How I Missed The Signs of Postpartum Anxiety (PPA)

As I’m watching close friends become mothers for the first time, I start to reflect on my postpartum period. And as I reflect, a great deal of sadness and grief come over me. You see, I am a PPD (Postpartum Depression) survivor, and I’ve talked openly about it in my blog posts. But the one thing I’ve never mentioned, mainly because until a few days ago I haven’t made the connection, I’m also a PPA (Postpartum Anxiety) survivor.

And just coming to this recent realization has brought up a mixed bag of feelings. On one hand, there is relief. I am relieved to have a name for all the debilitating symptoms I experienced after my eldest son was born. But on the other hand, I just feel guilty and ashamed of the fact that while I was suffering with those symptoms, I vehemently denied that there was a problem. But, I know I’m not alone. I’ve spoken to many moms who are also therapists and who missed their signs of PPD or PPA because they felt that due to their profession, they were fully equipped to deal with their problems alone. Which is completely untrue!!!!

And moms who are not therapists often miss signs of PPA (Postpartum Anxiety) because they are not usually screened for it. PPA (Postpartum Anxiety) is not recognized as a stand alone diagnosis under the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders), and thus needs to be diagnosed under the myriad of anxiety disorders.

Diagnostic Tools for PPA (Postpartum Anxiety)

When you’re trying to research information about PPA (Postpartum Anxiety), you’ll notice an absence of articles from the Mayo Clinic or WebMD on the topic. You will, however, find blog posts from various therapists and articles from newspapers. And that is because PPA (Postpartum Anxiety) isn’t an official diagnosis.

In order to get any sort of answer about your PPA, you will have to piece together information about Postpartum OCD, Panic Disorder, and Generalized Anxiety Disorder (GAD). But keep in mind, all the information you are trying to piece together will be about the disorders in general. You, unfortunately, will not find much that specifically relates to the postpartum symptoms.

Before we go into what symptoms you might encounter with PPA (Postpartum Anxiety), I wanted to share a few diagnostic tools with you that you can use at home. Use these to help yourself assess whether you may be suffering from PPA. And if it looks like you may have some PPA symptoms, make sure to screen shot or print your answers, and bring them to your doctor. Do not attempt to treat this yourself or let it go untreated. It can be dangerous for both you and your baby.

Screening Tools for PPA

The Generalized Anxiety Disorder Scale-7

Patient Health Questionnaire-9

Edinburgh Postnatal Depression Scale

I included the EPDS (Edinburgh Postnatal Depression Scale) because there are overlaps between PPD and PPA symptoms. So, it’s a useful tool to use even for PPA assessment. There is also a Perinatal Anxiety Screening Scale tool, but it is currently only available to trained clinicians, and still isn’t widely used for assessment. But it is worth asking your therapist about, and see if they have access to it.

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Symptoms and Risk Factors For PPA (Postpartum Anxiety)

In addition to using the online screening tools, I want to share with you what symptoms and risk factors you need to watch out for. When you and your partner know what to look for, it’s much easier to bring all this information up to your doctor. Doctor’s do better when you have concrete evidence to present to them at your appointment.

Risk Factors For PPA

• Personal or family history of anxiety and depression
• Living in an unsafe situation
• Financial problems or instability
• Relationship problems with your partner
• Lack of a support network
• Unplanned Pregnancy
• Difficult pregnancy or birth
• Giving birth to twins or multiples
• Previous miscarriage or difficulty getting pregnant

Symptoms of PPA (Postpartum Anxiety)

• Physical anxiety symptoms – faint, dizzy, nauseous, racing heart, “pit” in the stomach
• Panic attacks
• Racing thoughts
• Issues with sleep
• Changes in appetite
• Constant feeling of dread, as if something bad is going to happen to your baby, your family or you
• Irritability
• Yelling at your other kids and your partner
• Disturbing thoughts and images about your baby (baby is going to die, picturing yourself doing something to baby like dropping them from a second floor, etc)
• Afraid of being left alone in the house with baby because you believe you will act on your thoughts
• Constantly checking if baby is ok (not sleeping in the night and checking if baby is breathing all the time)
• Fear of leaving baby in the care of anyone else, like your family or partner, who you normally trust
• Afraid to leave your house with baby because something bad is going to happen (car crash, kidnapping, brick falling on you or baby, etc)

How Did I Miss The Signs of My PPA?

Now that you know what to watch out for, I just hope you don’t end up like me. I had a few of the PPA signs above, mainly random bouts of racing heart, nausea, dizziness, and feeling faint. I was also incredibly irritable and yelled a lot. But most importantly, I became obsessed with meeting my son’s every need. I felt proud if he cried for only a few seconds, and completely defeated if he cried for longer. Meeting his every need became the primary goal of my existence. Needless to say, when my husband took care of him and allowed him to cry for more than a few seconds, I would fly into the room in blind rage, snatch the baby away, and try to calm a crying baby, while sobbing myself. The atmosphere in our home was neither warm, nor pleasant.

And while looking back on it, at first glance, it’s hard to understand how I denied needing help, but when I think harder, it isn’t. You see, my son came into the world via an unplanned C-section (which made for a traumatic delivery experience for me). While he seemingly latched fine in the hospital, it appeared that he wasn’t getting enough milk. He lost a lot of weight by his first pediatrician appointment, which meant we spent the better part of his first week earth side driving to different medical professionals. All the focus was on him and his needs,

He was always hungry, so I was constantly trapped under him for feeds. Since we were worried about his weight, we had to weigh him before and after the feed to get an idea for how much he consumed. This happened multiple times a day and felt like an indictment on me as a mother. If he appeared to have eaten enough, I felt relief, but if he didn’t the blame and worry circle started in my head. I felt judged by this scale multiple times a day. And this for a person who spent her whole life trying to perform her best, was too much to bear.

It’s no wonder that I missed and dismissed my symptoms. I remember getting my heart palpitations and just thinking “Oh, how strange.” But I never thought about telling anyone about them. In comparison to my son not eating enough, that just seemed trivial. And when I did the Edinburgh Scale at my doctor’s office, I answered that I was perfectly fine. I thought, this is how motherhood is for everyone, and I just need to buck up and get over myself.

So, while it’s not an official symptom, I will say that any woman who is a type A personality, loves to have everything under control, measures her self-worth based on her accomplishments is at an increased risk for developing PPA (Postpartum Anxiety). *(This is by no mean an official diagnosis, just my personal opinion on the matter.) Because one thing in parenting is for certain – there is no certainty or playbook to follow. Babies are all individual and require an individual approach. And despite what the booming parenting industry wants you to believe, there is no one perfect parenting method. All methods have merit (except the ones that propagate physical and emotional abuse) and yield different results. And it’s for you to decide what you value most.

I hope that if you see even a glimpse of yourself in my story, that you will pause and assess your situation. It is hard being a mother, but it’s not as hard when you’re not suffering from mental health issues. I can tell you for certain, has this been my second experience, I would have known that something wasn’t right.

I didn’t experience any anxiety with my second child. There were no heart palpitations or constant feelings of dread. I felt more at ease with him crying for a few seconds longer. And I wasn’t as obsessed with meeting his every need. Yes, I still had a much milder PPD episode, mainly because my second son was a horrible sleeper in the first year, and I had to manage a very emotional 2 year old on top of that. But it was still not as bad.

Mama, if you’re struggling, please, get help. You can visit my Resource Library for some articles and help finding a therapist. And you can always find me and connect with me through Facebook in my Parent On Board Parenting Support Group. We have a very supportive community of parents and are always happy to welcome more into the fold. You are not alone!

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