Postpartum Anxiety: When to Seek Treatment
It’s normal to feel anxious as a new parent. But for some moms, worries about your baby can become overwhelming and hard to control. If anxious thoughts seem to take over your life, it could signal postpartum anxiety (PPA). This mental health condition can look like general anxiety but it’s specific to new parents.
“Postpartum anxiety is a remarkably common medical condition,” says Natalie Feldman, MD, a Mass General Brigham psychiatrist who treats and researches PPA at Brigham and Women’s Hospital. She and other researchers found that PPA affects 12.3% of mothers worldwide, making it almost as common as postpartum depression.
Yet many people have never heard of PPA. Dr. Feldman’s recent research, published in Lancet Psychiatry, found significant gaps in awareness and understanding of postpartum anxiety. Her work highlights how often PPA goes unrecognized and untreated, despite how common it is.
Without treatment, PPA can have consequences for both you and your baby’s health. That’s why knowing and recognizing the warning signs is so important.
How postpartum anxiety affects new parents
PPA is a mental health condition that can develop anytime in the first year after giving birth. “Essentially, it’s where women have overwhelming amounts of anxiety,” Dr. Feldman says. People with PPA may struggle to relax, and often report feeling on edge—like they’re about to jump out of their skin. This constant anxiety interferes with sleep, daily tasks, work, and quality of life.
Hormonal changes likely contribute to PPA. “Some women’s brains are more sensitive to hormone fluctuations,” Dr. Feldman says. “The changes in your hormones from pregnancy to postpartum can trigger big changes in mood and anxiety.”
Signs of postpartum anxiety
Recognizing PPA can be tricky because experts haven’t agreed on an official set of symptoms. However, the symptoms are in many ways similar to those of general anxiety:
- Compulsive rituals
- Difficulty concentrating
- Heart palpitations
- Intrusive or racing thoughts
- Muscle tension
- Nausea or loss of appetite
- Shortness of breath
Risk factors for postpartum anxiety
Anxiety levels are already higher for new parents. “It’s normal for people to be checking on their baby more and have occasional intrusive thoughts,” says Dr. Feldman. However, not everyone develops PPA. Certain factors may increase your risk:
- Breastfeeding (chestfeeding) challenges
- Difficult birth experience
- First-time mothers
- Health complications
- History of anxiety
- Lack of social support
- Previous pregnancy loss
How does postpartum anxiety affect health?
PPA doesn’t just affect how you feel day-to-day. “If you leave PPA untreated, it does have implications for both mom’s health and baby’s health down the line,” Dr. Feldman says.
In the short-term, PPA can impact breastfeeding. “High levels of stress have the potential to decrease milk supply,” Dr. Feldman explains. Anxiety may in some cases also interfere with mother-child bonding by making it harder to feel emotionally present or connected to your baby.
Untreated PPA may have health effects similar to other mental health conditions that elevate stress, such as postpartum depression. “Chronic stress is not good for your body,” Dr. Feldman says. “When your body is stuck in ‘fight-or-flight’ or crisis mode for a long time, that puts strain on different systems.”
Over time, chronic stress can affect brain, heart, and immune health. While most studies focus on postpartum depression, emerging research by Dr. Feldman and others suggests that PPA may impair memory, increase heart disease risk, and weaken the immune system.
Children of a parent with untreated PPA may also experience long-term health effects. Research has shown that they may struggle more with focus and emotional regulation.
Postpartum anxiety treatment
Some anxiety can be normal when you’re a new parent, so it can be difficult to recognize when you need help. “The key question is, do you feel worried all the time, and does it make it hard to live your day the way you normally would?” Dr. Feldman says.
She recommends reaching out to a provider if you’ve been feeling on edge or unable to relax for more than a week or two, or if anxiety is interfering with daily tasks.
“If you’re checking on your baby once or twice overnight to make sure they’re doing okay, that’s normal,” Dr. Feldman says. “If you can’t get anything done while they’re napping because you’re sitting there watching them, it’s time to check in with somebody.”
The good news is, PPA is highly treatable. It responds to many of the same treatments as general anxiety, including anxiety medications and cognitive behavioral therapy (CBT). CBT is a form of talk therapy that helps you identify and challenge unhelpful thoughts, behaviors, and beliefs.
“The best thing you can do for you and your baby is talk to somebody and get help so you go back to feeling like yourself,” Dr. Feldman says.