Postpartum anxiety looks like this (released in 2020)

This story was originally published on June 18, 2019 at NYT Partening.

At 3 am, sit in lukewarm water and count your breath to make sure you are alive. I feel like my chest is cracking, and my heart is awake even though I am tired from sleeping. Thoughts run through my head, keeping me in a lasting state of tension between fighting and fleeing. When does my 3 week old demand and stir my chest again? How can I withstand the choking and halved pressure of caring for my son for another night while trying to take care of my depleted body?

This is the way I felt when I had postpartum anxiety four years ago.

At the biological level, Experts believe Postpartum mood changes, in part, Sudden drop in progesterone and estrogen levels after childbirth.. However, it is not always the hormone levels that make new mothers more susceptible to anxiety and depression.

“The main theory 15 years ago was that women with postpartum mood disorders experienced excessive hormonal changes, but studies show that there is no significant difference in absolute hormonal levels.” increase. Dr. Patricia Widra, Maryland.. , Associate Professor of Psychiatry, University of Maryland. “The current working theory is that it is not a hormone in particular, but an individual’s brain chemical reaction to it.”

Postpartum anxiety Affects about 10 percent of new mothers, So it’s not uncommon — it’s complicated and its symptoms vary. While the anxiety felt trapped in my body, the author Jessica Freedman felt dissociated. “When anxiety strikes, I find myself floating outside my skin and desperately want to find a way to get back in,” Friedman wrote in her memoirs. I am. “Things that helped”

Impact 1 in 7 womenPostpartum depression often functions as a generic term for mental illness during the postpartum period and has historically been more commonly screened and diagnosed. However, many mothers, including Friedman and myself, switch between depression and anxiety. One mother’s constant anxiety may bring despair to the surface, while another mother’s feeling of separation from her baby may cause her anxiety.of One study14% of women who tested positive for postpartum depression also had anxiety disorders.

This combination of anxiety and depression among new mothers is “postpartum depression” in which female mental health providers and reproductive psychiatrists support PMAD (a more comprehensive “perinatal mood and anxiety disorder”). It is so widespread that it abandons the term). A spectrum of mental states in which pregnant and postpartum women are at risk. PMAD is a comprehensive term that includes mood disorders such as clinical and bipolar depression, as well as anxiety disorders such as generalized anxiety disorder, obsessive-compulsive disorder, and panic disorder.

“Postpartum depression is the catchphrase we used, but I think it always refers to people who have both sadness and anxiety at a clinical and diagnosable level,” he said. Alexandra saxophoneMD, a reproductive psychiatrist in New York, “No one tells you: A guide to your emotions from pregnancy to motherhood. ” “In the field, there is a consensus that when people present with depression, they often actually have more anxiety symptoms. Anxiety and depression are very common during pregnancy and postpartum anxiety. So I don’t necessarily think of it as two different illnesses. [period].. “

While History of women’s mental health May increase her risk of PMAD — there was a previous diagnosis of generalized anxiety disorder, which may have increased my susceptibility — Dr. Sax also has physiological and psychosocial factors. I quoted it. “Fatigue and hormones, combined with the tremendous changes in everyday life and identity that accompany becoming a mother, only sow seeds for anxiety,” she said. “As a new mother, there are a lot of worries, but for many women, being aware of how fragile your baby is can switch on worries that are very difficult to turn off.”

However, there is a difference between the new maternal vulnerability to everyday stressors and the diagnostic anxiety. Widra, who developed the postnatal screening program for obstetrics and gynecology at Dr. Georgetown Medical Center, described anxiety as a spectrum. Some anxiety can be motivating and vigilant, but too much can be an obstacle.

By the time my son was three months old, I had a disability. I couldn’t escape the feeling of suffocation. My anxiety swelled with almost daily panic attacks and compulsive concerns about my health and baby safety. The howling sound of his son made me almost intolerable of physical upset. When I visited the pediatrician’s office, I had a panic attack and her husband had to switch from work to Uber and take us home.

Doctor to manage clinical postpartum anxiety. Widra recommended talk therapy and, in severe cases, anxiolytics. “Cognitive behavioral therapy is very effective in treating pregnancy and postpartum anxiety, and the only risk is time or money. If someone does not go to treatment, or if the anxiety is so severe that it cannot be treated. , I recommend anti-anxiety drugs. “

If you use anxiolytics during pregnancy or breastfeeding, Bring risk to your baby However, according to Widra, untreated anxiety can be harmful as well.Stress is known to have a negative effect Milk productionThis can perpetuate the cycle of anxiety in new mothers, and untreated anxiety can have long-term effects on the family.

“I sometimes see families whose mothers have been anxious since they were babies, but now they aren’t allowed to go out,” she said. This is an extreme example, but according to Widra, “anxiety can create a contagious environment.”

When I couldn’t leave the house, I found a therapist who specializes in parental anxiety. The panic was resolved by expressing my anxiety, but most of the time I felt like I was drowning in my son’s needs.

“I’m not ashamed of what you’re experiencing, but this doesn’t have to be normal,” my therapist assured me. I agreed that increasing the dose of anxiolytics I was already taking would be a good first step. I talked to an obstetrician and gynecologist, and only a few weeks after about the new dosage, I started to emerge from the fog. The worries didn’t go away completely, but I no longer felt obsessed with their weight.

Four years have passed since the diagnosis of postpartum anxiety. I get more sleep and my hormones are as balanced as ever. Changes in parenting demands warn me, but when anxiety surfaced, my body feels like a safer place. And most of the time, so is motherhood.

Ashley Abramson is a freelance writer in Minneapolis and lives with her husband and two young sons.

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