How to deal with postpartum anxiety

Fretting is practically part of a parent’s job description. But when those worries multiply, it can be completely debilitating. Here's how to cope with postpartum anxiety.

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For the first three weeks of my daughter’s life, I was scared of pretty much everything. The task of taking care of this small person completely overwhelmed me. How could I possibly keep her happy and healthy—and safe? I imagined all the countless things that could happen to her, the ones I could control and the far too many I couldn’t. For me, pregnancy had been a lesson in how it feels to lose control, but once my daughter was born, that sensation amped up to a frightening level.

Afraid to fall asleep, I placed her bassinet beside the couch so my obsessive monitoring wouldn’t keep my partner up. I’d lie and watch her tiny chest lift and lower. If I did fall asleep, any small noise—a sigh, a gurgle—would wake me, and I’d grab my phone to illuminate her body to confirm she was still breathing.

I became increasingly sleep deprived. And petrified.

Every parent experiences some degree of anxiety. It comes with the territory: Alongside the intense love a baby brings, there’s also the paralyzing realization that you might not be able to stop bad things from happening to your child. When you factor in the massive life changes, hormonal shifts and exhaustion of those first blurry postpartum weeks, it’s no wonder about 80 percent of new mothers report experiencing the “baby blues.” (Those feelings usually resolve spontaneously within a few weeks and are not considered a mental health problem.) A recent study out of the University of British Columbia, however, shows that anxiety and related disorders affect about 15 percent of pregnant women and 17 percent of women in early postpartum—more than three times the incidence of postpartum depression.

“There’s probably something evolutionary about being a bit more cautious in pregnancy or feeling a little anxious when your baby cries,” says Simone Vigod, a psychiatrist at Toronto’s Women’s College Hospital who specializes in women’s mood and anxiety disorders. “It signals we have to do something about it.” But when these worries multiply and spiral out of control, it can become a mental health problem that requires attention.

The early signs of postpartum anxiety

There are anxious mothers everywhere, each of us dealing with different circumstances yet very similar feelings. When I started to open up about my fears, the stories came pouring in. One friend had trouble sleeping for months because she was so afraid of SIDS; another was so debilitated by anxiety and depression she barely left the house for six months. While online one day, I came across a Facebook post by a woman named Chrissy Mouland. Alongside a beautiful photo of Mouland and her daughter at the beach, she shared this: “You can’t tell by looking, but when this picture was taken I was suffering from postpartum anxiety.… At times I couldn’t leave the house or would take my anxiety out by screaming at the kids, shutting out my husband, crying uncontrollably when I was alone…. This smiling mother, holding a sleeping baby in the sunshine, is what postpartum anxiety looks like.” I immediately sent her a message. While her kids played in the background (and mine had a screaming fit), we talked about our struggles with worry.
When Mouland became pregnant with her fourth child, she began to feel overwhelmed. At the time, she had three young kids under age six, and the 32-year-old felt like she had all she could handle. “I was not coping well,” she says. And all of the stress leading up to her delivery didn’t go away when her daughter, Morgan, was born: Mouland experienced issues breastfeeding for the first time, Morgan wasn’t gaining weight, and her husband had to go back to work shortly after the birth. Soon she was unable to leave the house without her husband; just doing normal activities with her kids in public caused her to panic. “My brain would just race constantly,” she says. “I’d cry, not because I was sad, but because I was overwhelmed.” As a registered nurse working in mental health, Mouland says she should have recognized her symptoms, but “when you’re in it, it’s hard to see.”

My fears, too, appeared early on. I didn’t share my ultrasound photo on Facebook or host a gender-reveal party, and, much to my mother’s chagrin, I refused to have a baby shower. I felt like telling people about it would jinx the very thing I wanted the most. And then I felt guilty for being so stressed out. Many friends had experienced pregnancy loss, and they didn’t seem as anxious about their subsequent pregnancies as I was about my first. I had no real “reason” for feeling so worried. The ultrasounds looked normal. I was in good health. I tried a hospital-based meditation class, prenatal yoga and daily mindfulness podcasts. My doctor didn’t seem to think my anxiety was anything out of the ordinary. But my middle of the night panic attacks told me otherwise.

In retrospect, I should have told my doctor how intensely I was experiencing these feelings before my daughter was born. “Often, symptoms start during pregnancy,” explains Cindy-Lee Dennis, a professor of nursing and medicine in the department of psychiatry at the University of Toronto. Naively, I thought that once my daughter was born and I could count all her fingers and toes, all my worries would disappear. It didn’t work out that way.

How to treat postpartum  anxiety

Our brains are designed to compartmentalize so we can function day to day. But, Vigod says, “when you are mired in anxiety, you are in a constant state of overestimating the danger and underestimating your ability to cope with something if it did happen.” When you second-guess the repercussions of every action and run through all the worst-case scenarios, it can become harder and harder to compartmentalize and harder and harder to function. Vigod’s advice is this: If your worries are preventing you from interacting with your baby or leaving the house, then they need to be addressed. And if you’re already feeling on edge, avoid seeking things that trigger your anxiety.

