Postpartum Anxiety: One More Thing to Worry About With a New Baby?
Of all the things one is told to expect with the arrival of a new baby – lack of sleep, lots of crying (presumably the baby’s), more dirty diapers than you can shake a stick at – the one thing no one ever seems to mention is anxiety. What if I can’t get the baby to stop crying? What if I drop him? What if she gets sick? Will I ever be able to sleep again? Thoughts such as these are pretty normal for new moms (and most new dads as well), as suddenly you find yourself with a new, tiny, dependent little person. However, for most new parents, as the days and weeks roll by constant concerns about whether the baby is sleeping too much (or not at all), whether she is eating enough and growing properly, and concerns about germs or being stolen by strangers when out in the community begin to die down and fade away. For some new moms, however, these thought do not ease up and if they begin to interfere with day-to-day life, postpartum anxiety may be the reason. So how do you know if your worries are “normal” or whether you may need to seek help? Hopefully we can answer some of those questions here.
What is Anxiety? Is it Always a Bad Thing?
We all experience anxiety at some point in our lives for one reason or another. One thing to keep in mind is that anxiety in and of itself is not dangerous. It can be scary and downright annoying, but it will not kill you unless it leads you to act in a dangerous fashion. From an evolutionary perspective, anxiety served to protect us from the dangers of the environment. If we saw a predator the fight or flight response kicked in and we would quickly decide whether a particular danger could be faced and defeated, or whether we needed to hightail it out of there in order to save our skins. In today’s world, although we are no longer faced with wild beasts wanting to eat us, we do face a sometimes seemingly endless barrage of daily stressors, from things as minor as spilling our coffee down our fronts as soon as we arrive at work, to getting stuck in traffic and being late for a meeting, to being faced with a life threatening illness or situation. In each case, we must assess the severity of the situation in order to determine the appropriate response – fight or flight. Sometimes, however, it can seem hard to determine just how serious a situation is and how to respond appropriately, even if we know, rationally, that there is no need to be this upset by something. For example, someone who suffers from social anxiety may find it extremely difficult to remain at work with coffee spilled down his or her front, even though rationally he or she may know it is no big deal and it happens to everyone at some point or another. But to that person, this is basically the worst thing to happen and his or her anxious response is so strong that it interferes with day-to-day life (i.e., that person may select “flight” as the appropriate response for them and will go home sick).
What is Postpartum Anxiety?
In a similar fashion to the person described above who suffers from social anxiety, those who suffer from postpartum anxiety have anxious thoughts or feelings that become so overwhelming that they begin to interfere with daily life. Fears that someone may steal the baby if they go out for a walk in the park may prevent that mother from leaving the house with her baby (or letting anyone else go out with the baby). Worries about harm to the baby or fear of germs may also keep mom and baby at home, and forget about anyone else holding or caring for the baby – that person may drop the baby or get him sick.
Unfortunately, postpartum anxiety is less recognized by new mothers or their health care providers than is postpartum depression, and often their anxious thoughts and behaviours are chalked up to lack of sleep, rapidly changing and fluctuating hormone levels, and the challenges of caring 24/7 for a newborn. According to Postpartum Support International, it is estimated that anxiety develops in 6% of pregnant women and 10% of postpartum women, with 15-20% of women experiencing significant signs of anxiety and/or depression after the birth of a child.
Symptoms of postpartum anxiety can include some or all of the following:
- difficulty sleeping
- lack of appetite
- feelings of dread, or that something bad will happen
- constant worry
- feeling on edge, fidgety or having difficulty sitting still
- difficulty focusing or concentrating
Physical symptoms such as the following may also be experienced:
increased heart rate
- shallow, rapid breathing
- sore or tight stomach, feeling like a knot
- tightness in the chest or throat
- muscle tension (e.g., grinding teeth, clenched jaw, neck, back or shoulder pain, twitching muscle)
Risk Factors for Developing Postpartum Anxiety
While anyone can experience anxiety following the birth of a new baby, there are several known risk factors for developing postpartum anxiety, including a personal history of anxiety, depression, OCD or other mood or anxiety disorders, or a family history of anxiety or depression, including postpartum anxiety or postpartum depression. It is thought that a person’s personality may also play a role, such as in individuals who self-identify as Type A personalities (i.e., “worriers”).
Unfortunately, while getting treatment for postpartum anxiety is easy, there are many people who do not seek treatment either because they do not know that what they are experiencing is treatable, or because they fear that by seeking professional help their baby may be taken away or that getting help “proves” they are not fit mothers. Many people also believe that if they ignore the symptoms they are experiencing that the problem will go away. None of this is true. Seeking treatment for postpartum anxiety is extremely important because if not treated it can interfere not only with your enjoyment of your time with your baby, but it can also interfere with your ability to bond with your child, as well as place strains on other important relationships in your life, such as with your spouse/partner, older children, extended family and friends. Psychologists specializing in Cognitive Behavioural Therapy (CBT) can help individuals suffering from postpartum anxiety learn skills and strategies to change their patterns of thinking and behaving in response to stressful situations and anxiety triggers. Relaxation techniques can also be taught to assist with stress reduction and to help with sleep onset and sleep maintenance. Self-care is also extremely important. With the arrival of a new baby, it can be easily to lose sight of the fact that you as a person (but especially as a new mother) have needs too, and that if you don’t take care of yourself, it will eventually impact your ability to care for your baby. Think of it this way: taking time to care for yourself means you are taking care of your baby. While it is not always easy to find time for yourself, it is key that you recruit help from others (family, friends, older children, neighbours) and that you don’t be afraid to delegate tasks.
Medication may also be useful for those with more extreme cases of postpartum anxiety. Anti-anxiety medications (i.e., anxiolytics) and/or anti-depressant medications can be prescribed by your family physician or by a treating psychiatrist, both of whom will be able to discuss with you whether the potential benefits of medication outweigh the possible low risk to the baby (in the case of breastfeeding mothers). At the present time, psychologists in Ontario are not licensed to prescribe medications, but they can work in conjunction with your other health care providers to ensure you get the best and most complete treatment possible.
If you have concerns that you may be experiencing postpartum anxiety and would like to seek treatment, don’t hesitate to contact me. I provide one-on-one treatment for postpartum anxiety and will soon be offering a CBT group for mothers with postpartum anxiety. Group treatment for postpartum anxiety is an excellent way to learn the skills necessary to take back control of your thoughts and feelings while also meeting other moms struggling with the same issues. In this group, mothers with infants are welcome to bring their babies along if need be – after all, trying to find childcare is one more thing to worry about, so let’s get rid of that concern right from the start!