Postpartum Anxiety: Symptoms, Treatment, and Caring for Yourself & Your Baby

Not all postpartum distress is depression. Discover how Postpartum Anxiety shows up differently, and how to find relief and reassurance.

It is absolutely normal to be nervous when transitioning to being the parent of a newborn. This tiny, helpless creature is totally dependent on you, and everywhere you turn there is a new safety guideline to follow. But what happens when that worry goes beyond the typical “new parent nerves” and begins to interfere with the parent’s health and happiness?

What Is Postpartum Anxiety?

Postpartum Anxiety is a mental health condition that is characterized by excessive worry, racing thoughts, or a feeling of being “on alert” even when everything seems fine. About 15-20% of new parents experience Postpartum Anxiety (about the same as Postpartum Depression!), and depending on the severity of the symptoms, it could last from weeks to years.

Common Postpartum Anxiety Symptoms

• Nervousness, feeling on edge or anxious, trouble relaxing
• Feelings of anger, irritability and/or rage
• Difficulty concentrating
• Intrusive and/or racing thoughts
• Restlessness or an inability to sit still
• Fatigue or exhaustion
• Disturbances of sleep and appetite
• Constant worry, always feeling that something bad might happen
• Physical symptoms could include dizziness, headache, abdominal pain, hot flashes, diarrhea, and nausea

Any of these symptoms can range from mild to severe, and what classifies them officially Postpartum Anxiety is that they impact the new parent’s ability to function in their daily life. Yes, driving with a newborn in the car makes most new parents very nervous; but if they avoid driving altogether and can’t leave the house anymore because they are so anxious to drive with the baby, they may need some extra help before they can feel better. New parents do not need to show ALL of these symptoms before seeking treatment – if even one is interfering with day-to-day activities, it’s time to ask for help.

A Note About Intrusive Thoughts in Postpartum Anxiety

Intrusive thoughts are unwanted, persistent, and distressing thoughts that repeatedly enter a person’s mind, and are a common symptom of Postpartum Anxiety. For some new parents, these thoughts can involve intentionally harming the baby or letting them get hurt. Many parents falsely believe that if they admit to having these thoughts, protective services will take the baby away. It is important to understand that intrusive thoughts are your anxiety talking, and reflect the things you are AFRAID will happen, not things that you want to do – and they don’t make you a bad parent.

Intrusive thoughts are a sign that you need to speak to your OB, midwife, primary care provider, or therapist about how you’re feeling. It’s also important to tell the person on the phone the truth about what’s going on, or else they may try to book you for an appointment 6 months from now! The statement “I’m having intrusive thoughts and they scare me” should alert your provider that you need to see someone right away, but that you are NOT a danger to yourself or your baby. 

If a new parent is having hallucinations or intense delusions, or has actual plans to harm the baby or themselves, they may be experiencing Postpartum Psychosis and require immediate help from a professional. Do not leave them alone, and call 9-1-1 or go to the emergency room immediately.

What Causes Postpartum Anxiety?

There is no one reason a person might develop Postpartum Anxiety. Just like with Postpartum Depression, Postpartum Anxiety may result from a combination of chemical and situational factors. 

First, hormones like estrogen and progesterone decline sharply after birth, while other chemicals like oxytocin and prolactin start surging in order to promote lactation and bonding. These hormonal shifts may even trigger an underlying thyroid imbalance, which has a direct effect on anxiety symptoms.

Because of the demands of caring for a newborn, many new parents can’t manage their own basic needs, which makes caring for their mental health even harder. When a parent is not getting enough sleep, is not eating consistently, or is continually isolated, it can feel impossible to stay stable and regulated.

There may be other situational factors that increase a new parent’s anxiety. A recent study in the Journal of Neonatal Nursing found that mothers of preterm infants experience higher anxiety than mothers of term infants. Parents dealing with financial hardship, lack of social support, or their own addiction or mental health concerns are much more likely to develop Postpartum Anxiety. 

