Postpartum Anxiety Symptoms

Jill Williams Krause: On The Impending Doom of Postpartum Anxiety

By Katherine Stone May 13, 2012 9 Comments

Dear New Momma,

Wow. Are you tired, or what?

This mom thing, it is not for the weak… or those who can’t stomach coffee. I mean, I think eventually we all end up chugging a pot at some point, even if we hate the stuff.

If you’re feeling exhausted, fuzzy, sore, and, generally, like a truck hit you, please know that’s pretty normal when it comes to life with a new baby. Unfortunately.

What I want to tell you, though, is there are some things you may be feeling, hearing or seeing that are not so “normal.” I say this because it’s SO hard to decipher between what is and isn’t just a typical response to the 180 shift of your life once you become a mom when you are in the trenches.

See, I went for a really long time thinking what I was experiencing was just me being a mom… and really sucking at it. I thought what I was going through was a result of my inability to adapt. Instead, what I was experiencing was postpartum anxiety. [Read more...]

May 13, 2012 10:00 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms, Postpartum Depression

Postpartum Panic Attacks Give Way To Postpartum Joy

By Katherine Stone June 14, 2011

When I asked the members of the Postpartum Progress Facebook Fan Page for their stories on postpartum panic attacks, I was actually surprised by how many moms had them. I was fortunate not to experience a panic attack, but I’ve had postpartum anxiety, and I’ve been with people who are in the midst of having them and it’s a horrible thing to watch someone overcome by the symptoms and unable to control them.

Today, I’m sharing another story of panic attacks, this time from Laura Pejsa. It may be tough for some of you to read about she went through, which is why I’ve put up the emergency stop button, but there is a happy ending.

6 a.m.

It is 6 am. I know this not because I have heard an alarm or looked at my watch. I know this because “it” has started—just like “it” did yesterday, the day before, and the day before that. “It” starts with a muffled, scratchy sound in my ears, similar to radio static, which gradually builds to a roar. My heart begins to race too, too fast, and I sweat and shiver simultaneously. Sometimes everything goes dark and I must wait a few moments before my vision returns. Always, I am terrified. But I keep telling myself that I am not going to die, because I thought I would die those other days, yet I lived. I live.

As I wait for the roaring and racing to pass this morning, though, I start to experience a new sensation. My skin is trying to slither right off of my cold, sweaty body. I feel as if there are worms scurrying up and down my legs and arms. I clench and unclench my fists and kick my legs against the mattress — somehow the movement gives me something to do — but I cannot make it stop. Tears well up in my eyes as I flail in bed. I do not want to bother anyone, but I’m so, so scared. I call out for my mom. She comes rushing in to my childhood bedroom, bleary-eyed from the night of waking with my baby. I am here, at my parents’, because my husband has to work and I am afraid to be home alone with my four-week-old son. He slept next to her bed in a laundry basket last night while I tried desperately to sleep. I don’t think I did, at least not for more than a few hours. I am now sobbing and trying to explain to my mom that I feel bugs all over me and I can’t stop “it”. She grabs my hands and holds them tight while I kick and arch my back against the horrible slithering. I don’t know how long we are here like this — mother and daughter — both terrified, both holding on for dear life.

My mom spends the morning on the phone with doctors and nurses, trying to find help. Finally, an appointment is made. She pulls clothes from my suitcase and helps me dress, stopping to hold my shaking hands a few times and doing her best to smooth the static from my unwashed hair. She leads me out to the living room, where my dad is slowly rocking and feeding my little boy. My dad looks so tired. I see my parents, scared and growing older before my eyes, and I hate myself for doing this to them. I feel like their dreams of seeing their daughter as a mother are shattered. I look down at my baby, dutifully sucking down the formula we starting feeding him yesterday, because I couldn’t keep up with the feeding and pumping. I notice with some detachment that he is beautiful. The thought hits me that he is safer, more comfortable, more loved there in my own daddy’s arms than he ever will be with me. I feel this with all of my being. And then “it” starts again, and I have to steady myself on a piece of furniture to quell the shaking.

