moms that they can chat/text/meet up with,” she says. “Perhaps a trusted mom where they can take turns watching the other’s baby, so the mom can take a nap, shower, read or any other form of self-care to help reduce the chances of developing PPA, or alleviate the symptoms if she does indeed develop PPA.”
4. Work with your healthcare provider to consider postpartum anxiety medication.
“Many women hesitate to take medication, especially while breastfeeding,” Ellow says. “And while many women won’t need medications, many could greatly benefit from them. There are many medications which are well-studied and safe for breastfeeding. Moms who are worried can call the Infant Risk Hotline to speak about medications and breastfeeding, as well as talking with their doctor.”
5. Talk to your doctor about vitamins, supplements and alternative therapies.
Evidence-based supplements like omega-3s, vitamin D, magnesium, B vitamins and vitamin D are all worth discussing with your healthcare provider, as they may help address PPA symptoms, says Ann Smith, certified nurse midwife.
While many experts believe further research is warranted, some moms contending with PPA swear by cannabidiol (CBD) oil, which has been shown in early research to show promise curbing anxiety. The type of cannabinoid, a chemical found naturally in marijuana and hemp plants, is non-psychoactive, unlike tetrahydrocannabinol (THC), another type of cannabinoid.
While Devan found initial relief from a prescription selective serotonin reuptake inhibitor (SSRI), she has since weaned off of the drug under medical supervision and relies on individual talk therapy and CBD.
“It’s all I’ve been on for a year now, and it totally keeps my anxiety at bay,” she says. “It makes me think clearly, it makes me sleep well, it just makes me feel like myself.”
6. Implement self-care measures.
Moms coping with PPA would do well to prioritize habits like “getting more sleep by asking your partner to help more, hiring a postpartum doula or asking family to come help, getting outside every day if possible, and moving your body in ways that feel good, whether that be walks with the stroller or some gentle yoga,” Ellow says.
The bottom line on postpartum anxiety
Simply asking for help can set a mom facing the unnerving realities of PPA down a healing path.
“We pretend like motherhood is all rainbows and sunshine, and that’s just not reality,” Ellow says. “Many women really struggle with motherhood but feel they can’t admit that to anyone. I think we are becoming more aware of it as a society.”
She says previous generations likely experienced it just as much as women today but were never diagnosed or treated.
“Luckily, more women are speaking out about their experiences, and that reduces the stigma and opens the conversation for other women,” Ellow says.
This turning of the tide means more women are aware of PPA and other perinatal mood disorders and thus are more likely to seek the care they need and deserve.
