Secret Struggles of Anxiety in New Motherhood
Navigating Those Scary Thoughts No One Talks About and Approaches for Assistance
The current USA statistics show one in five new mothers will experience a perinatal mood or anxiety disorder, yet most suffer in silence, convinced they are alone in their struggle. While media often highlights serene mothers constantly gazing adoringly at their babies, the full reality of postpartum life can include a spectrum of experiences, from bliss to dreadful and frightening thoughts that leave you questioning everything about your identity.
Below are common anxiety-based symptoms and experiences to help explore this topic, to break stigmas and normalize the experiences below.
Terrifying Thoughts That May Make You Question Your Motherhood
Example:
You are gently rocking your precious newborn when suddenly a horrifying thought flashes through your mind: what if I drop her/him? What if I hurt them? What if something terrible happens and it is my fault? In response, you note your heart races, shame washes over you, and you wonder: "Am I the only mother who thinks such awful things?"
The answer is a resounding no. Research reveals that up to 70% of new mothers experience these intrusive thoughts, so if these thoughts are relatable, please understand you are not alone. Despite how incredibly common they are, these thoughts often stay shrouded in silence, fueling internalized shame. By acknowledging and communicating these intrusive thoughts, one can aim to normalize the adjustments and, in some ways, let the internalized guilt free; having these thoughts does not mean you will act on them, as these unwelcome mental visitors are symptoms of an anxious brain trying to protect what you love most, not warning signs of what you might do. To challenge the “anxious brain,” it is important to use deep controlled breathing, grounding techniques, and other evidence-based techniques to help regulate your body and eventually calm the body and mind.
When Your Worry Has Crossed into Postpartum Anxiety Territory
When postpartum anxiety transforms normal concern into something that hijacks one’s life it can lead to unwanted anxieties. Here are common examples of experiences, situations, and symptoms we often see and treat with postpartum anxiety in therapy.
Your worries play on an endless loop, resistant to reassurance
Physical symptoms appear, racing heart, tight chest, insomnia, nausea
You develop elaborate routines or checks to manage your fears
Daily activities become overwhelming because your anxiety filter makes everything feel dangerous
For some mothers, these anxieties evolve into Postpartum Obsession Compulsion Disorder (OCD), bringing:
Vivid, disturbing mental images that appear without warning
Repetitive behaviors like excessive checking, washing, or praying to prevent imagined disasters
Avoiding certain situations (bathing the baby, being alone with them) because they trigger frightening thoughts
Profound distress despite knowing with absolute certainty that you love your baby and would never hurt them
Recognizing When Professional Support is Needed
As many try to navigate milder thought disturbances with kinship and self-help approaches, it is time for professional postpartum counseling when:
These thoughts cause significant distress or interfere with your ability to enjoy your baby
You are developing avoidance behaviors or compulsions to manage your anxiety
You experience thoughts of harming yourself
Symptoms persist beyond a few weeks or intensify over time
Help is available through:
1. Evidence-based therapy approaches specifically designed for postpartum anxiety and intrusive thoughts
Psychotherapy is designed to help with an array of mental health challenges, and Postpartum symptoms can decrease or disappear with integrated evidence-based treatment(s) in individual treatment, couples counseling, or family therapy. If possible, find a therapist who has perinatal training and feels like a good fit to tailor treatment interventions to your needs.
2. Medication options (many are compatible with breastfeeding if needed)
Mothers often communicate rational concerns and/or preferences towards medication(s) while pregnant or breastfeeding. Although persistent symptoms can be taxing on an individual, please understand there are times when medication can be helpful in reducing symptoms while enhancing neuroplasticity (or the ability to rewire the brain). So, if needed, keep an open mind as certain medications are medically beneficial as they are effective in reducing symptoms. If you do have questions or concerns about medication during this time, open the discussion with your OBYN and/or primary care physician and discuss potential benefits vs concerns.
3. Holistic approaches that address both the psychological and physiological aspects of your experience
This is a larger topic, yet below are examples of a few holistic approaches alongside other helpful tools.
Understand that your thoughts are not you
Your mind generates thousands of thoughts daily. These thoughts are mental events passing through your consciousness, not reflections of your character or desires. Learning to observe and describe these thoughts without becoming entangled in them creates freedom and separates oneself from the thought.
The paradox of intrusive thoughts is that the harder you try not to think them, the more powerful they become. Instead, try acknowledging them neutrally as discussed in the video below: "I noticed having a thought about dropping the baby. That's my anxious brain doing what anxious brains do”.
This might sound easy, yet it takes practice. This video can help enhance observation and description skills, as it takes practice.
Embrace radical self-compassion
The postpartum period strips you raw, physically healing while learning to care for a completely dependent human on minimal sleep. This ongoing state makes your brain hyper vigilant for threats, which can lead to self-criticism. Speaking to yourself with the tenderness you offer to a friend can dismantle the shame that keeps intrusive thoughts stuck.
If needed, take time to explore self-compassion skills in individual or couples therapy. In the meantime, try using a mantra often communicated in Dialectical Behavioral Therapy (DBT); I’m human. I’m doing the best I can, and I can do a little better.
This mantra is an excellent example of using present self-awareness to express self-compassion while still acknowledging being human to seed forgiveness and room for growth/change.
Find your truth-telling community
The healing power of hearing another mother say "me too" cannot be overstated. Whether through a postpartum support group, trusted friend(s) who have been there, or a therapist who specializes in perinatal mental health, connection breaks the isolation that makes these experiences so painful. Feeling alone, having a loss of interest, and or isolation are common signs of perinatal anxiety and depression. Never underestimate the power of your shared voice and its ability to connect with shared experiences in an honest, safe environment. If this sounds like an area of interest, reach out to our office and ask about our telehealth Moms support group therapy sessions that meet on Tuesday afternoons, hosted by LMFTs and perinatal specialists.
Soothe your overactive nervous system
As mentioned above, when intrusive thoughts trigger your body's alarm system, calming practices become essential. Try this: Place one hand on your heart and one on your belly. Breathe in slowly through your nose for four counts, then exhale through slightly pursed lips for six. This simple practice activates your parasympathetic nervous system, telling your body it is safe to relax. So, enjoy the small victories of practicing this technique, as it is the foundation to achieving emotional regulation. If you want or need aid building this skill, therapy is an excellent tool to help!
Breaking the Silence That Perpetuates Suffering
In short, having anxiety during pregnancy or in postpartum stages does not diminish your love for your child or your capabilities as a mother. In fact, acknowledging these symptoms and experiences to seek help proves your deep commitment to providing the nurturing presence your child deserves.
Remember that perinatal mental health challenges are temporary detours, not permanent destinations. With proper support, you will find your way back to feeling like yourself again, perhaps stronger and more compassionate than before. By reading, sharing, and engaging in conversations about this post, you can provide potential positive change. Please remember the most dangerous aspect of postpartum mental health struggles is not the conditions themselves; it is the silence surrounding them. Mom guilt thrives in isolation, whispering that seeking help means you are failing, which could not be further from the truth.