We go to the hospital, where, after a long wait in a freezing cold room, I am interviewed by a new, young OB. She cannot hide the fear in her own eyes, and I wonder if she’s ever seen anything like me before. But she does the right thing. Thank God she knows what to do. Later that night I will swallow an Ambien and for the first time in a month sleep for longer than a couple of hours. A week later I will face a new day without “it” — no more sunrise panic attacks.

Months later, I will find myself at 6 am snuggled in my own bed, next to my slumbering baby boy, watching him sleep with the groggy joy of a new parent. Finally at peace … finally a mother.

June 14, 2011 10:08 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms

Postpartum Panic Attacks: One Mom’s Experience of Full-Scale Fear

By Katherine Stone June 13, 2011

Some moms start suffering panic attacks as the chief manifestation of postpartum anxiety. Panic attacks can involve having a racing heart, tightening in the chest or chest pains, shortness of breath, hyperventilating, dizziness or feeling weak, numbness and tingling and/or muscle cramps. People who are having them often don’t recognize them for what they are. Instead, they may think they are having a heart attack, or a stroke, or are suffering from some awful disease. Amy from Twisted Tiara was kind enough to share her postpartum panic and postpartum anxiety experience with the readers of Postpartum Progress:

A year ago, if you’d invited me to the beach, to shop an amazing sale, or even to meet you for coffee, I would have said no. I would have told you I had an upset stomach or a prior commitment.

In truth, I have Postpartum Anxiety and Panic Disorder. A year ago, not long after the birth of my third child, I was reluctant to leave my house unless I had absolutely no choice.

I have had some anxious tendencies all my life, which I understand much better in hindsight than I did at the time. My last pregnancy and postpartum period, however, brought forth panic like I had never known. I felt edgy, nervous and agitated all the time. The full-scale panic attacks began during the pregnancy, and worsened after delivery.

The panic attacks seemed to come from nowhere. They would often begin with difficulty concentrating, dizziness, or a tingling sensation under my skin; almost like my entire body had “fallen asleep”. The initial feeling freaked me out and heightened my perception of every little sensation in my body. My thoughts turned to potential causes of the symptoms – was it a heart attack, a seizure, a tumor, a stroke?

The fear of dying or having a medical crisis increased the panic, which only caused more physical symptoms. I would shake, sweat, develop phantom pains all over, and believe I was a hair’s breadth away from passing out. I felt completely out of control.

I developed phobias. I became afraid to drive, because the helplessness caused by the panic made me feel incapable of maintaining control of a vehicle. Horrifying thoughts of passing out behind the wheel and killing my children plagued me. I hated to do the dishes because I was afraid to handle the sharp knives. What if I had a psychotic break and stabbed myself, my children? I didn’t trust myself to stay me – it was as if a hideous beast was lurking beneath my skin, poised to take control and destroy my world.

“What if,” became my mantra. My thoughts constantly strayed to, “What if (insert horrible incident here)?” I began each day in fear of my own mind – “What if I have a panic attack today? What if this time I really lose my mind, permanently?”

I hated being alone. I was sure that I was dying of an undiagnosed disease, and that it was only a matter of time before I dropped to the floor in front of my daughters, traumatizing them for life and abandoning them against my will. More than once, my husband had to hold me and convince me that I didn’t need to go to the emergency room. Still, I had a complete cardiology workup, MRI, and so much blood work I’m surprised I didn’t run dry.

Day after day, I white knuckled it, pissed off at this damn disease of postpartum anxiety for robbing me of happy days with my family, yet too fragile to fight it. More than once I found myself thinking, “If I have to feel this way forever, I’d rather be dead.” My family was the only thing that kept me getting out of bed in the morning.

I began talk therapy, during which I was given advice on using cognitive behavioral therapy techniques to manage my phobias. I struggled through months of trial and error before finding medications and dosages that helped quell the symptoms enough for me to start gathering strength again.

I built my arsenal of weapons against the panic. I loaded my mp3 player with meditation and affirmation podcasts that I could listen to as I drove. I took note of anything that relaxed me, so I could turn to it when I felt my anxiety build. (These things are so random – anything from having my daughter brush my hair to listening to Harry Potter audio books.) I wrote quotes and positive messages on index cards and carried them with me. “You are in control.” “It is going to be a great day!” I listened to empowering songs. I started keeping a journal. I learned creative visualization techniques.

