"We call postpartum anxiety the hidden disorder because so few moms recognize it and it goes undiagnosed," says Jonathan Abramowitz, Ph.D., associate chairman of psychology and director of the Anxiety and Stress Disorders Clinic at The University of North Carolina at Chapel Hill. "It hasn't been discussed or studied much, even though it's a lot more common than postpartum depression (PPD)." In a study that tracked 1,024 women during the first three months after they gave birth, researchers from the University of Heidelberg in Germany found that more than 11 percent fell victim to postpartum anxiety disorders, while roughly 6 percent developed postpartum depressive disorders. "If you're anxious and it's getting in the way of your life, you may begin to feel depressed about that and vice versa," Abramowitz says.
According to Postpartum Support International, postpartum anxiety affects about 10% of new moms. A mom experiencing postpartum anxiety may have constant worries about the baby's health, well being, and/or development, her ability to be a good parent, and/or how she's going to balance work and home or care for multiple children. She may become restless and/or moody, and can even experience physical symptoms like a rapid heartbeat (tachycardia), dizziness, nausea, and/or insomnia.
"Some worry is adaptive, anxiety is a natural response to protect one's baby, and often that's expressed with hyper-alertness and hyper-vigilance," says Margaret Howard, Ph.D., director of postpartum depression at Day Hospital at Women & Infants' in Providence. That's why, according to the Mayo Clinic, eighty-nine percent of all new parents find their minds racing with questions and thoughts like: What if the baby suffocates? What if he/she slips under the water during a bath? What if someone breaks into the house and snatches her? "For most parents, this is just mental noise," says Abramowitz. "They learn to dismiss it, so the thoughts stop cropping up." On the other hand, if you know your worries are irrational but you can't get them out of your brain, that suggests you may be tipping the scale. The same is true if your anxiety isn't tied to any particular threat, or if it leads you to dread everyday situations like driving or going back to work, or if panic attacks come out of the blue, or if it interferes with your ability to function because you can't go back to work because of it and/or you can't function because you check on him/her constantly throughout the night to make sure he/she is still breathing. "Anxiety is a (real) problem when it overshoots reality," Howard says.
You may assume your symptoms will go away, but that can be risky as your anxiety may only worsen and worsened and heightened anxiety could affect the bond between you and your baby (as well as many other aspects of your life: work, spousal relationships, friendships, etc.). Seek help if anxiety is disrupting your sleep, if you are missing work, if you can't concentrate, can't eat, or are constantly preoccupied with worrisome thoughts.
Only you can bring it to a doctor's attention so tell your ob-gyn, or your general family practitioner, or even your child's pediatrician and ask for a referral to a psychologist who specializes in cognitive behavioral therapy (CBT). Therapy can give you the skills you need to change your thinking and behavior patterns that lead to your anxiety. "This isn't about positive thinking, it's about being rational," says Abramowitz. An expert can teach you techniques to help you relax, such as: meditation, progressive muscle relaxation, biofeedback, and mindfulness training. If done before bedtime, they can even set you up for a good night's sleep which in turn will help ease your overall anxiety levels. Getting up and getting out and getting moving can also relieve anxiety by helping you feel more in control. A study done by The University of Georgia showed that six weeks of resistance training or aerobic exercise led to a remission rate of sixty percent and forty percent, respectively, among women ages 18 to 37 with generalized anxiety disorder. A good support system is also highly beneficial. Be open and honest with your loved ones and close friends, explain that you know your anxieties are irrational but you cannot help it at the moment and you need time and space when your anxiety is kicking in. They should all be understanding and supportive and give you the space you need without poking fun or making you feel badly. If they do poke fun or make you feel badly for your anxieties bring them to the doctors with you so the doctor can explain postpartum anxiety to them.
For more severe cases of postpartum anxiety, medications can be used, even if you are nursing. "The use of medications needs to be determined on a case-by-case basis," Dr. Fitelson says. "Your mental health and your ability to take care of and bond with your child are so important that at some point they take precedence over the low or theoretical risk to your baby of taking an antidepressant."