Can I Have Both Postpartum Depression and Anxiety?

Yes, more than 60% of new parents with depression also have anxiety. Many of the risk factors are the same, and some of the symptoms can be the same. Symptoms of one can even exacerbate the symptoms of the other. For example, a parent can be so distracted by their racing thoughts that they miss an important appointment, and then feel intense guilt and shame about it.

Symptoms of Postpartum Depression	Symptoms of Postpartum Anxiety
Crying and persistent sadnessFeelings of apathy or numbnessFeelings of guilt, shame, worthlessness, or hopelessnessLoss of interest or pleasure in things once enjoyedLack of interest in the baby and/or in self-care	Nervousness, feeling on edge or anxious, trouble relaxingRacing thoughtsRestlessness or an inability to sit stillConstant worry, always feeling that something bad might happen
Symptoms of Both Postpartum Depression & Anxiety
Difficulty concentrating, remembering things, or making decisionsFeelings of anger, irritability, and/or ragePhysical symptoms (headaches, chest pains, abdominal pain, numbness, and hyperventilation)Disturbances of sleep and appetitePossible thoughts of harming the baby or oneself

It’s important to talk to your care provider about what you are experiencing – they can help you figure out the best way to feel better. 

What Helps Postpartum Anxiety?

Treatments of Postpartum Anxiety can vary depending on the severity of the symptoms and how many overlap with symptoms of depression.

• Just like the treatments for Postpartum Depression, caring for your basic needs – getting more sleep, eating nutritious food, drinking enough water, getting outside, or exercising – can help a new parent feel more stable. 
• Relaxation techniques can help keep both the physical and emotional effects of anxiety at bay.
• Talking about your feelings with people who care about you can also keep negative thoughts from spiraling out of control. A new parent support group or “Mommy and Me” class can be a perfect place to find the other parents who know exactly how you feel. 
• If those techniques are not enough, the next step is calling your care provider. That could be your OB, midwife, primary care provider, or even your baby’s pediatrician. They can help you decide if medical treatment is needed.
• Speaking with a professional therapist can help you learn new coping skills and change negative thinking patterns. Different therapy techniques may work better for Postpartum Anxiety vs Depression.
• Anti-depressant or anti-anxiety medication may also help alleviate symptoms and make it easier for the new parent to take care of their own needs. Some medications are perfectly fine to take while breastfeeding, so it’s important to talk to your doctor. 

Every parent deserves to enjoy the days with their new baby, and if anxiety is getting in the way, it is OK to ask for help (and to KEEP asking for help until you get it).

How Postpartum Doulas Can Help Parents with Postpartum Anxiety

All new parents can benefit from a network of support people after they have a baby, and this support is crucial if the parent is dealing with a mental health concern. 

A Postpartum Doula provides valuable support for parents facing Postpartum Anxiety by offering practical assistance, emotional reassurance, and education and connection to resources. While they can’t diagnose or treat a parent’s anxiety, they help prevent some of those situations that can make it worse. 

Postpartum Anxiety can be magnified by lack of sleep – a Postpartum Doula or Newborn Care Specialist ensures the parents get the best sleep possible. That extra set of hands allows many parents to take a moment to eat, drink, and shower, which goes a long way in making a parent feel human again. A doula can be a wonderful source of emotional support for a new parent, preventing isolation and validating these sometimes overwhelming feelings. Doulas and Newborn Care Specialists are also highly trained and well-educated in all aspects of postpartum care. If a parent needs resources or help finding more support, a doula is a great place to start. 

There are a lot of unknowns when it comes to bringing home a new baby. If you’re not sure whether your anxiety is normal “new parent nerves” or something more serious, the first step is to ask for help. A Newborn Care Specialist can be an invaluable member of your support team.

If you’re overwhelmed and need immediate support, our team offers in-home overnight newborn care so you can finally get some rest. Book a call today to get support for you and your baby.