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Postpartum Anxiety

Jenny’s knuckles whitened as she tightened her grip around the baby monitor. She tried to ignore the urge to peek at the screen, but the compulsion overtook her willpower. Her exhausted eyes snapped open, and automatically focused on her peacefully sleeping baby. She exhaled a sigh of relief and attempted to heed the advice of the well-intentioned motherhood-meddlers who instructed her to “get your rest when the baby rests.” No surprise, her own sleep evaded her. Her mind raced through all the terrible things that could possibly go wrong. The harder she tried to fight these intrusive images, the more they intensified. Intellectually, she knew her baby was safe, but emotionally she could not shake the omnipresent feeling of dread.

Jenny used to pride herself on her rational mind, but now since she brought her baby home, she hardly recognizes herself. In an instant she’d get pulled into a terrifying daydream in which tragedy inexplicably strikes, and she’s suddenly left struggling in an unsafe world as a single mom to a newborn. These thoughts invade her brain and take hold of her body. Her pulse skyrockets and she has trouble catching her breath. One time, the physiological response was so strong that she considered calling 911 because she thought she was having a heart attack. She tried to logically talk herself out of her emotional unraveling, but her formerly dependable coping mechanisms, no longer provided the reliable relief.

Three months postpartum, Jenny came to my psychotherapy practice. She explained that she felt close to her daughter, but alienated from her former self. As she expanded upon her emotional distress, it became clear she was experiencing postpartum anxiety. This perinatal condition can be challenging to pinpoint, because it does not meet the criteria for Postpartum Depression, and the symptoms are more diverse than Generalized Anxiety Disorder. In addition to traditional anxiety, new moms may also experience features of obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and phobias (including excessive social worries and fears of leaving the home).

Jenny lacked an understanding of her new normal, and felt ill-equipped to deal with it. I explained that the post-delivery activation of Oxytocin in our brains, which allows us to bond with our babies, can also heighten maternal anxiety during this period. It is commonly experienced as an uncontrollable concern that something will happen to your baby or partner, or as a prominent and pervasive sense of dread. During early motherhood, it is hard to get your basic needs met (ex: consistent nourishment and restorative sleep), which makes it more difficult to defend against these stressors. While this condition is starting to gain more attention, it is still in its infancy and can be highly isolating to the individual.

The secrecy and loneliness around Jenny’s postpartum anxiety significantly added to her internal distress. She recognized that she wanted to conceal her pain to maintain an illusion that she was a parenting prodigy. After unpacking this perfectionistic fantasy, she realized it was not serving its intended function, and paradoxically, it was making her feel worse. By speaking about her feelings and developing an understanding of the events that trigger her anxiety, she was able to access her authentic needs and gain greater control over her feelings.

Jenny’s insight into these biological and emotional underpinnings allowed her to develop the skills to fight back against the postpartum anxiety. She is now more successful at distinguish between healthy doses of anxiety and the onset of her maladaptive spirals. She also developed a greater capacity for self-compassion, granting herself tenderness and patience to move forward in her life.

Postpartum anxiety does not need to be a life sentence. It is treatable with appropriate psychological and medical interventions. If you think you are experiencing this condition, or having difficulty adjusting to motherhood, reach out to a licensed professional for help.

Name has been changed. This article is not intended to replace medical or psychiatric treatment. If you are feeling suicidal or having acute, threatening thoughts please call 911 or go to your nearest emergency room.

Lindsay Liben, LCSW, has a private therapy practice near Union Square, focusing on women’s issues including infertility, depression, anxiety, and life transitions. She believes that by helping her patients get in touch with their most authentic selves, they can make choices that set them up for personal success. Learn more about Lindsay and her work on her website.