What is Post Partum Anxiety (PPA) Pregnancy?

The life of a new mom is as challenging as it is rewarding. It is quite normal for new moms to experience a wide range of emotions during pregnancy but also following a life-changing event such as giving birth.

Once you welcome your baby into the world, you may experience feelings of deep sadness or excessive worrying within the first two weeks of postpartum.

While it is normal for new moms to experience the baby blues and some level of worry, if you are suffering from postpartum anxiety, these emotions can be overwhelming and all-consuming and can last for a prolonged period if left untreated.

This article will help you recognize the signs of postpartum anxiety, differentiate it from postpartum depression, and learn more about some treatment options. So, without further ado, let's get started!

Prevalence of Postpartum Anxiety

Postpartum anxiety (PPA) is defined as excessive worrying that occurs after childbirth or adoption (the postpartum period). Most new moms with postpartum anxiety end up feeling overwhelmed with the level of worry they experience, in addition to constantly feeling nervous or panicked. These feelings can last for a few days or for years if left undiagnosed or untreated.

Naturally, some level of worry is expected after welcoming a new baby into your family. But, if you have postpartum anxiety, the worry can be all-consuming or make you feel worried all day and all night. This often leads you to have irrational fears or excessive worries about events that are unlikely to happen.

Sometimes the anxiety is related to a specific incident from your past, or it may be stemming from a personal or family history of mental health issues, but other times the worry is general and vague. For example, you may feel a constant sense of danger threatening your new baby or your own health but be unable to put your finger on the underlying root cause.

It is important to be aware that postpartum anxiety can occur along with postpartum depression (PPD). Yet, the two mood disorders remain different despite the fact that they share some of the same symptoms.

Studies have shown that postpartum anxiety affects women's health acutely, where between 11% and 2% of people designated female at birth are directly impacted (source). Unfortunately, healthcare providers do not have specific screening to diagnose postpartum anxiety, which makes it difficult to determine exactly how many new moms suffer from the condition.

PPA is often identified during an assessment for postpartum depression (whose common signs are more researched and documented). It is crucial for new moms to recognize the symptoms of and risk factors for postpartum anxiety in order to seek treatment options promptly. If left untreated, postpartum anxiety can deeply affect your mental health as a new mom and, by extension, the mental health of other family members. 

Beyond Baby Blues: Uncovering the Signs and Symptoms of Postpartum Anxiety

Postpartum anxiety is often associated with irrational fears or constantly feeling on edge. These anxious feelings are often out of control and can take over your thoughts to the point where they manifest into panic attacks.

Below are a number of defined physical symptoms, emotional symptoms, and behavioral symptoms that can help you identify this form of generalized anxiety disorder.

Physical symptoms of Postpartum anxiety include:

• Nausea
• Hot flashes
• Dizziness
• Disrupted sleep
• Increased heart rate or heart palpitations
• Nausea or stomach aches
• Being unable to breathe or feeling short of breath
• Loss of appetite
• Trouble sitting still
• Muscle tension

Emotional symptoms of Postpartum anxiety include:

• Inability to relax or keep calm
• Racing thoughts, especially about worse-case scenarios
• Obsessing over irrational fears or things that are unlikely to happen
• Difficulty focusing or forgetfulness
• Irritability
• Feeling on edge or fearful 

Behavioral symptoms of Postpartum anxiety include:

• Staying awake all night because you are afraid your baby will stop breathing in their sleep
• Avoiding certain activities, people, or places
• Being overly cautious about situations that are not dangerous
• Checking things over and over again
• Being overly controlling 

Key Differences Between Postpartum Anxiety and Postpartum Depression

Distinguishing between mental health disorders that have similar symptoms or causes can be challenging. It is important to note that postpartum depression and postpartum anxiety disorders can occur together or separately.

If you have postpartum depression, you may experience excessive sadness, frequent crying, or feel like you cannot take care of yourself or your baby. You may also have trouble finding joy in motherhood or feel like you are not capable of being a parent.

On the other hand, postpartum anxiety is associated with excessive worrying, not with sadness. So if you feel panicked or overwhelmed with fearful thoughts, you are more likely to be suffering from postpartum anxiety.

The tricky part is that many of the signs of postpartum depression tend to overlap with postpartum anxiety. This includes symptoms like the inability to fall asleep, heart palpitations, or feeling afraid. To make matters worse, being sleep deprived alone can exacerbate feelings of severe anxiety and excessive worry.

It is common for people with postpartum depression to experience signs of postpartum anxiety. However, not everyone with postpartum anxiety is also depressed.

The strongest predictors of PPD include depression during pregnancy (perinatal depression), anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, low levels of social and professional support, and a previous history of anxiety or depression.

If you feel like some of the signs listed so far for PPA or PPD apply to you, you should consider seeking a professional's opinion.

It is important to discuss all of your symptoms and feelings with your healthcare provider so they can help you find the best course of treatment, either by prescribing anti-anxiety medication or advising on relevant clinical anxiety coping techniques that may be useful.

