What is Postpartum Anxiety and What Resources Can I Turn To?

Resources and FAQs about Some Lesser-Known Postpartum Symptoms

by Alexis Barad-Cutler

We tend to have a general familiarity with the concept of Postpartum Depression (PPD), but perhaps the reason many mothers do not identify with having experienced it is because of a misunderstanding of its full scope and definition. When we think of PPD, we tend to think of symptoms of “depression” — such as feelings of sadness, irritability, loss of appetite and sleeplessness.

But there are other categories within the group of perinatal mood and anxiety disorders — that can help expand our understanding of our more disruptive feelings surrounding motherhood. We now have terms such as postpartum anxiety (PPA), and postpartum OCD (PPOCD), to help us identify symptoms we may not have previously been able to put in a box. The Motherhood Center, of New York refers to Perinatal Mood and Anxiety Disorders (PMADS) as a group of symptoms that can affect pregnant and postpartum women. Mood disorders such as depression or bipolar disorder are the ones that we typically think of when we think of the “Hallmark” version of a woman suffering from PPD. The lesser-known disorders, and the ones that are less frequently reported by mothers, are the ones in the anxiety disorder category — such as PPOCD, and PPA.

With PPA, a mother might suffer disturbing thoughts or images that center around common OCD obsessions, and can include “harm” and “sexual” obsessions. Both of these obsessions can cause tremendous distress to a parent — obviously — as she worries that she will inadvertently cause her own child harm or not be able to keep her child safe. These fears can bring about great shame and sadness to the person suffering from them. 

With PPA, mothers might find themselves unable to ever rest because they are constantly worried that a horrible tragedy will befall their child. These worries can express themselves as physical symptoms.

We need to talk about these things more, and learn more about them, so we can identify what is happening to us, and not suffer silently. So many women are not aware of these disorders, or their symptoms, and are left feeling like pariahs, or feeling like they are going crazy. Many don’t even tell their partners about these thoughts.

Here are some articles and resources on these subtype, but very common postpartum disorders. 

The Motherhood Center’s Guide to Perinatal Mood Disorders

This FAQS page is a great breakdown and guide to Perinatal Mood and Anxiety Disorders (PMADS), including a description of postpartum anxiety, postpartum OCD, and postpartum psychosis. You can also contact or read about The Motherhood Center here to find out more about their one-of-a-kind Day Treatment Center, counseling sessions, resources, and support groups. They are my go-to resource for women suffering from a range of mood and anxiety disorders, from pre-conception, through pregnancy, too postpartum. I cannot recommend them highly enough.

Call The Motherhood Center at (212) 335-0034

A Q&A with Dr. Catherine Birndorf about How to Identify and Get Help for Postpartum Anxiety (via Goop)

A concise breakdown of what, exactly, PPA is, and how it differs from the larger umbrella of PPD. Dr. Birndorf — a reproductive mental health specialist— also addresses how you can tell if you are suffering from PPA, whether first time mothers are more likely than second or third-time moms to get PPA, what intrusive thoughts are, and also what you can do to cope with these disorders. Some highlights:

  • PPD is depression in the postpartum period, and PPA is a description of all the anxiety disorders that may occur in the postpartum period, like: generalized anxiety disorder, panic disorder, and obsessive compulsive disorder (OCD, which has now officially been moved to a category of its own). 

  • For mothers, and for anyone struggling with anxiety. . . It becomes a problem when it’s interfering with their life and causing them a great deal of distress.

  • When a mother answers that she can’t relax because she’s watching the baby, worrying about the baby, or generally too amped even when the baby is totally safe, then I know the line has probably been crossed and it’s interfering with her life.

  • It’s important to note that a certain amount of anxiety—especially for first-time moms who haven’t done this before—is normal. It’s when those worries and preoccupations become more consuming or distressing that a problem may exist

  • [Intrusive thoughts] are not totally abnormal, but they are super disturbing. And as long as a mother is disturbed by them, the likelihood of her ever acting on them is rare.

  • The thing about anxiety is that it’s highly treatable, but it’s best to speak with a professional who knows how to approach treatment with different kinds of therapies—and medication, if needed.

A Helpful Primer on How to Talk to Your Healthcare Provider About Your Feelings:

This is a great checklist — by Postpartum Stress International (PSI) — to bring with you to your doctor’s appointment, when you want to voice concerns about whether the feelings and worries you might be having are “normal” or if they might be getting in the way of your daily life and normal functioning. Learn how to be your own best advocate when speaking to your provider. Doctors usually have great intentions, but they aren’t mind readers. PSI is another great resource on perinatal mood and anxiety disorders. You’ll find online support groups, online chats, educational DVD’s, and more helpful info.

Motherhood Understood

My friend Jen Schwartz hosts Motherhood Understood —a platform and community that helps women with postpartum depression and anxiety to help understand their own symptoms, to find people who speak their language and who empathize with them, and to locate resources that can help them manage or get help with these emotional complications that often accompany pregnancy and childbirth. A must-read for all moms.

A Community For Those Suffering From OCD Symptoms

The website, Intrusive Thoughts is for all kinds of OCD sufferers, but also includes postpartum OCD sufferers as well. In their section on PPOCD, it describes the “harm obsessions” and “sexual obsessions” that are especially common in PPOCD, and the types of images associated with those obsessions. The site hosts a support group, a blog with personal stories, and an “OCD chat box.”

An Essay About Managing Intrusive Thoughts:

This is a personal essay from a mom who experienced intrusive thoughts as part of her postpartum anxiety. It addresses the guilt associated with these thoughts, and the feelings of being a “bad mom”, and also offers helpful tools that the author used to manage her anxiety — including speaking to other moms who also had these kinds of thoughts, talking to a therapist, engaging in Cognitive Behavioral Therapy (CBT), and keeping a worry journal.

An Essay from a Mom Who Has Been There

A good read.

If you think you might be suffering from a mood disorder, please seek professional help, or call your doctor. Visit The Motherhood Center of New York for support and counseling or call their help line at (212) 335-0034. If you have any thoughts about taking your own life, please call the National Suicide Prevention Hotline at 1-800-273-8255.

I am not an expert, or clinician. I am simply a facilitator, providing what I hope are helpful resources.