I realize now I tend to run toward my triggers. In the deep, dark moments of the night while attending to a hungry baby, I retreated, like many new mothers, to the online world. I’d find a news story and obsess over the possibility it could happen to my family too. I’d email my partner links to stories about kids who tipped TVs onto themselves, swallowed batteries or had illnesses that looked like the flu but proved to be deadly. I looked up every bump, rash and poop. I always found a source that told me it was far more serious than it was, and I worried incessantly.

This behaviour becomes a vicious cycle. “If you have an anxiety about something, it’s pretty easy to go on the Internet and find confirmation for that worry,” says Vigod. You track down information to validate your concern, which only intensifies all those anxieties. Stepping away from the Internet is one strategy, but what if you can’t avoid your triggers? That’s where psychological treatments like mindfulness and cognitive behavioural therapy come in, she says. Studies show these treatments are effective in managing anxiety. Mindfulness helps people learn how to have a thought, accept it and turn their attention elsewhere, and cognitive behavioural therapy (CBT) allows patients to become part of the problem-solving process, teaching them how to challenge over-generalized thoughts and adjust their moods.

Mouland was never formally diagnosed with postpartum anxiety; she began to recognize the signs through conversations with others and was able to put a name to the wave of emotions she was constantly managing. She saw a therapist, used the CBT techniques she teaches others at work and tried to communicate more with her husband so he could understand her stressors. She still experiences some anxiety, but she says it’s now manageable.

Finding resources within the healthcare system during pre- and postnatal care is crucial for setting up a network of professionals who can help you navigate the stresses of new parenthood. Dennis also recommends joining in activities where you can meet other mothers. “Peer support is absolutely critical,” she says.

A local moms’ group I attended once a week became my lifeline. Talking to other new mothers made me realize that yes, I was experiencing an abnormal level of worry, but everyone is concerned about the well-being of their kids—just in different ways. While I was obsessed with using only organic products lest my kid be exposed to cancer-causing chemicals, other moms agonized that their babies weren’t gaining enough weight or never sleeping through the night. Dennis says interactions with other mothers can increase your confidence when you realize many of you are experiencing the same things, or they can help you recognize when you’re not having an average experience and encourage you to seek help.

My moms’ group and baby dates with other new parents were like mini-therapy sessions. We’d down coffees while discussing every little detail of our baby’s daily lives, from poop textures to teething symptoms. Talking (and eventually laughing) about the ridiculous things I was worrying about often helped me realize my concerns were just that—ridiculous—and made me look at my situation with fresh eyes.

My daughter is now two, and I have to contend with a whole new realm of things I cannot control. While I’ve never experienced a deeper fear, I can also credit motherhood with the most intense, all-consuming joy I’ve ever felt. My anxiety will always be there, lurking just below the surface, waiting to jolt me with that stomach-churning sensation whenever my kid takes off running down a busy sidewalk or has a fever. But I don’t want my worries to affect the way my daughter sees the world. I want her to experience everything, to get dirty and to figure life out for herself. So I try to avoid my triggers. And when that doesn’t work, my partner is unfailingly good at reassuring me things will be OK. I take it day by day. And each day, as she grows bigger and more independent, I take a deep breath and remind myself she’s got this, and I’ve got this, too.

Feeling anxious? How to overcome postpartum anxiety

Talking about all the ridiculous things I was worrying about helped me realize my concerns were just that—ridiculous.

* Ask yourself how much your worrying is interfering with your life and whether it has become unmanageable. Are your anxious thoughts preventing you from going outside or interacting with your child? Whether someone has an anxiety disorder will depend on whether they are experiencing significant distress and having trouble functioning, says psychiatrist Simone Vigod. The treatment will differ depending on the type of anxiety and the severity.

* Discuss your concerns with a healthcare provider—be it your family doctor, an OB/GYN or a public health nurse.

* Seek treatment options such as counselling, mindfulness sessions or cognitive behaviour­-al therapy.

* Tell your partner and family how you’re feeling.

* Seek out a network of other mothers to build a circle of support.

Finding help for postpartum anxiety

* Mother Matters is an online support group offered through Women’s College Hospital in Toronto.

* Mount Sinai Hospital in Toronto runs a postpartum support group for mothers with babies under a year old who are experiencing anxiety and depression.

* Anxiety BC is an online resource for BC moms and moms-to-be that shares information on symptoms and self-care options.

* Many hospitals across Canada have mindfulness-based meditation sessions for maternal and postpartum clients. Contact your hospital to check availability.

Read more:
Recognizing the signs of postpartum depression
Parenting through severe postpartum depression
Everything you need to know about taking care of your postpartum body

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