How to Recognize & Manage Postpartum Anxiety (PPA)
Bringing a baby into the world is anxiety-inducing even at the best of times, but in the middle of the uncertainty and strife of a pandemic, it feels even scarier. You’re not only worried about normal baby things, you’re worried about everything. Now more than ever, learning how to recognize and manage postpartum anxiety (PPA) is key to new-mom survival.
The Realities of New-Momhood in a Pandemic
The pregnancy itself may have been difficult or easy, but it carried the added weight of wondering whether your partner could be present at the birth. Maybe you doubled up on masks, or you didn’t get to hug your own mom in celebration.
Then you brought home this tiny, fragile creature, and all of a sudden, everything became a hazard.
Day-to-day items could injure or scare him. A trip to the store might mean exposure to the virus that’s sweeping the globe. A friend pinching your baby’s cheek is an unacceptable risk of infection.
You’ve started to see danger everywhere you look.
While everyone is experiencing a heightened sense of concern and caution right now, you’re using yours to protect your defenseless babe.
But when is it too much? When is the anxiety no longer a useful defense mechanism but a hindrance? And are there tools to help manage postpartum anxiety?
How to Recognize Postpartum Anxiety (PPA)
It’s normal for new moms to experience anxiety.
The hypervigilance and attunement to your baby’s needs are a biological adaptation. They help ensure that you’re meeting your baby’s needs so he can thrive.
If your baby cries, your stress levels rise until you figure out how to soothe her. If an outside force threatens your baby, you do everything in your power to shelter him.
That’s part of what it means to be a mom.
But when every shadow becomes a monster, and your baby’s every whimper means she’s dying, this biological response has become a problem.
Postpartum anxiety often shows up in these ways:
- Feeling anxious or panicky more often than not
- Excessive irritability (more than just irritable about an interrupted night of sleep…or three, or ten)
- Inability to sleep even when your baby is calm and cared for
- Inability to lay your baby down or hand her off to a trusted caregiver
- Excessive worry about your baby’s health (to the point that you need to consult the pediatrician repeatedly for reassurance)
- Living in constant fear that something bad is going to happen
- Plagued by intrusive negative thoughts
If you’re experiencing PPA, you may worry that you’re going crazy. Anxiety can make you feel out of control and in a constant state of panic.
It may feel impossible to manage postpartum anxiety.
You may not want to tell friends and family what you’re experiencing for fear of what they’ll think. You may even worry that someone would take your baby away if they knew what was going on in your mind.
Postpartum Anxiety and Postpartum Depression Go Hand in Hand
Many moms who experience PPA also experience postpartum depression (PPD). In fact, in one study of ten thousand women, two-thirds of the women who experienced PPD also suffered from anxiety (Wisner et al., 2013).
What are the signs of PPD?
- Inability to sleep or wanting to sleep all the time
- Lack of energy, fatigue
- Difficulty concentrating on tasks
- Feeling overwhelmed by or unable to make decisions
- Feeling weepy or sad more often than not
- Difficulty bonding with your baby
- Feelings of guilt or inadequacy as a mother
While these lists of symptoms may seem overwhelming or dire, having PPA or PPD is not your fault. You’re not alone (in fact, 1 in 7 moms experience PPD in the first year after giving birth) (Langdon, 2019). And you’re not a bad mom.
Perhaps most importantly, there are ways to manage postpartum anxiety and depression.
Risk Factors for Developing PPA or PPD
Why do so many women experience PPA and PPD? There are several risk factors that can play into developing a more serious form of anxiety or depression after having your baby. These include:
- A high-risk pregnancy
- Pregnancy loss
- A traumatic birth experience
- A recent, unrelated stressful experience
- Insecurities (lacking financial or social support)
- Difficult relationship with partner
- A history of depression or anxiety
While these factors don’t necessarily mean you’ll develop PPA or PPD, they can increase the likelihood. Fortunately, understanding your risk can also help you prepare for and manage symptoms if they arise.
How to Manage Postpartum Anxiety
As a psychologist who specializes in women’s issues, fertility issues, and relationships, Dr. Irena has helped many women and couples manage postpartum anxiety. She helps women recognize when they’re struggling and implement the following strategies for themselves and with their partners.
1. Be Gentle with Yourself
Our society perpetuates the myth of the happy, put-together mother. The celebrity sneak-peek photos of moms in perfect makeup and laying on pristine white sheets don’t do us any favors.
Yes, a new baby is a cause for excitement and joy! It’s also a cause for stress, exhaustion, and a complete paradigm shift.
You need time to adjust to being a mother. This new role comes with big changes, new tasks to learn, and all sorts of big feelings.
So, remember to be gentle with yourself in the chaos of change. There’s lots to learn and adjust to.
2.Get Some Sleep
You may have just scoffed—how can I sleep when my infant needs me?
This one often involves some strategizing. But it’s crucial for your mental health to get some uninterrupted stretches of sleep.
Maybe your partner takes charge for a night, or your mother-in-law comes for an early morning shift to let you sleep in.
3.Limit Your Internet Use
Limiting the time you spend on the internet and social media can reduce how much exposure you have to those perfect-mom myths. It also gives you time and mental space to be more present with your baby and your loved ones.
4.Allow for Ambivalence
As you saw above, being a new mom comes with so many changes that it’s normal to have mixed feelings about them.
Your identity has shifted. You’ve lost some of the freedoms you had before, like doing whatever you want with your time, or sleeping in.
It’s okay to feel excited and full of love at the same time you’re grieving the loss of elements of your former self. It’s okay to feel frustrated with a complicated stroller or cumbersome car seat. And it’s okay to feel nervous about how you’ll be as a mom.
5.Remember that Thoughts are Just Thoughts
If you do have upsetting thoughts pop into your mind, remind yourself that they are just thoughts. It doesn’t mean they’re going to happen or that they represent your reality.
Exercise plays a huge role in mental health, even if it’s just a brisk walk. Prioritize raising your heart rate for 30-40 minutes a few times a week. That could be a dance video, some baby & me yoga, or a walk in the neighborhood.
7.Really Think About What You Need
Do you need to ask your partner for more help? Do you need to ask your mother to come stay with you? Could you ask your sister to bring a couple more meals?
If you thought you wanted to stay home, do you actually need to go back to work? Or vice versa?
8.Invest in Your Relationship
Your relationship with your partner has also experienced a lot of change. Taking the time to reinvest in it can be one of the greatest sources of emotional support for PPA.
Counseling is another excellent avenue of support to manage postpartum anxiety. Dr. Irena has over 20 years of experience working with women and couples who’ve recently had a baby. She has helped numerous new moms overcome PPA and PPD.
If you’re interested in seeking counseling to help with postpartum anxiety, Dr. Irena offers online therapy for women and couples in Texas and New York City. She specializes in helping women with postpartum anxiety and depression, and helping couples connect using Emotionally Focused Therapy. She can help you regain emotional balance and find the support you need.
Langdon, K. (Ed.). (2019, May 3). Postpartum Depression Statistics. Postpartumdepression.org. https://www.postpartumdepression.org/resources/statistics/
Wisner K.L., Sit, D.K.Y., McShea, M.C., et al. (2013). Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings. JAMA Psychiatry, 70(5):490–498. doi:10.1001/jamapsychiatry.2013.87