Postpartum Anxiety Disorders

Author: Kari Kagan, Psy.D.

Many women experience both depression and anxiety in the prenatal and postpartum period of having a baby. Although both are commonly experienced, anxiety is often less talked about and less researched in postpartum women. As such, the goal of this blog is to review common anxiety disorders that can be prevalent in the postpartum period in order to increase awareness. If you are experiencing any of these symptoms, be reassured that you are not alone and that you can get help.
 
Generalized Anxiety Disorder
Symptoms:

• excessive anxiety or worry about a variety of things (i.e., baby, work, finances, relationships, health, etc.)
• physical symptoms, such as muscle tension
• sleep disturbance
• common fears associated with postpartum GAD –
  • excessive fear of baby dying in crib/bassinet
  • fear of being criticized
  • fear of not having enough social support

 
Obsessive Compulsive Disorder
Symptoms:

• intrusive/anxiety-provoking thoughts, impulses, or images
• performance of ritualistic/compulsive behaviors in order to reduce anxiety
• common postpartum OCD symptoms –
  • intrusive thoughts of harming baby and subsequent avoidance of baby to prevent acting on those thoughts (*please note that OCD-related obsessions of harming baby are different than actual desire to harm baby in that the person experiencing the obsessions is aware of their symptoms, experiences them as unwanted, and tries to avoid acting on them)
  • fear of contamination and subsequent actions in order to keep germs away from baby (ie., excessive hand washing)
  • excessive checking (i.e., frequently checking to make sure baby breathing)

 
Panic Disorder
Symptoms:

• recurrent panic attacks that occur out of the blue
  • panic symptoms – increased heart rate,  feeling weak, faint, or dizzy, tingling or numbness in hands or fingers, sense of terror or impending doom, feeling sweaty or having chills, chest pain, breathing difficulties, feeling a loss of control
• worry about having future panic attacks
• worry about consequences of panic attacks (i.e., fainting)
• significant change in behavior as a result of panic attacks (i.e., avoid leaving home)
• common postpartum panic symptoms – isolating at home due to fear of having a panic attack

 
Social Anxiety Disorder
Symptoms:

• excessive fear of embarrassment or negative evaluation by others
• associated with significant distress, interference with functioning, and avoidance of social situations
• common postpartum social anxiety symptoms –
  • avoidance of social situations
  • difficulty participating in conversations
  • body image concerns
  • concern about negative evaluation of parenting skills

 
Post Traumatic Stress Disorder
Symptoms:

• exposure to a traumatic event that involves actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others
• re-experiencing of the event (i.e., having intrusive memories of the event or feeling as though it were recurring)
• avoidance of stimuli associated with the trauma (i.e., avoiding the place it happened) and/or numbing of emotions (i.e., using substances to suppress emotions)
• hyperarousal symptoms, such as feeling hypervigilant or having difficulty sleeping
• common PTSD symptoms in postpartum women –
  • flashbacks of the delivery experience
  • feelings of numbness or detachment
  • isolation

 
This is a summary of common anxiety disorders and how they can present in the postpartum period. Please note that it is completely normal for women to experience at least some of the above symptoms at any given point during or after their pregnancies. However, if any of these symptoms are causing significant distress to the point of interfering with functioning and do not seem to be improving on their own, it may be a good idea to reach out for help. Cognitive Behavioral Therapy has been shown to be effective for treating anxiety disorders in the postpartum period. At SF Bay CBT, we have training and experience in treating prenatal and postpartum distress. Please contact us for a free phone consultation to learn more about how we can help you cope with and improve postpartum distress.