Postpartum anxiety (PPA) is a condition that affects some new mothers following the birth of their child. Experiencing some worry or anxiety after childbirth is perfectly normal. Postpartum anxiety is when the worry becomes all-consuming, often accompanied by feelings of dread, panic, or intrusive thoughts regarding harm to your baby or fear about your baby dying.

Postpartum anxiety has two subsets or types. In addition to excessive worry, some new mothers may experience intensely intrusive irrational thoughts, which is known as postpartum OCD. The thoughts are usually related to harm or death befalling your baby, or an inability to protect them from harm. Other new mothers may experience postpartum panic disorder, which results in sudden and frequent panic attacks around similar fears.

Having concerns or worries as a new mother is normal. If you notice that the worries feel excessive and are impacting your daily level of functioning, it is important to contact your healthcare provider.

Postpartum Anxiety vs. Postpartum Depression

Postpartum anxiety (PPA) and postpartum depression (PPD) have some similarities but are considered two separate conditions. Some mothers may experience both conditions at the same time, or one without the other. There are some overlapping symptoms between the two conditions. The main distinction between PPD and PPA is that with postpartum depression, a person feels overwhelming sadness and may have thoughts about self-harming, suicidal ideations, or harming their baby. Mothers may feel that they are incapable of caring for themselves or their baby.

Is It Postpartum Anxiety or Just Worrying?

It is not uncommon for mothers to experience anxiety or feelings of worry after childbirth. The difference with postpartum anxiety is that the anxiety is extreme and all-consuming. It often feels out of control and significantly impacts your daily level of functioning. Postpartum anxiety may develop into postpartum OCD, resulting in intensely intrusive irrational thoughts and compulsive behaviors or postpartum panic disorder, resulting in sudden and frequent panic attacks, usually related to thoughts about harm coming to your baby.

Examples of excessive worrying or intrusive thoughts might include:

• Fearing that your baby will stop breathing in the middle of the night, so you stay up all night to make sure.
• Feeling paralyzed or unable to leave your baby alone with anyone for any amount of time, fearing something bad will happen to your baby if you do.
• Being afraid to leave your house, believing something bad will happen to your baby if you do.

Postpartum Anxiety Symptoms

Postpartum anxiety symptoms include:

• Inability to relax or stay calm
• Racing or intrusive thoughts
• Worst-case scenario thinking
• Irrational fears or worries
• Difficulty with focusing or keeping attention
• Memory issues
• Irritability
• Feeling of being on edge
• Panic
• Increased heart rate or heart palpitations
• Shortness of breath or difficulty breathing
• Sleep disturbance
• Stomach issues (nausea, vomiting, pain)
• Muscle tension
• Loss of appetite
• Trouble sitting still

What Causes Postpartum Anxiety?

There is no singular cause for postpartum anxiety. Most experts agree that it is likely to be due to a combination of factors. Causes may include:

• Hormone changes. Significant changes or drops in estrogen and progesterone after childbirth can impact mood and make managing stress much more difficult.
• Sleep deprivation. Caring for a newborn usually means marked changes in sleep patterns and reduced sleep, which may have a significant impact on your mental health.
• Heightened feelings of responsibility. A strong desire to protect and take care of your newborn may contribute to developing postpartum anxiety.
• Stressful events. Stressful events related to labor and delivery, breastfeeding, or other important milestones as a new mother can also trigger postpartum anxiety symptoms.

Risk Factors for Postpartum Anxiety

There are several risk factors that may increase your likelihood of developing postpartum anxiety. Risk factors may include:

• Family or personal history of depression or anxiety
• Prior pregnancy loss or death of an infant
• If your baby has a health condition
• History of an eating disorder
• Caring for several children
• Lack of spousal, family, or community support
• Having a personality that is prone to worrying
• History of having a significant increase in mood-related symptoms related to your menstrual cycle

Diagnosing Postpartum Anxiety

There is not a standard diagnostic tool for postpartum anxiety, however, there are postpartum anxiety questionnaires and other mental health questionnaires that your doctor may have you fill out. It is important to be transparent about any symptoms you are experiencing, especially if they feel more severe and more frequent than you have experienced before. Your doctor will take a thorough medical and family history and may order other tests to rule out any other conditions that could be contributing to your symptoms.

Postpartum Anxiety Treatment

There are several treatment options for postpartum anxiety. You and your doctor will determine what treatment options are best for you. Treatment is typically dependent on the frequency and severity of your symptoms and whether you are breastfeeding.

Treatments may include:

• Counseling (in-person or virtual)
• Medication (to help reduce symptoms of anxiety or depression)
• Support groups
• Regular exercise
• Healthy diet and nutrition
• Asking for help from family or friends
• Better sleep hygiene

Can You Prevent Postpartum Anxiety?

It is not always possible to prevent postpartum anxiety. But there are ways to reduce your risk for developing PPA, as well as learning healthy coping skills that would allow symptoms to be more manageable. If you have a personal or family history of anxiety or depression, especially if there is any history of OCD or panic disorder, it is important to reach out to a mental health professional if you are planning to get pregnant or during pregnancy.

Postpartum Anxiety FAQs

How Long Does Postpartum Anxiety Last?

How long postpartum anxiety lasts varies between individuals, but it usually stops being referred to as PPA at the 12-month mark. PPA does not tend to resolve on its own, so it is important to seek help when you notice symptoms. The earlier you address the issue, the better the treatment outcomes.

How to Help Someone With Postpartum Anxiety

Often, people with PPA feel alone in their overwhelm. One of the most important things you can do to help someone with PPA is simply to show up and listen. It can be hard for mothers with PPA to ask for help. Even small things like offering to do some household chores, run errands, pick up groceries, or help with childcare can go a long way. Symptoms of PPA can reduce when mothers trust that they have a solid support system around them.