Feeling some levels of stress and anxiety is likely when managing a new baby, but generally these feelings pass over time.
Ongoing disturbing thoughts or feelings of worry and tension that affect your ability to cope day to day, however, may indicate you are experiencing postnatal anxiety, which affects around 1 in 5 Australian women.
Anxiety is the broad term used that refers to range of conditions with a number of common symptoms:
Take our free and anonymous the Anxiety Self-Check and download the COPE Postnatal Anxiety Fact Sheet
Many people with postnatal anxiety disorders often describe feeling like they are ‘going crazy’ or ‘losing their mind’. Racing thoughts can cause them to feel a range of physical and emotional symptoms. This can be exacerbated by a lack of sleep that can come with anxiety and also with a new baby.
Women experiencing anxiety may try to get everything in order and under control to ensure they’re doing things ‘the right way’ or avoid ‘something bad’ from happening. For example, they may check on the baby continually (even when asleep) for fear that they will stop breathing, or have visions of something harmful happening to the baby.
My symptoms were so different to what I knew was normal. I was constantly having visions of accidentally harming him – they filled my mind. I thought I was just being an over anxious mother and I never mentioned it to anyone. Also, my lack of connection with him was difficult to put into words for ages because I didn’t really know what it should feel like.
Lack of sleep (sleep deprivation) can have a great effect on your mood, energy and ability to think clearly.
Anxiety is the most common type of mental health problem. It affects one in four people in their lifetime, and up to 1 in 5 Australian women in their first year after giving birth.
Anxiety is even more likely to occur among women in the year following the birth of a baby, particularly if you have experienced anxiety in the past. However, some women may only experience anxiety for the first time in the perinatal period.
Postnatal anxiety and postnatal depression co-occur in up to 50% of cases.
Thankfully, treatments for postnatal anxiety and depression are similar and can treat both conditions at the same time.
There is no single cause of anxiety. It is likely to be a result of:
A combination of these factors may increase your risk of developing anxiety.
There are also some factors that protect you, such as having good support networks.
Also, women who have experienced anxiety in the past may find that their symptoms return or get worse during pregnancy or early parenthood.
I struggled to get out of the house for fear someone would take my baby. Ridiculous to a normal person but in the state I was in I couldn’t tell anyone for fear they would think I was crazy! I think depression is talked a lot about but anxiety is just as bad.
There are a number of different types of anxiety conditions, each of which has a different set or cluster of symptoms:
Feeling worried about perinatal issues on most days over a long period of time (e.g., six. months). Some common topics of worrying include:
- The infant’s wellbeing, safety and possible threats (e.g., SIDS)
- Getting one’s life in order, having everything planned and sorted
- Constant worry about how they will cope
- Breastfeeding worries (e.g., had the baby had enough milk, will their milk supply run out)
- Keeping the household chores attended to
- How they will manage work and parenthood
- How to give their other children enough attention while meeting the needs of the new infant
Frequent attacks of intense feelings of anxiety that seem like they cannot be brought under control. These attacks can occur when:
- Thinking about leaving the house with their new baby
- Attending mother's groups
- Worrying about sleep and settling issues
- When transitioning their infant to solid food (fear of choking)
Involves an intense fear of criticism, being embarrassed or humiliated, even in everyday situations. Some common examples in the perinatal context include:
- Invasion of their personal space
- People touching their baby
- Worries about involvement of friends and family and different opinions on baby’s needs
- Infant drawing attention to them publicly
- Worries about mother’s groups
- Worries about people judging their parenting (e.g., crying baby in supermarket)
Fearful feelings about a particular object or situation. This can commonly include vomiting (babies often vomit), body changes (eating disorder traits/anxiety), death of a loved one, coprophobia
There are three main parts to OCD:
- Obsessions – thoughts or images that keep coming into your mind
- Anxiety
- Compulsions – thoughts or actions you repeat to reduce your anxiety
Obsessions and compulsions are often (but not always) focused on the baby – for example worrying about not sterilising your baby’s bottle or checking your baby through the night to make sure they’re still breathing. Some parents may find that previous OCD symptoms worsen during pregnancy or after having a baby while others may experience it for the first time.
Intrusive thoughts, otherwise known as “scary thoughts”, are unwanted negative thoughts and mental images.
Symptoms can develop gradually over time, or come on suddenly and intensely. If not identified or treated, symptoms can worsen over time – even to the point where the anxiety has ‘taken over’ and you cannot function. This can make life difficult to manage, especially with the demands of a new baby.
I remember times of sitting on the couch watching TV and just feeling overwhelmed with grief. I just felt so sad and anxious about everything… I’d lie awake at night waiting for her to cry… the sleeplessness, the anxiety, not being able to watch the news because everything made me so sad.
Your doctor or maternal and child health nurse may offer you screening with the Edinburgh Postnatal Depression Scale and/or the Antenatal Risk Questionnaire (which is used both antenatally and postnatally).
The Edinburgh Postnatal Depression Scale is a series of 10 questions about how you have felt in the last 7 days. For each question, you choose the response that describes your feelings. While this tool was developed to assess women for depression, it can also help your doctor or midwife identify anxiety symptoms.
The Antenatal Risk Questionnaire asks questions about your life more generally and helps to identify factors that may place you at greater risk of experiencing anxiety.
