Nothing can truly prepare you for having a baby. You can read What to Expect When You’re Expecting every day and listen to what any and every parenting expert has to say, and you’ll still go into the process unprepared; your body will ache and hurt, and your mind will be caught off-guard.
How do I know? Because I’ve given birth. Twice. And while my second pregnancy was somewhat easier — I knew what clothes to wear, which prenatals to buy and how to manage my acid reflux — the postpartum period rocked me. It crippled me and shook me to my core, and I became very anxious. In fact, my fears started affecting every aspect of my life, from my relationships with my husband and daughter to my ability to work.
But isn’t anxiety, as a new parent, par for the course? Well, yes and no. We spoke with doctors and consulted the research to help you figure out whether your new mom anxiety is normal. According to the experts — and the science — here are the tell-tale signs that you may need to seek help.
Racing thoughts are common, especially for parents who often find themselves overworked, overwhelmed, over-scheduled and overstressed. In fact, they are so common that Dr. Nicole Washington, psychiatrist and Chief Medical Officer at Elocin Psychiatric Services, PLLC, told Bustle “occasional periods of racing thoughts are nothing to be terribly concerned about as they could be related to a reasonable worry.” However, when coupled with other symptoms (like restlessness, irritability and/or a lack of focus) these thoughts could signal a more serious problem. “If your heart rate is elevated and you feel like you are in a constant state of panic, then you might have anxiety or an anxiety disorder and you should be evaluated by a professional,” Cali Estes, PhD., therapist and founder of The Addictions Academy, told Bustle.
Having visions and/or intrusive thoughts
Plenty of us have visions; we imagine, we dream, we fantasize… But anxiety visions are different. They are driven by fear and centered around danger, harm and/or a perceived risk. Of course, it is very normal for new moms to be anxious or afraid — every parent I know worries if their little one is eating enough, sleeping enough and/or spitting up too much — but if these visions impact your daily life, you may want to seek help.
Intrusive thoughts are also a signal that something is wrong. For example, I’ve pictured my baby boy, blue and lifeless, in his crib. I’ve seen myself smothering him with his swaddle — not intentionally but because I suck at swaddling; it’s a skill I completely and totally lack. And I’ve imagined the bus crashing into the tunnel wall under the Hudson River on my way to work, causing the concrete to fracture and thousands of commuters (including me) to drown.
These visions have incapacitated me. I stopped sleeping, stopped swaddling and stopped traveling. I was unable to go to my job. And while not all anxiety sufferers will endure such violent visions or intrusive thoughts, Dr. Stephanie Mihalas tells SheKnows that they are indeed a common sign. “Fears — such as getting into an elevator and being sure that you will never come out — are not proportionate to reality,” she explains. “If the fear becomes overwhelming, disruptive and way out of proportion to the actual risk involved, it’s a telltale sign of phobia, a type of anxiety disorder.”
Feeling irritable, short-tempered or angry
Plenty of people don’t associate anger with anxiety. I didn’t. But shortly after my son’s birth, I noticed a shift in my demeanor: I became irritable and short-tempered, I began yelling (which is not my M.O.), and one evening, I held my daughter’s body against a wall because she was laughing and being goofy. Because my 6-year-old was acting like a kid.
Shortly after, I called my psychiatrist; I knew something was wrong. And that’s when I learned that a short temper fuse can actually be a symptom of mental illness. “[Anger] is rooted in fear, and fear is just another word for anxiety,” therapist Kayce Hodos, LPC told Bustle. “When we feel threatened, we react with our natural stress response — fight or flight. Those of us who end up fighting often get angry when things don’t go our way. To figure out how to manage your anger, you need to be able to name your fear and learn to take control of what’s lying beneath: anxiety.”
Inability to eat and/or sleep
Insomnia and a decreased appetite can signal numerous health problems, but when coupled with any of the aforementioned symptoms, they could be a sign of anxiety and/or another mental health condition.
Difficulty focusing or sitting still
Sure, plenty of people have difficulty focusing — at least on occasion — but if you find yourself disjointed, disorganized and scattered on a regular basis, it’s possible you’re dealing with something bigger than an everyday distraction or stressor. If anxiety “is disrupting your ability to function (e.g., at home, at work, in school or in relationships) or causing extreme distress or disability in your life for an extended period of time, then it may have moved into the category of a disorder, and it may be worth considering seeking help from a mental health professional,” Dr. Simon Rego, director of psychology training at Montefiore Medical Center at Albert Einstein College of Medicine in New York, told SheKnows.
While worry may be the most well-known symptom of anxiety, physical manifestations of anxiety are also very common. For example, I clench my jaw, grind my teeth and become extremely fidgety. My hands tremble, my legs bounce, and my heart begins to race — and I am not alone. According to the Anxiety and Depression Association of America, many anxiety sufferers experience headaches, muscle aches, pain, nausea, fatigue, shallow breathing, rapid breathing, sweating, and/or express feeling overheated or flushed.
PSI is a strong believer in being your own advocate and we want to empower you to do just that!
Which is why we have created a Perinatal Mental Health Discussion tool that you can use to track your systems and discuss them with your medical provider! https://t.co/D8pyHSYHnB pic.twitter.com/aDab15hj2F
— Postpartum Support International (PSI) (@PostpartumHelp) May 31, 2019
The good news: Postpartum anxiety (and generalized anxiety) disorders are highly treatable. Cognitive behavioral therapy is very effective, as are support groups — like this one from Postpartum Support International. Meditation can help ease symptoms, and medication can manage them.
However, in order to truly overcome anxiety, you must change your behaviors. Marva Caldwell, MA, LMHC, NCC, told SheKnows that moms in particular need to eat well, sleep well and ask for help from their friends, family and loved ones. “Look after yourself,” Caldwell says. “It is OK to ask for help — and you need to let others help you.”
If you suspect you have a perinatal mood disorder, talk to your therapist, psychologist or psychiatrist. If you do not have one, reach out to your gynecologist or general practitioner and visit Postpartum Support International. The nonprofit has a helpline, in-depth information about each condition and dedicated volunteers will help you find support in your area.