What Is Postpartum Anxiety

  • Mariam Atique RPh. , Pharm D, University of Sargodha, Pakistan
  • Muna Hassan Bachelor of science in molecular biology and Genetics Üsküdar Üniversitesi

Are you a new mother? Are you feeling nervous about the new responsibilities rather than enjoying your new role as a mother? Relax; this may happen to some new moms. They may experience mild mood changes, usually called ‘baby blues,’ which may last a few days.

But if this condition persists, you may be having postpartum anxiety. It is a common condition that affects some new mothers. It involves nervousness, thinking, and fears, which may affect daily life and interfere with parenting responsibilities. Some level of worry is expected in all women, but when these worries seem to drain your energies, it’s called postpartum anxiety.

Having a baby is expected to bring joy and happiness rather than anxiety. Most of the women feel panicked about the well-being of their baby. New parents feel overwhelmed to accept the baby’s responsibilities, making it difficult to enjoy the early days of parenthood.

Symptoms of postpartum anxiety

In the case that you are experiencing postpartum anxiety, you might have ongoing feelings of danger for either yourself or your baby. Symptoms of postpartum anxiety include 

  • Disturbed sleep
  • Irritability
  • Being overly cautious
  • Feeling fearful all the time
  • Racing thoughts
  • Restlessness

Physical symptoms Include

  • Increased heart rate
  • Loss of appetite
  • Nausea
  • Stomach Aches
  • Trouble sleeping

If you are experiencing these symptoms, talking to your healthcare practitioner is essential. Be honest in discussing how you feel about seeking proper treatment and recovery.

Causes of postpartum anxiety

Only one factor cannot cause postpartum anxiety. Multiple factors play a role in the development of postpartum anxiety. Some of the factors are listed below.

Hormonal changes: 

Following the delivery, there is a notable decline in hormone levels (Estrogen and progesterone), which can impact mood and potentially lead to an increased sensitivity to stress.

Sleep deprivation: 

Getting up every few hours to feed your baby and diaper changes may be overwhelming sometimes. Sudden changes in the sleep routine can cause irritability.

The Study 1 findings indicated that poor sleep quality was significantly related to an increase in symptoms of depression and anxiety.

Breastfeeding: 

The first few weeks postpartum can be more stressful for nursing mothers due to various challenges associated with breastfeeding, such as sore nipples, engorgement, latching difficulties, and other common obstacles. Additionally, mixed feelings about bottle-feeding can further add to this stress.

Previous loss: 

A history of previous miscarriages and child loss may aggravate the symptoms of anxiety.

According to a study,2 it was discovered that women who had experienced a previous miscarriage or stillbirth had a higher likelihood of experiencing postpartum anxiety.

History of anxiety: 

If you have experienced anxiety in the past, both before and during pregnancy, symptoms of postpartum anxiety may resurface following childbirth.

Postpartum Anxiety vs Postpartum Depression

The symptoms of postpartum anxiety and postpartum depression are different, showing that these two conditions are separate and have their own signs.

Postpartum Depression is characterised by feelings of sadness, hopelessness, fatigue, irritability, and a loss of interest in what you have enjoyed once. Moreover, it is essential to note that this condition may lead to trouble sleeping, appetite fluctuations, and harmful thoughts directed towards oneself or the baby.

Postpartum anxiety, on the other hand, manifests itself as excessive worry, nervousness, and fear. It may make it difficult to concentrate and may cause sleep disturbances. In some severe cases, postpartum anxiety progresses to panic attacks.

Both conditions can significantly affect the mother’s ability to care for her child and herself. However, contacting a healthcare practitioner immediately for both conditions is advisable. Making an early diagnosis and promptly initiating treatment can result in substantial differences.

According to study 3, Postpartum anxiety and depression can significantly impact maternal and infant well-being. Clinicians should know their prevalence, comorbidity, and risk factors to ensure prompt identification, referral, and treatment.

How to know if it is postpartum anxiety, not just normal worrying of a new mom?

It is usual for a new mom to worry about her child’s well-being. Being conscious about the needs of the baby. But if this worry gets on your nerves and you always feel afraid, there’s something wrong. If you can’t trust anybody, not even your spouse, to take care of your baby for a few minutes or keep on checking the baby again and again whether he is breathing or not…

Then, it’s time to see your healthcare practitioner and get help. Don’t be shy about how you feel. Be honest with your healthcare practitioner and get some help.

Risk factors for getting postpartum anxiety

Some of the risk factors that may contribute to the development of postpartum anxiety include

  • Previously diagnosed with anxiety and depression
  • Family history of depression
  • Previous miscarriage or loss of a child
  •  Having a baby with health conditions
  • Caring for other children
  • Not having a support system after birth

Impact of postpartum anxiety on babies

The mother and child bond is heavenly. But when a mother has postpartum anxiety, she may feel unable to bond with her baby. And maternal anxiety seems to affect the baby adversely. 

