Navigating Postpartum Anxiety: Learn the Symptoms and Find Relief

Having a new baby, whether it is your first child or not, is an exciting time and can also be a time of heightened anxiety for some new parents. Perinatal Mood and Anxiety Disorders, often referred to as PMADs, encompass several conditions that can all make the postpartum period even more challenging. By learning the risk factors and symptoms of postpartum anxiety, you may be able to recognize and get help. In this article, learn more about what contributes to postpartum anxiety, how to identify if you are affected, and valuable resources for help if you are experiencing postpartum anxiety or other PMADs.

Perinatal Mood and Anxiety Disorders include a range of conditions during pregnancy and the postpartum period. The perinatal period is any time surrounding pregnancy and birth through the first year postpartum. Some other terms you might hear are antenatal or prenatal, referring to before birth, and postnatal or postpartum, referring to after the birth. (1)

• Depression

• Anxiety disorders

• Obsessive-compulsive disorder

• Post-traumatic stress disorder (PTSD)

• Bipolar disorder

• Psychosis

• Substance use disorders

The big shift in hormones experienced during pregnancy and after giving birth can affect a new mother’s mood. (2) Postpartum anxiety can also be triggered in people who have difficulty with the transition into parenthood. (3) It is a huge shift and alteration in life. Pregnancy and growing your family often change relationships with the other people in your life, your job, home and family dynamic, and financial situation. All of these changes can play a role in mood and postpartum anxiety.

• 1 in 5 mothers has a mental health condition around the perinatal period (4)

• 1 in 3 women have more anxiety during pregnancy (5)

• 75% of women with a PMAD are either undiagnosed or untreated (4)

• An estimated 10-20% of women experience anxiety after weaning (6)

• 5-15% of fathers may experience postpartum anxiety (7)

• Rapid heartbeat and experiencing panic attacks

• Shortness of breath

• Symptoms of Obsessive Compulsive Disorder

• Intrusive and unwanted thoughts

• Feeling excessive worry and overwhelm

• Having a hard time sleeping

• Constant and persistent worry about your baby

• You have a prior history of anxiety, depression, or other mental illness

• Lack of social support

• People of color (11)

• Low-income families

• Your baby spent time in the NICU, or you experienced birth trauma

• Prior history of trauma

If you are concerned you may be experiencing postpartum anxiety, the Perinatal Anxiety Screening Scale (PASS) is a questionnaire to help identify if your symptoms may be a result of postpartum anxiety. (12) The PASS questionnaire includes 31 questions and aims to assess a range of anxiety, including general worry, acute anxiety, control, trauma, and social anxiety. (13)

The Postpartum Health Alliance has the PASS assessment available, which can be found here.

Postpartum anxiety can be rooted in biological processes that are rapidly changing, like hormone shifts that occur during pregnancy and after giving birth, because of psychological changes, social stressors, or a combination of them all. Some of the symptoms can look similar to postpartum depression. So many changes during pregnancy and the postpartum period can be overwhelming. The transition into parenthood is layered with so many factors and can be made more difficult if you have any of the risk factors for anxiety. 

It is important to discuss how you are feeling and your symptoms with your healthcare providers. Together, you can decide what your options are and what the best treatment for you will be. You can help improve your symptoms in many ways as you navigate the situation with your doctor.

• Nutrition - support your body with nutrient-dense foods, including plenty of colorful fruits and veggies, high-quality proteins, and good fats. Limit highly processed foods, added sugars, caffeine, and alcohol. (14)

• Sleep - sleep patterns often change during pregnancy and the postpartum period. Your body is going through many changes, and after your baby arrives, you will wake more frequently to meet their needs for feeding and comfort around the clock. Focusing on getting enough rest can improve mood. (15) If you can, nap when your baby naps and consider going to bed in the evening a little earlier than normal.

• Get moving - gentle exercise has many health benefits, including reducing anxiety and improving mood. (16)

• Sunlight - being outside in the sunlight when you wake up is critical for regulating your circadian rhythm and can give you a boost of energy while also helping you to experience improved mood and better sleep. (17)

• Support system - This may include working with an IBCLC to address infant feeding and lactation difficulties, as well as asking family members and friends for help with chores so you can practice self-care while caring for your baby.