I also committed to anxiety prevention. I limit the things I do out of obligation, and I remove myself from triggering situations without feeling too guilty. I pay attention to my diet, since hunger, thirst, or sudden drops in blood sugar seem to leave me vulnerable to panic. I try hard to get enough sleep. I take my meds correctly.

I’m still fighting, but I have hope again. Last summer, I thought I was a lost cause. It took a lot of time and effort, but now I know I have the power to defeat the panic. Everyone does. If you’re struggling, please keep fighting.

When you’re ready, I’d love to meet you for coffee.

June 13, 2011 2:23 pm Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms

A Toolkit for Postpartum Anxiety & Panic Symptoms

By Katherine Stone May 4, 2011

The term postpartum depression can be a disservice to many, many women who struggle during pregnancy and/or postpartum. Many of these women don’t reach out for help because, well, they are not necessarily depressed and so therefore assume that their struggle is not with postpartum depression. In fact, the most common symptom of postpartum depression is not sadness at all- it is anxiety and agitation … and while many women who struggle might have periods of sadness, depression and tearfulness, the overwhelming symptoms that cause them great pain are difficulty concentrating, excessive worry, high level overwhelm, racing thoughts and difficulty sleeping. Many of these women will suffer from a varying degree of panic, and anxiety attacks are not uncommon (or perhaps have postpartum anxiety or OCD).

So, what is this all about and what can be done in the moment to alleviate some of the fear that comes along with these symptoms? So often moms want an answer, understandably to “Why is this happening to me? What is causing this?” As always, this is a question that does not necessarily come with one quick answer as each woman has a unique set of circumstances that might be playing a part. But we do have ideas of what may be at issue here and there are certainly a number of strategies that are known to work well and alleviating some of the symptoms of mild to moderate anxiety.

Brain chemistry imbalance: High-level anxiety (including postpartum OCD) is often caused by imbalances in the “feel good” chemicals in our brains. Serotonin, dopamine, and norepinephrine are the neurotransmitters that are responsible for emotional balance, and sudden drops in hormones postpartum are believed to have a direct impact on the functioning of these important systems of the brain. Antidepressant medication such as SSRI’s (including but not limited to Zoloft) have been shown to effectively work at reducing symptoms of anxiety in the postpartum period (usually a woman will notice a reduction in symptoms after 2-3 weeks of starting a medication). Many of these medications have been shown to be safe during pregnancy and while breastfeeding. Benzodiazepines (including but not limited to Xanax) have been shown to effectively work at reducing symptoms associated with panic attacks and high-level anxiety (often in conjunction with an SSRI). While it is recommended that women not cease using a benzodiazepine during pregnancy or breastfeeding if her symptoms are severe and/or if she has benefited from them prior to her pregnancy, some of these medications have a small risk to infants and so careful monitoring by a physician is important. For women whose anxiety is severe, the recommended treatment is medication along with psychotherapy.
Negative thought patterns: Oh, the many changes that occur when a baby is born! Women who are worriers, perfectionists, have high and often unrealistic expectations for themselves, and who have a tendency toward negative thinking prior to becoming pregnant are at risk of developing more severe postpartum anxiety once a baby is born. For these women, the new lack of control, many responsibilities of parenting and reality of caring for a newborn all contribute to racing thoughts and heightened worry. Psychotherapy is an important part of the treatment for these women. Cognitive-Behavioral Therapy (CBT), mindfulness and stress reduction strategies, work around identity shifting, and early trauma history processing (if it exists) have all been effectively supported through psychotherapeutic work with a trained professional.
Nutrient depletion: Numerous studies have linked nutrient depletion during pregnancy and postpartum to depression and anxiety in many mothers. The role of healthy eating and monitored vitamin supplements if/when necessary cannot be underestimated in moms’ health and wellness. Even women who think that they are eating a balanced diet may not be replenishing themselves after childbirth and breastfeeding enough to facilitate the production of serotonin and the balance of blood sugar. Often, symptoms such as agitation, shakiness, foggy-headedness and nervousness can be linked to hunger and poor eating habits in many women.
Sleep deprivation: Yes, I know: Having a newborn drastically limits the time that all moms spend asleep. Frequent night waking, breastfeeding, and high anxiety makes it difficult for most moms to get the rest that they need for optimum health. But here is the thing: Moms who are moderately or severely anxious are usually also moms who report less than four hours of uninterrupted sleep a night. When these moms increase their sleep time through medication, strategy building, and/or relaxation techniques, their anxiety symptoms often decrease.
Dehydration: Some studies have suggested that dehydration contributes to anxiety symptoms including jumpiness and agitation. Moms, especially those who are breastfeeding, are often not drinking adequate amounts of water (at least eight 8 oz glasses of water a day or more). Proper water consumption is required for efficient transportation of the hormones and neurotransmitters required for balanced emotion.
Pregnancy related physical ailments and insufficient breathing: Most women who feel anxious will notice that their breathing is shallow. Whether this is because a mom's diaphragm is being squished by her growing baby or because she is simply not focused on the length and quality of her breath, lacking oxygen to a brain leads to dizziness, further shortness of breath, light headedness, and elevated heart rate. Often, focused and mindful breath work will noticeably reduce these symptoms.

