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• Posted March 13, 2023

Postpartum Anxiety: What It Is, Symptoms and Treatments

You may have heard of postpartum depression and "the baby blues,"but did you know that there's another widely studied mental health condition called postpartum anxiety?

Dr. Erica Newlin, an obstetrician-gynecologist in Westlake, Ohio, said in a Cleveland Clinic podcast that, "Peripartum and postpartum anxiety and depression, and just mental health concerns in general, are super, super common. Most studies really cite a prevalence of around 10%. But we think that that might be vastly underreported."

And postpartum anxiety doesn't just affect mothers: A recent review published in the Journal of Psychosomatic Obstetrics & Gynecology revealed that about 1 in 10 dads were impacted.

To understand how to better manage postpartum anxiety and reduce your risk factors for developing the condition, it's important to learn what it is, its causes and key symptoms, and the treatments that are recommended by doctors, including commonly prescribed medications.

What is postpartum anxiety?

Postpartum anxiety is named after the time period immediately following delivery or becoming a parent.

"You can start to experience it any time during the pregnancy and in that first year after delivering,"said Newlin.

According to the Cleveland Clinic, what sets postpartum anxiety apart from normal worry is the severity of its symptoms.

The condition is marked by irrational fears that go well beyond the natural concerns parents have for their children's health and well-being. For example, you might have unfounded, repetitive thoughts that someone or something is going to harm you or your baby.

Postpartum anxiety causes

The causes and risk factors for postpartum anxiety are varied and may include:

• Shifts in hormones, which decrease in women after pregnancy and make it more difficult to manage stress
• Added life stressors, such as difficulty breastfeeding or issues during pregnancy and delivery
• Being overwhelmed due to the responsibilities of caring for a newborn
• A lack of sleep, which is common for new parents
• Certain health conditions, such as a history of eating disorders, anxiety or depression
• Life events that increase your risk for developing anxiety, such as a previous miscarriage or loss of a child
• Lifestyle factors, such as caring for multiple children at once or having a child with health issues

"There can be an expectation of how motherhood will be,"said Newlin. "And sometimes if reality doesn't always match expectations, that can be a contributor [to postpartum anxiety] as well."

Postpartum anxiety symptoms

According to Harvard Health, postpartum anxiety shares some symptoms in common with postpartum depression, including irritability, issues with relaxing, and trouble falling or staying asleep.

The Cleveland Clinic states that other common postpartum anxiety symptoms include:

• Shortness of breath
• Heart palpitations or increased heart rate
• Restlessness
• Nausea and decreased appetite
• Racing or irrational thoughts, particularly fearful ones
• Poor focus
• Social avoidance
• Control issues
• Overly cautious behavior

It's also not uncommon for postpartum anxiety to manifest as a type of anxiety disorder known as obsessive compulsive disorder (OCD), according to the U.S. National Institute of Mental Health.

Postpartum anxiety treatments and medications

Luckily, there is help for postpartum anxiety. These include:

• Therapy: Cognitive behavioral therapy is used to treat different types of anxiety, including postpartum anxiety and OCD. A psychologist or counselor helps you identify your thoughts, emotions and behaviors, and helps you work to change them.
• Medication: Postpartum anxiety medications can be prescribed by your doctor to help you manage and improve the physical, behavioral and emotional symptoms of the condition. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and the antidepressant mirtazapine.
• Social support: "There are national postpartum support groups that provide both virtual outlets, as well as organizing things like stroller walks or get-togethers that may help,"said Newlin. "Just talking with women that are going through the same thing and validating these feelings that you're having for some women is enough."

Harvard Health offers additional suggestions to help you ease your symptoms:

• Cuddle your child to release mood-enhancing oxytocin
• Include workouts that incorporate calming breathwork, such as yoga
• Wean your child from breastfeeding slowly to help keep hormone levels from shifting too quickly
• Do everything you can to get more sleep

When to seek help

"If you find that you're having what I call perseverating thoughts -- like if you can't move past that worry, if the worry is keeping you from living your life, or if you're constantly worried about something happening to you or something happening to the baby, or it's affecting your sleep or ability to function -- that's not on the normal side of things. And that would be a reason to seek care,"Newlin advised.

If you're wondering if you may have postpartum anxiety, you can start by taking this short anxiety quiz from Anxiety.org.