• Support groups - joining a parent support group can be a great way to hear what helps others and to share your experiences. Each group has its own unique dynamic, and if the group you attend doesn’t match your needs, try out another group, and you will likely find the group that feels right for you.

You are not alone. In addition to talking to your healthcare team, there are resources available if you have concerns about yourself or someone you know who may be experiencing postpartum anxiety.

• National Maternal Mental Health Hotline - provides 24/7 free and confidential support 1-833-TLC-MAMA

• National Suicide Prevention Lifeline - call 988

• Postpartum Support International - provides support and help finding local resources 1-800-944-4PPD

Welcoming a new baby is a life-changing experience filled with joy, love, and growth, but it's also okay if it feels overwhelming at times. If you're struggling with postpartum anxiety or other perinatal mood challenges, remember that you are not alone, and support is available. Understanding the signs, knowing the risk factors, and reaching out for help are powerful steps toward making change and improving how you feel. Taking care of your mental health is one of the most important ways you can care for yourself and your family. 

1. https://www.sabp.nhs.uk/our-services/mental-health/perinatal/what-does-perinatal-mean

2. https://www.acta-endo.ro/Archive/Abstract?doi=2019.410

3. https://www.mdpi.com/2036-7503/7/2/5872

4. https://pmc.ncbi.nlm.nih.gov/articles/PMC7204436/#:~:text=Perinatal%20mood%20and%20anxiety%20disorders%20(PMADs)%E2%80%94defined%20as%20mood,diagnosis%20do%20not%20receive%20treatment .

5. https://pmc.ncbi.nlm.nih.gov/articles/PMC6400346/#:~:text=One%20in%20three%20women%20(35.3,least%20one%20assessment%20(46.7%25) .

6. https://pubmed.ncbi.nlm.nih.gov/24160774/#:~:text=Survey%20participants%20are%20asked%20validated,referral%2C%20and/or%20treatment .

7. https://pubmed.ncbi.nlm.nih.gov/33632067/#:~:text=Results:%20A%20total%20of%2023,CI:%206.02%2D%2018.15%25 ).

8. https://pubmed.ncbi.nlm.nih.gov/25372562/#:~:text=Associations%20were%20also%20found%20with,or%20emotional%20detachment%20during%20childbirth .

9. https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13067

10. https://psychiatryonline.org/doi/10.1176/ps.62.6.pss6206_0619

11. https://www.liebertpub.com/doi/10.1089/whr.2021.0148

12. https://womensmentalhealth.org/posts/screening-for-perinatal-anxiety-using-pass-the-perinatal-anxiety-screening-scale/

13. https://pubmed.ncbi.nlm.nih.gov/24699796/

14. https://pubmed.ncbi.nlm.nih.gov/33763446/

15. https://pubmed.ncbi.nlm.nih.gov/30030650/

16. https://pubmed.ncbi.nlm.nih.gov/39624371/#:~:text=Postnatal%20interventions%20may%20be%20more,needed%20to%20substantiate%20our%20findings .

17. https://www.elcaminohealth.org/stay-healthy/blog/sunlight-screen-light-resyncing-your-circadian-rhythm#:~:text=Essentially%2C%20the%20goal%20is%20to%20trigger%20your,%22go%20to%20sleep%22%20hormone)%20later%20that%20night .

• https://mihp.utah.gov/wp-content/uploads/Perinatal-Anxiety-Screening-Scale.pdf
• https://www.mmhla.org/articles/maternal-mental-health-conditions-and-statistics
• https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline/champions#:~:text=Become%20a%20Champion%20%E2%80%93%20help%20us,833%2DTLC%2DMAMA).
• https://988lifeline.org/
• https://postpartum.net/#:~:text=Download%20%E2%80%9CConnect%20by%20PSI%E2%80%9D%20in,Heart%2Dempty