So … now for that toolbox. You know, the one that you need by your side if and when you begin to notice the early signs of anxiety and/or panic emerge…

Take 10 deep belly breaths (also known as diaphragmatic breathing).
Drink a big glass of water.
Eat a protein-based snack such as lean meats, nuts, cheese, or a hard boiled egg.
Ground yourself in the present: Look around you and note (out loud if possible) everything that you can access in all 5 senses. What do you see? What can you hear? What do you smell? What does it feel like to be sitting on your chair? What, exactly, do you taste as you eat your snack?
Find a “mantra” of sorts that you can tell yourself such as “I am going to be okay”, “I am doing the best that I can” or “I am taking care of myself”.
Go out side. Stretch. Feel yourself move and notice the sensations in your body.
Once your initial symptoms decrease, find some help so that you can take a nap and get the rest that you need.
If need be, call your therapist, your doctor, or someone who you trust to come and be with you until you feel better.

** As with all of my posts, this information is not intended as a substitute for in person medical or therapeutic support. For a trained mental health specialist near you, visit www.postpartum.net.

Kate Kripke, LCSW

For more on self care, you might enjoy visiting the blog Living Self-Care. There you can learn more ways to take care of yourself, and also join a contest where you can win self-care related prizes! They are also hosting a Twitter chat tonight at 9pm Eastern. To participate, use the hashtag #MEchat.

May 4, 2011 12:48 pm Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms

Obsessed With Cleaning & Organizing: Coping With Postpartum Anxiety

By Katherine Stone March 29, 2011

On yet another symptom of postpartum anxiety and postpartum OCD:

It was one of the most precious rooms we’ve ever created in our home. Each item was painted, hung, and constructed with love and anticipation of our baby. Its cheery yellow walls and the sweet smell of lightly scented baby powder would always invite me to come in every time I walked past it. I would often take a seat in the antique rocking chair, smoothing my hands over my swollen belly, excited and ready to fill this room with all the daydreams I had. The sleepless nights, the changing, the cuddles, the smiles, the happiness and the love would all take place there.

Those daydreams never came to life when we brought him home. That room, that cheerful loving room we created instead housed tears, anxiety, rage, and pain.

1…2…3…4

Was the number of times the washcloths had to be folded.

1…2…3…4

They were placed seam side down according to color.

1…2…3…4

If the washcloths weren’t perfectly aligned or folded or color coordinated or placed in the changing table perfectly I would start over …

And over …

And over.

I would spend anxiety-riddled hours toiling over the changing table’s organization. The diapers had to be aligned with the front facing out. The burp cloths where folded 3 times — no more, no less. The Vaseline label, wipe container label and baby lotion label had to be facing out. The changing pad cover was never to have any creases or lint.

