Pregnancy and Postpartum · Anxiety

Postpartum Anxiety and Feelings of Overwhelm

It may seem that being overwhelmed is just a given. You’re up to your eyeballs in dirty diapers and wet burp clothes. You can’t remember the last time you had more than a few hours of rest. What even is breakfast? You run on a steady stream of coffee and fistfuls of cheerios. When you put this all together, postpartum anxiety (PPA) and feeling overwhelmed seems to be par for the course.

If being overwhelmed or anxious has been your experience for the past few weeks (or months, or years), it is not fair and it’s not okay. It does not have to be like this. Postpartum is not meant to be a painful or miserable time. If you’re struggling with PPA (or similar symptoms), here are some tips to help.

Know the Signs of Postpartum Anxiety

Postpartum mental health gets overlooked because so many of its symptoms are normalised. Unfortunately, because having a new baby comes with lots of questions, PPA can get mistaken as “normal” adjustments to parenthood. Someone out there has claimed it is acceptable that you are this tired and irritable and anxious.

Yes, it’s normal to have questions and worries. This is part of being human, and certainly a part of being a new parent. However, it’s not normal to have these worries keep you up at night, cause conflict with your partner, or make you avoid time with the baby. Anxiety is only considered “normal” when it’s within your capacity to address it (a.k.a. your window of tolerance).

Postpartum anxiety is a genuine illness that requires attention and help. Here are the symptoms to look for:

  • Inability to stop worrying
  • Racing thoughts
  • Difficulty with sleep or appetite
  • Difficulty with focus and concentration
  • Inability to rest or relax
  • Feeling on edge
  • Panic attacks
  • Irritability or rage
  • Physical cues: tightness, tension, dizziness, nausea, hot flashes

One quick way for you to check about the severity of your postpartum anxiety is through the Edinburgh Postpartum Depression Scale. This is a screening tool that is used to identify postpartum mental health struggles (including PPA). Specifically, any score above 12 on this depression scale indicates a high probability of postpartum mood and anxiety disorders.

Three quick grounding techniques

If you’re struggling with overwhelming anxiety, you likely want these feelings to calm down ASAP. Here are three quick grounding techniques that can help reduce the panic and overwhelm.

1. Butterfly Hug

The Butterfly Hug is a popular technique used in Eye Movement Desensitization and Reprocessing (EMDR) to quickly settle your body and mind.

Why it’s helpful:

  • Does not require much thinking: This approach does not need you to think through things calmly. You don’t have to “logic” your way out.
  • Helps your brain process in a unique way: EMDR uses bilateral stimulation to activate both your left and right hemisphere while addressing extreme anxieties, traumatic memories, or distressing events
  • Activates your parasympathetic nervous system (the parts of your brain needed for relaxing)
  • Reduces your cortisol level (a.k.a. your stress hormones)
  • You can use this strategy anywhere. It does not require any “equipment”.
The following video shows the steps of the Butterfly Hug:

2. Temperature Change

The temperature change exercise is a great strategy that comes from Dialectical Behaviour Therapy. This approach triggers the mammalian dive reflex. This reflex occurs when we are submerged in ice cold water. In order to survive, our body is forced to slow down our heart rate and oxygen is only sent to key organs that are needed. Everything that is considered “non-essential” is overlooked.

Why it’s helpful:

  • Tricks your brain: Your body cannot go into “survival mode” and panic at the same time. Your heart rate is forced to slow down. Your oxygen level drops, thereby making it hard to panic.
  • Provides about 5-20 minutes of calmer thinking. This gives you some time to problem solve or find alternative coping strategies.
  • You don’t have to “think through” it to feel calmer.
The following video shows the steps of the Temperature Change technique

3. Mindful conversation with another person

Using distractions is really helpful to get through a distressing moment. However, if you cannot find a distracting enough activity, your mind tends to wander back to its original anxious thoughts. Participating in mindful conversation with another person face to face is more effective in helping you stay out of the overwhelm. Rather than focusing on the anxious thoughts, you’re turning your attention to the other person, asking and answering questions, and staying present.

Why it’s helpful?

  • When your postpartum anxiety is highly activated, your sympathetic and parasympathetic nervous system work overtime. Your body turns to survival strategies like fight, flight, freeze/shut down in order to cope. Social engagement, on the other hand, activates our ventral vagal pathway. This pathway tells our brain that we are in a safe and socially connected space.
  • Focusing on topics outside of your postpartum anxiety helps your system recognize that there are still safe options in your world.
  • Gives you the option to engage with someone else outside of your baby.