I know first hand how difficult it is to live, function, parent with postpartum anxiety. I could not sleep at night when everyone else slept, I was literally terrified that she would stop breathing. I was awake constantly looking for my daughters chest to fall and rise with each breath, I would try to feel for her breath if it was too dark to see, I would listen for the sounds of her tiny snores, I would stand there with tears in my eyes and a tightness in my chest and throat and this was on going through out the night. It wasn't the occasional wake up and the occasional check, it was literally every ten minutes throughout the night. I could not sleep when everyone else slept because I had the thoughts of what if?!?! What if someone took her, what if she dies, what about SIDS, what if she spits up while laying on her back and chokes, what if she messes herself and doesn't cry to wake me and she lays in it for hours before I get to her, what if I fall asleep and I don't hear her cry for a feeding or diaper....WHAT IF! I also had a very hard time going back to work.... I took the entire three months off and attempted to go back full time but that only lasted two weeks before my anxiety was so bad that I was hyperventilating in the bathroom with tears running down my face anxiously waiting to be able to get home and hold her because what if when I said goodbye was the last time I'll see her. So I ended up working part time for the first 18 months and even then I took off when I could, left early at every chance I had, and went in late because I had such a hard time saying goodbye. The first time her father came home later than expected I basically had his face and hers on a milk carton. I called his phone probably 10 times, sent numerous text messages, called his sister, called his mother, called his cousin, sent numerous texts to other family members, paced in my living room sweating and crying....he was 10 minutes later than what he had said he would be. It was at that moment that I realized my fears and worries were completely irrational and out of control. While I could not stop these thoughts and could not stop the anxiety, what I could do was talk to him about my anxieties and tell him I know they are irrational and I know they seem silly to you but emphasize that it is real to me and I simply cannot help it. It took him a bit of time to handle my anxieties with ease, I know it was frustrating to him at first because he didn't understand, but he never made me feel insane or weird or badly for it. He took it all in stride and over time we were able to look back at some of my "moments" and laugh, and that helped me more than anything else.
Other things that helped me were:
- Redirection. Constantly reminding me that she was fine and my fears and anxieties were unfounded, I had to keep telling myself that I was being irrational and had to literally fight with my brain to change my thought process.
- Distraction. I would distract myself with a fun and upbeat song, or get caught up in something I was interested in. Pinterest worked wonders and made the time fly by when I needed it to.
- Positive Thoughts. I would remind myself of what a great man and a great father he was, remind myself that my mother is just as OCD as me when it comes to child care, remind myself that the babysitter has been doing this for nearly 30 years and what a great lady she is.
- Meditation. I would close my eyes and breath in deeply then exhale slowly, all the while clearing my head. I would do this for 15 minutes several times a day. It helped to lower my overall anxiety. I also have happy spaces that I try to visit often and spend 15 minutes or more at a time there clearing my head.
- Reaching Out. I reached out to other moms who had the same struggle with postpartum anxiety as me. We shared stories, fears, moments, whatever you want to call them and it helped me to feel connected and not so crazy.
- Avoidance. I avoided triggers and anxiety enhancers. I stayed away from the negative Nancys, cut out caffeine and alcohol, and stopped watching all cop television shows (Law & Order, Bones, NCIS, Blue Bloods, and anything on Discovery ID).
- Exercise. My daughter is now at the age of two years old and I finally just signed back up for the gym and my only regret is not doing it sooner. This has helped to lower so much stress and anxiety. I feel like I can breath again.
- Time. With time my anxiety eventually started easing up a bit. And like most things, time is all it takes. So have patience.
- Support. Without the support, the understanding, the patience, and the love from her father I do not think I would have been able to pull through as quickly as I did. Yes, I still struggle, but having him there to support me, laugh with me after a moment, and help me through makes it a thousand times easier.
http://www.postpartum.net/get-the-facts.aspx
http://perinatal.anxietybc.com/new-moms/recognizing-post-partum-anxiety
http://www.postpartumprogress.com/the-symptoms-of-postpartum-depression-anxiety-in-plain-mama-english
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