Parents, especially new parents, are known for being endearingly worrisome creatures. Is the baby warm enough? Hungry? Sick? Hurt? Happy? Healthy? We love our children like we've never loved anyone or anything, so the stakes are pretty high. But where does one draw the line between "worry" and "anxiety"? And are there parenting behaviors that cause anxiety?
Usually, it's not that specific behaviors cause anxiety in and of themselves. Instead, and more often than not, anxiety occurs as the result of various factors. The behaviors described can contribute to, rather than cause, anxiety. Or a behavior may act as a catalyst for anxiety. But it's rarely as simple as one issue causing anxiety.
But for all this, anxiety is not rare. Everyone experiences some anxiety, per the National Alliance on Mental Illness (NAMI). Anxiety disorders, however, are marked by someone being unable to stop worrying, to the point that it interferes with their ability to function or perform every day activities. Approximately 18% of the adult population of the United States — a staggering 40 million people — suffer from anxiety disorders, according to NAMI data. While there are a number of different anxiety disorders, each with a unique set of symptoms, as a group they are defined by "persistent, excessive fear or worry in situations that are not threatening."
Romper spoke with Dr. Venus Mahmoodi, Ph.D., a clinical psychologist at the Seleni Institute with a specialization in perinatal mental health, to discuss parenting behaviors (and situations) that may contribute to one's personal anxiety:
Being Pregnant In The First Place
Being anxious and worried during a pregnancy is completely typical. Worries like, "Will my baby be OK?" and, "Am I ready for parenthood?" and fears related to birth are common. So how can you tell the difference between the worries everyone has from time to time and perinatal anxiety?
"The majority of women have worries during pregnancy and postpartum. It's a transitional period that is fraught with unknowns," Mahmoodi tells Romper. "With run-of-the-mill anxiety, anxious thoughts are fleeting. It's kind of like when someone stands really close to a subway platform and for a fleeting moment they think, 'What if I fall on the track?' Usually people dismiss the thought and move on. People with anxiety [disorders] will continue thinking about it and feeling worried about it. Then, when that's over, they may think about something else. When the thinking becomes so persistent that it's affecting functioning and behavior, then it's time to seek support."
Signs of perinatal anxiety include sudden and extreme anger or sadness, lack of mental clarity, inability to finish tasks, guilt, irritability, extremely anxious about their baby and children, and a "robotic" sense that you're just sort of going through the motions of living rather than truly engaging in anything, as noted by the American Academy of Pediatrics (AAP).
While perinatal anxiety is more common among pregnant people with a history of depression and anxiety (either personal or family), other risk factors include difficult birth or pregnancy experiences, a twins or multiples pregnancy, unplanned pregnancy, relationship or financial problems, or lack of support from loved ones.
Isolation That Can Come With Having A Child
It's completely understandable that a new parent wouldn't feel like venturing out of the house with an infant. A baby requires so much stuff, and as a new parent you're still waddling around with a saddle-sized, hospital-issue pad. Maybe you haven't fully recovered labor. Maybe you don't love the idea of breastfeeding in public. Or maybe you don't want to bring your not-yet-immunized infant around so many people with so many germs. Best to hunker down, right? Well, to an extent. But the isolation of new motherhood can sometimes lead to anxiety. Dr. Samuel Hunley, Ph.D., of Emory University, who studies how humans think about and perceive the space immediately surrounding the body, with a focus on how anxiety and phobic fears affect the way we see the space around us, writes in an April 13, 2017 article for Anxiety.org:
"There's ... growing evidence that loneliness might affect your mental health ... Dr. Manfred Beutel of Guttenberg University Mainz in Mainz, Germany, and his colleagues ... recruited more than 9,000 German residents and asked them about their feelings of loneliness, as well as their symptoms of various mental disorders. They found that those who reported greater feelings of loneliness were more likely to experience symptoms of depression, generalized anxiety, and thoughts of suicide. In other words, loneliness has a much greater impact on your life than you might have thought."
Couple that with a body surging with all kinds of hormones, sleeplessness, and very normal anxieties about learning how to care for your infant, and the possibility of anxiety is certainly something to bear in mind.
"When a new mom is isolated she often doubts herself and doesn't feel like anything she is doing is right," Mahmoodi says. "Feedings, bathings, diaper changes all feel like they aren't being done correctly. Isolation can also foster these anxiety thought patterns because there is no soothing, rational voice to say, 'You're good enough and you're doing a good job.' Reaching out to a moms group, family support, and friends reaching out can be very helpful."
