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Postpartum Anxiety Disorders

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By Alice Pickering, Psy.D.

The birth of a child is a time filled with a variety of emotions, from excitement, joy, and bliss to the less frequently discussed anxiety, unease, and overwhelm. And while not all women experience this, many new mothers may be prone to developing an anxiety disorder after the birth of a child due to significant role changes.

The various demands on their time, lack of sleep, additional financial responsibilities, concerns about parenting skills, and feelings related to changes in body image after pregnancy (Jacob and Storch, 2013) may all be contributing factors to increased levels of anxiety.

Many women who experience postpartum anxiety may initially be diagnosed with an adjustment disorder (coined “postpartum stress syndrome” by Karen Kleiman, MSW, LCSW, as it relates to the postpartum period). So when does an adjustment disorder become more than an adjustment disorder?

It’s important to consider multiple factors such as presenting symptoms, the duration of those symptoms, the intensity or severity of the symptoms experienced, and the level of impairment as a result of the aforementioned factors.

Generalized Anxiety Disorder (GAD) is characterized by excessive worry as it pertains to a multitude of events or activities (Jacob & Storch, 2013). Diagnostic criteria suggest the presence of symptoms for at least 6 months, although maternal anxiety notably increases during the first postpartum month (Britton, 2008).

In women during the postpartum period, this may present itself in various ways. Moms may report...

  • a low frustration tolerance due to feeling overwhelmed, which may result in one being reactive to situations as opposed to responsive
  • body aches and pains from places where moms hold tension, such as shoulders, back, neck, or chest
  • increased forgetfulness due to difficulty being present in the moment
  • difficulty trusting others to care for baby
  • difficulty enjoying experiences because of worrisome thoughts feeling paralyzed at the thought of leaving the house
  • feeling on edge
  • challenges falling or staying asleep even when given the opportunity
  • intrusive or unwanted thoughts, often related to the health and safety of the baby (it is important to note that at subclinical levels, thoughts related to the safety of baby are common aspects of parenthood)
  • checking on baby multiple times throughout the night
  • difficulty leaving the home or travel in a vehicle for fear of an accident

While the information above is not a diagnostic checklist, it is important for mothers to be informed of the ways in which anxiety may manifest during the postpartum period in order to properly advocate for their needs. Furthermore, failure to address a mother’s anxiety may leave her vulnerable to depression (Matthey, Barnett, Howie, and Kavanagh, 2003).

Anxiety disorders are prevalent during the postpartum period and affect approximately 10-15% of women. Early identification of symptoms, in addition to effective intervention, may improve a mother’s adjustment during this time. It may also reduce the potential for development of an anxiety disorder or exacerbation of pre-existing mental health related problems (Jacob & Storch, 2013).

Mothers may seek pharmacological or therapeutic intervention through referrals provided by their primary care provider or obstetrician, as well as, independently locating a provider. Postpartum.net is an excellent resource for mothers to find local support groups, or providers and therapists in their area who specialize in treating maternal mental health concerns.

Ongoing conversation around mental health as it relates to pregnancy and the postpartum period is imperative in order to ensure that mothers are receiving the best care available.

Dr. Pickering is a licensed clinical psychologist who believes that mental wellness is achievable for everyone. She has worked with a wide array of mental health concerns from her clinical experiences at the state hospital, and more recently, has focused her efforts on maternal mental health after becoming a mother. She hopes to share her knowledge so mothers feel supported, connected, and empowered throughout their motherhood journey. You can find her at https://momdocpsychology.com.

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References

Britton, J. R. (2008). Maternal anxiety: course and antecedents during the early postpartum period. Depression and anxiety, 25(9), 793-800. doi: 10.1002/da.20 325

Jacob, M. L., & Storch, E. A. (2013). Postpartum anxiety disorders. Asian Pacific Journal of Reproduction, 2(1), 63-68. doi: 10.1016/S2305-0500(13)60119-0

Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?. Journal of affective disorders, 74(2), 139-147. doi:10.1016/S0165-0327(02)00012-5




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