Postpartum Anxiety, More Common and Less Talked About Than Postpartum Depression
It can start innocently enough. You worry about the baby catching the virus your toddler brought home, that the visitors coming over may not wash their hands properly and transfer germs to your baby, people in the grocery store may touch without asking. Then it starts escalating, you find yourself constantly checking your baby to make sure they don’t have a fever, you google all the potential illnesses your baby may be susceptible to because they are so young, you start not wanting to leave the house to keep them safe from the germs of the outside world.
This is one example of how postpartum anxiety may progress. One of the problems with diagnosing postpartum anxiety is it presents so differently from person to person, leaving a lot of women alone to suffer in silence. Postpartum anxiety is more prevalent than postpartum depression yet there is much less education on the symptoms and what to do if you think you are experiencing it. A study of 1123 new moms from the Penn State College of Medicine revealed that out of 1123 new moms studied, 17% were experiencing postpartum anxiety and 6% postpartum depression. Another study in the Journal Archives of Women’s Mental Health concluded that amongst Canadian perinatal women referred for psychiatric care, the diagnosis of generalized anxiety disorder was more prevalent than major depressive disorder (49.5% versus 38.5%).
Many mother’s feel that they can’t be anxious because they should be experiencing “the best time in their lives?” That is what society tells us isn’t it. Many mothers also feel a lot of pressure to “just know” how to do everything, which also serves to increase anxiety.
So what is anxiety? Anxiety comes from your sympathetic nervous system being in in overdrive. Your sympathetic nervous system is responsible for your “fight or flight response”. If the body is exposed to long bouts of stress, the stress hormone cortisol gets elevated along with epinephrine (adrenaline) and norepinephrine and reduces the body’s ability to calm itself, resulting in anxiety.
Some worry and hypervigilance is biological as an evolutionary mechanism to make sure your baby is safe and thrives. Anxiety BC has a great infographic that helps to explain what is normal and what is problematic when it comes to anxiety. It labels normal everyday worries in the green zone, yellow zone when it is starting to take over your everyday normal functioning and the red zone.
Anxiety rarely presents the same in two mothers. There are a wide host of symptoms that can be related to postpartum anxiety
-constant worrying about your baby and your abilities as a parent
-feeling like your heart is racing, that you are more aware of the beats, or that it occasionally skips a beat
-feeling hot and sweaty frequently
-irritability or restlessness
-inability to sleep, yet being exhausted
If you have previously suffered from anxiety, had difficulty pregnancies, a previous miscarriage, a traumatic birth experience you are more at risk for postpartum anxiety. Anxiety can also present for the first time postpartum as it is caused by a number of physiological factors
Huge hormonal shifts happen during pregnancy and the postpartum period. During pregnancy estrogen and progesterone are quite high and suddenly drop within 24 hours of delivery, leaving you susceptible to an emotional rollercoaster. Compounding this is the gravity of your life being turned upside down by this new baby. I remember a patient who had adopted her first as a newborn and then given birth to her second telling me she couldn’t believe the anxiety and how it hit the second time. She felt she would deal much the same as she did the first time, probably even better given her parenting experience, but the anxiety was crippling and definitely felt physiological. Progesterone is a natural anti-anxiety hormone and its plummeting amount postpartum can be a trigger to physiological anxiety. Cortisol, the stress hormone is closely related to estrogen, progesterone, testosterone and DHEA.
Adrenal Fatigue and the Steroid Hormone Pathway http://www.one2onenutrition.co.uk/Newsletter-2008/Adrenal-fatigue-function.htm
The main precursor hormone is pregnenolone. When stress is high, cortisol gets elevated via the fight or flight response. Most of the pregnenolone gets pushed towards cortisol, called the pregnenolone steal, leaving little left over to make estrogen, progesterone, testosterone and DHEA. This can cause a whole host of symptoms including anxiety.
- Sleep Deprivation
I am sure many of you remember before you had children that if you went on a streak of not sleeping well, be it for exams, work or partying, that you were more irritable, anxious and had less energy to deal with life. Post-baby this is your new normal! It is physiologically normal for the body to not be able to regulate cortisol (stress hormone) as well when we are sleep deprived. For many people this results in anxiety.
- Nutrient Deficiencies
Postpartum nutrient deficiencies are VERY common. Why does this happen? Your baby is essentially a parasite….I know, not nice, but it is true. Your baby will take whatever nutrients they need from you in order to fuel their proper growth. If you were low in a certain vitamin or mineral before becoming pregnant, there is a good chance that you will be deficient in it postpartum.
- Self Care (or lack there of)
New babies are all consuming and that doesn’t change a whole lot in their first year of life. You may no longer have time to do those things you used to do to recharge be it time with friends, yoga, date nights, or your coffee break at work. You are now “on the job” 24/7, which increases cortisol and can lead to anxiety
You may be thinking that all or most of the above applies to you. Finding out what is causing the problem is the best place to start. As a Naturopathic Doctor, my goal is to figure out why your symptoms, in this case anxiety, are happening and what we can do to fix of the CAUSE of those symptoms. In my next post I will be discussing natural ways to balance hormones, help mitigate sleep deprivation (because let’s face it some degree of sleep deprivation is unavoidable), figure out which nutrients may be deficient, and learn how to easily incorporate self care into your daily life.
If any of this sounds familiar for you please share your story in the comments below
Dr Alexis practices via telemedicine and is accepting patients who live in Ontario. To book your appointment, click here
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