Postpartum Anxiety

When I became a first-time mother almost 8 years ago, I was a mess, but I chalked that up to a really difficult, traumatic birth experience that was pretty much the opposite of the beatific ideal that I’d naively been expecting. I was exhausted emotionally from worry after our child spent a week in the NICU, recovering physically from an emergency c-section under full anesthesia, had a fussy infant who didn’t sleep all that well, and the hormones, challenges of breastfeeding, and new dynamic with my husband were also contributing factors.

I tried to acknowledge all these things and address them when I could, but as the months wore on, what stayed with me was a constant anxiety. I had irrational fears about my health, the baby’s health, and our safety – especially when I was alone with her. My husband was working several nights a week at the time, and I would call him crying and beg him to come home because I simply couldn’t manage my fears.

I should have sought help, but I think I expected my healthcare providers to know if something was wrong with me. I didn’t answer their postpartum depression questions in a worrisome way, but for me, they were asking the wrong questions. Postpartum depression (PPD) is a serious problem that affects around 1 in 10 women. Doctors, nurses, midwives and doulas are much better about recognizing it and helping women deal with it than they were even 10 years ago. Postpartum anxiety (PPA), however, is not as well known and can be misdiagnosed or missed altogether.

According to the group Postpartum Support International,  “Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression. The symptoms of anxiety during pregnancy or postpartum might include:

• Constant worry
• Feeling that something bad is going to happen
• Racing thoughts
• Disturbances of sleep and appetite
• Inability to sit still
• Physical symptoms like dizziness, hot flashes, and nausea.”

It’s something that healthcare providers need to be better educated about, and something that new mothers need to know is a possibility so they can ask for help if they need it. I talked to a friend recently who shared her experiences with PPA with me. Her story illustrates how easily a healthcare provider can miss PPA:

“I only realized I had PPA after I was better, when I learned that such a thing existed and realized it matched what I had gone through. Before that, I had heard of postpartum depression, but it didn’t feel like what I was experiencing, and so I didn’t even consider the possibility that I was dealing with a different sort of postpartum mood issue. My symptoms were much more anxiety-based: panic attacks, irrational obsession over things like the baby’s sleeping and eating routines, inability to sleep even when exhausted. I was weepy sometimes, especially after several months (I was so tired!) but in general I was anxious and wired, not depressed.

“I started having trouble breastfeeding after about four months and saw a nurse practitioner. She found no physical issues and referred me to a social worker, who talked with me once and didn’t say much of anything. She never mentioned postpartum depression or anxiety. By then I was starting to suspect it, but since she didn’t bring it up I was left confused and wondering what was wrong with me.

“I ended up taking myself to an acupuncturist, who I saw regularly for a few months. I got a lot of relief from acupuncture – it was very calming, and I felt more like myself. Then my family moved and I no longer had access to those treatments, so I ended up asking my new GP for help. She prescribed Zoloft, which was also helpful, and I took it on and off for the next couple of years.
Advertisement“I was (and still am) appalled at the lack of clear communication and follow up from healthcare providers. New mothers should be routinely screened for PPD and PPA, not told to ‘try and relax’ when they present with symptoms that are possibly related to their mental health.”

Kristin Shaw is a local blogger who also experienced PPA. She had better luck getting it diagnosed than me and my friend did, but only because one of her oldest friends spotted the change in her. She wrote a blog post about that experience on her blog, Two Cannoli.

It’s my hope that more friends monitor their mom friends who seem a little more than overwhelmed; more OB/GYNs, midwives, GPs, therapists, and other healthcare providers learn about PPA and look for the signs of it in moms they treat; and new moms know that while parenthood brings forth a whole host of new worries, those shouldn’t be constant and disabling. If they are, moms need to know where to turn.

Googling “postpartum anxiety” can give you loads of information, and doing the same for “Austin postpartum resources” can hook up a mom with therapists, doctors, doulas, and others who specialize in this area. Kristin recommends Postpartum Progress as a “fabulous resource.” I really liked this article on PPA and PPD by Katherine Stone, the founder and editor of the website.

If you suspect you have PPA, please seek help as soon as possible. For me, I ended up going to several birth-healing group therapy sessions with Carrie Contey, a fantastic local parenting expert, when my child was about a year old. It was huge for me to share and release all those regrets, disappointments, and flashbacks about my difficult birthing experience, and it definitely helped. In retrospect, though, I needed to do more to treat the anxiety that remained because it continued to color my relationship with my child, and does to this day, although now I actively work on recognizing and defusing those triggers when they come up.

The friend who told her story at the beginning of this post is now studying acupuncture and Chinese medicine. She eloquently addressed the long-term effects of undiagnosed PPA:

“The first several months of my daughter’s life were much more anxiety than joy, and I often dreaded being alone with her. That gradually eased as I got better, but it left an echo that has taken a long time to fully go away. Long-term, it is one of the reasons I didn’t try to have a second child. My experience was one factor in my decision to go back to school in a healthcare profession – I hope to work with new mothers and help them get better care than I did.”

I’d welcome others to share their stories in the Comments section, help spread the word about PPA by sharing this post or others about the subject, or writing about it in your own blog.

This is us these days, much more relaxed.

Written by: Shannon Oelrich

2 Comments on Postpartum Anxiety

  1. I think the greatest disservice that we as “been there, done that” moms can do for a new mom is to tell her to “enjoy every minute!” – because when you’re sitting there and it sucks and you’re NOT enjoying it, you feel like a failure. It’s okay to not to find joy in every poop and it’s okay to resent waking up at 2 am, 2:15 am 2:30 am and 2:45 am in the same night.

    That kind of pressure ‘Enjoy every moment” makes it SOOOO much harder. I think the best advice or help a BTDT mom can give another mom is to say “sometimes it sucks. If it sucks more than it’s awesome, tell your doctor.”

  2. I shared this on my Facebook fan page for Two Cannoli! It is an important issue that more women need to know about. It’s terrifying, and it’s tough to diagnose yourself. You must let people around you know what to look for, even if you think you’re not at risk. My mom suffered from some general anxiety issues, and while that may or may not have affected me, I should have known the signs. Thanks for the article, Shannon!

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