And no matter how many times I tore it apart and organized and reorganized its drawers, it was never perfect enough. Because of this, the anxiety I was already experiencing was fuelled to crippling proportions and the rage I felt towards myself for not being “perfect” was terrifying. I remember my husband doing the laundry once and haphazardly putting the washcloths away. I was so enraged that I punched a wall and locked myself in the bathroom. While I was in there, my husband refolded and reorganized the cloths the way I specifically wanted. Then I ran in after him and redid them after he left the room.

It didn’t stop at the changing table. I had my baby’s closet organized by color. His socks were done by color. His books organized alphabetically and by size. There was to be no dog hair in his room. I swept his floor every hour.

After feedings or changes there would sadly be no cuddles or smiles or kisses. I would hurryingly and anxiously put him back in his crib so I could resume cleaning and organizing. I just couldn’t stop myself.

For the longest time, I thought that I was the only person in the world who was a changing table/nursery room Nazi and I had kept this little secret to myself. Then one night, I read a tweet from Katherine. She mentioned that she too had struggled with obsessing over burp cloths and washcloths and that this behavior was actually more common than I had thought. This is why I am writing this today.

I was never diagnosed with postpartum OCD, however, my psychiatrist said that this was a coping mechanism for me … that when I cleaned and organized, I was taking control because my mind and my world felt so out of control. Controlling what I could gave me a sense of power over my situation.

One of the things that helped me to let go of this behavior were 2 simple statements that my psychiatrist has said over and over at every appointment. I actually have them written out and placed in various “go-to organization” spots in my home, like the changing table.

“There is nothing in this world that is worth all this worry.”

When I find myself starting to fold and feeling the postpartum anxiety gripping my lungs tightly, I will repeat this line. After a while it does make me laugh. Like duh, why am I worrying about how many times I’m folding these wash cloths? Is it going to kill me if the green washcloths are mixed with the blue? No, so stop worrying about it.

The second statement:

“I only have to be good enough.”

This one took a while to sink in since I have always had issues with perfectionism, only postpartum depression and anxiety made it 100 times worse. I insert this statement when I feel tempted to rip apart a closet or my husband for not lining up the diapers correctly. It enables me to stop and to walk away.

Two years later, I still find myself rushing to organize something when things get overwhelming or when I feel out of control, but it is definitely better. Now my son’s room isn’t a trigger for anxiety, or sadness, or anger or rage.

It is a place that is finally filled with my daydreams of smiles, love and happiness.

Did you ever find yourself obsessing over the way things were organized or with constantly cleaning? Were you diagnosed with postpartum anxiety or postpartum OCD? What types of methods help you to overcome that compulsion?

Kimberly

March 29, 2011 10:54 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms, Postpartum OCD

Postpartum Anxiety: A Multitude of Fears

By Katherine Stone March 8, 2011

Continuing with yesterday's theme of postpartum anxiety and OCD, thought I'd share this from reader Della P.:

"I was never depressed. I didn’t feel despair or hopelessness. I didn’t lack the connection with my first baby or my second. I loved them. I also worried myself sick. I obsessed. I made mountains out of molehills. Eventually, I became paralyzed by fear. Fear, anxiety, paranoia — I don’t really know the difference — overwhelmed me. I couldn’t differentiate my maternal instincts from my obsessive and intrusive thoughts. It was terrible, the worst time of my life. Fear is such a four letter word.

This fear, anxiety and paranoia that I was feeling was a totally treatable illness that I waited longer than I should have to deal with. Sure, it’s natural to worry as a mother, but when has it gone too far? I don’t know, but professionals do. Learn from me and receive the help that is out there waiting to make you better. Get the help you need that will allow you to feel joy in the role of motherhood. Just by reading this, I know you are taking steps, and I applaud you for that.

Now, Ihave learnedthat most of what I worry about never happens. There is great truth to the old acronym, F.E.A.R., standing for False Evidence Appearing Real. I also know I am good mother who feels peace and is so very grateful to be a survivor. It is all because I received the help and treatment I so desperately needed and because I now take care of myself and my little girls."

Some moms have the symptoms of both depression and anxiety. Some have one or the other. What matters is that, no matter what combination of symptoms we have, we get the help and support we need and deserve.

