Can Therapy Help Postpartum Anxiety?
You may have found yourself worrying a lot since having your baby. Maybe you are checking on your baby repeatedly, worrying that something bad is going to happen, or having a hard time relaxing even when everything seems to be okay.
Maybe you have thoughts that you know are unlikely, but you cannot seem to stop thinking about them.
Or maybe you are functioning well. You are taking care of your baby, getting things done, and everyone around you thinks you are doing fine. But internally, you feel anxious all the time.
If this sounds familiar, you may be wondering, can therapy help postpartum anxiety?
The short answer is yes. Therapy can be an effective treatment for postpartum anxiety and can help you understand your anxiety, change unhelpful thought and behavior patterns, and learn ways to manage your symptoms.
What Is Postpartum Anxiety?
Postpartum anxiety is anxiety that occurs during pregnancy or after having a baby. Some worry is normal when you become a parent. Having a new baby comes with a lot of responsibility and uncertainty.
However, postpartum anxiety can become a problem when the worry becomes excessive, difficult to control, or begins interfering with your daily life.
Some common symptoms of postpartum anxiety include:
Constant worry about your baby
Fear that something bad will happen
Racing thoughts
Difficulty relaxing
Feeling restless or constantly “on edge”
Trouble sleeping because of worry
Repeatedly checking on your baby
Asking others for reassurance
Difficulty making decisions because you are afraid of making the wrong choice
Avoiding certain situations because they feel unsafe
Physical symptoms such as a racing heart, muscle tension, nausea, or difficulty breathing
Postpartum anxiety can also include intrusive thoughts.
Intrusive thoughts are unwanted thoughts, images, or impulses that pop into your mind. They can be especially upsetting when they involve your baby or something you are afraid could happen to your baby.
Having an intrusive thought does not mean you want it to happen. It also does not mean you will act on the thought.
How Is Postpartum Anxiety Different From Normal New-Mom Worry?
This can be difficult to determine because some worry is expected when you have a new baby.
You may worry about whether your baby is eating enough, whether they are sleeping safely, whether they are sick, or whether you are doing the “right” things.
The difference is often how much time and energy the worry takes up and how much it interferes with your life.
For example, you might notice that you:
Spend a significant amount of time researching your baby's symptoms
Constantly check to make sure your baby is breathing
Ask your partner repeatedly if they think your baby is okay
Avoid leaving the house because of fears about something going wrong
Have difficulty sleeping because your mind is constantly thinking about potential problems
Cannot enjoy time with your baby because you are focused on what could go wrong
If anxiety is taking up a significant amount of your day or keeping you from doing things you want or need to do, it may be worth talking with a therapist.
How Can Therapy Help Postpartum Anxiety?
Therapy for postpartum anxiety focuses on identifying what is contributing to the anxiety and learning ways to respond differently.
One of the first things you may do in therapy is identify your anxiety cycle.
For example:
Worry → Anxiety → Checking/Reassurance → Temporary Relief → More Worry
You may feel anxious about something happening to your baby. You check on your baby or ask someone for reassurance. Your anxiety decreases for a short time.
The problem is that your brain can learn from this experience that checking or reassurance is what keeps you safe.
This can lead to more checking and reassurance-seeking the next time you feel anxious.
Therapy can help you interrupt this cycle.
Cognitive Behavioral Therapy for Postpartum Anxiety
Cognitive Behavioral Therapy, or CBT, is one type of therapy commonly used to treat anxiety.
CBT looks at the connection between your thoughts, feelings, physical symptoms, and behaviors.
For example, you may have the thought:
“If I don't check on my baby, something bad could happen.”
This thought creates anxiety, which may lead you to check on your baby. Checking temporarily reduces the anxiety.
In therapy, you can learn to recognize these patterns and challenge unhelpful thinking. You can also learn different ways to respond to anxiety rather than automatically doing whatever makes the anxiety go away in the moment.
CBT can also help with perfectionism, which is common among new mothers.
You may feel like you have to do everything correctly, make the right decisions, or prevent every possible problem. Therapy can help you identify unrealistic expectations and develop more flexible ways of thinking.
Exposure and Response Prevention for Postpartum OCD
Sometimes postpartum anxiety includes symptoms of postpartum OCD.
Postpartum OCD can involve intrusive thoughts, images, or fears about something terrible happening to your baby. It can also involve compulsive behaviors such as checking, researching, avoiding, or repeatedly seeking reassurance.
When OCD is involved, Exposure and Response Prevention (ERP) may be an appropriate treatment.
