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Health Information | 04/30/2019

Recognizing Postpartum Anxiety and Panic

By  Atrius Health
You may have seen television advertisements with images of new parents looking very worried about giving their baby their first bath or doing the first diaper change. If you’re new to parenting, being nervous is expected given that your new responsibilities are often unchartered territory.

But what happens if that nervousness turns into something more debilitating? Postpartum anxiety may impact up to 17% of postpartum women. It is increasingly being recognized as a prevalent and distressing perinatal mood and anxiety disorder (PMAD) that warrants separate attention from the better known postpartum depression.

Postpartum anxiety is a clinically significant anxiety, panic, and worry-related disorder about the multitude of changes that coincide with parenthood. Fortunately, with proper screening and intervention, postpartum anxiety and panic can be effectively treated.

What to Notice

Your body has gone through some pretty significant hormonal shifts after giving birth. That, coupled with varying levels of sleep deprivation and other risk factors (e.g., type of birth, the health of mom and baby during pregnancy), may contribute to the development of postpartum anxiety and panic.

Commonly reported features of postpartum anxiety include worry about competence as a parent, infant safety and welfare needs, and worry about the overall psychosocial adjustment to motherhood. Symptoms may include fear or worry about being left alone with the baby (“What do I do if…”), difficulty controlling worries, muscle and body tension, restlessness, agitation and irritability, fatigue, and perpetually feeling overwhelmed or rushed.

Additionally, some women experience postpartum panic.  The symptoms seemingly come out of nowhere and may include feeling terror or impending doom, feeling sweaty or cold, chest pain, shortness of breath, increased heart rate, and feeling a loss of control.  The symptoms are so intense that some women become afraid to leave the house; they avoid certain situations, activities, or people; they become over-controlling to reduce the likelihood that they feel “out of control,” or they may seek constant reassurance.

When Do Symptoms Start?

The symptoms of postpartum anxiety and panic can emerge immediately following delivery through roughly one year postpartum. Many women report an increase in symptoms 1-3 months postpartum. Women may experience postpartum anxiety or panic differently with each pregnancy, if at all. If you had a previous perinatal mood and anxiety disorder, you might be at higher risk of developing symptoms with subsequent pregnancies.

Symptoms of postpartum anxiety and panic typically last longer than the “baby blues” which generally peak 3-5 days after delivery and resolve on their own around two weeks post-delivery.

Getting Help for Postpartum Anxiety and Panic

There is help available for postpartum anxiety and panic. If you experience any of the symptoms of postpartum anxiety and panic, it is important that you share your symptoms and experiences with your doctor, nurse, therapist, or another care provider. While the symptoms of postpartum anxiety and panic may overlap with “new parenthood,” they will generally not subside without an intervention that may include medication, therapy, and additional types of support.

If you’re a new mom, it can be helpful to join a new mom support group, either online or in person. You may be surprised (and comforted!) to learn how many other new moms feel the same way you do. If your symptoms persist and begin to interfere with how you interact with your baby or keep you from leaving the house, it’s important to seek professional help.

Other strategies that may help with postpartum anxiety and panic include:

  • Engage in self-care practices such as getting fresh air, physical activity, sleep, and regular nutrition during the day can alleviate some distress
  • Plan some activities that involve getting out of the house with the baby, even if you just take a walk down the street
  • Engage in supportive relationships with your primary care providers, OB, family, and friends
  • Work on accepting that a new mother (parent) cannot do everything on their own
  • Be open to asking for and accepting help

Many of the behavioral health staff at Atrius Health have training in treating postpartum anxiety and panic through various types of therapy. Our therapists can work with you individually, in a group setting, or can refer you to support groups and resources in your area so that you can feel supported every step of the way. Our prescribers can consult with specially trained doctors to determine safe and effective medications to use to reduce symptoms even if you are breastfeeding.

The important thing to understand is that you are not alone and there is hope for recovery.

Learn more about postpartum anxiety and panic:

Postpartum Support International: https://www.postpartum.net/

Anxiety Canada: https://www.anxietycanada.com/parents/new-moms/feeling-anxious/recognizing-post-partum-anxiety (website and app)

The Blue Dot Project: https://www.thebluedotproject.org/whataremmhdisorders




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About The Author

Atrius Health

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for adult and pediatric patients at more than 27 medical practice locations in eastern Massachusetts. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives.

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