March 8, 2011 12:13 pm Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms

Postpartum OCD: Does Having Scary Thoughts Mean You’ll Act On Them?

By Katherine Stone January 24, 2011

I got this email from Amy from Pretty Babies, and I identified so much with what she said that I wanted to share it with you (with her permission, of course):

“The entire trajectory of my recovery would have been different if I had known about the intrusive thoughts when I had my oldest. I thought that having the thoughts meant that I was capable of doing the things I thought about (in other words, if I thought about my kids drowning in the tub, I thought it meant that I WOULD drown them). I avoided getting help for months because I was afraid that “they” (my doctor, my husband, etc.) would take my daughter away if they knew what I was thinking. If I had known these sorts of thoughts were common, I would’ve been able to get help much sooner, but as a first time mother I had never heard of such a thing. Thank you for talking about this, so other moms don’t have to suffer the way we did.”

This is EXACTLY what happened to me when I had postpartum OCD. I had never heard of intrusive thoughts. I thought I was now a horrible monster, and I believed that since I was having these thoughts it must mean I could follow through on them. That was wrong, but no one ever told me that. I also thought my child would be taken away. I WISH, WISH, WISH this was discussed more. There’s no reason for mothers to continue to suffer.

If you have postpartum OCD or postpartum anxiety and have scary, disturbing thoughts known as intrusive thoughts it is highly unlikely you would EVER act on them. As Karen Kleiman writes in her new book Dropping the Baby & Other Scary Thoughts:

“When scary thoughts feel inconsistent with your belief in who you essentially are, your character, and your personality, they are referred to as ego-dystonic thoughts. When a thought is ego-dystonic, it is in conflict with whom you fundamentally believe yourself to be. This inconsistency creates piercing anxiety. However, this distress, as disturbing as it feels to you, provides reassurance that these thoughts are anxiety driven and not psychotic. In fact, your anxiety is an indication that you are aware of the difference between right and wrong.”

January 24, 2011 9:00 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms, Postpartum OCD

Breaking the Cycle of Scary Thoughts & Postpartum Anxiety/OCD … A Giveaway!!

By Katherine Stone December 13, 2010

When I had postpartum OCD in 2001, I had never heard of the illness with which I was eventually diagnosed. I had never heard of postpartum anxiety. I had never heard of intrusive thoughts.

Once I was fortunate enough to find out what was wrong with me, I got pretty pissed off. Why didn't anyone tell me??!?! Certainly it would have helped to have been warned ahead of time that I could experience scary thoughts. It would have saved me the horror of thinking I'd gone irreversibly "crazy" and would never be myself again. I would have reached out for help sooner and not have feared that I would be locked up forever or have my baby taken away from me. Couldn't somebody have at least mentioned it?

You'd think, nine years later, that most physicians would now be aware of the entire spectrum of perinatal mood and anxiety disorders, including postpartum anxiety and OCD, but they aren't. Still! Just the other day, Stephanie, who shared her story here with the post "Horror Movies In Her Head", informed me that her doctor just told her he'd never heard of postpartum OCD. It just shows you how much work we still have left to do.

Now, at least, we've got a book. A wonderful book! It's called Dropping the Baby & Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood. Written by Karen Kleiman and Amy Wenzel, it shares why we have such thoughts, how we can be certain we won't act on them and what we can do to get through them. You can buy it on Amazon! You can read it and see that you are not alone and that you're going to be okay. You can take it to your doctor, spouse, therapist, friend, patient and say "See! It's real. It's an illness. It's not forever."

I know that many of you are as pleased as I am that this book is now available as a source of information and support, so I'm excited to be able to give one away. To participate in the giveaway, please comment below (by no later than Tuesday, 8pm Eastern) by answering any one of the following questions (note: if you're on the Facebook page, you have to come and comment here on the blog to be eligible for the giveaway):

1) If you had/have intrusive or scary thoughts, what is one thing you did/do to manage them, or reduce their impact on you?

2) If you had/have intrusive thoughts, did you share them with anyone and if so, who? If not, why not?

