Studies have shown that postpartum anxiety affects between 11% and 21% of child bearing individuals. Healthcare providers don’t have a specific screening to diagnose postpartum anxiety, so it’s hard to determine exactly how many people suffer from the condition. It’s often identified during an assessment for postpartum depression (which researchers know more about).

Having a baby or becoming a parent and worrying go hand in hand. Postpartum anxiety is an excessive or extreme worry that feels like it never stops. If your worrying interferes with your ability to calm down and feels like it lasts all day, you may have postpartum anxiety. Postpartum anxiety is also associated with irrational fears or constantly feeling on edge.

Some examples of postpartum anxiety could be:

• Staying awake all night because you are afraid your baby will stop breathing in their sleep.

• Being terrified to leave your baby alone for a few minutes with an adult you trust (or your spouse).

• Being so afraid someone or something will hurt you or your child that the thought of leaving your house makes your heart race.

Anxiety is your body’s way of responding to danger or threat. The symptoms you feel are your body’s way of reacting to this constant sense of worry or fear, and become a problem when either danger of threat is actually present, or you feel unable to go about day to day activities, socialize, or leave the house without fear or worry.

Physical symptoms

• Disrupted sleep – postpartum taking more than 20 minutes to fall asleep at night is a risk factor for higher levels of anxiety and depression.

• Increased heart rate or heart palpitations.

• Nausea or stomach aches.

• Feeling like being unable to breathe or feeling short of breath.

• Loss of appetite.

• Trouble sitting still and inability to rest.

• Unyielding muscle tension.

Emotional symptoms

• Inability to relax or be calm.

• Racing thoughts, especially about worst-case scenarios.

• Obsessing over irrational fears or things that are unlikely to happen.

• Difficulty focusing or forgetfulness.

• Irritability.

• Feeling on edge or fearful.

Behavioural symptoms

• Avoiding certain activities, people or places.

• Being overly cautious about situations that aren’t dangerous.

• Checking things over and over again.

• Being controlling.

There are certain conditions like obsessive-compulsive disorder (OCD) or panic disorders that can affect you during the postpartum period. If you are suffering from either of these conditions, you may be at higher risk postpartum and have panic attacks or obsessive thoughts.

Be honest with your healthcare providers about all the symptoms you feel. They are there to support you and recommend treatments to help.

There is no one cause for postpartum anxiety. Healthcare providers think several factors can cause it:

• Change in hormones: The sharp, abrupt changes in hormones after delivery can cause changes in mood or cause you to not cope with change and stress as well.

• Lack of sleep: Caring for newborns is a 24-hour job and causes sleep deprivation which is very hard on our nervous system. Sleep is essential and needs to be a large priority during the postpartum period. When waking many times through the night, daytime sleep is non-negotiable. Sleep deprivation has proven implications on maternal mental health.

• Feelings of responsibility: You may be overcome and overwhelmed with feelings of needing to protect and care for your new baby.

• Stressful events: Certain milestones or events in your baby’s life could trigger anxiety. For example, difficulties with fertility, difficult pregnancy, a delivery that was traumatic or did not happen the way you hoped, issues with breastfeeding, a high need baby or baby with colic. Even though COVID is not as prominent in our day to day lives any more, most people are still dealing with increased baseline stress, due to the past 3 years.

• Personal or family history of depression or anxiety.

• Previous pregnancy loss or loss of a child.

• Having a baby or child with health conditions

• History of eating disorders.

• Caring for multiple children.

• Personality type (being a natural worrier) – being a more anxious person prior to pregnancy

• Not having a supportive partner or a support network after childbirth.

• High needs baby, feeding issues, or colic

Society’s messages that new motherhood should be a happy time can create barriers to getting help.

A new mother may be reluctant to recognize that she needs help with depression or may not seek treatment because she fears admitting (even to herself) how she is feeling (or not feeling) about herself, her baby and motherhood.

If you have postpartum depression, you may experience excessive sadness, frequent crying or feel like you can’t take care of yourself or your baby. You may have trouble finding joy in your baby or feel like you aren’t capable of being a parent. Postpartum anxiety is associated with excessive worrying, not with sadness. If you feel panicked or overwhelmed with fearful thoughts, you may be suffering from postpartum anxiety.