What Causes Postpartum Anxiety and Who's at Risk?

There are a number of risk factors for PPA you should familiarize yourself with. For one, the changes that your body goes through during and after a pregnancy can cause a drastic change in hormones. The sharp decrease in hormones after delivering your baby can cause major changes in your mood or cause you to overreact to stress.

While all new parents struggle with a lack of sleep, it can be another factor that worsens the feelings of PPA. Caring for newborns is a 24-hour job that often causes sleep deprivation. Consequently, sleep deprivation may lead you to experience trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change.

As a new parent, you may feel overwhelmed with feelings of being responsible for a newborn baby. You may also be overcome with feelings of needing to protect and care for your new baby. These feelings are natural to a certain degree, but they can be contributing factors to PPA if they are intense or extreme.

The process of caring for a newborn baby can be filled with milestones or events that could be challenging enough to trigger anxiety. For example, if you experience issues with breastfeeding or have a difficult pregnancy or stressful delivery, you may be more susceptible to struggling with PPA. 

Coping Strategies and Treatments for Postpartum Anxiety

The first step to addressing and coping with PPA lies in figuring out how long postpartum anxiety typically last. As mentioned earlier, the sudden decrease in hormones following a baby's delivery can cause you to experience feelings of sadness and stress. However, if these symptoms worsen or persist for longer than a couple of weeks, then it is a sign to take action.

Healthcare professionals recommend that you seek help in diagnosis and treatment as soon as possible. There are a number of methods used to treat PPA, ranging from therapy to medication options, and often some combination of both. 

Medication

Notably, there are potential complications that can arise from breastfeeding and taking medication at the same time. Based on if you are breastfeeding or not and in addition to your health history and symptoms, your healthcare provider will recommend a suitable course of treatment.

Medication is not always needed to treat postpartum anxiety. Sometimes it is sufficient for you to speak to a therapist or a psychologist that can help you using behavioral or cognitive psychotherapy techniques.

Cognitive Behaviour Therapy

A common form of recommended therapy to deal with symptoms of PPA is Cognitive behavioral therapy (CBT). CBT is a technique used by mental health professionals to help you identify your emotions and change your thought patterns. Through CBT, you can unlearn negative thoughts and behaviors and adopt healthier thinking patterns and habits.

CBT typically takes place over several one-on-one sessions. Using a question-and-answer format in your sessions, your therapist or counselor helps you learn to respond better to stress and anxiety. In some cases, your therapist may specialize in the emotions and behaviors of the postpartum period.

Seeking Support

Ultimately, being a parent is hard work. You may feel like you are being pulled in 100 different directions. Do not be afraid to lean on your support network because it really does take a village. Try to ask for help from family or friends. For example, if you need someone to help with chores or babysitting, ask. That way, it can take some pressure off of you.

Another way you can feel seen and heard in your struggle is to find a support group for new parents (some are 100% online). These can be a great space where you can share your feelings with people in a similar situation and have access to advice, resources, and help.

Adopting Healthy Lifestyle Choices

Remember to take care of yourself by prioritizing eating a healthy diet and sleeping as much as you can. This will give you enough energy to deal with the stressors of the day. Staying active also goes hand in hand with maintaining a healthy lifestyle. Try to take a walk or get exercise every day, or practice yoga to help with relaxation.

In mild cases, these lifestyle changes, self-care tips, or speaking with a counselor can help reduce symptoms. However, if your anxiety worsens or is interfering with your life, your doctor may recommend medication. 

What Medications Are Used for Postpartum Anxiety?

SSRIs (selective serotonin reuptake inhibitors) are the most widely used and most researched medication for postpartum anxiety and postpartum depression. SSRIs work by increasing the level of serotonin in the brain.

Another commonly used medication is Serotonin-norepinephrine reuptake inhibitors (SNRIs), which are similar to SSRIs in that they increase certain chemicals in your brain.

Other medications like tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs) can be used to treat anxiety. However, SSRIs are typically the preferred medication because of their fewer side effects.

That being said, please remember that all medications come with possible side effects. If you are breastfeeding or plan to breastfeed, let your provider know so they can provide a breastfeeding-friendly treatment. Medications are passed to your baby through your bloodstream and breast milk.

Certain medications are safe to use during pregnancy and while breastfeeding, but others are not. Before taking medication to treat your anxiety, weigh the risks and benefits with your healthcare provider.

Conclusion

Being a new mom is an incredible journey filled with joy, love, and new discoveries. However, it is essential to acknowledge that it can also be overwhelming and challenging, particularly when postpartum anxiety creeps in. As we discussed, recognizing the symptoms of postpartum anxiety is crucial for both your well-being as a mother and for the healthy development of your child. By addressing these concerns early on, you can prevent the condition from escalating and impacting your daily life and relationships.

Remember that you are not alone in this journey, and reaching out for support is a sign of strength, not weakness. Speak openly with your healthcare provider, friends, or family members about what you are going through. They can offer guidance, empathy, and practical assistance to ease your burden.