Watching Your Baby On A Baby Monitor
I don't think I know a single parent who hasn't worried about their baby's breathing at night. For some parents, that anxiety becomes so intense that they fear going to sleep, and seriously consider just watching their baby to ensure that their little one's chest is rising and falling as it's supposed to. So you'd think that the high-tech baby monitors of today, the ones that track oxygen levels and heart rate, that provide a live-feed of everything that's going on in the baby's crib, would alleviate that anxiety. Not necessarily, it turns out. While baby monitors can certainly be a helpful tool that gives parents much needed peace of mind, for others it can be what psychotherapist Nitzia Logothetis referred to as"a gateway to greater insecurity" in a 2014 article for HuffPo. She writes:
"Rather than providing calm reassurance, it was whipping me into a hyper-vigilant frenzy. ... This made sense. The experience of anxiety often involves obsessively seeking reassurance, only to be made more anxious by the relentless search for unsatisfactory answers. And it was robbing me of good sleep, which is protective against anxiety."
Mahmoodi says the usefulness of a monitor depends on the individual. "The majority of the new moms I encounter are able to use video monitors and it helps them train their babies to self-soothe," she says. "However, some moms with anxiety will obsessively check monitors to see if their babies are breathing and if the baby is moving." Mahmoodi warns that for parents dealing with anxiety, especially OCD, monitors may provide momentary reassurance, but that anxiety will often quickly flare up again.
Like baby monitors, attachment parenting (AP) — a parenting style articulated by Dr. William Sears — can be something that gives parents a great deal of confidence and reassurance. It can also create anxiety in others.
The basic principle of AP is that parents (especially mothers) should seek above all else to build a strong physical and emotional connection between parent and child through what Sears refers to as "the seven Bs" — birth bonding; breastfeeding; baby wearing; bed-sharing; belief in your baby’s cries; beware of baby trainers; and balance. According to Sears' website, babies raised in this manner are smarter, healthier, and more emotionally secure.
Dr. Gwen Dewar, Ph.D., writing for Parenting Science states that attachment parenting can"leave parents feeling overwhelmed, unsupported, and socially isolated from other adults," all of which can contribute to anxiety.
(Of course, the truth is there is no evidence that the attachment parenting style of child-rearing is the only way to form a secure attachment with your baby — many of the benefits purported by AP supporters often conflate "attachment parenting" with "attachment theory.")
A reported 83% of new moms will try breastfeeding, according to the Centers of Disease Control and Prevention (CDC). But not all women will ultimately breastfeed for as long as they'd hoped, and that can put them at risk, via internalized anxiety ("I'm not enough to take care of my baby") or externalized anxiety ("I'm not doing as well as this other mom who loves breastfeeding.").
Speaking to Romper in 2017, Dr. Bridget Young, Ph.D., Research Professor and Certified Lactation Counselor stated “Women place so much shame and guilt upon themselves when they don’t meet these breastfeeding goals. Some women internalize it so deeply that it can contribute to increased postpartum anxiety and depression.”
Breastfeeding anxiety can also fall into the realm of "medical mystery." Writing for The Bump, health journalist Julie Revelant talks of her experience nursing her child:
When my daughter latched on and my milk let down, an intense feeling of anxiety, panic and doom would wash over my entire body. For a brief moment—about 20 or 30 seconds—I had a sudden irrational fear that something bad was going to happen.
This rare condition is known as Dysphoric Milk Ejection Reflex or D-MER. It's a physiologically induced emotional reaction to the let-down of breast milk. These anxious feelings — ranging from mild irritation to melancholy, to complete despondency and thoughts of self-harm — last anywhere from a few seconds to two minutes. Scientists believe it is caused by the sudden drop of dopamine necessary for the body to release breast milk. Fortunately, this unusual condition has not been linked to generalized anxiety or negative mental health outcomes.
But struggling to meet goals and medical curiosities aside, even moms who don't struggle to breastfeed can still experience anxiety brought on by nursing.
"Breastfeeding is hard," Mahmoodi says. "Physically, women experience nipple pain, breast pain, and at times mastitis. ... Mentally, there are so many unknowns associated with breastfeeding. Is my baby getting enough to eat? What if my supply runs low? What if I can't do it?"
Breastfeeding may be "natural," but even under the best of circumstances it can sometimes be a source of worry or even anxiety.
If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.