Just Like Postpartum Depression, Postpartum Anxiety Deserves to Be Recognized
Kristie, 32, didn't know postpartum anxiety was "a thing" when she was pregnant with her daughter. "I was plenty aware of postpartum depression and was alert for it," she tells Good Housekeeping. "I really didn't see anxiety coming." It wasn't until her daughter was 10 months old that she was finally diagnosed.
"It was almost like a lightbulb moment for me," she says. "Like, 'Wait, it isn't supposed to be this hard?' I was struggling so much, but not in ways that seemed like depression. It was hard to recognize myself."
As a psychologist specializing in women's reproductive and maternal health, I bear witness to these lightbulb moments on a near-daily basis. My patients are usually aware of postpartum depression (PPD) symptoms — even quick to self-diagnose — due in no small part to the increased awareness postpartum depression has received in recent years in the media, and as more high-powered celebrities like Chrissy Teigen and Gwyneth Paltrow publicly discuss their own experiences with postpartum depression.
Expecting mothers and their support systems are often encouraged by their healthcare providers to educate themselves on the signs and symptoms of PPD, so they're a bit more prepared for the possibility of it once their babies are born. Even pediatricians, who are often the only physicians to see new moms immediately after they give birth — and frequently within the baby's first year of life — have been trained to look for signs that their patients' parent(s) are experiencing PPD symptoms. In other words, postpartum depression is considered to be the most common mental health complication new mothers face.
This is, of course, overall a net positive. Openly discussing the commonality of postpartum depression — a reported one in nine postpartum women will be diagnosed, according to The U.S. Department of Health and Human Services — has made new parents feel less alone and more empowered to seek support and treatment.
But the increased awareness of PPD has cast a very large shadow over postpartum anxiety — another common postpartum mental health disorder that impacts a reported 15% of new moms. A parent enduring what we've come to consider to be "stereotypical" signs of depression, including excessive crying, difficulty bonding with her baby, or withdrawal from friends and family, can be alarming. But a mom "worrying" about her baby? That's just normal, right? No, it's not. Because postpartum anxiety is so much more than worrying about your child.
"The anxiety crept in slowly," Amanda, 30, tells Good Housekeeping. "And I doubted that I could even call it postpartum anxiety because my son was nearly 6 months old at that point." Amanda had previously passed her postpartum depression screening, but was experiencing what later turned out to be symptoms of postpartum anxiety — rage that wasn't directed at any one person in particular, intense flashes of a "worst case scenario" that took her breath away, and feelings of panic when she even considered leaving her home.
"These episodes were happening multiple times per day in response to everyday life events," she says. "I actually was looking through pictures of my son from this period of time the other day and it broke my heart. I see such a happy baby but seeing him at that age immediately took me back to how unhappy I was feeling. I wasn't as present with him as I am now and I feel like I was robbed of those days that are supposed to be a happy time and those memories are clouded."
Yes, it is common to worry about your baby and experience a robust amount of anxiety when you're a new parent adjusting to life as a caregiver. In fact, scientists who've studied the changes in a mother's brain post-birth have found that adjustments in the amygdala — a small set of neurons shaped like an almond — can make a mother hypersensitive to the needs of her newborn. As Pilyoung Kim, maternal brain researcher, told The Atlantic, "Mothers actually report very high levels of patterns of thinking about things that they cannot control. They're constantly thinking about baby. Is baby healthy? Sick? Full?"
But when that anxiety impacts a new parent's ability to function, care for her baby, or care for herself, support and treatment are necessary. Without help, postpartum anxiety can even become intractable and result in ongoing mental health issues.
Symptoms of postpartum anxiety can include a constant worry that you can't shut off, persistent feelings of dread, inability to sleep, fatigue, heart palpitations, shortness of breath, nausea, vomiting, and shakiness. Intrusive thoughts — mental images or imagined scenarios that seemingly come out of nowhere and cause distress, anxiety, and panic — are also common, haunting symptoms of postpartum anxiety.
"I was afraid to leave the house with my kids," Elizabeth, 31, tells Good Housekeeping. "I was constantly worrying that they were going to get sick or get hurt somehow. I was terrified that they were going to die." The mom of two living daughters, who has also experienced three losses, says she couldn't "be in the moment" when caring for her rainbow baby. "I was so preoccupied with worry and fear," she explains. "I was so hypervigilant from my pregnancy and previous losses that my brain was rewired to prepare for the worst."
Herein lies one of the reasons postpartum anxiety often goes undiagnosed and overlooked — many of these symptoms have come to be synonymous with motherhood in the United States. Turn on the news and you'll find a hundred reasons why you should be worrying about your child and their wellbeing. Feeling tired and unable to sleep? Well that's just "life as a new mom." Imagining a "worse case scenario" that's undoubtedly distressing? Oh, you're just being a "vigilant" parent.
"Social media has helped normalize the tough parts of motherhood, so I just thought I had to tough it out and join the mother-army," Kristie says. "I saw other moms who seemed so calm about everything. I just blamed [my postpartum anxiety] on my 'type-A' personality." After receiving her diagnosis while speaking with her therapist, Kristie met with a psychiatrist who specializes in perinatal and postpartum mood disorders, was prescribed medication, and later joined a moms-with-anxiety support group. "It was a real game changer for me," she explains. "I learned the difference between coping mechanisms and coping strategies."
Just like postpartum depression, it will take an increased awareness in postpartum anxiety to ensure moms like Kristie and Amanda are not alone. "I wish I'd known that it doesn't have to be this hard," Amanda says. "Talking about our experiences is one thing, but being able to seek help is another beast."
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