Postpartum anxiety: How to spot the symptoms and what to do next

Having a baby is a huge life change, so it’s normal to feel excited, anxious, and overwhelmed all at once. Newborns require round-the-clock care and don’t come with a handbook, so the first few weeks after birth can be a worrisome time. Add shifting hormones and broken sleep into the mix, and taking care of a new baby can get pretty stressful. 

These first weeks after you’ve given birth are called the postpartum period. There’s currently some discussion about how long the postpartum period should be defined. It’s often considered to be the first six to eight weeks after you’ve given birth. However, pregnancy and birth can impact everyone’s bodies differently. This is why the American College of Obstetricians and Gynecologists considers the postpartum period to extend up to 12 weeks after birth. You might have heard this time referred to as the fourth trimester.

During this time, you might feel anxious about everything from your baby’s health to your parenting skills and how to navigate this challenging new role. These panicked feelings should ease off once you get oriented. However, if your fears get worse, keep you awake at night, or start to interfere with everyday life with your baby, it could be postpartum anxiety.

If this sounds familiar, try not to be too hard on yourself. It’s normal to worry when you’re a new mom, and many parents feel the same. The hardest step is asking for help, but don’t suffer in silence. Your doctor has experience helping new moms, and with the right care and attention, you can get better quickly and start to enjoy this precious time with your baby. 

To understand a little bit more about what causes your anxiety so you can learn to manage it, we asked psychologist Kelly Vincent, Movement Therapy Spaces, California, US, to talk us through what postpartum anxiety really is, what might cause it, and what you can do to ease your fears. Flo member Maria,* 38, from London, also shares her experience of postpartum anxiety — and what helped.

*Name changed

Key takeaways

• As many as one in five new moms experience mental health problems such as anxiety.
• Anxious feelings can strike during pregnancy or anytime in the first year after childbirth.
• Postpartum anxiety is not the same as postpartum depression, although symptoms do overlap.
• Treatments are available, and simple lifestyle changes can help.

What is postpartum anxiety?

Postpartum depression is well documented, but it’s a little-known fact that postpartum anxiety also affects as many as one in five new parents. “Postpartum anxiety is a common condition that affects many new mothers, and it is different from the baby blues that many women experience in the first few weeks after giving birth,” explains Vincent. 

Anxiety is a normal human emotion that everyone experiences at some point. In fact, it’s a healthy response to danger and can help to keep you safe. However, problems arise if anxiety kicks in when no real threat exists. 

Are you terrified that something bad might happen to your new baby while they sleep in their crib? Or are you constantly fretting about their safety when someone else is looking after them? These could be signs of postpartum anxiety. Of course, it’s normal to worry to some degree. But living in a constant state of high alert can take its toll on your health. 

Maria experienced this after the birth of her little boy. She says: “I didn’t want to go out because I was worried something would happen to him, so I started to withdraw from seeing people or even going to the shops. Then I stopped sleeping because I was worried the house would catch fire while I was asleep. In the end, I was filled with panic the whole time.” 

Vincent explains that feeling like this can have a major impact on your life. “Postpartum anxiety can make it difficult to care for yourself and your baby, and it can also interfere with your ability to enjoy motherhood,” she says. If this sounds familiar, then don’t be afraid to ask for help. “It’s important to recognize the symptoms of postpartum anxiety and seek help if you are experiencing them,” Vincent adds.

Maria’s midwife, partner, and mom encouraged her to go to the doctor. “I explained how I was feeling, and the doctor was so helpful,” she says. “They talked me through my options, including therapy and medication, and explained that postpartum anxiety is really common, especially if you’ve been diagnosed with anxiety before. I immediately felt less alone.”

What are the symptoms of postpartum anxiety?

When you become a parent, worry comes with the territory. It’s normal to worry about what they eat, how often they sleep, if they’re hitting all the developmental milestones, and how to keep them safe from harm. 