When a mother has anxiety, her infant is more likely to develop insecure attachment, negative affect, and dysregulated attention and arousal.

Along with the various aspects of brain development, such as physical, cognitive, and language development, it is worth noting that a baby’s emotional development starts early on. Furthermore, babies rely on their parents’ emotional reactions to understand and respond to their environment.

Diagnosis

To diagnose postpartum anxiety, your healthcare provider would ask specific questions.

He may engage with you in conversation and employ different screening tools. Be honest and accurate to your doctor about your condition so he can accurately assess your symptoms’ severity.

Management and treatment

The good news is there are several treatment options for postpartum anxiety. Your healthcare provider may suggest the treatment based on the severity of your symptoms.

Counselling and meditation

If the symptoms are not severe, modifying daily activities or seeking counselling support can be beneficial in alleviating the symptoms. But if the symptoms are mild to moderate and disturbing your daily chores, then meditation may help.

Cognitive behavioural therapy

Cognitive Behavioral therapy is the first line of treatment for postpartum anxiety. In CBT, the therapist tries to change the thought process and help you adopt healthier thinking and improved behaviour. CBT takes several sessions. Your therapist or counsellor guides you through the process of enhancing your ability to handle stress and anxiety by incorporating a question-and-answer format in your sessions. 

Medicated treatments

Severe cases of postpartum anxiety require treatment with drugs. These medicines are pretty responsive and help in reducing the symptoms. But if you are breastfeeding, you need to talk to your healthcare practitioner to advise you on breastfeeding-friendly medications. 

SSRIs are the most commonly used medications, which are preferred because of their fewer side effects. Other medications are also available. The healthcare provider suggests the medicines according to your symptoms.

Other treatment options

Other than medication, some other treatment options can help improve the symptoms and relax your mind and body. 

Family: Never hesitate to ask for support from the family. If you get support from someone for babysitting for some time, you can rest and refresh yourself.

According to study 4, postpartum mothers who get good family support have a reduced degree of postpartum anxiety.  

Light Exercise: Try to start some light exercises after talking to your healthcare provider. Doing simple exercise or even walking can improve your mental health.

Healthy Diet and proper sleep: A healthy diet and proper sleep can reduce anxiety and make you feel better and energised.

Quit Smoking: Many people believe that smoking is a way to relax and find relief. But smoking aggravates the symptoms of anxiety 5. So, try to quit smoking to reduce the symptoms of anxiety.

Summary

Postpartum anxiety is a common condition that may affect new mothers. It is characterised by excessive worry, nervousness, and fear. Symptoms can include difficulty sleeping, irritability, racing thoughts, and physical symptoms such as increased heart rate, loss of appetite, and nausea.

Several factors can contribute to postpartum anxiety, including hormonal changes, sleep deprivation, breastfeeding challenges, previous loss, and a history of anxiety.

Postpartum anxiety can be confused with usual new parent worries, but there are some key differences. Postpartum anxiety is more intense and persistent, and it can interfere with a mother’s ability to care for herself and her baby.

In the case that you suspect you may be dealing with postpartum anxiety, it is of utmost importance that you make an effort to communicate with your healthcare provider. Several effective treatments are available, including counselling, medication, and lifestyle changes.

References

  • Okun ML, Mancuso RA, Hobel CJ, Schetter CD, Coussons-Read M. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J Behav Med [Internet]. 2018 Oct [cited 2023 Nov 10];41(5):703–10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192841/
  • Giannandrea, Stephanie A. M., et al. ‘Increased Risk for Postpartum Psychiatric Disorders Among Women with Past Pregnancy Loss’. Journal of Women’s Health, vol. 22, no. 9, Sept. 2013, pp. 760–68. liebertpub.com (Atypon), https://doi.org/10.1089/jwh.2012.4011.
  • Farr, Sherry L., et al. ‘Postpartum Anxiety and Comorbid Depression in a Population-Based Sample of Women’. Journal of Women’s Health (2002), vol. 23, no. 2, Feb. 2014, pp. 120–28. PubMed, https://doi.org/10.1089/jwh.2013.4438.
  • Bila, Zakia & Santoso, Budi & Aldika Akbar, Muhammad. (2023). Relationship between Family Social Support and Anxiety of Postpartum. Journal of Maternal and Child Health. 8. 148-153. 10.26911/thejmch.2023.08.02.02. 
  • nhs.uk [Internet]. 2022 [cited 2023 Nov 10]. Stopping smoking for your mental health. Available from: https://www.nhs.uk/live-well/quit-smoking/stopping-smoking-mental-health-benefits/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Mariam Atique

RPh. , Pharm D, University of Sargodha, Pakistan

Mariam is a registered pharmacist passionate about pursuing a career in medical writing. With a solid scientific background and experience in both hospital and community pharmacy, she loves to share her medical knowledge. She is currently interning as a medical writer at Klarity.

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