Recognizing Post-Partum Anxiety

"It’s like I have all this nervous energy; I can’t slow down or turn my brain off. Like my adrenaline is pumping all the time. When I look at my baby, instead of feeling lovey-dovey, I feel my throat and chest clench. What is wrong with me?" –Jennifer

"I am so nervous all the time, I feel so out of control with worries. I don’t even want to leave the house and bump into anyone I know. If I go out I worry about Arman starting to cry – what if I can’t console him, and everyone stares at me and thinks I am a terrible mother?" –Salima

 

Having a newborn at home is a time of emotional upheaval, even under the best circumstances. Whether it’s a woman’s first venture into motherhood or her fourth, anxiety is a common feeling during this time. However, for some women, anxiety can start to build gradually and interfere with her ability to enjoy and take care of her new baby – and herself. Unfortunately, even medical care providers can miss the signs of prolonged postpartum anxiety, sometimes mislabeling it as postpartum depression or attributing it to all the sudden life changes. Many people don’t know that it’s possible to have an anxiety disorder and depression at the same time.

A moderate amount of new fears and worries is normal and expected during this time of change. If you are experiencing quite a bit of anxiety, it can be helpful to first learn more about what anxiety is, and how it can show up for new moms.

What is Anxiety?

Anxiety is a natural, adaptive response we experience when we feel unsafe or threatened. We perceive many kinds of “threats”; some can be specific and real (e.g., being followed down a dark alley). Some feel more vague, like a general sense that something “bad” will happen. We may also have an anxious response to a threat we are imagining in our heads, like picturing a loved one getting into an accident.

We can experience anxiety in these areas:

  • In our bodies (increased heart rate, sore stomach, tight chest and throat, shallow breathing, loss of appetite, difficulty falling or staying asleep, etc.)
  • In our mind (racing thoughts about the future; imagining the worst-case scenario; ruminating; worrying and obsessing, etc.)
  • In our actions or behaviours (avoiding certain situations, activities, places, or people; over-controlling; asking others for constant reassurance; checking things repeatedly; being extra careful and vigilant of danger, etc.)

Other possible signs of anxiety during the postpartum period:

  • loss of appetite
  • difficulty sleeping
  • irritability
  • muscle tension (grinding teeth, neck and shoulder pain, back pain, muscle twitching)
  • difficulty concentrating and focusing
  • forgetfulness

For more information on anxiety, see What is Anxiety?

 

Everyone experiences anxiety differently

 

       

Salima experiences anxiety in her body as dizziness, feeling jittery, and suddenly feeling her heart racing. Some of her anxiety-producing thoughts include “What if I go out and Arman starts crying hysterically and I can’t calm him down” and “What if someone grabs him?” As a result, her behaviours include constantly asking for repeated and excessive reassurance from friends and care providers, obsessively reading and re-reading parenting books and blogs for hours, and avoiding going outside.

   

Jennifer experiences her anxious thoughts as repeated and intrusive obsessions about harm coming to her baby. Her anxious and compulsive behaviours include checking in on her baby over and over through the night, and repeating prayers to “prevent” something bad from happening. In her body, she experiences anxiety as a constant tightness in her throat and chest. She also feels nauseous. Jennifer’s obsessions and compulsions slowly started to consume more and more of her energy and time and caused her significant distress.

   

After a traumatic birth experience, Ellen’s anxious thoughts involve extremely frightening flashbacks of the birth, and nightmares. She repeatedly replays her experience of the birth over and over, tormented by what could have been. She also experiences panic attacks, especially when triggered by something that reminds her of her experience (such as hearing an ambulance). She experiences this in her body as a wave of anxiety coming over her, teariness, a racing heart, and difficulty catching her breath. Her behaviours include avoiding going near the hospital and avoiding watching certain TV shows.