Postpartum care

Postpartum anxiety treatment

Postpartum anxiety is underdiagnosed and often mistaken for "normal new-parent worry." Postpartum anxiety is not a separate diagnosis, but anxiety disorders such as generalized anxiety, panic disorder, and OCD often begin or worsen after birth. They are treatable when recognized.

It is one of several conditions that can appear during pregnancy and the first year after birth. For the wider picture, see our overview of perinatal mental health.

Symptoms of postpartum anxiety

• Racing thoughts you can't slow down
• Constant, uncontrollable worry about the baby's safety
• Physical symptoms — racing heart, chest tightness, dizziness, nausea
• Difficulty sleeping even when the baby sleeps
• Panic attacks
• Intrusive thoughts (postpartum OCD is closely related)
• Avoidance — of leaving the house, of being alone with the baby, of driving

Postpartum anxiety and postpartum depression frequently occur together, and the two are treated as related conditions rather than separate problems.

Postpartum OCD

Postpartum OCD often presents as intrusive, unwanted thoughts about harm coming to the baby — thoughts that are terrifying precisely because they are unwanted. This is not the same as postpartum psychosis. Intrusive thoughts in postpartum OCD are unwanted and distressing, and research has not found that mothers who have them are more likely to harm their babies (Fairbrother et al., J Clin Psychiatry 2022). If the thoughts come with confusion, hallucinations, or beliefs that seem real to her, treat it as an emergency and call 911. It is also distinct from postpartum psychosis, which is a medical emergency with very different symptoms.

Treatment approaches

• CBT — particularly exposure and response prevention (ERP) for OCD
• Psychiatric medication management that weighs the risks and benefits during pregnancy and breastfeeding
• Mindfulness-based stress reduction adapted for postpartum
• Group therapy with other postpartum mothers
• Partner and family education

When residential care may be discussed

Residential care for postpartum anxiety may be discussed when symptoms are severe enough to compromise daily functioning or safety, when outpatient care hasn't been enough, or when the mother needs a structured environment to practice recovery skills before returning home. Our guide to mental health levels of care compares outpatient, IOP, PHP, residential, and inpatient treatment, and a licensed clinician can help you work through when residential treatment may be considered.

An outpatient option in Kendall Park, NJ