When Aparna* welcomed her first son, she was instantly in love. She could just sit and stare at his little hands and face all day. But as she watched him sleep in her arms, she felt her pulse begin to race. Anxiety was creeping in. And it soon became debilitating.
"I thought every twitch was a seizure," she remembers. "I was beside myself. It got to the point where I didn't want to be in the same room with him because I thought I was going to find something abnormal."
As a physician who specializes in pediatrics, she often met with parents who were concerned about the health of their babies. She knew the warning signs of postpartum depression (PPD) so she could help these families. But her experience felt different than how she’d always thought of PPD — she just couldn’t shake the 24/7 feeling that something bad was going to happen.
"I thought my baby was the cutest baby ever, but every time I looked at him, all I could think about were all the things that could go wrong," she says.
Then, around four weeks postpartum, her husband was working an overnight shift, and it was just her and her son at home. In the middle of the night, she began to panic over her baby’s development and called one of her best friends who lives in California. “I knew she'd be up, and I just started crying on the phone … telling her how worried I was."
Finally, her husband raised the red flag: He said she needed to go to the doctor to get help. Aparna broke down and agreed.
Aparna was shocked to learn that she was experiencing postpartum anxiety (PPA), a PMAD she had heard about, but hadn’t been able to recognize in herself.
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She wants other moms to know that everybody's symptoms are different when it comes to postpartum mental health. But if something feels off in any way, you should absolutely feel comfortable getting help. When she finally did, it changed her life.
Her diagnosis brought both sadness and relief
The prevalence of PPA isn't consistently tracked separately from PPD, but both conditions combined affect about 1 in 5 new moms, according to Postpartum Support International.[1] PPA typically describes feelings of constant worry, like an endless concern that something bad is going to happen. This anxiety could cause trouble sleeping or eating, among other symptoms.
For Aparna, it affected every second of her postpartum life.
"Every twitch my son had, I thought was a seizure," Aparna remembers. "I would bring my husband in and say, ‘Did you see that one twitch?'"
She’d look into his eyes and worry that he wasn’t making eye contact, even though that was developmentally normal for his age. Aparna just kept watching and waiting for a sign that something was wrong with her beautiful son.
Then Aparna’s husband told her it was time to get help, and she knew he was right. She called her hospital's postpartum mental health center (which was fortunately very robust, she says), and less than two weeks later, she began working with a therapist and psychiatrist for treatment.
At the end of her first session with her therapist, she was officially diagnosed with postpartum anxiety. Her therapist explained that she was right in seeking help, and her anxiety was not just something that would go away on its own. "When she said that, it made it real," says Aparna. "I was sad and scared when I got the diagnosis. I was sad that this happened because it wasn't how I saw myself."
It also didn't sink in that it was "postpartum," she says. "It more so felt like it was anxiety that I already had, and it just happened to be after I had a child. I didn't quite accept or truly understand that this anxiety was different, that it might be temporary and related to hormonal and physiologic changes."
But through her sadness and her need to accept what was happening, she also felt relief. Aparna worried that she would have to live with her debilitating anxiety forever, and knowing there was a condition triggering it gave her hope that she could overcome it.
"The diagnosis was really helpful," she says. "It validated my feelings, and also validated that all my worries were not the truth."
In the weeks that followed, therapy really helped Aparna. She learned the importance of asking for help when she needed it and was able to talk through the things about her son that worried her.
She couldn't believe how much better she felt. She no longer had those panicked thoughts of something being wrong with her son, and she found the little moments with her son and family actually enjoyable when a lot of the worrying was gone.
"I really thought that this was just my life, that I’d feel horrible and sad and not function,” she says. “But I wish I had known that I did have something to look forward to and I can be myself again.”
The signs of PPA are sometimes hard to recognize, but important to know
Aparna felt bad that she didn't know more about postpartum anxiety before receiving her diagnosis. "I felt a lot of guilt and shame after my diagnosis that, as a physician who works with children and families…"
She says she always prioritized knowing the warning signs of postpartum depression, but that PPA was often overlooked.
"We're taught very quickly that there are certain questions we should ask new moms in the pediatrician's office, like how they're feeling emotionally and what their postpartum experience has been like so far," she says. But they're mostly geared towards postpartum depression. "They really don't teach us what to look out for when it comes to postpartum anxiety specifically and what to say to patients in the event they may have it," she says.
There are many warning signs of PPA to look out for in yourself and others[2]:
Constant worry
Feeling that something bad might happen
Racing thoughts
Disturbances of sleep and appetite
Inability to sit still
Physical symptoms could include dizziness, hot flashes diarrhea and nausea
Feelings of anger, irritability and/or rage
Feelings of nervousness or being on edge and anxious
Trouble relaxing
"If I had known that not wanting to do things, struggling to go to work, struggling to even get up on Saturdays were signs, I would have reached out to mental health professionals sooner," Aparna says.
She wants other moms to know that there is a large spectrum of feelings that come in waves during postpartum, but if you're feeling off or having any of these symptoms, you should seek help. "Sadness can mean many different things to many different people, and so can anxiousness," she says.
She also wants moms to know they can call their doctors before the standard six-week postpartum visit to talk about these feelings. Moms can also confide in their child's pediatrician for help since that's often the first physician you see once you have your baby.
Aparna went on to have a very healthy second pregnancy, with no PPA afterward. And then even when her third pregnancy was unplanned and caused a bit of anxiety both during and after, she knew the concerning signs of PPA to look for and was able to get help through it all.
"Be honest,” she says. “If you're struggling, say something. Your physician can help identify that you might need help, and they won't know unless you say something … If I had said, 'I'm having a really hard time,’ just straight up, I think my son's pediatrician would have checked in and asked more questions."
Resources for postpartum anxiety
Postpartum anxiety affects many moms, and there are ways to get help when you need it most. If you or a loved one is having symptoms of PPA, these free resources can help:
Postpartum Support International (800-944-4PPD)
Health Resources and Services Administration (1-833-TLC-MAMA)
If you're ever thinking of harming yourself or your baby, call or text the National Suicide Prevention Lifeline at 988 immediately for free, confidential support and resources. You deserve to have the care you need.
Remember, these feelings and struggles don't mean there is something “wrong” with you. Your body and life are changing, and it's so common to need help through these transitions. "Things can get better," says Aparna. "Believe me."
*Aparna's last name witheld to protect her privacy.
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