Understanding Postpartum Anxiety 

Postpartum anxiety is confusing - it can be hard to distinguish from regular new mom worry. What we look for is severity - has worry completely taken over? Are you unable to relax and enjoy your baby? Are you unable to rest at all? Are you having trouble turning off your brain? Are you worrying about everything? Is it difficult to focus on one thing?  Do you have nervous energy? Do you have a relentless to-do list? Are you ‘present’ but really in your head the whole time? Are you having sleep difficulties due to excessive thoughts? Is your appetite non-existent? Did you quickly lose your pregnancy weight? Do you have perfectionist traits? Are you focused on trying to do everything 'right' (when there is no right way to care for a new baby)? Are family members constantly telling you to just relax or calm down but you can’t?

Postpartum anxiety is experienced by approximately 10 percent of new moms. It can be related to having a history of anxiety before or during pregnancy, or from birth trauma or a newborn health concern. It can be impacted by higher levels of cortisol (the stress hormone), which are present during pregnancy and early postpartum. Postpartum anxiety can be challenging to identify – it often gets grouped under the more commonly known postpartum depression, but is its own maternal mental health concern. It is a common concern in SF - I see more moms with postpartum anxiety in my practice than postpartum depression. One of the biggest regrets I hear from moms with postpartum anxiety is they feel they wasted their maternity leave worrying and constantly doing, rather than just slowing down and being with their baby and enjoying this special time. 

It is not always easy to tell others that you are having scary thoughts or excessive amounts of worry. Please know there is much strength in being open with others about feeling this way. If any of this describes your experience, please reach out for support to help manage these thoughts and stabilize your mood.

I’m glad to see that postpartum anxiety has received more media coverage in the past year. Below are links to some helpful articles.

Postpartum Anxiety Is a Thing—Here’s What to Watch Out For
https://greatist.com/live/postpartum-anxiety-symptoms-and-treatments

This is What It's Like to Have Postpartum Anxiety
https://www.scarymommy.com/postpartum-anxiety-exhaustion/

Postpartum Anxiety Affects 1 in 10 Moms
https://www.vogue.com/article/postpartum-anxiety-vogue-april-2018

The Lonely Terror of Postpartum Anxiety
https://www.thecut.com/2017/08/the-lonely-terror-of-postpartum-anxiety.html

Lonesome Motherhood

How do you find your mom tribe?

The loneliness of parenting an infant takes many new moms by surprise. You may wonder where you fit in now - your main group of friends may have older children, or be childless. It can be hard to connect and feel you are contributing socially with these friends  – you may worry you don’t have much to say since you don’t do much on maternity leave outside of caretaking an infant. There will be days when you don’t talk to any adults all day. This is where many women really feel like they lost their previous identity – the isolation and reduction in social interaction can really impact mood.

Parenting a newborn can feel isolating. As soon as your partner leaves for work, you’re looking at a full day with a blank slate with a baby. Then comes the complex anxiety feelings around staying in or attempting to go out. The challenges of getting out of the house with a baby plus all the baby gear seem insurmountable, so of course, staying home seems most appealing.

It’s essential that new moms find the strength within oneself to do the opposite action and find some source of connection. Joining mommy and me or breastfeeding support groups can help reduce isolation. It’s ok to be late to these meetings. It’s ok to be a mess. It’s ok to cry there. It’s also ok if you don’t particularly like or connect with any of the moms; the social exposure for you and your baby is key. Some moms find wonderful support online through mothers’ groups and parenthood apps. This is a great way to feel understood by others, ask questions, and, most of all, laugh from reading and posting funny things about a mother’s day that others totally get.

Choose whatever path feels right to help you connect to others going through motherhood at your child’s stage. It can be so rewarding. I still remember the anxiety I felt going to the first mommy and me group. I teared up, and almost went home. Then I looked at my baby and thought, we got this. Some of those women still support me today, two years into motherhood. Find your tribe.  

Here are a couple of related articles:

The Loneliness of Motherhood

The Facebook Moms

Coming into Motherhood after Infertility

How to let go of one's infertility identity? 

Many women report not knowing how to accept a pregnancy, or to transition from years of living in the uncertainty of infertility and longing for a child, to becoming a mom. During pregnancy, there are often two paths:  feeling ambivalent or detached from the pregnancy, or feeling overwhelmed by anxiety of something going wrong.

Post-birth, many women are thrilled to become a mom, but complex feelings may arise. How wonderful to finally be part of the motherhood club, yet familiarity with the previous infertility identity and associated thoughts, feelings and behaviors makes it difficult to leave that way of being behind. Some experience loss of support from moving onto a different path from friends whom they bonded with during infertility treatment. Others may have a difficult postpartum experience, which can heighten feelings of guilt and maternal ambivalence.

It can be challenging when partners and family quickly accept this identity change, and forget about the complex emotions of the previous fertility journey. Yet, for someone who has gone through this journey, infertility may always be a part of them. It’s hard let go of something painful that has defined you for so long. Thoughts of the long TTC journey may resurface during the first few years of parenting. That's part of the healing. It is only with time that you can integrate the previous parts of your identity into new ways of being, and become more confident in the new mother role. 

Resolve has some great resources to help with this transition.

https://resolve.org/support/pregnancy-after-infertility/
 

Postpartum Wellness

Let’s focus on maternal mental health. There is much post-birth emphasis on newborn health, but a new mom’s own health is also a priority. Postpartum mood changes affect both biological and adoptive moms. You have to be able to take care of yourself in order to take care of a newborn.

It can be helpful to talk about what you are experiencing as a new mom.

How are you feeling emotionally? Physically?
Is your body healing from the birth?
Are you sleeping? How is your appetite? Are you getting outside?
Who helps at night when the baby wakes?
Are you having any breastfeeding, supply or latch difficulties?
How is your mood? Are you sad or tearful? Are you irritable or angry? Detached and numb?
Are you anxious? What are your worries? Are any of your thoughts scaring you?
How do you feel about your connection to your baby?
Your connection to your partner?
What worries you the most about the way you feel? Does your partner know how you’re feeling? Is there anything you’re holding back from telling others?
How are you taking care of yourself?
Who can you turn to for support?

Many women experience difficulties adjusting to new motherhood. It makes sense; you've never been a new mom caring for a newborn or infant before. New motherhood is filled with transitions, some expected, but also many, many surprises. And cumulative sleep deprivation can wreck havoc. Often moms report that something feels off, but they may not know how to express what they are feeling or worry they may be judged so stay silent.

How can you take care of yourself? Learn about postpartum mood changes and check in with yourself. Ideally during postpartum and pediatric checkups, you will spend some time focusing on your health as a new mom. If not, find friends, family members or a mental health professional who will check in with you. If you’re not feeling like yourself, tell someone. Remember, it’s essential to put on your own oxygen mask first.