3) If you had a copy of Dropping the Baby & Other Scary Thoughts how would it help you to help yourself or others?

On Wednesday morning I'll do a random drawing of the commenters to pick a winner! Good luck!

Oh, and P.S. I wrote the foreword to this book, which was a complete and total honor of the highest order!

December 13, 2010 10:22 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms, Postpartum OCD

Jedi Mind Tricks With Dr. Dave: How To Stop Postpartum Anxiety Fears

By Katherine Stone October 18, 2010

This is a GREAT guest post from postpartum anxiety survivor and pregnant mama Amy, blogger at Pretty Babies. She shares the tips & tricks she has learned in cognitive behavioral therapy from her doctor, Dr. Dave, how they’ve worked for her to reduce her postpartum anxiety symptoms and how they can work for you. Wanna stop what she calls “obsessive anxious magical thinking crazy-making”? Read on …

I’m in therapy. I’m not ashamed to admit it. I’ve done the whole “Oh, I’m so ashamed of my postpartum anxiety and postpartum depression” thing before, and it was bad for everyone – my husband, my kids, my extended family, my friends… Not to mention that it was bad for me. This time I’m charging into it head first, with my face painted blue and a sword aloft, screaming, “FREEDOM!” like some pregnant Mel Gibson…

The thing I love about Dr. Dave is that we don’t spend a lot of time with the whole “tell me about your childhood” shtick. Yes, I’ve told him enough about my background that he has a good sense of who I am and where I come from. But he doesn’t bother with much of it. His approach to psychology is a lot more practical (not to mention faster!) and, in my experience, it really works.

If you’re going through postpartum anxiety or depression, or antenatal anxiety or depression, I can’t recommend Cognitive Behavioral Therapy (CBT) enough. Basically, the premise is that your thoughts create your emotions – not the other way around. A lot of people think that they feel sad, and that’s why they’re having sad thoughts. In truth, though, you have the sad thoughts first, and those sad thoughts make you feel sadness.

Think about it. You could see a perfectly neutral thing – how about a suitcase? So you see this suitcase, and it reminds you of the trip you just took to your favorite place, and you have all these happy thoughts of all the fun you had, and consequently you start to feel happy. Meanwhile, I see the suitcase, and I think about the business trip BJ has coming up, and how lonely I’m going to be, and how much work it’s going to be to take care of the kids by myself, and then I start worrying about going into labor while he’s gone, or his plane crashing, and suddenly I’m sad and anxious. The suitcase was neutral in both cases – it was the thoughts that were happy or sad. Those thoughts caused the emotions we experienced.

The idea of CBT is that you can get in better thought habits — you can train yourself to neutralize the negative thoughts that we all have, and over time they become less and less powerful. It actually re-wires the neural pathways in the brain, which is pretty amazing when you think about it.

So how am I re-wiring my postpartum anxiety brain these days? Well, Dr. Dave and I decided that whenever I have an anxious thought (and sometimes they’re not even fully-formed thoughts, sometimes it’s just an “Oh shit!” feeling that hits me out of the blue, especially in the middle of the night, and I have to really think about what thought triggered it – thoughts are sneaky!), I deliberately say to myself, “Reducing my postpartum anxiety level is good for the baby, it’s good for the labor and delivery, and it will improve my ability to make decisions.” I actually “hear” it in Dr. Dave’s voice, which I find funny. That phrase addresses some of the specific concerns that underlie what’s been causing my anxiety – that I’ll hurt the baby by freaking out all the time, that something bad will happen during labor, and that I won’t make good decisions about the delivery (for example, whether or not to induce). I’ve been thinking that thought 4 – 6 times a day, sometimes more, and it’s really helping. I’d say that alone reduced my anxiety from an 8 (on a scale of one to ten) to a 6 or 6-1/2.

I’ve also been doing some deep breathing. I have a tendency, especially as I get physically bigger, to breathe very shallowly. I’m getting a lot better about breathing into my abdomen, which is probably an awful lot better for the baby. It’s also helping me to relax.

