Becoming a mother is such a rewarding experience.

However, parenting brings about a great deal of anxiety. This anxiety can be quite pronounced during the postpartum phase.

I describe anxiety as an evolved state that is intended to protect us from danger. And it is highly effective in doing so. Think about it from a historical perspective. Which women were most likely to produce children that survived? The mothers who experienced sleep deprivation; the mothers who made sacrifices; the mothers who foresaw problems and took proactive measures to prevent and address them. The moms that worried.

Evolution didn’t care about our internal state, but evolution cared greatly about our ability to keep our offspring alive.

However, in this modern world, such dangers are not the norm. Yet we still grapple with these outdated, alarmist feelings in the body. And because our feelings are so intense, new mothers cannot help but look for reasons that give these feelings merit. They smell smoke, and they want to put out a fire. But the nature of an anxiety disorder causes problematic thinking, to the point that our problem solving, in and of itself, creates the problems we want to solve.

Let’s start with intrusive thinking. New mothers often come into treatment because they are scared of something happening to their child or to their partnership. Intrusive thinking appears practical on the surface. After all, it is possible that something really bad can happen. However, the worries we have are not only uncommon and unanticipated, but they are often things that we have no control over. The presence of anxiety in our bodies no longer places us at an advantage anymore. When anxiety is overwhelming to the point that a client is suffering cognitive intrusion, sleep impairment, and seeking out therapy, it often results in a parent feeling less equipped for the imminent tasks of motherhood. The intrusive thoughts are draining and resulting in feelings of powerlessness, helplessness, and inadequacy.

To solve any problem, we have to first call it out and acknowledge that it is, indeed, a problem for us, and second, we have to want to solve it. We have to acknowledge that the quality of our thinking is the problem- as opposed to the solution. This itself can be quite the hurdle, because intrusive thinking is not only addictive, but its widely accepted in our culture. Social media is a forum for continuous intrusive and circular thinking. It has been a form of entertainment and escapism, but it ultimately results in even more anxiety. In fact- and I address this in my work with clients- we can even seek out some sources of anxiety to distract us from the deeper, more painful sources of our anxiety, which only seeks to cover over the real issues even further, burying us deeper in the unconscious and creating more alarmist feelings and reactions in the body and mind.

Anxiety comes to a head during times of transition, stress, trauma, and having a child is certainly stressful and sometimes traumatic. It is a huge transition from one phase of life to another. It is not only our hormones and our physical state that prods us to go on alert mode in order to protect this new and precious human being- we are also about to rebirth ourselves. Many clients say that becoming a mother made them long to understand- who am I? Where did I go? Becoming pregnant and having a child are both major transitions, and anxiety is especially prone to rearing it’s head during times of transition. Those of us with preexisting anxiety conditions and highly sensitive/conscientious/overthinking temperaments, are the most prone to getting a diagnosis of PPD or PPA or both.

Transitions such as getting married- wedding planning- getting pregnant- having a baby- becoming a mother- not only bring about superficial stressors, but also deeper-seated and even unconscious stressors. Getting married and becoming a mother are both situations that invite us into the realms of caring for someone as much if not more than we do ourselves. This kind of deep, pervasive love also brings out our hidden fears. It also leads to deeper questions about your own personal identity. Who am I now that I am becoming a partner, a spouse, a parent? Where do I end and this other human being begins?

Even though these transitions are delightful and exciting, they scramble up anxiety just like a good dusting fills the air with allergens, and bring about a myriad of sneezes.

Here are some suggestions for coping with postpartum anxiety:

Get a proper diagnosis and a treatment plan and seek the support of medical professionals. A doctor may or may not prescribe medication. A therapist is always helpful in collaborating with a client to come up with a treatment plan to address the client’s core issues/concerns. PPD often requires a “team” of professionals to treat this diagnosis.

Practice mindfulness and relaxation techniques. My favorite book on somatic work is Somatic Psychotherapy Toolbox. It is a great guide for understanding the importance of connecting with our body. Often anxiety can take over our mental train and we are lost in our thoughts and afraid of our feelings, connecting with the body allows you to get in touch with all of your centers, to become more present and mindful, and to see how yoga, pilates, stretching, and breathing does cause the mind and body to relax. This is great as part of a daily self care plan- clients report that it is something that works when it is part of a daily, regular practice.

Consider a social media detox. A lot of new mothers are active on social media. Forums can be especially problematic not only because of the plethora of conflicting advice and the occasional sad and anxiety provoking stories, but also because it pulls you out of your present moment and into your heads. If anxiety is a problem for you, consider taking a social media detox. You can call your pediatrician for advice and guidance. Being around other people is very important, not necessarily for the advice they provide (which may trigger anxiety), but because we all need community and this will sometimes begin to slip after a baby is born. Keep your social network strong. See your friends as often as you can and seek out real human connection over internet ones whenever possible.