Many of the signs of postpartum depression overlap with postpartum anxiety like disrupted sleep, heart palpitations or feeling afraid. It’s common for people with postpartum depression to experience signs of postpartum anxiety. However, not everyone with postpartum anxiety is also depressed.

It’s important to discuss all of your symptoms and feelings with your healthcare provider so they can help you.

Having a baby is a life-changing experience. Being a parent is exciting but can also be tiring and overwhelming. It’s normal to have feelings of worry or doubt, especially if you are a first-time parent. However, if your feelings include extreme sadness or loneliness, severe mood swings and frequent crying spells, you may have postpartum depression.

Postpartum depression (PPD) is a type of depression that happens after someone gives birth. Postpartum depression doesn’t just affect the birthing person. It can affect surrogates and adoptive parents, too. People experience hormonal, physical, emotional, financial and social changes after having a baby. These changes can cause symptoms of postpartum depression.

Postpartum blues or baby blues

The baby blues affect between 50% and 75% of people after delivery. If you’re experiencing the baby blues, you will have frequent, prolonged bouts of crying for no apparent reason, sadness and anxiety. The condition usually begins in the first week (one to four days) after delivery. Although the experience is unpleasant, the condition usually subsides within two weeks without treatment. The best thing you can do is find support and ask for help from friends, family or your partner.

Postpartum depression

Postpartum depression is a far more serious condition than the baby blues, affecting about 1 in 7 new parents. If you’ve had postpartum depression before, your risk increases to 30% each pregnancy. You may experience alternating highs and lows, frequent crying, irritability and fatigue, as well as feelings of guilt, anxiety and inability to care for your baby or yourself. Symptoms range from mild to severe and may appear within a week of delivery or gradually, even up to a year later. Although symptoms can last several months, treatment with psychotherapy or antidepressants is very effective.

Postpartum psychosis

Postpartum psychosis is an extremely severe form of postpartum depression and requires emergency medical attention. This condition is relatively rare, affecting only 1 in 1,000 people after delivery. The symptoms generally occur quickly after delivery and are severe, lasting for a few weeks to several months. Symptoms include severe agitation, confusion, feelings of hopelessness and shame, insomnia, paranoia, delusions or hallucinations, hyperactivity, rapid speech or mania. Postpartum psychosis requires immediate medical attention since there is an increased risk of suicide and risk of harm to the baby. Treatment will usually include hospitalization, psychotherapy and medication.

Postpartum depression is common. As many as 75% of people experience baby blues after delivery. Up to 15% of these people will develop postpartum depression. One in 1,000 people develop postpartum psychosis.

Many people have baby blues after giving birth. Baby blues and postpartum depression have similar symptoms. However, symptoms of baby blues last about 10 days and are less intense. With postpartum depression, the symptoms last weeks or months, and the symptoms are more severe.

You may have the baby blues if you:

• Have crying spells.

• Feel overwhelmed.

• Lose your appetite.

• Have trouble sleeping.

• Have sudden mood changes.

Remember, it doesn’t hurt to share your symptoms with your provider. They can assess if you need treatment for your symptoms.

Certain factors increase your risk for postpartum depression:

• Having a personal or family history of depression, postpartum depression or premenstrual dysphoric disorder (PMDD).

• Limited social support.

• Marital or relationship conflict.

• Unplanned pregnancy

• Pregnancy complications like health conditions, difficult delivery or premature birth.

• You’re younger than 20 or a single parent.

• Having a baby with special needs or a baby who cries a lot and is hard to calm.

Some people feel ashamed about their symptoms or feel they are terrible parents for feeling the way they do. Postpartum depression is extremely common. You’re not the only person who feels this way, and it doesn’t mean you’re a bad person.

You may have postpartum depression if you experience some of the following:

• Feeling sad, worthless, hopeless or guilty.

• Worrying excessively or feeling on edge.

• Loss of interest in hobbies or things you once enjoyed.

• Changes in appetite or not eating.

• Loss of energy and motivation.

• Trouble sleeping or wanting to sleep all the time.

• Crying for no reason or excessively.

• Difficulty thinking or focusing.

