An estimated 13% of pregnant women and new moms experience some form of anxiety. Keep in mind, prenatal and postpartum anxiety are likely underreported as are many other mental health disorders.
Despite its prevalence, postpartum anxiety is not officially recognized by the American Psychiatric Associations diagnostic manual. Instead, it is considered a subcategory of perinatal mood disorders. Both postpartum depression and postpartum psychosis are classified as separate disorders, however, anxiety is rather listed as a symptom.
Women with depression, anxiety and/or post-traumatic stress disorder prior to or during pregnancy are at an increased risk for experiencing postpartum psychiatric disorders.
Normal Worry or Anxiety?
The process of trying to conceive and fear of miscarriage, particularly if you have experienced a previous loss, can cause or exacerbate pre-existing anxiety. Couple that with hormonal fluctuations and being inundated with advice from seemingly everyone you encounter, it’s surprising anxiety during pregnancy is not more prevalent.
It is natural to worry during pregnancy and in the postpartum period that follows, but postpartum anxiety is much more intense and persistent than typical new parent concerns. But, how can you tell the difference?
Normal worry tends to dissipate after the problem has been solved. For example, nursing mothers may worry whether their child is getting enough milk. When evidence proves healthy weight gain consistent with sufficient feeding, that worry resolves. With anxiety, the thought will persist regardless of evidence to the contrary.
Signs of Prenatal and Postpartum Anxiety
Like generalized anxiety, anxiety during pregnancy and the postpartum period may present differently for each individual. There are three core areas to be aware of:
-
Body: Anxiety may present itself as physical symptoms such as increased heart rate, upset stomach, tightness in the chest or throat, shallow breathing, loss of appetite, and difficulty falling or staying asleep.
-
Mind: You may find yourself imaging the worst-case scenario or experience racing thoughts about your future. These thoughts are obsessive in nature with logical thought offering little to no relief.
-
Actions and Behaviors: Anxiety during pregnancy or in the weeks or months that follow may cause you to avoid certain situations, activities, places or people as a way of feeling in control. You may also seek constant reassurance from others, check things repeatedly, and are overly cautious and vigilant of danger.
Other possible signs include irritability, muscle tension, difficulty concentrating and forgetfulness.
Available Treatment Options
Untreated perinatal mental health conditions such as anxiety are linked to adverse consequences for both mother and child, making effective and timely treatment important. Medication is a safe and appropriate option for many pregnant or nursing mothers, and the decision should be made with a perinatal psychiatrist rather than avoided because of pregnancy or breastfeeding alone. Other treatment options include:
-
Cognitive behavior therapy aims to identify negative thoughts, assess whether they are an accurate depiction of reality, and employ strategies to challenge and overcome the ones that are not.
-
Nutritional supplements Some early research suggests omega-3 fatty acids and riboflavin (vitamin B-2) may help with anxiety in pregnancy and postpartum. Check with your clinician before starting any supplement, especially if you take psychiatric medication, are pregnant or breastfeeding.
-
Mind-body practices such as meditation, yoga, massage or acupuncture can help manage anxiety.
-
Lifestyle changes may include increased exercise, dietary changes or less screen time.
When to Seek Treatment
It’s important to know that everyone experiences anxiety different. If you are experiencing even a few of these symptoms, it is important to reach out for help. Expectant and new moms need time for self-care, sleep, exercise and if needed, therapy.
Postpartum psychosis (sudden confusion, hallucinations, paranoia, severe agitation or thoughts of harming yourself or your baby) is a medical emergency: call 911 or go to the nearest emergency room right away. If you are having thoughts of suicide or are in danger, call or text 988 or call 911 now.
Dr. Beata Lewis, MD and the Mind Body Seven team specialize in women’s health and can work with you to create an individualized treatment plan based on your needs. If you do not have anyone who can stay with your baby at home, you are welcome to bring your baby with you to a session. Contact us via the web or call (212) 621-7770.
