One day when my son was 11 months old, I was sitting next to him on the playroom rug. He was busy with his toy trucks, making little vroom-vroom sounds as he pushed them around the carpet. It was November, and snow had trapped us in the house again. And, as I often found myself doing, I was staring at the wall, caught in a loop of panicked thoughts.
What was I worried about that day? Money, maybe, or something that happened long ago. Something small that no longer mattered. But in the moment, whatever it was paralyzed me. My skin flushed and I felt short of breath. My eyes and head ached. Often in these moments, I'd grip onto something compulsively — the hem of my jeans or the corner of the rug — because I was certain that if I let go I'd plummet further into this dark space.
On that day in November, I eventually broke out of the grip of panic. When I calmed down, I realized I had no idea how long I had been disconnected from that room and my son. I stood up and found my phone, and called my doctor. When the nurse answered, my voice shook as I told her, “I think I have postpartum anxiety.”
It was a huge step — one I look back on with pride — but what followed was a revealing look at how postpartum mental health issues are often misunderstood, even by health care professionals. Postpartum anxiety (PPA), especially late-onset cases like mine, is frequently misdiagnosed, ignored or missed completely by patients and doctors alike.
Because it had been 11 months since I gave birth, the nurse I spoke to at my OB's office told me that I must have typical, non-postpartum anxiety and to call my general practitioner instead. But that's incorrect. Postpartum anxiety isn't as studied as postpartum depression (PPD), but the research that does exist suggests it can occur anytime in the first year.
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In my case, anxiety had slowly crept into my life in the months after my son was born. The newborn stage was exhausting and overwhelming, and I had no energy left to worry about anything but day-to-day survival. But as my son learned to sleep for longer stretches, and breastfeeding became easier, I had more time for my own thoughts — thoughts that often became debilitatingly anxious. I worried about important things, like our finances and my career, and things that weren't so important, like whether lead dust was getting tracked into the house on our shoes.
I obsessed over illness, convincing myself that every sniffle and cough was meningitis or pertussis. My thoughts slipped occasionally into bouts of paranoia, wondering if someone driving behind me was following me to our house.
Living with untreated anxiety is exhausting in every sense — mentally, emotionally and physically. My anxious thoughts would wake me up, even when my son was sleeping through the night. I'd stare at the ceiling for hours, and wake up in the morning with headaches and muscle pain from tensing up in my sleep.
My relationships suffered, too. I was impatient and short-tempered, snapped frequently at my husband and, like that day in the playroom, acted listless and distant when I was with my son. I panicked when anyone but me was caring for my child, certain they would do something harmful. The result was that I almost never had time to care for myself.
But still, in those first 11 months, I had convinced myself that what I was dealing with was normal. Babies are tough, I thought. You're just tired. Suck it up and keep going. The idea of asking for help made me feel weak and ashamed.
When I explained what was happening to the nurse practitioner at my doctor's office, she listened intently and prescribed me a low dose of an antidepressant. I was grateful. But even then, I was given the wrong information: she said I should wean my son before I took my first dose.
Her statement confused me; I knew many other moms who had taken antidepressants while breastfeeding. She told me she preferred to have patients wean “just in case.” Later, I would learn this was misguided advice, as well. Some antidepressants, including the one I was prescribed, are considered compatible with breastfeeding, and are frequently a life-changing option for moms who need treatment for PPD or PPA and also want to keep nursing. Conflicted and unsure of whose advice to follow, I split the difference and started taking the antidepressant during the weaning process.
A few weeks after starting the antidepressant, I asked my husband if he noticed a change in me. The nurse practitioner had said that usually loved ones saw a difference before the patient did. “Yes,” he said quietly. “It's amazing.” The overall tone of our lives and our everyday interactions had improved, he told me.
Then, I started to notice it too. I laughed more with my son. We went on adventures outside the house. When something minor went wrong, I could shrug it off. I felt a difference in my thoughts — before, under the grip of anxiety, my mind was crowded and foggy. Now, it felt like someone had cleared all the clutter out of my brain and I could focus for the first time in a long time.
As I progressed, seeing a therapist helped me build my “toolbox” of ways to handle stress — tools like deep breathing and mindfulness exercises that allow me to address symptoms of my anxiety as they happen. When I had my second child, these tools helped me navigate the postpartum period in a healthier way.
My experience showed me how much work we have to do to help other new moms who face PPA, PPD or any form of postpartum mental health issue. I had a number of advantages — including a stable support system and health insurance — and I still ran into obstacles and misinformation when I finally sought treatment. Measures like depression screening for pregnant and postpartum patients are a step in the right direction, but we still have far to go to ensure diagnosis and treatment options are improved, and to help all moms get access to the mental health care they need.
It took me awhile to face the fact that anxiety, like any other mental health issue, is not something you ever really get over. I'll never wake up one day and discover I'm cured. It's a journey, a marathon, and something I work on every day.
My firstborn is now nearly 8, and sometimes, like any little kid, he gets anxious. But now I know ways to help him. When he was nervous on his first day of school, we stopped and took big, lung-filling breaths together. I showed him what I do when I feel anxious — touch the tips of my fingers together to bring me back to the present. I told him I loved him and that sometimes we have to do things that scare us, but that we will always do them together.
If you or someone you know is suffering from PPA or PPD, remember that you’re not alone and help is available. Check out these resources for more support and information:
- Office on Women's Health (800-994-9662)
- National Library of Medicine, Medline Plus
- Postpartum Support International (800-944-4PPD)
- National Alliance on Mental Illness (800-950-NAMI)
- What to Expect's Postpartum Depression Group
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