Postpartum depression (PPD) has been highlighted regularly in recent years, and to the benefit of pregnant women. Now moms-to-be are guaranteed to get an informational pamphlet and their doctors will conduct regular screenings. Unfortunately, this is not the case for postpartum anxiety (PPA). Although it's starting to get more attention, there's more work to be done to prepare expectant mothers. That's why moms like me want pregnant women to know about postpartum anxiety.
I have a history of depression, so postpartum depression was very much on my radar. When I got pregnant I met with my psychiatrist and we decided that staying on my anti-depressant was the best choice. We hoped it might inoculate me against PPD, and to that end, it worked. Postpartum anxiety, however, I never saw coming. I was constantly worried that something terrible was going to happen to my baby and found myself unable to quiet my mind. My obsessive compulsive tendencies went into warp drive until I finally sent up my bat signal with friends and family and got help.
During pregnancy, it's natural to fantasize about how amazing life will be with this new little person to care for. It may well be, but I for one think it's worthwhile to prepare yourself just in case it's not. If you're pregnant, you should know the following about PPA:
Postpartum Anxiety Is Different Than Postpartum Depression
It's true that PPA and PPD can be comorbid (occurring at the same time), but they are distinct disorders. Both can affect sleep and eating habits, but postpartum depression is marked by feelings of sadness, hopelessness, and guilt, according to the American Pregnancy Association (APA). Moms with PPD experience fatigue and may feel disconnected from their baby.
Postpartum anxiety, on the other hand, is characterized by the APA as a new mother having racing thoughts and constant worry. It can include physical symptoms, like dizziness and nausea, and occur along with postpartum panic disorder and postpartum obsessive compulsive disorder.
It Can Be Hard To Diagnose
Postpartum anxiety is known as a hidden disorder. According to the Massachusetts General Hospital Center for Women's Health, there is a clinical overlap between PPD and PPA. Routine screenings assess symptoms of depression, but symptoms of anxiety are often masked. When anxiety occurs in the absence of depression, PPD gets ruled out and many women who still don't feel like themselves simply stop seeking help.
It's Fairly Common
It might surprise you to know that postpartum anxiety may be even more prevalent than postpartum depression among new mothers. According to Postpartum Support International, approximately 10 percent of postpartum women develop anxiety. A study recently published in the Journal of Affective Disorders puts that number at 15 percent. When a mood disorder is that significant in the population, pregnant women owe it to themselves to be informed.
Know Your Mental Health History
Your mental health history is a significant predictor of whether or not you will get a postpartum mood disorder. According to Postpartum Progress, a family history of mental illness can result in a genetic susceptibility. If you yourself have suffered from anxiety, depression, obsessive compulsive disorder (OCD), or eating disorders, you're also at a higher risk, especially if any of those occurred during pregnancy.
You Can Reduce Your Risk Now
There's a nature component, to be sure, but there's also a nurture aspect when it comes to postpartum depression and anxiety. I'm in no way saying that it's your fault or that you did something wrong if you end up with PPD or PPA. You can't help your genetics.
However, if you know you have risk factors and you are pregnant, it might be a good idea to practice healthy habits such as eating a balanced diet, drinking enough water, getting adequate rest, and incorporating stress-reducing practices (e.g. mindfulness, meditation, etc.) into your daily life. There's not a ton within your control here, but these are (and they're good for you anyway).
Familiarize Yourself With The Signs
Increasing your awareness about PPA is one of the most crucial things you can do for yourself as an expectant mom. Be on the lookout for the following symptoms of postpartum anxiety:
- Racing mind
- Constant worry
- Checking things constantly
- Scary thoughts
- Lack of appetite
- Sleep disturbances
- Physical symptoms like dizziness, nausea, or headache
If you pass the PPD test but still know something is wrong, bring up PPA with your doctor.
Don't Be Afraid To Ask For Help
Now is a great time to build your support system. As a mom with a new baby, you're going to need help with laundry, breastfeeding or bottles, food preparation, and the like. Make sure you have people lined up to pitch in. You'll want that even if you don't develop a mood disorder, but if you do, you'll have people around to encourage you to get medical attention and watch the baby so you can.
Perhaps most important, if you're pregnant and at risk for PPD or PPA, make sure your doctor or midwife knows and involve your mental health care team in your prenatal care. Once the baby comes, their pediatrician can also be a great resource.
Treatment Options Are Available
You don't just have to put up with anxiety. If you do, you could end up harming your bond with your baby. Rest assured that there are a range of safe and effective treatments for PPA. Counseling was very effective for me. Just having someone objective to talk to was helpful, and my therapist worked with me on specific strategies like thought-stopping and referred me to a mindfulness coach.
For mild to moderate PPA, the Centre of Perinatal Excellence suggests two psychological treatments: cognitive behavioral therapy and interpersonal therapy. More serious cases may require a medical intervention such as a selective serotonin reuptake inhibitor or tricyclic antidepressant. Don't let anybody make you feel bad for taking a pill if the other interventions don't work. I run on citalopram.
It Can Last For A While
At least with pregnancy, you know you'll be done with it in roughly 40 weeks. Postpartum anxiety doesn't have an expiration date. My daughter is 2 and while the disturbing thoughts have abated, I still feel the need to constantly be doing something. I don't say this to scare or depress you, but to help you manage your expectations. Enjoy every moment of your pregnancy, but please, don't let postpartum anxiety take you by surprise.
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