However, if your anxious thoughts never seem to stop, you can’t trust your spouse or another family member to co-parent, or you’re scared to sleep in case something bad happens, you may have postpartum anxiety.

According to Vincent, common symptoms of postpartum anxiety include:

• Excessive worrying or fear about your baby’s health and safety
• Racing thoughts that are difficult to control
• Trouble sleeping even when your baby is asleep
• Dread or fear about what could happen

Some people also experience physical symptoms of postpartum anxiety, such as:

• Heart palpitations
• A feeling of being constantly on edge or irritable
• Panic attacks
• Sudden and intense fear or discomfort that can include symptoms such as chest pain, shortness of breath, or dizziness

Having intrusive thoughts, such as constantly imagining the worst-case scenario, is another common symptom of postpartum anxiety. “These thoughts can often be extremely unsettling and, at times, disturbing,” says Vincent. “Please know they can be normal; however, please consult with a licensed provider to get support, as this can be a very difficult thing to experience on your own.”  

What causes postpartum anxiety?

It’s not always clear why some new moms seem to cruise through the postpartum period while others find it extra challenging. “It’s important to note that postpartum anxiety can affect any new mother, regardless of her background or circumstances, so seek help if you are experiencing symptoms,” says Vincent. “It is so key to get support and/or treatment as soon as you realize what it is you are experiencing.” 

There is no single cause of postpartum anxiety, but a number of factors can increase your chances of experiencing it:

• Hormonal changes after childbirth
• Broken sleep
• Increased responsibility for caring for a newborn
• Previous pregnancy loss or loss of a child
• Having a premature baby or baby with health issues
• Having a difficult or traumatic birth experience
• Societal pressure to be a perfect mom

Other potential risk factors

Other postpartum anxiety risk factors can include:

• A personal or family history of anxiety, depression, or mental health conditions
• A history of eating disorders
• The stress of caring for multiple children or aging family members
• Not having a supportive partner
• A lack of social support
• Financial stress

Postpartum depression and anxiety: What’s the difference? 

You’ve probably heard about baby blues – a short period of roughly two to three weeks just after childbirth when new moms experience a dip in mood, crying spells, and anxiety, or the more serious condition known as postpartum depression. “While postpartum anxiety and postpartum depression share some symptoms, they are different struggles,” says Vincent. 

“Postpartum depression is a mood disorder that can cause feelings of sadness, hopelessness, and a loss of interest in activities you used to enjoy,” she explains. “In contrast, postpartum anxiety is characterized by excessive worry, fear, and physical symptoms such as heart palpitations or sweating. While both conditions are serious and require treatment, they can have different impacts on your daily life.” 

It’s also worth noting that you can have postpartum anxiety and depression at the same time. “If you are experiencing symptoms of either condition, it’s important to talk to your health care provider,” advises Vincent. They’ll be able to give you the support and treatment you need.

Treatment options for postpartum anxiety

Postpartum anxiety can make caring for your newborn baby harder than it needs to be, so don’t be afraid to ask for help. There are a number of treatments available, and you are not alone. Talk to your doctor about the following options:

Talk therapy

Your doctor will likely refer you to a mental health professional who has experience treating new moms. Mild to moderate postpartum anxiety is often treated with cognitive behavioral therapy, a talk therapy that can help you manage your problems by changing the way you think and behave. Your doctor may also suggest solo or group counseling sessions and mindfulness practices.

Medication

If postpartum anxiety starts to interfere with your everyday life, medication may be an option. Selective serotonin reuptake inhibitors (SSRIs) are often the first-line drug treatment for anxiety disorders. Research over the last several years has resulted in some reassuring data about most psychiatric medications, including that SSRIs are compatible with breastfeeding. Talk to your doctor about the risks and benefits of using SSRIs.

