The Many Faces of Anxiety
by Tiffani Lawton, RN
Antepartum & Postpartum Doula
Pampered Pregger & Beyond

Maternal anxiety occurs in approximately 15% of new mothers, although anxiety is not diagnosed as often as postpartum depression. Anxiety manifests as delivery approaches, when important decisions need to be made and extends into the postpartum period. High levels of anxiety can result in debilitating panic attacks. Anxiety disorders, like postpartum depression are more apparent when there is not a support system in place.

A new mother's feelings of anxiety may be general or specific. The mother may feel generally incompetent or more specifically, may fear doing specific care taking tasks such as bathing her baby or traveling with her baby. Signs that mom is experiencing anxiety may include irritability, a constant feeling of worry, fear or apprehension and is frequently tense.

Mothers may have a genetic predisposition to anxiety; consequently women with a personal or family history are at greater risk. Some moms have a biological tendency toward anxiety and have difficulty adjusting to the immense hormonal shifts taking place within her body. Women with "Type A" personalities or women who have had no experience with babies as well as professional women are susceptible. These women are used to being in control and mothering a newborn is not something that is controllable.

Types of Postpartum Anxiety

Panic Attacks
A panic attack occurs in the presence of intense fear whether real or perceived. At least four of the following symptoms occur suddenly and reach their worst within 10 minutes. Some symptoms include shortness of breath, feeling of being smothered, chest pain, palpitations, hot flashes or chills, sweats, trembling, tingling, faint, nauseous, disorientation, fear of going crazy, or a sense of impending doom.

Obsessive - Compulsive Disorder (OCD)
OCD involves obsessive and intrusive thoughts with resultant unwanted and uncontrollable behaviors. Signs include recurrent thoughts, impulses, images that result in great levels of anxiety. The mother feels driven to perform repetitive behaviors in response to these intrusive thoughts. She may be exceptionally rigid with certain rules. She may express behaviors or mental acts to prevent or limit distress or to avoid a perceived dreaded event.

Medical and non-medical help is available and women or family members should seek it. If left untreated, anxiety can negatively shape the mother-child relationship because anxiety affects mom's ability to cope with everyday life.

Anti-anxiety medication and counseling is the classic medical course of treatment. Non-medical support may include resources that connect new moms and facilitate moms to create a support network such as support groups. Preventative medicine, offering new mothers education and counseling during the prenatal period regarding the importance of good nutrition, exercise, and sleep will prepare mothers for the postpartum adjustment. Education and resources may also include relaxation techniques, such as visualization or progressive muscle relaxation as well as herbal and aromatherapy. For the women experiencing panic attacks, it serves those best to learn the triggers and try to avoid them. Through education and comprehension of the many faces of anxiety, women need not suffer in silence.

References:
Journal of Nervous & Mental Disease. 1998 Jul;186(7):420-4