Understanding Postpartum Anxiety

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Despite being nearly as common and just as debilitating as postpartum depression (PPD), postpartum anxiety (PPA) often goes unrecognized and undiagnosed. If you, or someone you know, is feeling “off” around the time of the arrival of a new child, it could be postpartum anxiety disorder. And while adoptive women don’t have the same physical experience that a birth mother does, there are still similar emotional and mental stresses that come with welcoming a new child into the home – and PPD and PPA can affect an adoptive mother.

Even today, as PPD has gained greater awareness as more women share their struggles, PPA often goes undiagnosed. Often referred to as “the hidden” disorder, it isn’t recognized, despite affecting approximately 10% of new moms. PPA, or “the other baby blues” is a cousin of PPD but with some distinct symptoms.

Dr. Nina’s What You Need to Know: About Postpartum Anxiety (PPA)

PPD causes moms at the time of welcoming their new child to experience extreme sadness and, often, disinterest in their new babies. Whereas PPA manifests itself mainly in the form of experiencing intense and persistent anxiety.

PPA goes beyond normal and expected anxious thoughts about the new baby, generally beginning sometime prior to birth and the baby’s first birthday. And, estimates are that nearly 50% of women who are diagnosed with PPD also have PPA. 

Some experts explain PPD as a loss of heart and PPA as a loss of balance or calm, that manifests as:

  • Worry that is constant and excessive which can also be seen with postpartum depression
  • Feeling on edge, pending doom, or catastrophizing. An example of this is concerns their baby will die in their sleep and in turn, constantly watching their chest rise and fall. Or, that harm will fall on the child because “mom” is not breast feeding them, causing guilt.
  • Racing thoughts, or the mind jumps from one thing to another. This can interfere with the enjoyment of precious moments, caring for the baby, or yourself.
  • An inability to remember things
  • Restlessness, constantly moving or fidgeting (unable to be still)
  • Irritability with minor things 
  • Disturbed sleep, which admittedly is challenging after the arrival of a newborn
  • Lack of appetite
  • Physical symptoms like dizziness, hot flashes, nausea, muscle tension in the neck, shoulder, and back

Also, the arrival of a newborn can infringe on sleep, affect relationship dynamics, cause exhaustion, and create an added responsibility of a precious life that is dependent on mom. These stressors can also factor into the equation, even provoke PPA—along with cultural, societal, and familial expectations that this is the happiest time of life.

Some women experience panic attacks with a sudden onset of intense fear and doom –often accompanied by physical symptoms of a shortness of breath, racing heart, chest pain, sweating, stomach upset, and dizziness.

Emotional symptoms include panic or feeling a loss of control. Symptoms can become debilitating, affecting mom’s ability to eat, sleep, and function in any meaningful way—including, connecting with their newborn.

What Causes PPA? Anxious thoughts, fear, and worry are normal human emotions that are built-in to help people survive. For example, if you see a car racing towards you, you experience fear which works in unison with your body to get out of the way. Similarly, the arrival of a new baby can provoke anxious feelings that improves a mom’s alertness and vigilance, which are essential to protect the health and safety of the newborn. However, these anxious thoughts and worry become problematic when they overshoot reality.

And while not completely understood, both PPA and PPD are likely the result of a “complex interplay” of genetics, hormones, and stress. Pregnancy is associated with significant hormonal changes necessary for the growth, development, and delivery of the unborn baby. In fact, estrogen and progesterone levels can increase by a hundred times during pregnancy! And, then suddenly drop to near zero levels within 24-hours after delivery. This hormone roller-coaster can contribute to PPA and PPD – and it can affect any birth or adoptive mom.

While PPA can resolve on its own, the key to getting better begins with awareness. And responsibility belongs not just to the mother, but also her partner or spouse, loved ones and healthcare providers. Because not much is known about PPA, too many mothers go untreated with symptoms unrecognized. If you (or someone you know) is feeling overwhelmed with any of the PPA or PPD symptoms, get help, talk to your family, your ob-gyn or pediatrician.

Dr. Nina Radcliff is dedicated to her profession, her patients and her community, at large. She is passionate about sharing truths for healthy, balanced living as well as wise preventive health measures.

She completed medical school and residency training at UCLA and has served on the medical faculty at The University of Pennsylvania. She is a Board Certified Anesthesiologist. Author of more than 200 textbook chapters, research articles, medical opinions and reviews; she is often called upon by media to speak on medical, fitness, nutrition, and healthy lifestyle topics impacting our lives, today.

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