Another trick Dr. Dave taught me was the Fade Technique. Let’s say that BJ is on a business trip. Before, because I’m a nutjob, I would have a lot of anxiety about his flight. I would picture, like a horror movie, all the terrible things that could happen in excruciating detail. Then I’d get on FlightAware.com and I’d hold his plane in the air through the sheer force of my own will, only relaxing (a little) when he landed safely (after all, he still has to fly home). Well, from now on when I have those thoughts, I’m going to deliberately picture BJ on the plane, happy and safe, reading and drinking a Coke, maybe taking a nap, then landing safely, getting his luggage, and arriving at his hotel. For every one time I go all horror movie in my head, I’m going to imagine the happy outcome twice, in detail. Research shows that over time the horror movie will fade and it won’t bother me anymore.

The third technique was the first one Dr. Dave taught me, back when MG was a baby and I saw him the first time. I had a lot of anxiety that I was going to ruin her, and that if I loved her the best way to protect her was to get as far away from her as possible because I’m such a horrible mother. Dr. Dave had me write down a list of what constitutes a “good mother.” Big surprise, I was already doing everything on my list. So, I logic myself out of that “I’m a bad mom!” thought, now, when it comes. It was hard at first, but it’s gotten really easy now. Now when that voice says, “You’re an awful mother!” it doesn’t take any mental effort or energy at all for me to shout it down.

I do this obsessive anxious magical thinking crazy-making in several different ways, so we talked about some different ways I can apply these three techniques to some specific things I tend to worry about.

Dr. Dave told me about a longitudinal study (14 years?) that was done on normal, healthy people. They kept track of all the things they worried about. Over the course of the study, 98% of the things that they’d worried about never happened at all, and the 2% that did happen weren’t as bad as the people had predicted. He said that people tend to overestimate the likelihood that something bad will happen, and at the same time they’ll underestimate their own capacity to deal with it. “Oh yeah, I totally do that,” I said.

So that’s what I’m working on right now. We don’t expect to get me to the point of having no anxiety at all – only sociopaths can claim that distinction, and I don’t aspire to be one! There’s a functional level of anxiety around 3 or 4 on a scale of one to ten, that’s actually beneficial. It’s an inverted U shape, with anxiety on the x-axis and performance or ability to function on the y-axis (see image below which I borrowed from this website). I was at an 8 before, as I mentioned. I’d say I’m down to a 6-1/2 now. We’re aiming for that optimal 3 or 4.

October 18, 2010 9:01 am Filed Under: Postpartum Anxiety, Postpartum Anxiety Symptoms, Warrior Moms

Suffering Postpartum Anxiety? Why It’s On the Rise Among Women

By Katherine Stone October 17, 2010

Last week many of you commented on your own postpartum anxiety after reading Stephanie’s guest post. Whether it’s manifested in the form of postpartum OCD or postpartum panic attacks or general anxiety, for a lot of you your symptoms are more about fears and worries than sadness and lack of interest in things you used to enjoy.

I think you will all be interested in this in-depth story from Glamour, currently appearing on the MSNBC website, on why anxiety disorders are on the rise among women in general.

It’s well-written and balanced, with input from serious experts. If you have or think you have anxiety, or treat women who do, I really would go read it. One interesting highlight for me:

Ironically, despite the condition’s seeming ubiquity, experts Glamour spoke to agree that anxiety is actually underdiagnosed among women. “The average length of time between the onset of symptoms—the time a woman starts feeling bad—and when she gets actual diagnosis is between nine and 12 years,” says Robert Leahy, Ph.D., a clinical professor of psychology and psychiatry at Weill Cornell Medical College in New York. “And of those who are diagnosed, only a very small percentage get adequate help.”

Part of the problem, say doctors, is that a woman with anxiety may fail to seek help quickly, even if she’s seriously on edge. “To her, that is normal,” says Richard A. Friedman, M.D., a professor of clinical psychiatry at Weill Cornell Medical College. “If you’re a healthy woman and you come down with the flu, you know you’re sick. You know what it’s like to feel good, and you know you feel worse now. But if you have this sickness that’s been hanging on since you were 5, that’s your baseline. You believe it’s normal, and that everyone else must feel this way too.”