About Postpartum Anxiety

What is Postpartum Anxiety?

Postpartum anxiety, also known as perinatal anxiety or PPA, is a type of perinatal mood and anxiety disorder (PMAD). Mothers with PPA experience high levels of worry and fear, along with other distressing symptoms that impact their mental health and ability to care for their infant.

Postpartum anxiety can feel like your mind is a constant whirlpool, always spinning with worries and “what-ifs.” Imagine trying to float in a calm lake, but someone keeps tossing pebbles in, and each tiny splash sends ripples that throw you off balance. You might be holding your baby, but your thoughts are miles away, worrying about things that haven’t even happened yet—like an overwhelming "what if" that keeps circling back. And it’s not just in your head; it’s in your body too—tight shoulders, a racing heart, that restless energy that makes it hard to relax, even when you desperately want to. 

How common is postpartum anxiety?

Roughly 20% of new mothers experience PPA after pregnancy, making it the most common PMAD, even more common than postpartum depression. The study of these disorders shows a significant prevalence among postpartum women in the weeks following delivery of the new baby. Despite its high occurrence, PPA often goes undiagnosed and untreated because many mothers assume their anxiety is a normal part of new motherhood after pregnancy. Early identification and treatment are crucial, especially for those who may be at higher risk due to factors like a history of anxiety disorders or lack of family support. 

Mothers with PPA experience worry or fear about a variety of things related to birth, caring for a newborn, and adjusting to life as a new mother.  

These worries can be intense and persistent, often interfering with daily life and the overall health of the mother and baby. Anxiety during the postpartum period can affect sleep patterns, increase the risk of developing depressive disorders, and strain family relationships. Early intervention and access to mental health care are essential for managing these symptoms effectively.

Common fears reported by new mothers include:

• Juggling multiple roles and daily responsibilities.
• Lack of sleep and its impact on their mental health.
• Financial stress related to childcare and maternity leave.
• Baby’s health and safety, including excessive fears of sudden infant death syndrome (SIDS).
• Concerns about parenting skills and self-doubt.
• Body image issues and physical recovery after childbirth.

It’s important to note that fathers and non-birthing parents may also experience anxiety after welcoming a new baby. While we recognize that all parents can be impacted by PPA, for this article, we use the term “mother” and focus on research conducted on birthing women. Understanding the risk factors and ensuring access to treatment can help the entire family navigate this important period. 

What are the signs and symptoms of postpartum anxiety?

The most common postpartum anxiety symptom is the feeling of worry and fear which may make it hard for a mother to function and carry out her responsibilities. A mother with PPA will also experience other symptoms such as:

• Irritability and mood swings that may be prompted by even minor stressors. 
• Difficulty sleeping, even when the baby is asleep, often due to excessive worry or rumination. 
• Racing thoughts that feel uncontrollable and often focus on worst-case scenarios. 
• Poor focus and concentration, making it hard to carry out daily tasks efficiently. 
• Low energy levels, which can lead to feelings of exhaustion and depletion. 
• Muscle tension, restlessness, other physical symptoms that manifest ongoing stress. 

Some mothers with PPA may experience panic attacks, which are episodes of intense fear or discomfort. Panic attacks often feel like they come out of nowhere. These panic attacks can disrupt sleep, increase the risk of developing other mental health disorders like OCD, and significantly impact the mother's ability to care for her baby. During a panic attack, a mother may experience:

• Heart palpitations or rapid heartbeat, often accompanied by a feeling of impending doom. 
• Sweating, chills, and shaking, symptoms that mimic physical illnesses and can be frightening.
• Shortness of breath and dizziness, which might exacerbate feelings of panic. 
• Chest pain or tightness, similar to sensations experienced during a heart attack.
• Nausea or stomach pain, common symptoms during moments of acute stress.
• Fear of losing control or dying, a common sensation during a panic attack that can be distressing.
• Numbness or tingling, contributing to the sensation of panic.
• Dizziness, often correlating with hyperventilation or heightened anxiety.
• A sense of being detached from one’s self or reality, often described as feeling "out of body." Such symptoms can lead some mothers to avoid public places for fear of an episode.

While panic attacks may only last a few minutes, they are very scary for the person experiencing them. A person who experiences panic attacks may fear having future attacks and avoid going out in public.

