What is Postpartum Anxiety, and How is it Different From Postpartum Depression?

A young Asian American mother is holding her infant in her arms as she kisses their forehead.

Becoming a parent is a life-changing experience filled with joy, love, and excitement. But it’s also a time of immense change and adjustment, which can bring about unexpected emotional challenges. While many have heard of postpartum depression (PPD), postpartum anxiety (PPA) is less talked about, yet just as impactful. If you’re a new mom struggling with persistent worry, racing thoughts, or an overwhelming sense of dread, you might be experiencing postpartum anxiety.

Postpartum Anxiety vs. Postpartum Depression: What’s the Difference?

An African American mother is breastfeeding her baby girl in her bedroom.

Both postpartum anxiety and postpartum depression fall under the category of perinatal mood and anxiety disorders (PMADs), but they present in different ways.

Postpartum Depression (PPD) is marked by persistent sadness, feelings of hopelessness, emotional numbness, and disinterest in activities once enjoyed. Some mothers with PPD may struggle to bond with their baby, feel extreme guilt or shame, and experience thoughts of self-harm.
Postpartum Anxiety (PPA) is characterized by excessive worry, fear, and panic, often centered around the baby’s well-being. Mothers with PPA might constantly check if their baby is breathing, have intrusive thoughts of harm coming to their child, experience restlessness, and suffer from physical symptoms like nausea, dizziness, or trouble sleeping—even when exhausted.

While PPD and PPA can co-occur, the key difference is that PPD is more focused on depressive symptoms, whereas PPA involves heightened anxiety, excessive worry, and sometimes panic attacks.

3 Ways to Overcome Postpartum Anxiety

If you’re struggling with postpartum anxiety, know that you are not alone, and there are effective ways to manage it. While the stakes can feel higher because you are in a trying and important time of life, the methods for dealing with postpartum anxiety are actually rooted in managing all types of anxiety. There are tried and true methods for addressing this nervous system response, and you can put them to good use with a little effort and practice. Here are three strategies that can help:

1. Practice Mindful Grounding Techniques:

A young woman is laying on the floor on a yoga mat, meditating.

Anxiety is a different level of energy than depression. A depressed nervous system might be slow, subdued, tired, apathetic. An anxious nervous system is often jumpy, jittery, and restless. This is why it is important to slow down your thoughts, your heart rate, your breathing, and your body in general to try to help your nervous system relax. Groundedness is a great way to connect with your body and banish the shakiness and tension of anxiety. When anxious thoughts take over, grounding techniques can help bring you back to the present moment. Try:

Deep Breathing: Inhale for four seconds, hold for four, and exhale for four. Try to find a comfortable way to do this if you can, whether you are able to sit or lie down, but there is no reason not to connect with your breathing while standing if that’s the situation you’re in. Close your eyes if it is safe to and if it helps you to tune out some of the world around you so that you can focus on your breathing. Slowing down your breathing can help to slow down your heart rate as well if it is elevated. Regulated breathing can help stabilize your entire body by dispersing oxygen more evenly. Focus on breathing deep into your belly (this means letting your stomach relax instead of holding it in), and place a hand there if it helps you to be conscious of the area. Breathe through your nose if you can, at least on the inhale if not on the exhale. Feel your ribs and abdomen expand with every breath you take, and relax when you are holding; try to let go of any head or neck tension. Control the exhale so that your breath comes out fairly equally over each second. Then repeat.
5-4-3-2-1 Method: Identify five things you see, four you touch, three you hear, two you smell, and one you taste. Utilizing your senses helps you locate yourself in the present when your mind is ruminating on the past or worrying about the future. The more time you spend feeling focused on and in the present, the greater amount of inner peace you will experience. Seek out simple solutions when you can’t make a full list: smell some gum, then chew it; play some music; turn around where you are in order to spot more things. Most of all, remember that these lists are goals. If it’s only possible to hear two things, accept that and focus on those two sounds while breathing slowly and relaxing your body as much as possible. Sometimes, we get caught up in trying to utilize tools “perfectly”, but there is no such thing as perfection. If you can’t make a full list, be kind to yourself.
Progressive Muscle Relaxation: Tense and release each muscle group to ease tension. Sometimes, we don’t realize we are holding tension somewhere until we focus on that area and make a conscious effort to release it. Tensing and releasing each muscle group can feel like wringing out the stress. There is also something empowering about tensing a muscle consciously and then releasing it, as opposed to it tensing on its own. You may choose to sit or lie down and take it one area at a time, staring with your feet and moving up the body. If you have to be quick about it, do a body scan to see if you can identify an area of the body that needs attention and focus on only that muscle group.

These techniques help regulate your nervous system, reducing the physical symptoms of anxiety. It can be very difficult to feel mentally and emotionally relaxed when you are carrying physical tension in your body.

2. Challenge Your Anxious Thoughts:

Postpartum anxiety often brings intrusive thoughts, like “What if I’m not a good mom?” or “What if something terrible happens to my baby?” When we are tired, we either try to suppress these thoughts or don’t feel as though we are capable of combating them. Because the postpartum time is fraught with fatigue, that leaves us submitting to these thoughts more often than not if we’re not careful. Instead of accepting these thoughts as facts, ask yourself:

A young woman is sitting on her couch in her living room, with her hand resting on her knees.

