How to handle anxiety and depression
when you are a mom? - with Dr. Gail Saltz
Associate Professor of Psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine and host of the "Personology" and "How Can I Help?" podcast from iHeartRadio.
How to recognize the signs of postpartum anxiety?
- You worry too much. That is normal to fear. However, when you worry a good bit of the day every day, and you can't get it out of your mind, that is the first sign of anxiety.
- Some of the worries are irrational. When you check the monitor all night long because you can't get the idea that the child might stop breathing out of your head, that's anxiety.
- Physical symptoms. You might have nausea, sweating, hot flashes; it could interrupt your sleep. It might interfere with your appetite or your ability to concentrate or think about just about anything else.
- Previous experience with anxiety. If you had an anxiety disorder or depression in the past, you would get some anxiety symptoms or mood symptoms.
- Some people are more sensitive to hormone fluctuations. Your estrogen and progesterone levels increase from 10 times their usual to 100 times during pregnancy. Then you give birth, and they plummet back to their original time. Those massive shifts in hormones can precipitate a mood or an anxiety problem.
Postpartum anxiety vs. Postpartum Depression
They can co-exist. Around a third of people that have postpartum depression will also have postpartum anxiety. If a person has an anxiety disorder for a long time and untreated, it leads to depression. So they often come together, particularly for women who develop clinical depression and clinical anxiety twice as often as men.
The symptoms of postpartum depression as opposed to postpartum anxiety: mother feels hopeless, helpless, guilty, irritable, down, agitated, numb. It doesn't resolve on its own. It does compromise, as does postpartum anxiety, your ability to care for yourself and care for your infant. So the bond that you form with your baby in those early months of mothering is crucial.
About 10% of women with postpartum depression can have active suicidal ideation and thoughts of harming themselves or even harming their infant. These are irrational thoughts, but they're part of the illness. If you see the mom getting depressed, help her get treatment, bring her to somebody, or make an appointment. You are saving a life.
What can a mom do to decrease
the level of anxiety?
- Offload baby time with your partner or other family members to do things to help with your anxiety level.
- Practice mindfulness and meditation. Mindfulness is a type of meditation in which you focus on being aware of what you're sensing and feeling in the moment, without interpretation or judgment.
- Progressive muscle relaxation. Tense a group of muscles as you breathe in, and you relax them as yobreathe out. When your body is physically relaxed, you cannot feel anxious.
- Communicate with people who understand your problems. Many mothers face similar issues. There is nothing strange or scary about your feelings.
- Seek out a psychologist or psychiatrist who teaches cognitive-behavioral psychotherapy. It helps irrational worries and gives new cognitions or thoughts more in line with a rational not trying to deny reality.
- Postpartum anxiety is a shift in neurochemicals in your brain that occur when you have an anxiety disorder of any sort. However, it is often hormone-driven and requires chemical intervention.
How long does it last?
If you genuinely have a postpartum anxiety disorder or postpartum anxiety, it may not resolve without treatment. Once you've moved into a more severe postpartum anxiety disorder, you must seek treatment because it might not go away on its own.
There is the kinetic effect. We have wiring connections in the brain that we don't often use, so they are weak. When you stay ill, the activity goes on in that wiring and builds neuronal strength. The longer you stay ill, the more likely you are to relapse again in the future. It is essential to get treatment as early as possible.
What are specific signs that partners, families, and close friends can watch out for?
- The difficulty with sleeping, even though she's tired.
- The change in appetite or loss of appetite. This is dangerous because if you're nursing, you need calories.
- The inability to take pleasure in anything, so things that previously would have brought her happiness.
- Passive suicidal ideation and expressions of sadness and hopelessness or guilt of not being a good mother. Expression of guilty feelings or being incredibly irritable.
Feelings of sadness and hopelessness, or guilt. It's normal to have more irritability.
However, high irritability would be a tip for family and friends.
How can you recognize the difference between isolating and the need for alone time?
If a person has always been an introvert and needs time to be alone to recover, she also needs this time after the child's birth. That doesn't mean that person always was alone and socially isolated.
If you see that she does not pick up the phone, she refuses to see for no reason - this is a standard deviation from where they were. You probably need to push a little more than you did before.
If a new mom doesn't respond to your requests, you may need to pay more attention to her behavior.
If you see significant deviations from normal behavior - ask about it. A new mom may need support or help. Show that she is not alone, that she is still important to you.
One of the first things mothers do when they have postpartum depression is judgment and self-observation. Friends and family need to show support, recognize the first signs and offer some help.
Top Tips for new mothers who struggle with postpartum anxiety
Understand that becoming a parent is a massive developmental change, and it takes some time to adjust to that. Have some empathy for yourself. It is normal to be afraid and scared. All new moms feel that way.
If thoughts are stuck in your head, and it goes around and around, and you can't get rid of it - seek out some help. Anxiety impairs your ability to have joy and feel good during this development change. Some professional treatment would help you to make the most of this transition.