Is it normal to have scary thoughts?

Yes, as many as 90% of new mothers experience intrusive thoughts. Intrusive thoughts are distressing ideas or images that can pop into your head out of nowhere. Mothers may feel like they have no control over these thoughts. Intrusive thoughts are very common during the postpartum period, especially among mothers with anxiety. These thoughts are often scary and involve something bad happening to the baby. These thoughts may be of a violent or sexual nature. It’s common for mothers to feel terrible for having these thoughts, but the truth is that they are outside their control.  

It's important to remember that intrusive thoughts do not define you. The treatment approaches described below can help mothers manage and cope with their intrusive thoughts. 

How can you tell if it’s postpartum depression or postpartum anxiety?

Many people wonder about the difference between postpartum anxiety vs. postpartum depression. Postpartum depression (PPD) and PPA are both PMADs that cause distress during the postpartum period.

The key difference between PPD and PPA is the primary symptoms. For mothers with PPD, the main symptom is a sad mood that persists nearly every day, while for mothers with PPA, the main symptom is chronic worry or fear.

That being said, some of the symptoms of PPD and PPA are the same including irritability, difficulty concentrating, low energy, and sleeping problems. Many mothers experience both PPD and PPA at the same time and experts believe that two out of every three women with PPD also has PPA. The recommended treatments for PPD and PPA are similar, so mothers experiencing both can get the help they need in one concerted effort.

Causes of postpartum anxiety

The exact causes of PPA are unknown. The consensus among experts is that it is likely caused by a combination of hormonal changes, genetic factors, and the stress of adjusting to parenthood. From an evolutionary perspective, moderate amounts of anxiety are adaptive during the postpartum period. Anxiety can keep parents alert to threats and motivate them to take action to protect their babies. The problem arises when anxiety becomes severe enough to affect a parent’s health and functioning.

Risk factors

Risk factors are characteristics or events that increase the likelihood of experiencing a condition. Risk factors for PPA include:

• Anxiety or depression during pregnancy, which may predispose mothers to continue experiencing symptoms postpartum.
• Premature birth, being directly related to increased caregiving stress and anxiety for mothers.
• Feeling a lack of control during labor and delivery, potentially leading to persistent anxiety and trauma-like responses.
• Giving birth via cesarean section, associated with increased postoperative recovery stressors.
• Marital conflict, which can intensify anxiety levels by reducing emotional support.
• Lack of family support, leaving mothers without a necessary buffer against stress and anxiety.

Having more risk factors increases the chances of developing PPA, but it’s also possible to develop PPA without any risk factors. Keep reading to learn about treatment options and strategies for coping with symptoms.

Effective Treatment for Postpartum Anxiety

Postpartum anxiety is treatable. There is no reason to suffer when help is available.

Therapy

Like treatment for postpartum depression, the most effective treatment for postpartum anxiety is therapy. There are many different types of therapy available, but a specific type of therapy called cognitive behavioral therapy (CBT) is effective for treating PPA. CBT focuses on how a person’s thoughts, feelings, and behaviors are connected. It assumes that negative emotions, like anxiety, are tied to a person’s thoughts. One of the main goals of CBT is to identify and change thought patterns that contribute to negative emotions. 

Medication

Mothers with moderate to severe anxiety may also benefit from medication. A type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be prescribed for anxiety during the postpartum period. Other types of medications may also be prescribed to alleviate panic attack symptoms. Many mothers understandably have apprehension about taking medication for their anxiety. They are often concerned about whether it is safe to take medication while breastfeeding or if they become pregnant again. They may also worry that medication could be addictive or have a numbing effect. Because of the complexities of prescribing medication during the perinatal period, mothers must work with a psychiatric provider who is trained in this area. They can conduct a thorough evaluation to determine whether medication is right for you and help you consider the pros and cons. 

