HealthAfter Giving Birth, When Does Normal Worry Turn To Anxiety?

After Giving Birth, When Does Normal Worry Turn To Anxiety?

Editor’s Note: The author is a recognized authority in reproductive psychology, from pre-natal planning through the extended postpartum period. This article is the first in a series about post-partum anxiety, and serves as a general overview. Future articles will speak to risk factors and steps to take prior to the post-partum period, treatment options, and what happens if postpartum anxiety is ignored.

When you become a mother, everyone understands that worrying comes with the territory. After all, you now have another life that has been entrusted to your safekeeping, which can be a daunting thought. To a certain extent in our cultural lore, worrying is closely associated with motherhood: being concerned that if a child has wet hair they will catch a cold or checking that your child knows to look both ways before crossing the street. Often, if a new mom starts to worry, it is easy for her (or others) to dismiss the thoughts as just something that is “par for the course”.

What’s Normal?

For some women, normal worrying becomes full-fledged anxiety during the post-partum months. This can begin shortly after birth; for some women, it doesn’t start until the baby is, for example, six months old or older. Anxiety, for many women, can be experienced as being centered on a particular issue (such as the baby’s appearance) or it may be associated with nearly any thought, which can be unnerving as even what might have been a banal thought will take an anxious turn (such as running an errand might lead to the thought of getting in a car accident). Nursing mothers will often manifest anxiety in the form of “is my child getting enough milk?” While this thought makes sense, especially in the early days, for anxious new moms, the thought persists despite evidence to the contrary (the baby is gaining weight or the baby isn’t fussy and seems satiated after feedings). Other new moms might have the persistent thought that is focused on others not being able to care for the baby (including her partner, family members, babysitters, or day care providers). This can be additionally limiting as it restricts time where mom can replenish herself by being away from her baby. These are two of many examples of what anxiety might look like in a new mom.

Here are some related articles you may also find informative:

How do you know when normal worry becomes anxiety? Worry tends to be something transient, and can be managed with looking at how true the thought might be (or how based it might be in reality). An example is worrying that the baby is too cold (or too hot). With basic worry, you can ask yourself, how would I know if the baby needed his or her temperature adjusted, and solve that. Once it is solved, the worry evaporates. However, with anxiety, even if you solve the problem (and often times, anxiety doesn’t let reality come in easily), the relief might be short-lived, as the thought persists. Some women will “solve” this problem by pairing an action with their anxiety as if that action will be enough to ward the intense anxiety away (i.e. If I turn on and off the light 5 times in a row, I’ll be safe with my baby in the car). With severe anxiety, new moms know that their thoughts sound crazy to others, and might be hesitant to share what they are thinking, as they don’t want to be thought of as a “bad mother”. Some of these anxious thoughts might look like a woman being afraid that if she holds her baby while walking down the stairs, she might drop her baby. This thought might evolve to the woman thinking that she would throw her baby down the stairs. Once aware of this thought, she takes action to prevent the thought from expressing itself, but often feels shaken for the thought alone.

5 Simple Suggestions

An important consideration with anxiety is the physiological fact that our bodies can’t be anxious and calm at the same time. And we can manage our body’s response to stress purposefully. It is common for someone that is suffering from anxiety to think that she is having a heart attack, when her physical symptoms (racing heart, sweating, shallow breathing) are actually a result of anxiety. To calm a body down, different people rely on different tools. Popular strategies include: deep breathing, tensing/relaxing muscles, focusing on an object that you can touch, or focusing your energy on another tactile sense.

Here are five quick suggestions that might help you manage your anxiety post-partum:

      1. Breathe. Inhale for a 3-5 count and then exhale for the same.
      2. Distraction. See family, friends, go on a walk, watch TV, read….
      3. Talk about it. Write about it.
      4. Self-care: make sure you are sleeping and eating when you can. Aim for 3 meals a day, and closing your eyes when the baby naps.
      5. Remember that thoughts and actions are two totally different things. Having a thought doesn’t mean that you will follow through with action.

If your anxiety persists, gets worse or your thoughts are too scary to manage, call a mental health professional that has training in working with women that have perinatal mood disorders. A great list is at:

Reproductive Psychologist and Co-Director at George Washington University

Dr. Julie Bindeman is a Reproductive Psychologist outside of Washington, DC where she is the Co-Director of Integrative Therapy of Greater Washington. She is a graduate of The George Washington University and is an active member of the Maryland Psychological Association, the American Society for Reproductive Medicine, Uprooted, Postpartum Support International, Path2Parenthood, and others. Dr. Bindeman works with the spectrum of reproductive health including planning for pregnancy, fertility issues, perinatal loss, perinatal mood disorders, and birth trauma. She writes and presents frequently around these topics and is the Healthcare Director for the website


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