If you think you might be experiencing anxiety, you can ask your doctor or maternal and child health nurse for these screening assessments. Your score(s) will tell you and your doctor or maternal and child health nurse if further mental health assessments would be helpful.
A GP or trained mental health professional can diagnose anxiety. They do this by asking whether you have had certain symptoms over a period of time (usually 2 weeks or more)
Thankfully the treatments for both postnatal anxiety and depression are similar and can treat both conditions at the same time.
There are many safe and effective treatments available for postnatal anxiety. The right treatment for you will be determined by your personal history, and how severe your anxiety condition is.
Mild to moderate anxiety usually means you are experiencing a few symptoms and, while affecting your quality of life and ability to get things done, you are still likely to be able to function generally. Emotional and practical support, plus support counselling and/or psychological treatments can be very effective.
Support counselling for postnatal anxiety can be provided individually or in groups. This can allow you to talk through how you are feeling and thinking with someone who can support and listen in a non-judgemental way. Support counselling can help you to develop strategies to deal with challenges that may be contributing to your feelings of anxiety generally, or in specific situations.
Two types of psychological treatments can be effective for treating mild to moderate anxiety – cognitive behaviour therapy (CBT) and interpersonal therapy (IPT).
These treatments can be conducted one-on-one, in groups, or online, and are generally delivered by a trained health professional with expertise in mental health.
Therapies can involve you and your infant together, focussing on your relationship and bonding as you also learn to manage anxiety.
Cognitive behaviour therapy is a structured treatment that targets your way of thinking (cognition) and acting (behaviour), which can impact the way you feel – in this case by reducing your feelings of fear and anxiety.
It is common for people with anxiety to view things catastrophically, leading them to believe that the worst will or has happened.
Cognitive behaviour therapy can help you to identify these thinking styles, rationalise your thinking, and look at things more objectively. Once these thinking patterns are recognised, you can begin to consciously and deliberately challenge and replace these thoughts to help reduce anxiety and control its symptoms.
CBT can also help you to reduce the intensity of physical feelings of fear and anxiousness and/or panic, and manage symptoms through a range of strategies, including deep breathing and muscle relaxation. Because anxiety can cause people to avoid situations that cause them distress, cognitive and behavioural techniques can also help you approach situations you may have been avoiding.
Often, anxiety may be caused by tensions with others, personal losses, changes and/or conflicts in relationships.
Interpersonal therapy (IPT) helps people to find new ways of approaching and dealing with particular situations that may lead to ongoing feelings of anxiety.
There are safe and effective medications that can be used to help bring the often overwhelming symptoms of anxiety under control. Getting anxiety under control can improve your quality of life and overall experience of parenthood with your new baby.
Although commonly associated with the treatment of depression, antidepressant medications can be very helpful in treating anxiety disorders. In particular, two types of antidepressants are recommended – selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These medications can be safely used to manage anxiety (and depression) symptoms, and can be safely used when breastfeeding.
These medications can take up to three weeks to have an effect, and may cause some side-effects. It’s a good idea to talk to your health professional about the prescribed medication.
When anxiety symptoms are very severe and/or that person is experiencing panic attacks and faster relief is required, a class of medication called benzodiazapines may also be prescribed while antidepressants take effect. Benzodiazepines should only be used for a short period (up to three to four weeks) as they are addictive.
Benzodiazepines vary in the amount of time it takes for the body to eliminate them. Those that are eliminated more quickly (short-acting benzodiazapines) are the type that can be used, while long-acting benzodiazapines should be avoided. Again, discuss medical treatment with your health professional to clarify the nature, type and action of the medication you are being prescribed, as well as common side effects.
Taking medication may feel concerning, but it’s important to weigh up the pros and cons. Medication can help give you the resources to manage the symptoms and get on top of anxiety so you can benefit from other psychological or supportive therapies.
Learn about the range of emotional challenges that Renee and Stevie each experienced on their journey to motherhood, and how their friendship helped them through.
Anxiety can worsen if not treated early. Plus, managing the demands of a new baby may mean it’s more difficult to get on top of anxiety without professional help.
The sooner you can get anxiety under control, the sooner you can improve your quality of life and overall experience of parenthood.
These questions are designed to explore whether you may be currently experiencing any symptoms of anxiety.
COPE is committed to providing high-quality perinatal mental health information and has developed a series of postnatal mental health fact sheets for women and their families.
Types of postnatal mental health conditions, their signs or indicators, plus what to do if you feel you may be experiencing symptoms.
Postnatal depression is a common but debilitating condition that affects one in seven women following the birth of their baby.
Postpartum psychosis, also referred to as postnatal psychosis or puerperal psychosis, is a rare condition affecting 1-2 in every 1000 mums.
Bipolar disorder is a serious mental health condition. Those with a history may have a relapse of bipolar disorder in the postnatal period.
Signs and symptoms, treatment, management, and additional support for schizophrenia in the postnatal period.
Living with borderline personality disorder can be challenging. Having a baby makes things more difficult - that's why it's important to get help.
Post traumatic stress disorder (PTSD) following birth can develop if you have personally experienced or witnessed a traumatic birth event.
Intrusive thoughts, otherwise known as “scary thoughts”, are unwanted negative thoughts and mental images.
Click the Exit Site button or press "Esc" on your keyboard to exit this site quickly. Click here to learn how to keep your identity safe online.
