When I became pregnant with my first child, I started researching (because that’s the kind of person I am). I learned about fetal development. I learned about the fourth trimester. And I made sure I read about postpartum depression – because as someone who has dealt with depression in my life, the last thing I wanted was for that monster to creep back into my brain. But in all of my reading and researching, I can’t remember seeing anything about postpartum anxiety. This is the monster no one warned me about. I feel that this is something that needs to get out there more, so today, we’re talking about postpartum anxiety.
Warning: this post may be highly triggering if you’ve been dealing with postpartum anxiety. Skip this first section (“Let’s Talk About Postpartum Anxiety”) and go straight to “Postpartum Anxiety Facts” if you feel this may be a problem for you.
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LET’S TALK ABOUT POSTPARTUM ANXIETY
The Edinburgh screening sheets they would hand me at my postnatal appointments and my daughter’s well-child checks don’t ask if you are dealing with intrusive mental images of things happening to your baby. It doesn’t ask if you’re constantly picturing the worst case scenario. The closest it comes is “I have been anxious or worried for no good reason.” But reading about things like SIDS, or babies who died of positional asphyxiation, or babies killed by neglect, or tragic accidents – I felt like I was anxious and worried for very good reasons. My little daughter was so fragile. The world was huge and had a lot of elements I couldn’t control. What if she got RSV? What if she got measles? What if we were in a car accident and something happened to me? What if- what if- what if…
I made sure to get videos of me playing with her, and me telling her how much I loved her, because I thought about how I wanted her to have something when something happened to me, or how I wanted to remember her giggles when something happened to her. When – not if. I got pictures and videos of my husband with her for the same reason. I considered things like, would I bury her lovey with her, or keep it to remember her? If people called her an angel, I’d smile outwardly, but I’d feel my chest clench and my heart race – I felt like she was too perfect and I shouldn’t be allowed to keep her in my life.
In my previous life, back when I worked in law enforcement, I worked to keep myself sharp by constantly envisioning the worst case scenario – if an inmate tried to shank me, or someone attacked me while I was out on a medical run. I rehearsed scenarios in my head on a daily basis – what I would do if there was a fight in my pod, how I would restrain someone who was actively fighting. It was important to do it in my job. When I quit and became a stay-at-home-mom, the scenarios kept coming, they just changed. What if I dropped my daughter? What if she rolled off the bed? What if she was in the wrong position for just a little too long and asphyxiated? What if I tripped while carrying a heavy object near her and it came crashing down on top of her head?
When she would fall asleep in the swing, I’d tickle the bottom of her foot until she twitched. When she was in the car, I’d reach back and feel for her hand and see if she would curl her fingers around mine. I bought an Owlet when she was two weeks old because I couldn’t sleep – I’d listen for the soft sound of her breathing.
But I could always honestly check the boxes on the Edinburgh scale – yes, I could laugh. No, things weren’t getting on top of me, I was coping with my stuff. I wasn’t crying. I was able to enjoy life. For the most part, depression wasn’t my issue – but anxiety? They didn’t ask me about that.
POSTPARTUM ANXIETY FACTS
If you check Google for “postpartum anxiety,” you know what shows up? Postpartum depression. I will never downplay how incredibly difficult PPD can be – unfortunately, I knew an acquaintance who wound up taking her life due to PPD – but you do not need to have postpartum depression to have postpartum anxiety. While I personally have dealt with some slight depression occurrences, I can identify that it’s due to the anxiety. It’s hard to go through your day with unwanted, intrusive thoughts, and not feel a little depressed.
According to Postpartum.net, up to 10% of postpartum women develop anxiety. I had to put that in bold because that’s amazing to me. TEN PERCENT! You probably know someone who has been dealing with this. It can also show up in up to 6% of pregnant women.
SIGNS AND SYMPTOMS OF POSTPARTUM ANXIETY
What can trigger postpartum anxiety?
- A history of anxiety or depression
- Prior pregnancy loss
- Difficult or traumatic birth experience
- Previous cases of postpartum depression or anxiety
- History of thyroid issues
Like postpartum depression, this can occur any time within the first year of your child’s life.
