New Mom Anxiety: 7 Signs It's Time to Talk to Someone

Some worry is part of being a new mom. Your brain is wired to keep this tiny person alive, and it takes that job seriously. But there is a line between new-mom worry and postpartum anxiety, and moms ask me about that line constantly: "Is this normal, or do I need help?" Here is how I help them tell the difference, and the seven signs that it's time to talk to someone.

Normal new-mom worry vs postpartum anxiety

Postpartum anxiety is about as common as postpartum depression, and many moms have both. It gets talked about far less, so a lot of moms don't recognize it. If you're not sure whether this is anxiety or ordinary stress, I wrote about that here.

7 signs it's time to talk to someone

1. You can't turn the worry off

You know the baby is fine. You tell yourself so. It doesn't matter, because the worry keeps going: the same search five times today, the monitor again, a loop of worst cases you can't get out of. Normal worry responds to reassurance. Anxiety doesn't. When the logical part of your brain can't talk the anxious part down anymore, that is a sign.

2. Your body is sounding the alarm

Anxiety often shows up in the body before you'd ever call it anxiety. A racing heart when you're sitting still. Tight chest, short breath, dizziness. Nausea or a knot in your stomach that won't go away. Tension in your jaw and shoulders. Many moms get sent home with antacids, or go to urgent care for a heart that checks out fine, when what they actually need is mental health care. If your doctor has ruled out a medical cause and the symptoms keep coming, it's worth asking whether this is anxiety.

3. You can't sleep even when the baby sleeps

Your partner takes the next feed and tells you to rest. You lie there with your eyes open and your mind racing. Or you drift off and wake up twenty minutes later in a panic. This is anxiety taking the sleep you finally had the chance to get, and less sleep makes anxiety worse, which makes sleep harder still.

4. Your world is getting smaller

You stop accepting help because you don't trust anyone else with the baby. You avoid leaving the house because too much could go wrong. You can't let your partner do a bath without supervising. Avoiding things brings relief in the moment, but it teaches your brain that those things really are dangerous, so the list keeps growing. If your life has shrunk since the baby, and it's because of fear rather than logistics, pay attention to that.

5. You're having scary thoughts

Sudden, unwanted images of the baby falling down the stairs, slipping in the bath, or getting hurt in the car. Most new moms have thoughts like these at some point. They feel awful because they go against everything you want, and being horrified by them is a good sign. They do not mean you will act on them. When they come often, take up a lot of your day, or you start doing things to make them stop, like avoiding the stairs or checking over and over, it's worth getting help. Here is more on what scary thoughts mean, and when they cross into postpartum OCD.

6. You keep needing reassurance, and it doesn't stick

You call the pediatrician's nurse line again. You ask your partner whether the baby seems okay, then ask again an hour later. You post the same question in a parenting group. You feel better for a few minutes, then the doubt comes back. Reassurance-seeking works like a short-term fix that makes the anxiety stronger over time, which is one reason it's hard to break on your own.

7. You don't feel like yourself

You used to be fairly easygoing, and now you're tense all the time. Your partner says you seem on edge. You snap at people you love, then feel terrible. If your pre-baby self wouldn't recognize how you feel now, and you feel run by the anxiety instead of just having some, it's time to reach out.

Who is more likely to get postpartum anxiety

Anyone can get it, but the risk is higher if you've had anxiety or panic before, if pregnancy or birth was hard or traumatic, if your baby spent time in the NICU, if you went through infertility or a loss, if anxiety runs in your family, or if you don't have much support. Having risk factors doesn't mean it will happen. If the signs do show up, take them seriously.

What helps

Postpartum anxiety responds well to treatment. In my practice, that usually means therapy with practical tools: catching the "what if" thoughts and checking them against what is actually happening, and slowly doing the things anxiety has been telling you to avoid. When intrusive thoughts and checking are a big part of it, the specific treatments for those, exposure and response prevention and inference-based CBT, work well. Medication can help too, and there are options considered compatible with breastfeeding. That is a conversation with your OB or a prescriber who knows perinatal care. I wrote about treatment options for postpartum anxiety here.

A few things you can do today, while you decide:

• Exhale for longer than you inhale. Breathe in for four, out for six or eight. A long exhale tells your nervous system you're not in danger.
• Name what's around you. Five things you can see, four you can hear, three you can touch. It pulls you out of the "what if" and back into the room.
• Check once, then stop. Look at the monitor, see that she's breathing, and say "I checked" out loud. Then wait a little longer before the next check than you did last time.
• One hour a day that is yours. Time to recharge with nobody needing anything from you. A nap, a walk, a shower, whatever fills you back up. Anxiety runs hotter on empty.

These help, and when anxiety is running your days, you also need treatment.

What to do right now

Tell one person what's been going on. Your partner, your mom, a friend. Saying "I think I'm dealing with postpartum anxiety" out loud makes the next step easier. Then call your OB or midwife and ask for a screening, or reach out to a therapist who specializes in perinatal mental health. Postpartum Support International can help you find one at 1-800-944-4773, and the National Maternal Mental Health Hotline is open 24/7 at 1-833-852-6262. If you are ever in danger, call 911, and you can call or text 988 any time.

If you want to work on this on your own

I made a self-paced course, Anxiety Management for New Moms, for moms who want real tools they can use in the middle of the day. It teaches calming techniques that work even during a feed or a 3 a.m. wake-up, how to catch the anxious thoughts that fuel the spiral and check them against the facts, and how to keep worry from taking over your whole day. Each module comes with a printable workbook, and you can go at your own pace and come back whenever you need it.

Working with me

I'm a licensed clinical psychologist, a certified perinatal mental health specialist, and postpartum anxiety is a big part of my work, including the intrusive thoughts and checking that come with it. Many of the moms I see look fine from the outside and are holding everything together while their nervous system runs on high. I see moms in Austin or on video, and babies are always welcome in my office.

You don't have to be "bad enough" to benefit from support. Many of the moms I work with aren't clinically depressed at all. They're dealing with the everyday stress of becoming a mom, and therapy helps with that just as much as it helps with depression or anxiety.

The first step is a free 15-minute call. Tell me what has been going on, and I will tell you honestly what I think would help.

Book a free 15-minute call