Post Partum Anxiety

By Dr. Sophie Grigoriadis with Emily VonderPorten

Postpartum depression (PPD) is receiving more and more attention in the media, thank goodness. Along with women suffering from depression during the postpartum period, many women also suffer in silence from postpartum anxiety disorders.

While some anxiety during the postpartum period can be quite common and normal (due to the increased stress and responsibility of a new baby), for some women it can also reach a significantly impairing or distressing level. Even watching the news on television becomes anxiety-provoking, for fear the infant may come in harm’s way. When anxiety becomes so prominent, a mother’s functioning can be affected, which impacts the family and the bonding and care of her baby.  

According to research, including that done by our team, postpartum anxiety may be more common than PPD, as well as often overlapping. Anxiety disorders during the postpartum include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, phobias and post traumatic stress disorder (PTSD, although no longer classified with the other disorders). 

Many women often worry that they will somehow harm their child, either by accident or intentionally. They may have intrusive, unwanted thoughts, which can be very scary and confusing. This may cause the mother to become more and more anxious about having these thoughts. Fortunately, postpartum psychosis, the condition that women are typically suffering from when thoughts to harm the infant are acted upon, is very rare.

Though postpartum anxiety is a major mental health issue that can be impairing and have negative outcomes if left untreated, there are many treatment options available for women who seek and accept treatment. However, much like with PPD, many women often feel shame, stigma, or even fear, regarding discussing feelings of depression or anxiety with a health care provider or even a family member. This is especially true if she is experiencing intrusive thoughts. She may avoid reporting these symptoms to anyone, for fear the baby will be taken from her. I have had several patients with postpartum anxiety say to me, “I was terrified to tell anyone anything because I worried CAS [Children’s Aid Society] would be called.” 

It is important that women know that a doctor is trained to assess the difference between intrusive thoughts and a real threat to infant safety. In fact, a woman with severe anxiety will sometimes avoid her baby because she is so anxious about the intrusive thoughts. Discussing her symptoms with a health care provider will allow her to get the help she deserves.

Unfortunately, much like PPD, postpartum anxiety often goes undetected and untreated. Education for families, as well as for communities, regarding perinatal psychiatric disorders and their treatments, will help to reduce the stigma and may help to decrease fears many women face. Increasing the opportunity for treatment that women deserve will help to increase positive outcomes for these mothers, their babies and their families. If you or someone you know is suffering, please urge them to see their family doctor, local health unit or hospital. The Women’s Mood and Anxiety Clinic: Reproductive Transitions at Sunnybrook is also here to help. 

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Dr. Grigoriadis is an associate professor at the University of Toronto and Head of the Women’s Mood and Anxiety Clinic: Reproductive Transitions. 

Ms. VonderPorten is a research coordinator with the program and holds a Master of Public Health.  

http://sunnybrook.ca/content/?page=women-mood-anxiety-research-program

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