• Thoughts of suicide or wishing you were dead.

• Lack of interest in your baby or feeling anxious around your baby.

• Thoughts of hurting your baby or feeling like you don’t want your baby.

Contact your healthcare provider if you think you have postpartum depression. This can be your obstetrician, primary care provider or mental health provider.

More research is needed to determine the link between the rapid drop in hormones after delivery and depression. The levels of estrogen and progesterone increase tenfold during pregnancy but drop sharply after delivery. By three days postpartum, levels of these hormones drop back to pre-pregnancy levels.

In addition to these chemical changes, the social and psychological changes associated with having a baby increase your risk of postpartum depression. Examples of these changes include physical changes to your body, lack of sleep, worries about parenting or changes to your relationships.

If you’ve had any of the following symptoms, please notify your healthcare provider right away.

• Thoughts of harming yourself or your baby.

• Recurrent thoughts of death or suicide.

• Depressed mood for most of the day, nearly every day for the last two weeks.

• Feeling anxious, guilty, hopeless, scared, panicked or worthless.

• Difficulty thinking, concentrating, making decisions or dealing with everyday situations.

• Loss of interest or pleasure in most activities nearly every day for the last two weeks.

Getting support is important for both you and your baby.

It can be hard to detect mild cases of postpartum depression. Healthcare providers rely heavily on your responses to their questions.

Many healthcare providers use the Edinburgh Postnatal Depression Scale to screen for postpartum depression. It consists of 10 questions related to symptoms of depression such as feeling unhappy, anxious or guilty. You’re asked to check the response that comes closest to how you’ve felt the last seven days. A higher score indicates possible postpartum depression.

If your provider feels you have signs of postpartum depression, they will recommend an appropriate treatment.

Postpartum depression is treated differently depending on the type and severity of your symptoms. Treatment options include anti-anxiety or antidepressant medicines, psychotherapy (talk therapy or cognitive behavioral therapy) and support group participation.

If you are breastfeeding (chestfeeding), don’t assume that you can’t take medicine for depression, anxiety or even psychosis. Talk to your healthcare provider about your options for medication.

Untreated postpartum depression is dangerous and affects you, your baby and those who love you. Reach out for support and let people know how you are feeling.

Postpartum depression isn’t entirely preventable. It helps to know warning signs of the condition and what factors increase your risk. Here are some tips that can help prevent postpartum depression:

• Be realistic about your expectations for yourself and your baby.

• Limit visitors when you first go home.

• Ask for help — let others know how they can help you.

• Allow yourself to sleep

• Exercise — take a walk and get out of the house for a break.

• Keep in touch with your family and friends — don’t isolate yourself.

• Foster your relationship with your partner — make time for each other.

• Expect some good days and some bad days.

With professional help, almost all people who experience postpartum depression can overcome their symptoms.

You should seek professional help when:

• Symptoms persist beyond two weeks.

• You can’t function normally or cope with everyday situations.

• You have thoughts of harming yourself or your baby.

• You feel extremely anxious, scared and panicked most of the day.

For immediate help or if you have thoughts of hurting yourself or someone else:

• Dial 911 in an emergency.

• Call the Suicide and Crisis Lifeline at 988 or use their chat feature online. They can also provide free and confidential emotional support.

Yes, both partners can have symptoms of postpartum depression. You and your partner need to seek medical care if you have signs of depression or anxiety after bringing home your baby. An estimated 4% of partners experience depression in the first year after their child’s birth.

People with postpartum depression need lots of support. Here are some ways you can help:

• Know the signs of depression and anxiety and urge your friend or partner to seek medical care.

• Help find resources for support and care

• Be a good listener. Let them know you’re there to listen and help. Call to check on the mom not to check on the baby

• Offer to help them with daily tasks like cleaning, meals, and running errands. –

• instead of saying “let me know what you need” give options

• “I would like to help today – Would you like me to help with laundry, or with food prep”

• “Have you eaten? Can I bring you a meal and mind the baby while you eat?”

• “What seems the most overwhelming right now? Can I help you with that?”

• Encourage them to seek help from a therapist or other mental health provider. Offer to set up an appointment or go with them as a support person.

• Help find support/parents groups – dates, times, registration information