The day I found out I was pregnant with my first son, I just about had a panic attack—but that was nothing new. I’ve struggled with an anxiety disorder since childhood, so I knew it would be part of my journey as a parent. With my doctor and midwife’s support, I decided to continue taking the low-dose antidepressant I’d been on prior to pregnancy. And once the initial shock of learning I was pregnant wore off, I somehow felt mentally better than I had in years. Then, on a warm night in May, my son made his entrance—and so did my postpartum anxiety.
For the unfamiliar, postpartum anxiety, or PPA, is a lesser known, but equally common cousin of postpartum depression (PPD). A 2021 study published in Psychiatry Res. showed that 1 in 5 women suffered from anxiety while pregnant or postpartum during the COVID-19 pandemic. PPA is like other anxiety, but it is linked to giving birth. It can include symptoms of various anxiety disorders (think: excessive worry, restlessness, difficulty concentrating, and irritability) or can meet criteria for a clinical diagnosis of an anxiety disorder, like generalized anxiety disorder (GAD).
There wasn’t anything distinctly traumatizing about my delivery experience, and while I certainly had my fair share of worries leading up to my son’s arrival, I was excited to get to know the tiny human I’d been expecting for nine months, and I was grateful we were both healthy. Still, while those things were true in my brain, I noticed on my first day home from the hospital that my body wasn’t getting the message.
All the new physical sensations of parenthood—sleep deprivation, hormonal ups and downs, a growing baby dependent on my body for breastmilk—propelled my anxiety to new heights. I felt on edge all day, everyday for the first month of my son’s life. I couldn’t sleep at night, even when I had been awake since the night before. Mustering up an appetite was hard, too. My body ached from all it was carrying, both physically and mentally, and I became so overwhelmed I never wanted to leave the house.
Luckily, I did, for a routine postpartum checkup. A month after my son’s birth, my midwife officially diagnosed me with PPA and recommended I increase the dose of my antidepressant. If I’m being honest, I was both surprised and yet not surprised. I knew what anxiety felt like, but I also thought it was normal to feel as terrible as I did as a new parent.
That’s common, says Elizabeth Corvino, the lead psychiatric nurse practitioner at Minded. Parenting is inherently tough, so it can be hard to tease out what’s par for the course and what’s a mental health condition. For example, if you're tired all the time, you might think you’re just exhausted from getting up every three hours at night, not depressed. Likewise, you might dismiss your persistent fears about your baby’s safety as being an attentive parent, not an anxious one.
According to Corvino, a red flag that could signify a mental health condition is when your symptoms start to interfere with your day-to-day functioning as a parent (and human). Maybe, like I was, you’re too tired to take care of yourself, or you’re worrying so much you don’t want to leave the house. Either way: You might benefit from professional help.
Asking for help, no matter how hard it seems, is important for anyone, but Corvino says it can be especially vital for new parents. “In the case of postpartum, the concern isn’t just for your health, but for the well-being of your baby,” she says. “Now there are two people, at minimum, impacted by your inability to function.”
"Looking back, I realize my biggest failure would have been trying to manage my postpartum anxiety on my own."
Because you’re likely already in touch with your OB-GYN for postpartum follow-ups, Corvino suggests checking in with them (or even your baby’s pediatrician) if you think you may be experiencing symptoms of PPA. Either provider can diagnose you, if they’re concerned about your symptoms, and suggest a treatment plan (including medication). You can also connect with a psychiatry provider online. Minded, for example, offers video appointments within days (and you don’t have to worry about leaving the house with your new baby or finding childcare).
In my case, while it was fairly easy to come to terms with my diagnosis, I was nervous about increasing my antidepressant dosage. Even though I knew I shouldn’t, I already felt a little ashamed about needing an antidepressant in the first place, especially while I was breastfeeding. But both my family doctor and my midwife reminded me of something really important: My untreated anxiety also posed a risk to both me and my son.
“It all comes down to weighing the risks of untreated mental illness during the postpartum period and the potential risk of medication,” says Corvino. “You have to determine if it’s worse to be anxious or depressed than to take a medication that’s generally seen as safe during postpartum.”
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By the time I met with my midwife, my anxiety was interfering with my sleep, eating, and self-care routines, which could directly impact my overall health. I was so on edge all the time that I was missing out on activities I usually enjoyed, like meeting up with friends and going outside for walks, which was honestly starting to make me depressed. And, just as importantly, I wasn’t enjoying motherhood as much as I wanted to. My son deserved an attentive mom who did whatever she could to take good care of herself and him.
Admitting you’re struggling can be hard—almost as hard as dealing with the anxiety or depression symptoms themselves. Society does a great job of making moms feel like postpartum should be blissful, and if it’s not, you might feel like you’ve failed. Looking back, I realize my biggest failure would have been trying to manage my postpartum anxiety on my own.
Thankfully, with each passing day on the higher dose, my anxiety lifted. I eventually started to see a therapist and open up to my friends about my struggle, which also helped. By the time my son was six months old, I felt back to myself (except, of course, for the whole sleepless nights and leaky breasts thing).
It’s been almost eight years since I first became a mom, and I’m still taking mental health medication. I sometimes wonder if I’ll ever get off it, or if I’ll need it for the rest of my life, but I’ve come to the conclusion that it doesn’t really matter. If medication helps me live a fuller life, both as a parent and as a human, then to me, it’s more than worth it.
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