The District at Tustin Legacy

by Alaura Weaver

Fear and worry are common in the bleary-eyed, sleep-deprived months after giving birth, especially when you’re exhausted and overwhelmed with task of caring for a newborn. These are understandable reactions to a major life change, and most mothers experience them at some point during the newborn phase (or the toddler phase — or the teenage phase, for that matter).

However, if constant fear and obsessive worries begin to consume you, you may be suffering from a lesser-known but surprisingly common maternal mood disorder known as postpartum anxiety (PPA). This simple guide will help you understand the symptoms of PPA and the best ways to help you overcome it.

You Aren’t Alone And It’s More Common Than You Think    

Each year, approximately 6.4 million pregnancies are reported in the US. About 1.3 million pregnant women will experience postpartum anxiety and mood disorders. This makes maternal mood disorders more common than diabetes, for which about 800,000 women are diagnosed annually, and breast cancer, with about 230,000 women diagnosed each year.

A 2013 study of postpartum mood disorders (PPMD) published by the American Academy of Pediatrics revealed that symptoms of postpartum anxiety (PPA) may be more common than postpartum depression (PPD) in first-time, breastfeeding moms. Of the 1,000 mothers who participated, 17 percent were positively screened for anxiety symptoms, while less than half as many reported symptoms of depression. But that was only a study of first-time mothers and women who had live births; women can develop postpartum mood disorders regardless of the outcome of their pregnancies or the number of pregnancies that they’ve had.

How Does Anxiety Work?     

Women’s bodies still carry around the same equipment as their Paleolithic foremothers. Their brains are programmed with a response called “fight or flight” when confronted with a dangerous situation — like when a predator is near — that requires them to be on high alert. The fight-or-flight response mimics the physiological symptoms of anxiety: rapid heartbeat, an “on-edge” feeling, a need to escape or a need to lash out.

This response is controlled by the almond-shaped portion of the brain called the amygdala, which acts as a channel between sensory input and interpretation. The amygdala has been observed by neurologists to play a role in obsessive fears in anxiety disorders. Brain imaging of anxiety sufferers show that the amygdala has increased levels of fear-producing chemicals such as cortisol and norepinephrine, which in healthy brains decreases once a perceived threat is over. However, in a brain with an anxiety disorder, the amygdala doesn’t turn off the fight-or-flight response; it holds onto the memory and continues to flood the body with stress hormones.

Postpartum Anxiety: A New Mom’s Survival Guide

What Causes Postpartum Anxiety?

There’s no single thing that causes postpartum mood disorders, but here are a few contributing factors:

.   Genetic predisposition: Your mother or grandmother may have had PPA but went undiagnosed due to the common belief that new mothers are just naturally anxious.

.   Traumatic birth experience: If your delivery didn’t go as planned, or you or your baby had medical complications, you can be scarred emotionally as well as physically. Post Traumatic Stress Disorder and postpartum anxiety share many symptoms.

.   Hormonal imbalance: The rush of hormones as your post-pregnancy body adjusts itself can adversely effect the regulation of your emotions and thoughts. Most women can expect to experience the “baby blues” for a few days after the birth of their babies as their brains release high levels of oxytocin and prolactin and decrease progesterone levels. If the extreme emotions continue to overwhelm you for over two weeks, however, it’s most likely due to a PPMD.

.   Sleep deprivation: Chances are, unless your child is a “great sleeper,” you are getting about two to three hours of sleep at a time during the first three months of your baby’s life. You need at least five hours of uninterrupted sleep a night to give your brain and body the optimal amount of rest. Anything less than that can contribute to feelings of anxiety.

.   Unrealistic social expectations: You’re probably feeling that you’re far from the mythical “perfect mom,” or may be ashamed to admit that you have ambiguous feelings about your baby. Despite the popular maternal love narrative, not every mother immediately falls in love with her child the first moment she sets eyes on him or her,  nor does she have to love every moment of being around her baby.

