Postpartum Anxiety or Normal New Mom Fears?
Anxiety is common among pregnant women and new moms, but often dismissed as part of parenthood. How to know when to get help.
Allison McGill’s first six weeks with her new baby, Jack, were as smooth as they come. Jack was healthy and happy, and McGill enjoyed being a new mom.
“I didn’t have anxiety, I didn’t have lot of the things that would eventually take over my life,” says McGill, a 40-year-old District of Columbia resident and president of the Atlanta-based nonprofit Lazarus Ministries. “I was actually pretty calm.”
But that didn’t last.
While taking a walk with Jack along the Anacostia River last August, McGill had a vision of him falling in. From then on, she made sure to stay at least 15 feet away from the water’s edge. Later, McGill feared that Jack would fall out of her seventh-floor apartment window. After that, she insisted that Jack stay at least five feet away.
Next, compulsions set in. McGill often checked on Jack four times a night – even when he wasn’t crying. “I started to get worried that he would stop breathing,” despite the fact that the baby monitor indicated he was, she says.
McGill never stopped worrying. She was afraid, for example, that taking a phone call at a softball game would put Jack at risk for being hit by a ball. Afraid that if she didn’t constantly cradle his neck, it would snap.
“The thing that keeps going through my brain is that if I make one mistake with Jack, it could have tragic consequences,” McGill says. “The stakes were just up.”
Depression, which affects about 15 percent of new moms, is not the only mood disorder that can hit women after they give birth. About 10 percent of new moms have postpartum anxiety, and about 5 percent struggle with postpartum obsessive-compulsive disorder, according to Postpartum Support International. McGill had all three.
“I thought I was being a good mom by checking [Jack] all the time because I love him so much and want to make sure he’s OK,” she says. “But what I was doing was driving myself crazy.”
‘The Gerber Myth’
At least 30 percent of cases of postpartum anxiety and depression begin during pregnancy, according to Barbara Byers, a reproductive psychiatrist in Chevy Chase, Maryland, who says new motherhood is “the perfect storm” for these mood disorders.
“The stakes are higher because women have a baby who’s completely dependent on them – especially if they’re breastfeeding – and their outlets [for stress-relief] go away,” she says. “It’s this time period where anxiety really just explodes.”
What’s more, some women buy into what Byers calls “the Gerber myth,” or the belief that once you have a baby, “you’ll live happily ever after,” she says. “What women come to find is that’s not true.”
There might also be physiological explanations for mood disorders during and after birth, says Emily S. Miller, an assistant professor of Maternal Fetal Medicine at Northwestern University. Her research has found that women with postpartum depression are more likely to also experience short-term anxiety and longer-term obsessive-compulsive symptoms.
“We have to profoundly adapt our immune systems to maintain a pregnancy, so maybe pregnancy is a particularly vulnerable time” for conditions such as depression and anxiety, Miller says.
Hormonal changes after birth might also affect the likelihood of developing mood disorders for some women. A dip in estrogen, for one, can have mental health consequences since “estrogen is our anti-anxiety producing, anti-depression hormone,” Byers says.
To make things worse, new moms may be reluctant to seek treatment because they think drugs will interfere with breastfeeding. However, experts say there are safe anti-anxiety medications for women who choose to breastfeed.
Even more common? New parents who eschew help, chalking their thoughts and behaviors to part of the parenting package.
“Every parent worries that they’re not doing something right … that there’s going to be some harm to this little precious baby that’s so vulnerable and tiny. And that’s normal,” says Sarah Allen, a clinical psychologist outside of Chicago who directs the Postpartum Depression Alliance of Illinois. “But anxiety is when it goes on and on – day in, day out, night in, night out – and there’s no let up. That’s the difference.”