What is Postpartum Anxiety?
After giving birth to her second child, Stacy* felt overjoyed at first. Adding a daughter to a family which already included her three-year-old son completed her family of four. Plus, she found handling an infant easier the second time around as she was equipped with experience and knowledge. But a few weeks later she found herself crippled with anxiety. “It started when I was driving to the pediatrician’s office,” says Stacy. “All of a sudden, I felt this overwhelming feeling of dread and I had to pull off the road. I didn’t feel safe.” Eventually, Stacy was able to drive home that day but she had a hard time forgetting that feeling.
She worried constantly about her daughter’s well being, often checking on her several times throughout the night to make sure she was still breathing.
Driving became an issue as she ruminated about getting into a car accident with or without her children in the car. She rarely felt safe outside her house. “I knew something was not right- I didn’t feel like myself at all,” says Stacy. “But everyone commented on how well I was doing managing the two kids and I didn’t feel depressed -I loved being with the baby so I was confused and all that made it hard to connect the dots.
“ Although it does not have its own official diagnosis, according to Postpartum Support International, about 11 percent of new moms experience postpartum anxiety similar to the way Stacy did.
Despite it’s prevalence, postpartum anxiety often goes undiagnosed.
“Many women don’t recognize postpartum anxiety symptoms because they are not feeling that stereotypical depression and detachment from their child that most people associate with postpartum depression” explains Amy Grimaldi a clinician with Lotus Psychotherapy in Darien, CT. “ As a result, it can take them a lot longer to seek help.” Though some anxiety is adaptive and serves to protect us and our offspring from danger, postpartum anxiety becomes an issue when that anxiety peaks to a level that interferes with functioning. Symptoms such as hyper-vigalance, (a state of constantly being on the look-out for danger), obsessive thoughts, always fearing the “worst,” panic (feelings of unexplained dread), can make it hard to complete the tasks of everyday life. Further, many women also experience both anxiety and depression during the postpartum period.
Similar to postpartum depression, postpartum anxiety stems from both biological and psychosocial origins. Hormonal changes like a sudden and drastic drop in progesterone and estrogen after delivery play a big role in the development of postpartum mood disorders as does the lack of sleep which inevitably accompanies life with a newborn. The role transition to parenthood can be overwhelming for a first time mom and even women who have other children can feel inundated with the changes brought on by a new family member. Women with a history of bipolar disorder, obsessive compulsive disorder and anxiety disorders may also be more vulnerable to developing postpartum anxiety. Previous losses and traumas, especially those that happened in during a prior pregnancy, can also impact this. “Many times the trauma is not processed immediately but is stored somatically in the body,” states Amy Gustavson, a psychotherapist with Emotional Equity Consulting in New York. “So when a woman gives birth and is in a vulnerable state, she may feel flooded with the feelings of the past trauma, especially if that trauma had something to do with a pregnancy like a miscarriage or still birth.” In addition to medication, psychotherapy effectively treats postpartum anxiety by helping to establish new coping skills when old ones are no longer operable. Modalities such as Cognitive Behavioral Therapy (CBT) reduce negative thoughts which feed anxiety, Dialectical Behavior Therapy (DBT) increases mindfulness and reduces stress, and Psychodynamic based therapy provides insight into changing family roles and expectations. Finally, after months of struggling, Stacy decided to confide in her physician about how she was feeling. He prescribed her an anti-depressant and she began seeing a therapist who helped her to develop skills to alleviate her anxiety. A few months later, Stacy began to feel like herself again. “It took me a long time to ask for help, to admit that something was really wrong,” says Stacy.
Written by Jen Baumgold, a Postpartum Project Therapist