We often hear about postpartum depression, but did you know anxiety is actually the most common symptom in postpartum women? Symptoms of postpartum anxiety include:
- Anxiety. My clients talk about struggling with feeling anxious throughout the day and overwhelmed about everyday life after having their baby. Things that used to be easy often start to feel suffocating and exhausting, including getting dinner ready, doing chores, managing finances, etc. Add the many layers and challenges of caring for a baby, and it can start to feel like too much.
- Fear. The women I’ve treated often have intrusive thoughts about their baby being harmed. According to postpartum expert Karen Kleinman in her book Dropping the Baby and Other Scary Thoughts, 91 percent of postpartum women struggle with these kinds of thoughts. Intrusive thoughts often include baby dying from suffocation, accidents, contamination, thoughts of intentional harm, unacceptable sexual thoughts, etc. These thoughts often bring on high anxiety and panic but actually pose no true danger to the baby, even though they feel really scary.
- Worry and nervousness. Women with postpartum anxiety share that they worry about every little thing, including baby’s health, balancing work, time with older children and their spouse, etc. They worry about not being good enough and sometimes worry they have made a big mistake in bringing a baby into the world.
- Tension. Women often talk about physically feeling tense. It’s hard for them to relax and enjoy the present moment with their baby and other loved ones. They are on edge, often hyper-vigilant about something bad happening.
- Irritation and anger. When you’re anxious, overwhelmed and tired, it doesn’t take much to trigger anger. Every little thing can start to annoy and irritate – baby’s cries, toddler’s demands, partner’s needs and desire to keep up the home and life, in general, all may start to grate on nerves.
Treating Postpartum Anxiety
The good news is while these symptoms are really hard and often feel unbearable, they are all completely treatable. My treatment approach for postpartum anxiety includes four models, based on TEAM-CBT, created by Dr. David Burns. Rate your anxiety from 0-100 (with 100 being most intense) before and after each exercise to see if it was effective in helping you feel better.
- Consider the positives. Before we use tools to get rid of anxious symptoms, it is helpful to see why the anxiety is there first and what motivates it to stay around. It is counterintuitive, but the more we try to suppress anxiety, the louder it gets. Instead, we can honor it and see that it’s here for a reason. Write down 1) the benefits of your anxiety and 2) what your anxiety shows about you and your values that’s positive. For example, anxiety shows I really care about my baby’s well-being. It drives me to do research and seek advice so I can give my baby the best care possible. It shows I care about balancing time between my children and partner. I really care about doing a good job with this most important work. Even the intrusive thoughts drive me to see the worst case scenario so I can really prevent harm from happening to my child.
- The double standard. Write out your thoughts in a moment when you’re feeling anxious (for example, others are judging me and think I’m a bad mom). Then imagine you have a dear friend who is sharing with you her current struggles and her negative anxious thoughts and asking you if you think her negative thoughts are true. Write down what you’d say back to her. We’re often more likely to give grace, affirmation and validation to others than ourselves. It is important to remember to not use the cognitive model to seek certainty with intrusive thoughts since 100 percent certainty is often not attainable regarding anything in life. Continuing to engage or argue with the content of the intrusive thoughts often keeps it around longer and makes the anxiety worse.
- Face the anxiety head on. Avoidance is the food that continues to feed the anxiety monster. Ask yourself what it is that you’re avoiding and begin to face it. Exposure and facing your fears will take some courage but will allow you to see that anxiety can be defeated. If you’re afraid of contamination, exposure may include refraining from washing your hands; if you’ve been avoiding the baby, you would start interacting with your baby alone starting at 30 minutes then increasing the length of time. If you’re having intrusive thoughts, instead of pushing them away or seeking reassurance from others, you’d sit with the thoughts and just let them be there. You could even write out a script of the worst-case scenario and read it twice a day. While you’re facing your fears, it is important to sit with the anxiety instead of trying to suppress it. This may include facing sensations of anxiety where you allow your body to feel symptoms like your heart racing, sweating, discomfort, etc. You notice these sensations as if you’re observing your body from outside of yourself, you let time pass and then proceed with life.
- Examine underlying emotions. When you’re anxious, there may actually be something that’s bothering you in the here-and-now that you’re sweeping under the rug. You’re often not dealing with it because you want to be nice or not rock the boat. There are two steps to this method: First, figure out what is bothering you. Look for patterns of increasing anxiety (for example, you have panic attacks or over-worry at night when you’re actually upset with your spouse for not helping out more with the bedtime routine). Second, you have to take action before the anxiety can get better (like having a healthy and open conversation with your partner and coming to a balanced solution that feels fair for both of you).
If you or someone you love is dealing with postpartum anxiety, identifying symptoms and considering these methods to move toward healing are great starting points. Seek the help of a professional if you find yourself needing additional guidance and support.
Editor’s note: This column is the seventh in a year-long series on family mental wellness, written by local experts on topics pertinent to parents and children. Columnists include Truong, Jeanae Neal, registered behavior therapist and mom of one; Dr. Erica Faulconer, pediatrician at Northwest Pediatrics and mom of three; Stacey Johnson, LPC, (@staceyjlife) in private practice at The Purple Couch and mom of eight; and Dr. Lisa Marotta, a psychologist, writer, speaker and mom in private practice in Edmond.
Thai-An Truong, LPC, LADC is a postpartum therapist and mother of two who is passionate about helping pregnant and postpartum women overcome depression and anxiety. She has overcome her own battle with postpartum depression and anxiety and loves helping moms feel like themselves again so they can enjoy life with their baby and family. To learn more about her, visit lastingchangetherapy.com.