ERP is a form of cognitive behavioral therapy that helps you gradually face fears or uncertainty while reducing the compulsive behaviors you use to feel safe.
The goal isn't to prove that nothing bad will ever happen.
Instead, you learn that you can experience uncertainty and anxiety without having to respond to it with compulsions.
This is an important distinction because reassurance can sometimes provide short-term relief but keep the OCD cycle going.
If you are experiencing intrusive thoughts, it is important to work with a therapist who understands the difference between intrusive thoughts associated with anxiety or OCD and other mental health concerns.
What Happens During Therapy for Postpartum Anxiety?
Your first sessions will typically focus on understanding what you are experiencing.
Your therapist may ask about:
When your anxiety started
What you are worrying about
How often you experience anxious thoughts
Whether you are experiencing intrusive thoughts
What you do when you become anxious
Your sleep
Your relationships and support system
How anxiety is affecting your daily life
What you would like to be different
From there, you and your therapist can develop a treatment plan.
Therapy is collaborative. Your therapist may teach you different strategies or introduce different interventions, but you should also be able to provide feedback about what is and isn't helpful.
You may try something between sessions and come back the next week to discuss how it went.
If it helped, you can continue using it. If it didn't help, you can figure out why, modify the approach, or try something different.
How Long Does Therapy Take for Postpartum Anxiety?
There isn't one specific amount of time that everyone needs therapy.
Some women benefit from short-term, focused treatment, while others need longer-term support.
The length of therapy depends on several factors, including:
How severe your anxiety is
How long you have been experiencing symptoms
Whether you are also experiencing depression or OCD
How much anxiety is interfering with your life
Your goals for therapy
How you respond to treatment
You also don't have to wait until your anxiety becomes severe before starting therapy.
In fact, addressing anxiety earlier may prevent it from becoming more established in your daily life.
Do I Need Therapy If I Am Still Functioning?
Yes, you can still benefit from therapy even if you are functioning.
One misconception about postpartum anxiety is that you have to be unable to care for your baby or unable to get through your day for your symptoms to “count.”
This isn't true.
You may be going to work, taking care of your children, keeping your house running, and appearing completely fine to everyone else while spending much of your day feeling anxious.
Sometimes high-functioning anxiety can be difficult to recognize because you are still getting everything done.
The question isn't only “Can I function?”
It’s also:
“How much energy is it taking me to function this way?”
If anxiety is taking up a significant amount of your mental energy, affecting your sleep, interfering with your relationships, or preventing you from enjoying your life, therapy may be helpful.
When Should You Seek Help for Postpartum Anxiety?
Consider talking with a therapist if your anxiety is:
Difficult to control
Interfering with sleep
Preventing you from enjoying your baby
Causing you to avoid activities or situations
Leading to frequent checking or reassurance-seeking
Taking up a significant amount of your day
Causing significant distress
Making you feel unlike yourself
You do not have to wait until you reach a breaking point.
A therapist can help you determine whether what you are experiencing is within the range of normal adjustment or whether you may benefit from treatment.
Can Postpartum Anxiety Get Better With Treatment?
Yes. Postpartum anxiety is treatable, and there are several effective treatment options available.
Therapy can help you understand why anxiety is happening, recognize the patterns that keep it going, and develop healthier ways of responding to anxious thoughts and uncertainty.
For some women, medication may also be part of treatment. A therapist can work alongside your physician, psychiatrist, or other medical provider when medication is appropriate.
The goal of treatment is not to make you a mother who never worries.
The goal is to help you feel more confident in your ability to handle the worries that come with motherhood without anxiety controlling your decisions, behaviors, or daily life.
You Don't Have to Keep Managing the Anxiety on Your Own
Having a baby is a major transition. It is normal to have questions, worries, and moments of uncertainty.
But if you feel like your mind is constantly looking for the next thing that could go wrong, or you are spending your days checking, researching, avoiding, or seeking reassurance, you may be dealing with more than typical new-mom worry.
Therapy can help with postpartum anxiety.
If you are experiencing postpartum anxiety, intrusive thoughts, or symptoms of postpartum OCD, working with a therapist who specializes in perinatal mental health can help you better understand what is happening and determine what treatment approach may be right for you.
If you are located in Conroe, The Woodlands, or surrounding Montgomery County, Texas, or are looking for telehealth support, reach out to learn more about therapy for postpartum anxiety and OCD.
You don't have to figure this out alone.
with care,
Alison