Postpartum anxiety can manifest itself in various ways.
- Racing heart
- Tightness in chest
- Panic attacks
- Nausea
- Inability to sleep
- Lack of appetite
- Racing or intrusive thoughts
- Worrying about situations (even when you know, rationally, there’s no reason to worry)
- Irritability
- Muscle tension
- Difficulty concentrating
- Forgetfulness
- Avoiding situations
OTHER THINGS TO LOOK OUT FOR
Postpartum anxiety can occur at the same time as other mental health issues. There are a few big ones to watch out for.
- Postpartum depression. Anxiety and depression often go hand-in-hand with each other. Keep an eye out for not wanting to get out of bed or out of the house, feelings of worthlessness, feeling like you’re inadequate, feeling overwhelmed by life, or thinking you’re not a great mom and your child deserves someone else (which is completely false!).
- Postpartum Obsessive Compulsive Disorder. This is actually part of what I’ve been dealing with. This tends to manifest itself as intrusive thoughts, obsessively checking the baby, or compulsions in an attempt to gain some sort of control (cleaning, counting things, etc). This can affect 3-5% of women, but most women don’t want to admit they’ve been dealing with this. Having to admit that you’ve been picturing terrible things that can happen to your child – despite the fact you have no control over it – is embarrassing. But keeping them to yourself can make them worse.
- Postpartum psychosis. If you suspect you or someone you know may suffer from postpartum psychosis get them professional help immediately! It’s characterized by obsessive-compulsive behavior, but it’s extreme. People suffering from it are having a hard time distinguishing between their thoughts and reality. The good news is, it’s very rare – approximately 0.1% of new moms suffer from it. The bad news is, 4% of those suffering with postpartum psychosis will harm their child or themselves. This is why it’s so important to get help!
TREATMENT OPTIONS FOR POSTPARTUM ANXIETY
Here’s the good news – it’s very easy to treat postpartum anxiety. You don’t need to suffer from it.
You can use cognitive behavioral therapy (CBT) with a licensed and qualified therapist in your area. There are medications available, some of which are perfectly safe to use while breastfeeding – and in the event that you need a medication that is not safe to use while breastfeeding, it is more important that your child has a mother who is mentally healthy than breastmilk!
You’re the only person who can determine how bad your anxiety is. If you feel that you would benefit from talking with a professional, please consult one!
UPDATE: TWO YEARS ON
I originally wrote this post before my daughter was a year old, and had planned on doing a separate update post. It’s currently August 2020, and my daughter just turned two.
In many ways, I kept looking forward to her being a year old, because I felt like it was a milestone that would help make things better – and it was. Part of that is because the incidence of SIDS deaths goes down to almost zero at one year. It was one of the “worries” I could cross off my list.
I recognize that my anxiety has morphed from postpartum anxiety to the more general anxiety I have had (without realizing it) for years. I don’t think there is ever a time the anxiety will be completely gone – that’s just part of being a mom.
I am currently pregnant with my second child, and I’m worried about the postpartum anxiety coming back. I’m working on things like a journaling habit and trying to actively focus on my mental health now, in an attempt to be preventative – but I recognize it may not be enough. If that’s the case, or I start to feel any symptoms of PPD, I’m going to seek treatment immediately with a counselor, and if that’s enough, I will get medication. My children’s infancy is a short time and I don’t want to spend it in a state of panic.
Ironically, my baby is going to be born in January – where flu, RSV, and COVID-19 are all concerns – but at this point, I’ve spent so much of the year in a state of anxiety, it’s like my ability to be anxious has burned out. I really have no idea how bad it may be after the baby is born.
For more resources, check out Anxiety Canada, Postpartum.net (here’s their page about postpartum OCD), and Dr. Sarah Allen.
If you’ve been dealing with postpartum anxiety, I offer you a virtual fist bump, because I understand. Please know that your mental health is not a reflection of who you are. You can be a great mother, a great partner, a great employee, and still be dealing with mental health issues. This is nothing to be ashamed of. Please feel free to email me at kate@mamasworkingonit.co or through my Facebook page. I’m happy to talk with you.
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