Establish a daily self care plan. This may be very simple or more complex. For some clients, even the idea of committing to a 15 minute practice before bed is stressful. You can adopt a self care practice from a book or from a therapist, or you can create your own.

For those on the anxious spectrum, it may feel like taking 15 minutes out for ourselves is a waste of precious time in which we can be doing something. Meditation or a hot bath or a massage can feel like self indulgence. But I notice the clients that still take out some time for themselves every day tend to feel better. Things naturally fall into place more. In a time where you literally feel like you have to decide between sleep and cleaning the home (and yes it is a common report, the stress of going to sleep in a messy home) it may feel like a burden to commit. This is another area where we are invited to change the pattern of our thinking.

Exercise- I know you know, and you know that I know. But yes, research shows it helps for so many reasons, find an activity you enjoy; my favorite is pilates, but many moms enjoy just walking around their neighborhood.

We can’t control our feelings, and behaviors are also resistant to change, but we can learn to rewrite and manage our stories. Our stories have a strong connection to our feelings and our behaviors. If we watch the way we speak to ourselves, our feelings and even behavior will eventually follow. This is not a one-time action, but rather, an ongoing practice and a new way of living.

What are stories? Ideas about who we are, who other people are, and how the world works. These constructs may be simple or elaborate, but once they involve negative rhetorics, include a bunch of “should” and “oughts,” or lead us into the ditches of intrusive, circular thinking and rumination, they become harmful. Many people want to keep their stories, even their negative ones, for many reasons I won’t go into here. Many people don’t want to change their internal landscape; we are all secretly hoping to force some aspect of their environment to fit their will, or force themselves to meet certain external goals. It is rarely our stories that lead us into therapy. It is, rather, the feelings associated with their stories.

For example, they long to please everyone and make sure- on a daily basis- that they do not let down anyone, but they live with constant dread and anxiety that goes along with such an unrealistic goal. They may not know how to change this pattern, but they know they want to be rid of the feelings associated with it. However, anxiety is a symptom, not an illness. It is a symptom that begs us to analyze our stories and to reassess who we are and what we want to be in this world. Do we really want to have to worry about pleasing everyone? How long do we want to keep doing this? These are common questions that come up for new mothers who suddenly find that it has become an impossible and increasingly painful process to please everyone, and they want solutions. In this case, a major transition, like having a child, is a wake up call that forces us to change the way we think. Anxiety will plague us until we begin to do the work to dismantle that story and replace it with something that works better for us in the long run. Here is an example: I can’t possibly please everyone, but I can work on becoming someone that I am pleased with. Or, another example, I seek to maintain a relationship and a connection with myself on a daily basis. Or I have to prioritize honoring my gut instincts as a mother, which may mean repairing our own self esteem and sense of worth- something that has always been a core issue, but never gained as much attention or concern until now.

Parenthood compels us to do the work on ourselves. That is what makes us such a valuable process for ongoing self growth. Our children, from day one, are begging us to do the work on ourselves. They want us to join them on an incredible journey of self discovery and healing.

Most of my clients are not looking for a quick fix.

Most of my clients are not looking for a quick fix. They don’t even seem that interested in advice, and I don’t blame them. While their complaint may be the pain of postpartum anxiety, few clients actually expect a quick word of advice that is going to solve their problems. Regardless of whether they are taking medicine or not, they are seeking me for a deeper reason. On some level they realize that something powerful has happened to them. They are tired of the outside noise with all the conflicting advice. They want to trust themselves. They want to know that its ok- that they are ok- that they are going to get through this transition. They want to honor their maternal gut instincts. Giving birth to a human being is an incredible task and honor, and yet, as all mothers tell you, we all tend to learn as we go. And it’s ok. It’s ok to take care of ourselves, and it’s ok to parent differently than our parents did.

Many mothers have grown tired of the outside noise and want to listen to their gut. They want peace of mind far more than they want to have to learn how to ask for help or go to sleep. Most of all, they realize in this incredible transition from woman to mother, that somewhere along the way, they have unconsciously neglected or failed to nurture parts of themselves. There are seeds that are waiting to be watered. Therapy can be a place where someone gives a mother permission to listen to her inner voice, and to know when enough is enough. The process of creating trust with ourselves is similar to the process of creating trust with anyone else. We have to allow time, space, vulnerability and intimacy; we have to be able to empathize with the other and communicate honestly without fear of what we are showing or seeing. If we can take time to connect with ourselves, our minds, hearts and bodies, we can’t help but develop more trust and affection for ourselves.

If you are struggling with PPA or PPD, don’t hesitate to contact me.

*I am an LCSW in the state of Georgia. My resume includes a career spanning over 20 years, beginning with work in the foster care system and progressing to my individual practice. I am certified in the Enneagram and a graduate of Dr. Shefali’s conscious parenting institute. The information I offer is based upon personal experience and acquired learning. The teachers who have inspired me and my work the most are as follows: Russ Hudson, Sheryl Paul, Shefali Tsabary, Eckhart Tolle and Viktor Frankl.*