At The Motherhood Center, we provide support and clinical treatment to pregnant and postpartum women that are experiencing perinatal mood and anxiety disorders (PMADs), otherwise known as postpartum depression. Treatment ranges from a Day Program for new and expecting moms with acute PMADs with an onsite nursery, outpatient therapy and medication management for women with mild to moderate symptoms, and support groups. We hear the following comments from new and expecting moms on a daily basis:
‘I just couldn’t get out of my mind. My body was tense, all day, every day, I had an ongoing feeling of nausea and I couldn’t eat for most of the day; I could not pull myself out of it, to focus on myself, my baby, or anything else. I was paralyzed’.
‘Every time I tried to do something for my baby, I was sure I would hurt her. Did I put detergent in her bottle? If I walked near the window, could she fall out of the window? Did I leave something in her diaper when I last changed her?’
‘I was so overcome with worries all the time. I couldn’t leave the house. What if my baby started crying in public? What if people think I am a bad mother?
Postpartum Anxiety: What is it?
Anxiety is a normal emotion for which humans are hardwired to experience. We needed and still need the ‘fight or flight’ response to know how to deal with fearful and life-threatening situations. With anxiety disorders, however, this normal response is the system over-reacting, becoming over-stimulated and developing into an illness which inhibits you from functioning normally in your personal and/or professional life. Women are especially vulnerable to anxiety during the postpartum period, when there is a major shift in one’s sense of self - their identity as an individual, a partner and as a professional. Additionally, there is a now a tiny human being who is fully dependent on her for all his or her needs!
According to Postpartum Support International (PSI), approximately 6% of pregnant women and 10% of postpartum women develop anxiety. By comparison, approximately 10% of pregnant women experience depression and up to 15% experience it in the postpartum. Often, anxiety can be experienced on its own, however, it is common for anxiety to be experienced together with depression. It is important to note that almost 50% of postpartum depression and anxiety disorders existed before or can develop during pregnancy, so we prefer to use the term “Perinatal Mood and Anxiety Disorders” which refers to both depressive and anxiety disorders before, during and after pregnancy (ie: the “perinatal” timeframe.)
Postpartum anxiety is not as widely discussed in popular culture or medical sources as is postpartum depression. A Google search of postpartum anxiety yields an ad for postpartum depression as the first hit and a quick Amazon book search of postpartum anxiety yields 4 books specifically geared to postpartum anxiety versus the numerous books that cover either postpartum depression alone, or both postpartum depression and anxiety together. There is even a Postpartum Depression for Dummies book, but not one for postpartum anxiety. The less commonly discussed postpartum anxiety disorders are often missed as women who have only heard of postpartum depression and don’t identify as being depressed, don’t realize they may be experiencing postpartum anxiety.
What are the signs and symptoms of postpartum anxiety?
Physical symptoms can include feeling jittery, dizzy, and/or the sensation of a racing heart. You can have thoughts that are characterized by relentless worries, such as ‘what if my baby cries and I can’t console him/her; what if I am not feeding my baby enough; what if my baby stops breathing.’
Common behaviors that accompany these thoughts and feelings are incessantly asking for reassurance, obsessively researching the internet or calling the pediatrician out of fear that there is something is wrong with the baby. Isolation from friends and family can occur when there is resistance to going outside with the baby.
Other signs and symptoms of postpartum anxiety may include, irritability, panic attacks, loss of appetite, difficulty sleeping, muscle tension (sore neck, back, jaw, clenching/grinding teeth), trouble concentrating and focusing, memory lapses, frequent episodes of crying for no reason, or thoughts of harming yourself or the baby.
Who is at risk of developing postpartum anxiety?
Top risk factors for postpartum anxiety include a personal prior history of anxiety, a family history of anxiety both in the perinatal and non-perinatal periods, or medical issues such as a thyroid condition. History of trauma, such as physical or sexual abuse, a difficult/traumatic delivery, are significant risk factors as well.
Is there effective treatment for postpartum anxiety?
Yes! Postpartum anxiety disorders (like postpartum depression) are highly treatable. Treatment for postpartum anxiety starts with recognizing your symptoms. Often, a family member or close friend may recognize these before you do. A full psychiatric evaluation by a mental health professional, which can rule out other medical causes of anxiety (such as thyroid imbalance), is recommended. From the evaluation, recommendations for therapy and/ or medication may be indicated.
Maximizing your sleep, ensuring adequate nutrition and exercise (in moderation and according to what your Ob/Gyn recommends), and engaging in mindfulness/meditation/yoga are other interventions that can help to decrease anxiety. You can work closely with your perinatal therapist on defining which of these measures is right for you.
To learn more about perinatal mood and anxiety disorders, visit The Motherhood Center:
Dr. Weiss graduated from the Albert Einstein School of Medicine of Yeshiva University and completed adult psychiatry residency at Montefiore Medical Center. Dr. Weiss completed a fellowship in child and adolescent psychiatry at New York Presbyterian Hospital. She then completed the Sackler Infant Psychiatry Fellowship at Weill Cornell Medicine where she developed expertise in parent-infant relationships and early childhood development. She has published articles and book chapters, presented at national medical conferences and received training and teaching awards. Dr. Weiss is board certified in both adult psychiatry and child & adolescent psychiatry.