Maria started taking an SSRI. She says: “Once I’d been on the medication for a few weeks, I felt so much better. I began to live in the moment more, and although I was still not sleeping great (I had a newborn, after all!), I was able to switch off my brain and fall asleep easier. Soon, I was enjoying being his mom rather than worrying about him all of the time.”

Caring for your mental health at home

There are several steps you can take at home to help with postpartum anxiety:

Get enough sleep

“Lack of sleep can worsen anxiety symptoms,” says Vincent. “Ensure you get enough sleep by taking naps when possible and delegating some responsibilities to others. This, of course, is very hard with a newborn or infant. Something that can be helpful is becoming more aware of when you are hitting that breaking point in regard to sleep deprivation. When you get closer to this point, it is critical to seek ways to support yourself either through your partner, family members, or friends.” 

Exercise regularly

“Exercise is a natural mood booster and helps to reduce anxiety,” says Vincent. “Even a 10 to 15 minute walk can help alleviate symptoms. Next time you are at one of the many doctor appointments, take the long way to get a few extra steps in or perhaps the stairs if you use a baby carrier. These little moments of movement add up and can help a lot. Getting outside in the sunshine can be extremely helpful as well.” 

Eat a healthy diet

“Eating a balanced diet can help regulate mood and reduce anxiety,” says Vincent. “Avoid processed foods and focus on whole foods such as fruits, vegetables, and lean proteins. Of course, simply eating can be hard for a new mom. If you have family or a partner to help support you with fueling your body with the proper nutrition, that is highly recommended. Also, it can be supportive to your body to have handy, healthy snacks that you can grab easily. Convenience is key, like string cheese, turkey sticks, almonds, or popcorn.” Also, consider limiting your alcohol intake. This can be helpful as, while having a drink can temporarily muffle anxiety by inducing a relaxed state, in the long run, alcohol can worsen anxiety.

Practice relaxation techniques

“Relaxation techniques such as deep breathing, meditation, or yoga can help reduce symptoms of anxiety,” says Vincent. “This, of course, is hard to do when you are on an endless cycle of changing, feeding, burping, and diapering. Even if you close your eyes for a few moments when feeding your baby and just breathe, this can be helpful to calm your nervous system. Even the small mindful moments can be really impactful.” 

Seek support

“Surround yourself with a supportive network of family and friends who can help you through this time,” says Vincent. “You can also join a support group for new mothers to connect with others who are going through similar experiences. When you surround yourself with other moms who are going through something similar, it can be a powerful way to feel seen and heard.” 

Maria found that meeting other women with babies made a massive difference. “I googled local moms groups and asked other parents I saw in coffee shops around the area if they knew of any classes or groups I could join,” she explains. “They told me about a local mom’s group on WhatsApp. I joined and went along to one of their meetups. I now have some great friends with similar-aged children who I chat with regularly. We all support each other.”

What to do if you think you have postpartum anxiety

New moms often put their baby’s needs before their own. But left untreated, postpartum anxiety can quickly snowball and may even make caring for your new baby harder than it needs to be. If anxiety is taking over your life, there are a couple of steps you can take:

Reach out to a trusted friend: When you’re struggling, the first instinct is often to retreat inward and isolate yourself. If you’re feeling down, you might find yourself withdrawing from friends and family. “Tell someone. Tell your partner, a close friend, another mom, or a family member. Seek support from people who feel safe,” says Vincent.

Call your doctor: Parenting is hard at the best of times. If you’re feeling down or you’re concerned about postpartum anxiety, always speak to your doctor. “The next step could be telling your primary care provider or obstetrician and gynecologist, who can then give you referrals to a maternal mental health specialist,” says Vincent. “When postpartum anxiety goes untreated, it becomes a more exasperated experience. If you’ve always struggled with anxiety, getting support is even more critical. You deserve support!” 

If you’ve been affected by any of the symptoms in this piece or are struggling with your mental health and would like to speak to someone, Flo has gathered links to support services that might be helpful. Please visit this page for helplines in different countries.