Our culture and media depict new motherhood with joy and satisfaction, cuddles and connection. Often, the reality of drastic changes in hormones along with new responsibilities can leave a mom with overwhelming and anxious emotions. Every birth brings huge life changes and adjustments. In fact, pregnancy and its aftermath are considered the most complex event in human experience (Brockington, et al., 2017). Although postpartum depression has, in recent years, gained more attention, postpartum anxiety, though very common, has not (Pawluski, et al, 2017). Between 10%-20% of women experience anxiety in the postpartum period and research suggests it may be even more common than postpartum depressive disorders (Ashford, et al, 2016). If you are struggling with fears and worries, you are not alone and there is help for you.
When to Get Help
Worry is normal at this time of life, especially for first-time moms, and it can be difficult to know when the anxiety has become problematic. If you are feeling persistent fear, worry, and tension, or if your sleep and concentration are affected, additional help may be needed. Severe symptoms of panic and recurrent intrusive thoughts or images, often related to harm of the child can also be experienced and require additional intervention (Dennis, et al., 2016). Anxiety, at this time of life, often focuses on fear of harm to the baby, lack of support, or feelings of inadequacy. Thoughts such as “What if I can’t do this?” , “What if I hate being a mom?”, “What if she stops breathing?” can plague a young mom even if she planned and desired to have children. It is estimated, however, that about half of pregnancies are unplanned and, although many were merely mistimed, an unwanted pregnancy or traumatic birth are further causes of anxiety (Brockington, et al, 2017).
Hormonal Changes Contributing to Anxiety
Some young mothers may chide themselves for having anxiety, believing that they just need to be stronger. It may be helpful to understand the hormonal changes that occur in a mother’s body surrounding the birth of her child in order to normalize her struggle with anxiety. During pregnancy, the body increases production of progesterone and prolactin. Immediately after birth, the level of progesterone drops. Prolactin stays high for milk production but is no longer mediated by high progesterone. This can lead to moodiness, low energy, and just generally not feeling like yourself. So it is not surprising that with all the changing hormones, anxiety will have a prime opportunity to grow.
Effects
Anxiety in the postpartum period may negatively impact maternal and infant outcomes. When a mother is preoccupied with fear, she might avoid situations that make her feel insecure which can lead to her avoiding direct care for her new infant. She might become afraid to be alone with her baby which can, in turn, undermine her feelings of competence. It can also distract her from bonding. Research indicates higher levels of fatigue, decreased self-confidence, decreased body image self-confidence, and a significantly higher risk of developing depression for the mother. High anxiety in the mother can also affect infant and child outcomes including excessive crying, distress in novel situations, internalizing difficulties, and poor motor and cognitive development (Dennis, et al., 2016).
Treatment Guidelines
The good news is that anxiety disorders are highly treatable, and a great deal can be done to help the mother adjust to her new role (Brockington, et al., 2017). There is no need to suffer with anxiety alone. There are counselors trained in perinatal mental health who can provide compassionate support and help you feel seen, heard, and understood. Mothers with postpartum anxiety have been able to find relief through addressing emotional conflicts, maladaptive thoughts and beliefs in counseling and participating in mindfulness and group therapy (Brockington, et al., 2017). If you are wondering where to start, Postpartum Support International (PSI) is a helpful resource and can be found at Postpartum.net. This site includes a helpline, access to local support, and other resources. Knowing that you are not alone nor weak as a mother for seeking help for anxiety that has overridden you is a necessary step in the journey to building a healthy bond with your newborn. By creating a safe place to explore your experience and address your anxiety, a trained therapist can help to improve your health and well-being as well as that of your baby and family.
References
Ashford, M. T., Ayers, S., & Olander, E. K. (2017). Supporting women with postpartum anxiety: Exploring views and experiences of specialist community public health nurses in the UK. Health & Social Care in the Community, 25(3), 1257–1264.
Brockington, I., Butterworth, R., & Glangeaud-Freudenthal, N. (2017). An international position paper on mother-infant (perinatal) mental health, with guidelines for clinical practice. Archives of Women’s Mental Health, 20(1), 113–120.
Dennis, C. ‐L., Falah, H. K., Brown, H. K., & Vigod, S. N. (2016). Identifying women at risk for postpartum anxiety: A prospective population‐based study. Acta Psychiatrica Scandinavica, 134(6), 485–493.
Pawluski, J.L., Lonstein, J.S., Fleming, A.S. (2017). The neurobiology of postpartum anxiety and depression. Trends in Neurosciences, 40 (2): 106 DOI: 10.1016/j.tins.2016.11.009