Is this fear based on evidence? Those we see for anxiety therapy in Woodland Hills do have past histories of trauma and unfortunate events, and those are triggers that are deserving of attention and care. However, you will often find that there are fears you experience that aren’t rooted in any real-life circumstance or evidence. Yes, there are terrible things that happen without warning, but they are rare, and they cannot be stopped when they do happen. Is your fear based on something you see as wrong, such as an unstable crib? That can (and should) be fixed. If your fear is based on a rare worst-case scenario, consider that there are no signs indicating that it will happen.
What would I tell a friend going through this? Often, we are our own worst enemy and our own worst critic. Where we would offer gentle support, compassion, and patience to a friend, we are hard on ourselves. Where we would normally be able to step back and try to see the bigger picture or think strategically about the issue, we get caught in a feedback loop of negativity. The tactic of considering what you would tell a friend is one that allows you to have a little objectivity, and a little objectivity can go a long way. If you are struggling to get out of your own head, close your eyes and picture your best friend. They have just disclosed a worry to you, and they are struggling to let go of their anxious thought. If you feel comfortable, speak to them aloud. You might offer comfort, solidarity, advice, or support. Hear what you are saying. If you say something that really strikes a chord with you, repeat it for yourself. It may become a mantra you use more often or be just right for the situation you have found yourself in.
What is the most realistic outcome? Of course, we can think of our best-case scenario or our worst nightmare. Sometimes, what we need to do is to focus our thoughts on the average and predictable. When you hear hoof beats, think horses and not zebras. Ask yourself, “Is my fear likely to come true?” You might initially think to yourself, “No, but it could still happen”. This can become a seemingly endless loop. To combat this, list other things that are more likely. See how many you can think of. When you are considering an action like going out for a walk, but are faced with the idea that something might happen to your baby if you take them outside, ask yourself, “What is the most realistic outcome?” If it’s a hot day, the most realistic outcome is that you come home a little sweaty. Maybe your baby cried the whole walk, or maybe they slept. Both of those are more realistic than a rare and random misfortune. Visualize the more likely scenarios you come up with. Picture them going well.

Challenging your anxious thoughts can feel lonely, or daunting to undertake alone. Journaling or speaking with a therapist can help you reframe these thoughts into more balanced perspectives. Give yourself permission to express how you feel.

3. Seek Support and Professional Help:

You don’t have to go through this alone. Connecting with others who understand your experience can make a difference. Consider:

A group of women are taking part in a mother's support group, as they sit in a circle on the floor breastfeeding their babies.

Join a Postpartum Support Group to share and learn from other moms. It can be so isolating to struggle with parenthood. Having a group of people with whom you can connect about anything and everything to do with parenting can offer solidarity and community that you desperately need. There are in-person and online groups and organizations that you can participate in. In-person networks can offer tactile support, especially if you connect with moms who live nearby and can meet up for a walk in the park, or who you can call on for help and who can call on you. Online networks are great because anyone from around the world can join, which means that if the group is big enough, there will almost always be someone online if you are struggling. Being able to make a post, or have a chat, can help to stave off the feeling of being alone in your anxiety. You are not alone.
Therapy: There is a mode of therapy called Cognitive Behavioral Therapy (CBT) that is used to address anxious thoughts and trauma. As an anxiety counselor in Woodland Hills, I use CBT to work with clients in exploring the thoughts that are occurring, the choices and patterns that result, and the behaviors that are more beneficial for dealing with the issue. Those who come to our practice for in-person or online anxiety therapy learn to address these negative thought patterns through determining their origin, moving away from the past response, and creating a tailored plan to react in more productive ways. Professional guidance can help you to process your thoughts and emotions, and provide you with a safe space to try new methods.
Speaking to a Doctor: If symptoms are severe, medication may be an option. Medications typically used to lower anxiety include… This step should be discussed with and supervised by a doctor, especially if you are nursing. Do not assume that nursing excludes you from obtaining medical help; be honest about your needs and symptoms. You and your doctor may be able to find a medication that facilitates what you want to do, or determine that the priority should be medication. A parent who is alive and mentally well is the most important resource a baby has. There is no shame in ensuring that you can be that parent for your infant.

Therapists and medical professionals understand that postpartum anxiety is not an indicator of unfitness to parent; they are in place to help you navigate common and understandable responses to this big life change.

A mother is holding her newborn infant in her arms.

We have come a long way, but there is still a lot of stigma and shame regarding postpartum struggles. There is an expectation that this should be a happy time, that there is no greater miracle, that your wishes have come true, and complaining or experiencing negative emotions makes you ungrateful, or an unloving parent. In actuality, being a parent is hard; it’s hard in different ways depending on the stage of life, but it’s hard. And being a parent to a human who has just arrived is a specific struggle of sleep deprivation, hormonal changes, and constant learning. This is the perfect breeding ground for anxiety about what you’re doing, if you’re making the right choices, and is the world a safe and kind enough place for your baby? Postpartum anxiety comes up often in our Woodland Hills anxiety therapy sessions; you are not alone in your feelings, which means you are not alone. There are ways to approach this anxiety, to obtain support from others, and to be kind to yourself as you do the work.

Anxiety Therapy at Embracing You Therapy

Do you often feel overwhelmed by stress and struggle to control your worries? Do you find it challenging to maintain a healthy work-life balance, navigate life transitions, or set firm boundaries with others?

With Anxiety Therapy in Woodland Hills, CA, you’ll gain valuable tools from CBT and mindfulness practices to help you regulate your emotions, develop healthier thought patterns, and create behaviors that support your well-being.