How to cope with postpartum anxiety

Regardless of whether you are seeking professional treatment, learning how to cope with postpartum anxiety can make a significant difference for your well-being. Simple strategies like mindfulness, deep breathing, and seeking professional support can help ease anxious thoughts. Finding time and energy to prioritize self-care strategies during the postpartum period can be incredibly challenging and it may take time to create a routine. Aim for baby steps to start, and anticipate slow but steady progress. Here are some additional ways to cope with PPA and improve your mental health:

• Lower your expectations: Many mothers with high levels of anxiety put immense pressure on themselves to keep up with everything that they did before. They have trouble accepting that they need to rest and take things easy during this time. If this sounds like you, try to work on giving yourself permission to do less. Remember that your worth is not tied to how productive you are.
• Delegate: As you accept that you need to do less, consider delegating tasks to others. Don’t expect yourself to do it all.
• Incorporate movement: Exercise offers positive benefits for your mood and has been shown to lower stress and anxiety. Just 30 minutes of movement a few times a week can go a long way. Walking and stretching are good ways to start once you are cleared to do so by your healthcare provider.
• Connect with other mothers: Social support is an important part of maternal mental health. Connection, especially with other new mothers, is vital. If you do not have an existing support system, consider joining a support group or mommy-and-me class. There are many in-person and virtual options available. 
• Limit caffeine: Caffeine can worsen anxiety and some women are more sensitive to the effects of caffeine. If you notice that your anxiety gets worse after consuming a caffeinated beverage, consider cutting back or stopping altogether.

Natural Remedies & Lifestyle Changes for Postpartum Anxiety

Managing postpartum anxiety with natural remedies can be an effective complement to therapy or medication. Many mothers find that incorporating holistic practices into their daily routine helps reduce anxiety symptoms and promotes overall well-being.

As you explore these options, remember to consult with your healthcare provider to ensure that any new practices are safe and suitable for your unique needs. 

Mindfulness and Meditation

Practicing mindfulness helps you stay present and grounded, reducing the impact of racing thoughts and worries. Start with short, daily meditation sessions to ease into a more focused and calm mindset. Over time, you may find that regular mindfulness practice significantly lowers your anxiety levels.

Deep Breathing Exercises

Deep breathing techniques activate your body's relaxation response, easing tension and stress. Methods such as diaphragmatic breathing or the 4-7-8 technique can be practiced anywhere, offering a quick and effective way to calm your nervous system during anxious moments.

A Balanced Diet

A nutritious, balanced diet is essential for both physical and mental health during the postpartum period. Eating a variety of whole foods—such as fruits, vegetables, lean proteins, and whole grains—helps stabilize blood sugar levels and supports a balanced mood. Consult with a nutritionist for personalized advice to optimize your diet during the postpartum period.

Incorporating omega-3 fatty acids into your diet can benefit brain health and lower anxiety levels. Foods rich in omega-3s, such as fatty fish, walnuts, and flaxseeds, help reduce inflammation and support overall mental well-being. Consider discussing supplementation with your healthcare provider if needed.

Regular Physical Activity

Engaging in regular exercise—such as walking, jogging, or light resistance training—boosts endorphin levels and helps reduce stress hormones. Even gentle physical activity can improve your mood and energy levels over time.

Yoga offers a holistic approach by combining physical postures, deep breathing, and meditation. Whether you choose restorative or postnatal yoga, this practice can help relieve anxiety, enhance flexibility, and foster mindfulness.

Sleep Hygiene

Quality sleep is critical for mental health. Establish a consistent sleep schedule, create a relaxing bedtime routine, and minimize screen time before bed to improve sleep quality. A calm and dark sleep environment can make a significant difference in managing anxiety.

Journaling and Expressive Writing

Writing down your thoughts and feelings can help you process emotions and gain perspective. Whether you try gratitude journaling or simply note your daily experiences, expressive writing is a useful tool to reduce rumination and clear your mind.

Aromatherapy and Essential Oils

Aromatherapy with essential oils like lavender, chamomile, or bergamot can create a soothing atmosphere. Use a diffuser at home or add a few drops of your favorite oil to a warm bath for a calming sensory experience. Always ensure proper dilution and consult a professional if you’re breastfeeding.

Herbal Supplements

Herbal remedies, such as lemon balm or passionflower, have been traditionally used to ease anxiety. However, it's essential to consult with your healthcare provider before starting any herbal supplements to ensure they're safe for you during the postpartum period.

Social Support and Connection

Building a strong support network is vital. Join a postpartum support group, participate in online communities, or engage in local classes for new mothers. Sharing your experiences and challenges with others who understand can help reduce feelings of isolation.