Working with your anxiety

So now that you’ve coped more effectively in reducing the anxiety, you may be wondering about your next steps. After all, these earlier coping strategies only resolve things for a short time. They’re not actually fixing the issue, and instead, providing brief respite. This is where the hard work of listening to our anxiety comes into effect. In order for you to gain more clarity, you will need to work with your postpartum anxiety.

Internal Family Systems Therapy (IFS) explains that there is always a positive intention to our worries (even though it rarely feels “positive”). It’s challenging to slow our body and mind down enough to hear what your postpartum anxiety has to say. But, we can break down the steps to better support our mental health.

Step One: Find where your anxiety is in your body.

Daniel Siegel coined the term “name it to tame it”. Basically, when you are able to find the feeling in your body and label it, you can get a bit of space from that feeling. Rather than “being” the emotion, you can observe it. So, call out what and where you are feeling things: “I am feeling scared… There is a ball of anxiety in my chest… my shoulders are feeling tense and stressed.”

Step Two: Stay curious

In this step, you will use a bit of mindfulness to approach your emotions. Now that you’ve noticed the emotion, keep your awareness on this feeling. Be aware of the thoughts, sensations, memories, and whatever else comes to mind as you focus on this feeling.

This step involves staying curious about your anxiety is telling you without judging it, trying to get rid of it, or needing it to change. Your anxiety will start to share more as you stay open to it.

As a word of caution, your anxiety may not share the nicest feedback. It may share beliefs such as: “Get me away from this baby! I can’t do this! What was I thinking? I need this to stop!” Stay aware of these thoughts so long as you are within your window of tolerance.

Step Three: Understand what your anxiety is trying to protect

IFS recognizes that our anxious parts are trying to help out in some way or form. Because they tend to communicate in harsh and overwhelming ways, it’s often difficult to understand what our anxieties are trying to achieve.

As you complete step one and two, you will start to identify what your anxiety is telling you. Then, ask yourself, what would happen if these anxious thoughts stopped? What is your anxiety trying to prevent? For example, if your anxiety is often saying, “Get me away from this baby”, what would happen if this warning was no longer present? You might presume that you’d be calmer. While that’s true, what else would happen? Would you suddenly be considered calm enough that others encourage you to parent independently? Would you spend more time with your newborn and make a mistake? What if your baby keeps screaming and you’re reminded that you’re not cut out for this whole parenting thing?

Sometimes your anxiety gets triggered, and it forces you to escape the circumstances. Your brain says, “This is too much, I can’t cope,” and you turn towards avoidance, drinking, zoning out in front of your phone or some other strategy. I’m not saying that these are effective ways to manage things. In all likelihood, this form of “self-soothing” will create new problems. But, as far as your anxiety is concerned, it is satisfied that it has reduced your distress and gotten you away from the “danger” (e.g. time alone with baby).

Step Four: Befriending

Have you seen “Beauty and the Beast”? The Beast is known for being a lousy character. He’s rude, ill-tempered, and scary. But, we see that meeting the Beast with compassion (mixed with assertive boundaries) helps him shift out into a kinder character. (For those who are cringing reading this example, humour me. It’s an analogy. I’m not trying to condone Stockholm syndrome).

In many ways, your anxiety is like the Beast. It’s loud, frightening and has awful manners. However, what happens when you approach your anxiety with compassion or confidence? Have you ever shown any desire to get to know this part of you? What happens when you acknowledge what your anxiety is actually trying to do? Imagine what it would be like to approach your anxiety by saying: “I get it… I get that you’re really scared of me making a mistake… I know this feels like the only way you can help me.” How would it respond to you?

Becoming kinder to yourself

IFS brings in a different level of self-compassion. We are not only meeting our inner system with kindness, but we’re also identifying what our anxious parts are attempting to achieve. When we treat ourselves in this manner, our anxieties will soften. These steps don’t cure postpartum anxiety. We have to address the actual issue, whether it’s the fear of making mistakes, feeling insecure about parenting, or addressing our own childhood traumas. But, meeting our anxiety in this way will reduce the overwhelm.

Curious to learn more?

Postpartum anxiety is treatable. If you found the above examples helpful in reducing your overwhelm, please let me know. If you have any questions about the above steps, or want to work with your own unique circumstances, reach out.

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.