Do I Have Postpartum Anxiety?

Have you known anyone who had Postpartum Depression? What about Postpartum Anxiety? Postpartum anxiety (PPA) might not be as well-known as Postpartum Depression. Many people have gone to great effort to raise public awareness of the risks of PPD, and as a result, most women are aware of the risks, and healthcare providers often screen for PPD at follow-up appointments after childbirth.

But what about Postpartum Anxiety – not just the anxiety that is a symptom of depression, but its own separate mood disorder? Some mental health experts believe that PPA is at least as prevalent as PPD, especially if you consider that both disorders often occur simultaneously, yet with enough distinct symptoms that PPA could qualify for its own diagnosis.

It’s important to distinguish the two disorders because Postpartum Anxiety can occur without feelings of sadness as a symptom, leaving new moms unaware that their distressing symptoms may actually be a mood disorder that needs treatment.

When moms are unaware that what they’re experiencing is Postpartum Anxiety, they won’t be able to get treatment for their mental health. Lack of treatment can leave them at risk for future mental health struggles because PPA doesn’t always resolve on its own over time.

As mentioned above, when people think of mental health conditions accompanying pregnancy and childbirth, Postpartum Depression is usually what comes to mind. It’s important to recognize other postpartum mood disorders as well:

• The “baby blues” is the mildest and most common condition.
• Postpartum Psychosis (PPP) is perhaps the most serious and risky.
• Postpartum mood disorders also include Postpartum Obsessive-Compulsive Disorder (PPOCD), Postpartum Post-Traumatic Stress Disorder (PPTSD), and Postpartum Anxiety.

Any of these disorders may overlap (e.g., someone with PPA may also have PPTSD). Also, “postpartum” in this setting can refer to a mood disorder that begins either during or after pregnancy.

It is difficult to even find wide-ranging statistics on PPA, especially since the DSM-V does not offer a separate diagnosis apart from PPD, but we do know that about half of women with PPD also report symptoms of anxiety. Anxiety can be a symptom of PPD, or it can be a separate condition.

A recent small study suggested that Postpartum Anxiety is more common than Postpartum Depression, with about 16-17% of study participants reporting anxiety during or after pregnancy, while only 4-5% reported depression during or after pregnancy.

Read on to learn more about Postpartum Anxiety symptoms, how to distinguish them from Postpartum Depression symptoms, and what to do if you think you might have Postpartum Anxiety or a related mood disorder.

How to tell if you’re suffering from PPA

What are the most common Postpartum Anxiety symptoms? They are similar to other anxiety symptoms. Recognizing them may also depend on whether you suffered from anxiety before pregnancy, and if your symptoms began or even worsened during or after pregnancy.

Here are some possible symptoms of Postpartum Anxiety:

• Racing thoughts: Feeling like you’re constantly thinking quickly and can’t calm your mind down.
• Worrying: Fixating on specific fears.
• Lack of concentration: This symptom may feel like brain fog or simply the inability to focus. It can be especially hard for new moms to figure out what is anxiety-related and what is related to sleep deprivation.
• Restlessness: You might feel unable to relax or calm down.
• Feeling of doom: Do you wake up in the morning with a sense of impending doom or a vague feeling that something has gone horribly wrong, but you can’t put a finger on what it is? This can be related to Postpartum Anxiety.
• Sleep disturbance: It almost sounds humorous to suggest this as a symptom, but if you have insomnia even when you’re exhausted, or all you want to do is sleep day and night, this may signal that something else is going on besides sleep deprivation.
• Irritability: Again, you might feel irritable due to normal new-parent sleep deprivation, but this symptom can also be a sign that your hormones have triggered PPA.
• Physical tension: This symptom is related to the inability to relax or feel calm. Your muscles might feel constantly tensed, or you may experience neck pain, back pain, or headaches.
• Changes in appetite: Do you have trouble eating or feel that you can’t stop eating? This symptom, along with others, may point to PPA.

What causes PPA?

It’s difficult to draw conclusions about why some women develop postpartum mood disorders and others do not. If we knew a direct cause, it would be easier to avoid the condition. But, we can observe correlating factors that seem to trigger the disorder in some cases.

In the case of Postpartum Anxiety, we know that if you have a personal or family history of anxiety, particularly if you have had Postpartum Anxiety in the past, you’re at higher risk for developing the condition.

Here are some of the other correlating or risk factors for Postpartum Anxiety:

• Thyroid imbalance
• Poor sleep
• Previous pregnancy or infant loss
• Teenage pregnancy
• Lower socioeconomic status
• Lack of social support
• Job/housing/financial crisis

After giving birth to a baby, a woman’s estrogen and progesterone levels drop dramatically. This does not trigger a mood disorder in every mom, but it definitely can act as a trigger for someone who is at risk for Postpartum Anxiety.

How is Postpartum Anxiety treated?

Even though postpartum mood disorders are triggered by the process of pregnancy or childbirth, this doesn’t mean they automatically go away on their own as the postpartum period progresses. Someone who has anxiety after giving birth (or during pregnancy) may face future mental health struggles if their condition is not diagnosed and treated in the postpartum period.

If you think you might have Postpartum Anxiety, it’s important that you talk to your doctor. Many providers screen for symptoms of Postpartum Depression in the weeks following childbirth, but if you’re not experiencing persistent feelings of sadness, your anxiety may go unnoticed and undiagnosed.

Don’t be afraid to let your provider know how you’re feeling and that you think you may need treatment for PPA.

Self-care

Think of self-care as the first line of defense in treating a mood disorder. Depending on the severity of your symptoms, you may wish to try a variety of self-care coping strategies before, or alongside of medication or therapy.

The “catch-22” with postpartum mood disorders is that many of the self-care methods used to treat generalized mood disorders are incredibly difficult to accomplish in the postpartum period while caring for a newborn.

It’s imperative that you have support as much as possible. If you have very little access to real-world support, consider looking for support groups in your area through a resource such as the YWCA or Postpartum Support International.

Social support is critical in the postpartum phase, and support doesn’t just mean when people come over to hold the baby while you scrub the kitchen counters. Make sure you find at least one person who you can share with about how you’re feeling.

Other self-care strategies for coping with PPA include exercise(even a 10-minute yoga session or a walk around the block), personal hygiene (it’s okay if you let the baby fuss for a few minutes while you take a shower), and nutrition (don’t just rely on empty calories or you’ll feel even worse). If you have enough support that you can squeeze in extra naps, make sure you take advantage of it.

If you’re unable to find support through other avenues, consider searching online for groups through Facebook or moms’ forums. There are private groups where you can talk to other women in the same season of life who have similar struggles.

Therapy

Conventional talk therapy and cognitive behavioral therapy can both be helpful for Postpartum Anxiety, but both can be expensive. Check to see which providers are covered by your insurance, or see if you can find a local therapist who works pro bono. Again, the YWCA can be a resource for therapy. Search for counseling or therapy services through your local chapter.

Medication

Many new moms are hesitant to try medication for Postpartum Anxiety because they don’t want to jeopardize breastfeeding if that’s what they’ve chosen.

Only your healthcare provider can answer all these questions, but there are options for you to discuss. In the end, your mental health affects your baby just as breastfeeding does, so no matter which route you decide to take, know that you are making the best decision for your baby by taking care of yourself.

Don’t ignore the warning signs of Postpartum Anxiety; you don’t have to suffer alone.