.   Difficulty shifting into a new role and identity: If you’ve never had a child before, your new identity as a mother can be disorienting. The act of parenting a newborn demands that you set aside a part of your old, independent identity to make room for a new one that revolves around the well-being of your child. This shift can make you feel like you’ve lost touch with who you were and who you want to be, especially when it’s hard to get time to yourself.

.   Undiagnosed generalized anxiety disorder: You may have had problems with anxiety prior to having a child, but you didn’t realize the extent of the issue until the symptoms interfered with your ability to cope with being a caregiver.

What Are The Symptoms of Postpartum Anxiety?

Anxiety can be experienced in the body, in the mind and through certain behaviors. There are many symptoms, and you may be experiencing a drastically different combination of them than other mothers with PPA. Common physical symptoms of postpartum anxiety include:

  • Increased heart rate
  • Shallow breathing
  • Upset stomach
  • Tightness in throat or chest
  • Insomnia
  • Decreased sex drive
  • Decreased appetite
  • Tightness in muscles (back, neck and jaw pain)
  • Dizziness
  • Feeling “jittery” or “wired”
  • Panic attacks

Common mental and emotional symptoms (or common thoughts that occur) associated with postpartum anxiety include:

  • Imagining worst-case scenarios
  • Racing thoughts
  • Inability to concentrate
  • Ruminating (letting problems eat at you instead of thinking about a solution)
  • Negative self-talk
  • Intrusive thoughts and worries
  • A sense of dread
  • Tearfulness
  • Obsessive thoughts
  • Worrying about the future
  • Irritability
  • Restlessness or a feeling of being trapped
  • Mood swings

Common behavioral patterns exhibited by sufferers of postpartum anxiety include:

  • Obsessively checking on things or repeating simple actions
  • Over-controlling care of the baby or other household responsibilities
  • Lack of self care
  • No longer pursuing things previously enjoyed
  • Avoiding going to certain places
  • Avoiding certain people
  • Avoiding certain activities or objects
  • Withdrawing socially
  • Being extraordinarily careful for fear of danger
  • Self-harming behaviors
  • In need of constant reassurance
  • Refusing to seek help for fear of being judged an unfit parent

What Can You Do To Overcome Postpartum Anxiety?

You’re already taking the first step to overcoming PPA by learning more about it. Taking a moment to recognize that you may be suffering from a maternal mood disorder and knowing that there are resources available to get you the help you need is a tremendous turning point.

The next step will be to reach out to someone for help. Your women’s health provider or family doctor should be able to give you referrals to professionals who specialize in maternal mood disorders. You might also want to look into the support groups in your area and social media discussion groups. Knowing that you aren’t alone and hearing other women’s stories of struggling with PPA can be comforting and therapeutic.

Just as the symptoms of postpartum anxiety come in many forms, treatment varies depending on your needs. It may take a while to find the best course of action because treatment of mood disorders isn’t one-size-fits-all. Based on your background and symptoms, a mental health professional may recommend talk therapy or medication or a combination of both. If you are reluctant to take medication because you’re breastfeeding, let your doctor know; there are several anti-anxiety medications that are compatible with nursing mothers.

One of the most important things you can do to reduce anxiety is to care for yourself. Self care isn’t just about getting away from the baby for a few minutes to grab a shower or put on some makeup; it’s about caring for your self — getting in touch with the woman you believed yourself to be and had confidence in before you had your baby. Self care can be making an agreement with your partner to have at least an hour every day when you can leave the house and go somewhere by yourself. Self care can be going to the gym or going for a walk, not only to get exercise but also to clear your head. Self care can be giving yourself a project that has nothing to do with being a mother, so you can say “Not only am I a mom, but I also …”

Not only are you a mom, but you’re also a survivor. Postpartum anxiety is a dark and confusing disorder that adds turmoil to the major transition you’re experiencing as a new mom. Fortunately, there’s light at the end of this tunnel; you’ll come out a stronger mother and woman when you emerge from it.