Postpartum Anxiety: A Psychiatrist Explains

“Doctor, I’m terrified of being left alone with my baby. I constantly check if he’s breathing. I barely sleep. Is something wrong with me?” These were the words of Meera, a 34-year-old new mother of a baby boy during her first session with me. She had undergone a high-risk pregnancy, which included progesterone shots to prevent preterm labor. Despite a healthy delivery, she found herself trapped in an overwhelming cycle of worry and fear. She had postpartum anxiety.

As a psychiatrist, I’ve seen how postpartum anxiety often gets overshadowed by postpartum depression, leaving many women like Meera feeling confused and alone. In this article I will attempt to explain postpartum anxiety with the help of Meera’s example and also offer tips to manage and reduce it. I will explain its symptoms, its causes, coping strategies and the treatment options available, and how to break the stigma around it. But first, let’s understand what postpartum anxiety really looks like.

What Postpartum Anxiety Looks Like

Postpartum anxiety is a condition where new mothers experience excessive worry, fear, or nervousness after giving birth. Unlike postpartum depression, which is characterized by feelings of sadness or disconnection, postpartum anxiety often involves constant, overwhelming thoughts about the baby’s health, safety, or wellbeing. It may also cause physical symptoms like restlessness, a racing heart, or trouble sleeping, even when the baby is asleep. While some level of concern is natural for new parents, postpartum anxiety goes beyond typical worries, interfering with a mother’s ability to relax or enjoy her time with her baby.

Symptoms and Causes of Postpartum Anxiety

1. Symptoms of Postpartum Anxiety

Meera’s Experience: Meera was constantly worried about her baby’s breathing, checking on him every few minutes. She had difficulty sleeping, even when the baby was asleep, and often felt her own heart racing.

Common symptoms of postpartum anxiety include:

• Physical Symptoms: Rapid heartbeat, shortness of breath, dizziness, muscle tension, and fatigue.
• Emotional Symptoms: Persistent worry, fear of something bad happening, irritability, and difficulty relaxing.
• Behavioral Symptoms: Over-checking the baby, avoiding social interactions, and excessive concern over minor issues.

Recognizing these signs early is critical, as untreated anxiety can intensify and impact both mother and baby.

2. Causes and Risk Factors

Meera’s Case: Her risk factors included receiving progesterone injections throughout her pregnancy and ongoing family and financial stressors. She had also been detected with high blood pressure [preeclampsia] during the third trimester, and this added to her stress.

The key contributors to postpartum anxiety are:

• Hormonal Changes: After delivery, the sharp drop in progesterone and estrogen can disrupt emotional stability, especially if hormone levels were artificially elevated during pregnancy.
• Multiple Births: Mothers of twins or triplets face higher stress levels due to increased caregiving demands and heightened responsibility.
• Sleep Deprivation: The relentless cycle of feeding, changing, and soothing newborns exacerbates anxiety symptoms. With multiples, sleep deprivation can become a serious issue, affecting health and wellbeing of the mother.
• Previous Mental Health Issues: A history of anxiety or depression increases the likelihood of postpartum anxiety.
• External Stressors: Financial concerns, family pressure, or a lack of support can contribute to increased anxiety.

3. Impact of postpartum anxiety on Mother and Baby

• On the Mother: Persistent anxiety can lead to emotional exhaustion and diminished confidence in her ability to care for her child/children.
• On the Baby: Babies are sensitive to maternal stress, which can affect their emotional development and attachment.
• On the Family: The strain on partners and other family members can lead to isolation and tension, further deepening the anxiety cycle.

Meera’s Bonding Concerns: She felt emotionally disconnected from her son despite her constant vigilance, leading to guilt and fear of failing as a mother.

Coping Strategies

1. Treatment Options for Postpartum Anxiety

When Meera finally sought help, we developed a comprehensive plan combining self-care and professional interventions:

Self-Help Techniques

• Breath work and Relaxation Exercises: Meera practiced deep breathing to reduce her panic symptoms during high-stress moments. Also read: How to Fix Your Breathing to Mitigate Stress
• Mindfulness and Meditation: Daily mindfulness practices helped her stay grounded, recognizing her intrusive thoughts without spiraling into fear.
• Postpartum Yoga: Gentle, restorative yoga focusing on breath and body awareness eased her physical tension and anxiety. Also read: Proven Yoga Techniques to Manage Stress

Professional Help

• Therapy: Cognitive-behavioral therapy (CBT) helped Meera challenge her anxious thoughts and reframe her perspective on motherhood.
• Medication: In cases of severe anxiety, short-term medication, safe for breastfeeding, can be prescribed to help balance neurochemical imbalances.

2. Building a Support System

Meera’s Support Network: Involving her partner and parents in her care allowed Meera to delegate responsibilities and focus on recovery.

Effective support strategies include:

• Family Involvement: Educating partners and family members about postpartum anxiety ensures a supportive environment.
• Community Resources: Joining local or online groups for mothers of multiples provides a sense of belonging.
• Healthcare Providers: Maintaining open communication with doctors and therapists ensures early detection and treatment.

6. Breaking the Stigma

Meera’s Struggle: Like many mothers, she feared being judged as weak or incapable. Sometimes well-meaning relatives and friends unintentionally belittle their anxiety, adding to the mother’s feelings of guilt and self-doubt. Addressing these issues is vital for recovery.

• Educating the Public: Normalizing postpartum anxiety through awareness campaigns and healthcare conversations helps reduce stigma.
• Encouraging Openness: Sharing personal stories, whether in support groups or online forums, can inspire others to seek help without shame.

Conclusion

Meera’s story illustrates that postpartum anxiety is real, common, and treatable. Women who experience high-risk pregnancies, take progesterone shots, or have multiples should be vigilant about their mental health. With early intervention, support, and appropriate treatment, recovery it’s not only possible—it’s probable.

If you or someone you know is experiencing symptoms of postpartum anxiety, don’t hesitate to seek professional help. Remember, reaching out is the first step toward healing and reclaiming joy in motherhood.