By: Lori E. Borg PhD, RN
The postpartum period plays an important role in both the short-term and long-term physical and mental health of the woman and her newborn. The postpartum period begins after the delivery of the baby and usually lasts for about 6-8 weeks. It is well understood that many new mothers suffer from postpartum depression. Postpartum anxiety, however, is less studied and often underdiagnosed by clinicians. Studies reveal that about 15-20% of woman suffer from postpartum anxiety compared to about 12.5% of women with postpartum depression. Untreated postpartum anxiety is associated with reduced maternal confidence and delayed mental development in children. New moms are often given educational material regarding postpartum depression or the “baby blues”, but most are given no guidance as to postpartum anxiety symptoms and treatment recommendations.
Postpartum anxiety may manifest as excessive worrying or panic after childbirth. New mom’s with postpartum anxiety may experience some of the following symptoms:
· Extreme worry that feels like it will never stop
· Racing thoughts
· Inability to fall asleep or stay asleep
· A feeling of impending doom for yourself or your baby
· Feeling constantly overwhelmed/stressed about being a good parent
· Difficulty focusing or forgetfulness
· Increases in heart rate and breathing; panic attacks
· Agitation and/or restlessness
· Nausea
· Muscle tension
· Loss of appetite
Postpartum anxiety may start right after birth or several months later. Anxiety may also start during pregnancy and continue into the postpartum period. There are many factors that contribute to postpartum anxiety including shifts in hormones after delivery, increased stressors, and a personal/family history of anxiety and depression. Postpartum anxiety symptoms persist for different lengths of time in different individuals and require treatment.
Treatment can be effective for postpartum anxiety. Cognitive behavioral therapy (CBT) has been shown to be an excellent treatment for anxiety disorders. Some women may require medications along with therapy. Selective serotonin reuptake inhibitors (SSRIs) are typically first-line medications. Women should discuss the risks/benefits of taking any medication while breastfeeding. Other potentially helpful strategies include support groups with other new mothers, increased exercise, and maximizing sleep. New mothers should be educated about postpartum anxiety symptoms and advised to reach out for help when needed.
References
Centers for Disease Control and Prevention, Depression During and After Pregnancy,
Cleveland Clinic, Postpartum Anxiety Opens a new window, April 2022.
Harvard Health Publishing, Harvard Medical School, Postpartum Anxiety Is Invisible, but Common and Treatable Opens a new window, July 2021.
Nakić Radoš, S. (2018). Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression. Acta Clinica Croatica, 57(1), 39–51. https://doi.org/10.20471/acc.2018.57.01.05
Zappas, M. P., Becker, K., & Walton-Moss, B. (2021). Postpartum Anxiety. The Journal for Nurse Practitioners, 17(1), 60–64. https://doi.org/10.1016/j.nurpra.2020.08.017
Van Der Zee-van Den Berg, A. I., Boere-Boonekamp, M. M., Groothuis-Oudshoorn, C. G. M., & Reijneveld, S. A. (2021). Postpartum depression and anxiety: A community-based study on risk factors before, during and after pregnancy. Journal of Affective Disorders, 286, 158–165. https://doi.org/10.1016/j.jad.2021.02.062
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