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Welcoming a new baby into the family is a joyous occasion, but for many new mothers, it can also bring unexpected emotional challenges. Postpartum anxiety is a common yet often overlooked condition that affects many women after childbirth — in fact, an estimated 1 in 5 women experience postpartum anxiety. Unlike the baby blues, postpartum anxiety is marked by persistent worry, overwhelming fear and physical symptoms that can interfere with daily life. Understanding the signs and seeking timely support are essential steps toward managing this condition. At Texas Children’s Hospital, we’re here to help you recognize postpartum anxiety symptoms and find the care you need to regain your emotional well-being.
What is postpartum anxiety disorder?
Postpartum anxiety disorder is a condition that can develop after giving birth, either alongside postpartum depression or as a separate experience. Postpartum anxiety is a mental health condition that affects new mothers, characterized by excessive worry, fear and tension related to their baby, themselves or their role as a parent. Unlike postpartum depression, which often involves feelings of sadness or disinterest, postpartum anxiety is primarily marked by heightened nervousness and a sense of constant unease. This condition may manifest as intrusive thoughts, difficulty sleeping even when the baby is resting or physical symptoms, such as a racing heart or shortness of breath. Post partum anxiety disorder is defined by its persistence and impact on a mother’s ability to function and enjoy the postpartum period, making early recognition and treatment essential.
For many women, the abrupt decrease in estrogen and progesterone at the time of delivery can lead to a greater sensitivity to stress, causing some to feel overwhelmed, fearful or panicky. Sleep deprivation from newborn care can also contribute to these feelings. In addition, especially for first-time mothers, the responsibility of caring for a newborn and the feelings of wanting to protect and keep the baby safe can be incredibly overwhelming.
What are the common signs of postpartum anxiety?
Women with postpartum anxiety disorder will often feel as if they can’t relax or might feel distracted by a constant sense of worry or dread that something bad will happen. Worries might get in the way of sleep or cause decreased appetite. Some mothers might have trouble sitting still or experience symptoms such as dizziness or nausea. Postpartum anxiety signs to look for include:
- Excessive worry: Persistent and overwhelming concerns about the baby’s health, safety or well-being that go beyond typical parental caution.
- Intrusive thoughts: Recurrent, unwanted thoughts that are often distressing and hard to control.
- Physical symptoms: Experiences such as a racing heart, shortness of breath, dizziness or nausea without a clear medical cause.
- Sleep disturbances: Difficulty falling asleep or staying asleep, even when the baby is sleeping, due to constant worry.
- Irritability or restlessness: Feeling on edge or easily frustrated, often without a specific reason.
- Avoidance behaviors: Avoiding certain activities or situations out of fear of something bad happening to the baby.
Sometimes people aren’t sure if what they’re experiencing is a normal level of concern or something more. If you’re staying awake all night because you’re afraid the baby will stop breathing or feel too scared to leave the baby alone with your partner or an adult you trust, talk with your doctor about postpartum anxiety. An open conversation about your symptoms can help your doctor determine the best treatment options for you.
How long does postpartum anxiety last?
How long someone experiences postpartum symptoms depends on the individual as well as whether the anxiety is treated. Postpartum anxiety symptoms may start right after birth or several months later, and symptoms may not resolve on their own. Seeking treatment as soon as you begin experiencing anxiety is the best way to resolve your symptoms as quickly as possible.
Postpartum depression and postpartum anxiety
Postpartum depression and postpartum anxiety are distinct disorders, but they can occur at the same time. The key difference is that postpartum depression is marked by excessive sadness and feeling incapable of caring for yourself or your baby, while those with postpartum anxiety experience excessive worrying and fearful thoughts rather than sadness. Other symptoms, such as trouble sleeping or heart palpitations, are common among both disorders.
While it's common for people with postpartum depression to experience symptoms of postpartum anxiety, not everyone with postpartum anxiety is also depressed.
Postpartum OCD and symptoms
Postpartum anxiety can take the form of obsessive-compulsive disorder (OCD). Obsessions can present as persistent, intrusive thoughts bringing along repetitive references or mental images related to the baby, which can be incredibly upsetting. Compulsions are actions performed repeatedly to reduce fears. These could involve constant cleaning, checking things, counting and reordering objects. Postpartum OCD usually brings a feeling of horror about the obsessions, fears of being alone with the baby and a strong desire to protect the infant. New mothers with postpartum OCD recognize their thoughts are bizarre and would never act on them but might feel shame or discomfort when it comes to sharing these experiences with their doctor or loved ones. It’s not clear how long postpartum OCD can last. Symptoms affect each person differently and resolving them is often dependent on treatment and support.
What causes postpartum anxiety?
While researchers aren’t exactly sure what causes postpartum anxiety, several factors likely contribute to the condition, including:
- a personal or family history of anxiety or depression
- hormonal changes that cause changes in mood
- sleep deprivation from caring for the new baby
- stressful events that trigger anxiety, such as breastfeeding or specific milestones in baby’s development
Other risk factors, such as having a child with medical problems or lack of support network, can also increase the risk of developing postpartum anxiety.
Postpartum anxiety treatment
Your doctor will recommend treatment based on your symptoms and health history. In mild cases, talking with a mental health professional and making lifestyle changes (such as taking a daily walk or practicing yoga) can help tremendously. Individual psychotherapy can be used to help target and challenge the anxious thoughts. For more severe postpartum anxiety symptoms, medication may be an option.
Additional support in caring for baby also enables mothers to better care for themselves. Often, handing off the baby to a partner or family member for a break from feeding can be a big help, even if it’s only for 30 minutes or an hour. In addition, new mothers groups are usually helpful in decreasing isolation and providing relevant support. Once mothers recover physically from childbirth, exercise and outdoor activity can be helpful in decreasing anxiety. Free or low-cost meditation apps, such as Headspace, are available for self-guided relaxation and meditation exercises.
If anxiety continues to worsen, causes a lot of distress, impacts relationships or halts your ability to enjoy life with your baby, medication can be a safe option. These medications are usually prescribed for a specific time period and tapered off as recovery progresses.
Postpartum anxiety support for women at Texas Children’s
The Women’s Place at Texas Children’s Pavilion for Women offers psychiatric consultation and treatment plans to help you and your family deal with a variety of disorders at any phase of the reproductive cycle. We’re one of only a handful of programs in the nation dedicated to the care and treatment of women’s reproductive mental health.
Mood and anxiety disorders after pregnancy are the most common complications following delivery, more than infection and hemorrhage. We’re able to offer evaluations, individual psychotherapy, medication management, a new mothers group and much more.
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