Nature Exposure and Grounding Techniques

Spending time outdoors and connecting with nature can significantly reduce stress. Even a short daily walk in a park or time spent gardening can help lower anxiety levels by grounding you in the present moment.

Acupuncture and Alternative Therapies

Some mothers have found relief through acupuncture, which involves stimulating specific points on the body to balance energy flow. If you're interested in exploring this alternative therapy, seek out a certified practitioner experienced in working with postpartum clients.

Commonly asked questions

How long does postpartum anxiety last?

Many mothers wonder how long postpartum anxiety will persist. While symptoms typically begin within the first few weeks after birth, the duration varies. Some mothers experience anxiety for a few months, while others may struggle for a year or longer. Seeking professional treatment can significantly reduce the length and severity of symptoms.

Will postpartum anxiety go away on its own?

Postpartum anxiety may improve on its own over time, but it's not guaranteed. While some women may experience a reduction in symptoms as their hormone levels stabilize and they adjust to motherhood, others may find that their anxiety persists or even worsens without intervention. Seeking professional help, such as therapy or counseling, can be incredibly beneficial in managing and reducing symptoms. Early treatment not only helps alleviate anxiety but also supports overall well-being and mental health. If you’re struggling with postpartum anxiety, reaching out for support is an important step toward recovery. 

How to support a friend or partner with postpartum anxiety

Loved ones play a crucial role in helping a mother navigate postpartum anxiety. Practical ways to offer support include:

• Encouraging her to seek help from a professional.
• Offering to handle household tasks or baby care to give her a break.
• Providing emotional reassurance without dismissing her feelings.
• Learning more about postpartum anxiety to better understand her experience.

Postpartum Anxiety vs. Generalized Anxiety Disorder (GAD)

Although postpartum anxiety shares similarities with generalized anxiety disorder (GAD), they are different conditions. Postpartum anxiety is specifically tied to the postpartum period and often involves fears related to the baby. GAD, on the other hand, can occur at any stage of life and affects multiple aspects of daily living.

What to Do if Postpartum Anxiety Is Getting Worse

If your anxiety is intensifying or interfering with daily life, it’s important to seek support. Here’s what you can do:

• Talk to a Professional – A therapist specializing in maternal mental health can help you develop coping strategies and provide guidance.
• Prioritize Rest & Self-Care – Lack of sleep and exhaustion can make anxiety worse. Accept help from loved ones and carve out time for yourself.
• Join a Support Group – Connecting with other moms who understand your struggles can reduce feelings of isolation.
• Reach Out for Immediate Help – If you’re experiencing panic attacks, distressing thoughts, or feel overwhelmed, don’t hesitate to contact a mental health professional or crisis hotline.

Postpartum anxiety is treatable, and you don’t have to navigate it alone. Seeking help is a sign of strength, not weakness.

When to Seek Immediate Help for Postpartum Anxiety

While many cases of postpartum anxiety can be managed with therapy and support, knowing when to get immediate professional help for postpartum anxiety is crucual. Signs that require urgent attention include:

• Severe panic attacks that interfere with daily functioning.
• Inability to care for oneself or the baby.
• Persistent intrusive thoughts of harm.
• Symptoms that worsen rather than improve over time.

Why does partum anxiety occur?

Postpartum anxiety occurs due to a combination of hormonal changes, physical recovery from childbirth, and the emotional adjustment to motherhood. After giving birth, a woman's hormone levels fluctuate rapidly, which can contribute to feelings of anxiety. Additionally, the demands of caring for a newborn, lack of sleep, and the stress of adjusting to a new routine can overwhelm new mothers. Some women may also have a predisposition to anxiety disorders, making them more susceptible to experiencing postpartum anxiety. It's important to recognize that postpartum anxiety is a common condition, and seeking support through therapy or other resources can help manage and reduce symptoms. 

Help is only a click away

Postpartum anxiety is the most common PMAD experienced by new mothers. Treatment can help you manage your symptoms and feel more in control of your own thoughts and feelings.

At Phoenix Health, we specialize in treating maternal mental health conditions like postpartum anxiety. Schedule an appointment with a maternal mental health specialist and start feeling better today.