Anxiety in pregnancy and postpartum

Anxiety in Pregnant and New Mothers

What is perinatal anxiety?

Perinatal anxiety involves the changes to one’s thoughts, actions, feelings, and bodily sensations during pregnancy and after the baby is born. Everyone feels anxious sometimes, but some people find it hard to control their worries. Some people with anxiety also have panic attacks, which can be very frightening.

It’s natural to feel a bit anxious when you're pregnant or after your child is born. But if you feel anxious most of the time and find it difficult to relax you may need help. Anxiety often happens along with perinatal depression, but it can come on its own, too.

Some pregnant or new mothers feel distressed or guilty about feeling anxious or panicky when everyone expects them to be happy. Anxiety is a mental health condition and not a sign of weakness, or something that will go away on its own, or that you should just ‘snap out of’.

What causes anxiety in perinatal women?

Although there's no one definitive cause of postpartum anxiety, there are several common factors that can contribute to its development. These include:

  • For the mother, rapid changes in estrogen and progesterone.

  • Sleep deprivation

  • Relationship changes

  • New responsibilities

  • Societal expectations that you should be a perfect parent, or it should be the happiest time of your life

  • Personal or family history of anxiety

  • Personal history of depression

  • Personal history of PMS symptoms like feeling weepy or agitated

  • Past miscarriage or stillbirth

  • History of obsessive-compulsive disorder (OCD)

  • History of eating disorder

What do perinatal anxiety symptoms look like?

The symptoms of anxiety are sometimes not that obvious as they often develop gradually. You might already be feeling a bit more anxious than usual, so it can be hard to know how much is ‘too much’. If you’re experiencing symptoms of anxiety yourself, or notice any changes in a friend or family member who is pregnant or recently had a baby, you should seek professional support.

Anxiety symptoms can include:

  • feeling anxious all or most of the time and not able to control it

  • restlessness

  • feeling very worried (for example, in pregnancy you may feel constantly worried about your baby)

  • feeling a sense of dread

  • being unable to concentrate, or feeling like your mind goes blank

  • feeling irritable

  • feeling constantly on edge

  • difficulty falling or staying asleep.

Panic attacks can come on very quickly and for no apparent reason. Symptoms can include:

  • a racing heartbeat

  • a feeling of dread or fear of dying

  • chest pain

  • shortness of breath

  • dizziness

  • sweating

  • feeling faint

  • shaky limbs

  • tingling

  • a churning stomach.

Most panic attacks last for between 5 and 20 minutes. They can be very frightening, but they are not dangerous.

What does perinatal anxiety feel like?

New parents with anxiety often fear they are losing control or ‘going crazy’. Many try to do everything without any help (e.g. keep the house immaculate) and often worry that what they’re doing with their baby is not ‘right’ or ‘good enough’. This can lead to low self-confidence and fear that they’re not doing well enough as a parent, partner, or in managing the home.

Women who have experienced anxiety before having children may find their symptoms get worse during pregnancy or in the year after the baby is born. For other women, the antenatal or postnatal period is the first time they experience anxiety.

Signs that you may be experiencing anxiety 

  • anxiety or fear that interrupts your thoughts and interferes with daily tasks

  • panic attacks — outbursts of extreme fear and panic that are overwhelming and feel difficult to bring under control

  • anxiety and worries that keep coming into your mind and are difficult to stop or control

  • constantly feeling irritable, restless, or on edge

  • having tense muscles, a tight chest, and heart palpitations

  • finding it difficult to relax and/or taking a long time to fall asleep at night

  • anxiety or fear that stops you from going out with your baby

  • anxiety or fear that leads you to check on your baby constantly.

Anxiety Treatment Options

With more responsibilities and less sleep, most parents have some difficulties coping during the perinatal period. While the experiences described above can be fairly common – if they are causing distress, happening much of the time, or interfering with daily living, then it is time to take action. Support from family, friends, and support groups can be helpful. But for some new parents, they will require more help. 

 

There are many different kinds of treatments that can help, including psychotherapy and medications. It is important to seek treatment as soon as possible so that symptoms do not continue or worsen.  Some new moms are afraid to tell other people about what they are going through because they are afraid of being judged negatively and, even worse, that someone might try to take their baby away. Others are worried that there are no safe medications for pregnant or breastfeeding women. If medications are needed, there are reproductive mental health specialists who can choose the safest, most appropriate medications for women. 

Where To Get Help

Don’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step.

Reach out to your health insurance, primary care doctor, or state/country mental health authority for more resources.

Contact the PPSC SupportLine to find out what services and supports are available in your community. 

If you or someone you know needs help now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

CONCERNED ABOUT HOW YOU FEEL? 

Wondering where to turn for help? Doing a self-assessment for depression, anxiety, or OCD can help.

ARE YOU FEELING ALONE?

Practical and emotional support are important in protecting against perinatal mental health disorders. Take this survey to see how your social support system measures up.

If you are having suicidal thoughts or are concerned about someone else who may be suicidal, please call the Buckelew Suicide Prevention Hotline: 

For Sonoma County: 1-855-587-6373

For Marin County: 415-499-1100

For Grief Support: 415-499-1195

National Lifeline: 1-800-273-8255

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