Postpartum Anxiety: Why It’s Common, How to Know When You Might Benefit From Therapy, and How Therapy Can Help

Written By Jess Coleman, Ph.D.

Table of Contents

1. Understanding postpartum anxiety

Postpartum anxiety is one of the most common mental health concerns after birth. During the postpartum period, many people expect the exhaustion and emotional changes that come with sleep deprivation. Fewer people expect the constant worry, urges to check on the baby, sense of dread, or the feeling that something terrible is about to happen, that can emerge in the early weeks and months.

It can be challenging to differentiate between what is an understandable amount of worry after having a baby versus what meets the threshold for a postpartum anxiety disorder. Normal worry tends to arise around specific stressors and is alleviated with problem-solving, checking the facts, or time. Postpartum anxiety disorders involve persistent, constant worry that people experience little or no relief from.

This can look like repeatedly asking oneself, “Am I a bad parent?”, “Am I doing enough?”, or “Is the baby breathing?”, with the mind unable to quiet even with reassurance. Postpartum anxiety can begin during pregnancy or after birth, and it can last through the first year or longer.

Experiencing anxiety during the postpartum period is not a personal failure. It is a human response that can occur due to a combination of immense hormonal shifts, increased responsibility, sleep deprivation, and the cultural pressure placed on parents. I view anxiety disorders during pregnancy and the postpartum period as treatable medical conditions and believe they are just as important to treat as physical health conditions such as preeclampsia or gestational diabetes.

2. What postpartum anxiety can feel like

People experiencing postpartum anxiety disorders often describe:

  • Constant worry about the baby’s health or safety
    Continuing to feel worried after reassurance from others or researching online
  • Difficulty sleeping, even when the baby is asleep
  • Feeling “on edge” and unable to relax
  • Sudden waves of fear or panic
    Getting stuck on worst case scenarios
  • Physical symptoms such as chest tightness or a pit in the stomach
  • Irritability or emotional overwhelm
  • Fear of making a mistake
  • Unwanted and distressing intrusive thoughts, sometimes about harm coming to the baby

Signs that normal worries are worsening into significant postpartum anxiety are: finding it difficult to function, impossible to turn worries off, or challenging to have moments of ease. Postpartum anxiety can impact people with or without a prior history of anxiety, and birthing and non-birthing parents.

3. Why postpartum anxiety is common but minimized

Our culture normalizes struggle in early parenthood in ways that can overlook the importance of how parents are feeling emotionally and physically. People hear messages like “you’re just tired,” “this won’t last forever”, or “this is what new parents go through,” instead of having their experience taken seriously.

Something being common does not make it healthy or manageable without support. Postpartum anxiety deserves care in the same way any other medical or psychological concern does. Society tends to look the other way when early red flags show up, treating them as phases or signs of weakness instead of warning signs. As a result, these social norms often delay intervention, and people end up seeking or being referred to mental health care only after symptoms have intensified into something serious or debilitating.

4. How therapy can treat postpartum anxiety

Evidence-based therapies, including cognitive behavioral therapies (CBTs) such as Acceptance and Commitment Therapy, are effective for treating postpartum anxiety disorders. Therapy can involve:

  • Cultivating awareness of what contributes to experiencing anxiety
  • Developing coping tools for overwhelming moments
  • Learning how to respond skillfully to anxious thoughts so they don’t dictate how you move through your life
  • Practicing skills to regulate intense emotion in a way that feels safe and supportive
  • Exploring cultural and societal expectations in early parenthood to reduce negative impacts on mental health
  • Reducing self-blame and practicing self-compassion
  • Developing skills to reduce the impact of anxiety on sleep quality and quantity

When I treat postpartum anxiety, I take a collaborative approach. I work together with my therapy clients at a pace that respects their capacity and honors their goals.

5. How telehealth postpartum anxiety therapy works

Online therapy can reduce barriers to engaging in treatment during a time when leaving home can be difficult. Many parents appreciate the ability to access specialized care from home without additional logistical stress. As a therapist, I find online therapy to be especially productive because we can practice new skills in the person’s home environment where they often experience stress and anxiety. I use approaches from Cognitive Behavioral Therapy and tailor them to my clients’ needs and goals. I provide telehealth therapy for anxiety to clients in North Carolina, California and many PSYPACT states using a secure video platform.

6. When to reach out for help

It may be time to seek therapy if you notice:

  • Anxiety that feels constant or overwhelming
  • Worry that interferes with sleep or daily tasks
  • Feeling “on edge” and not able to relax even when your baby is safe
  • Fear that something bad will happen if you stop checking, avoiding situations, seeking feedback or reassurance from others, or researching online
  • Physical symptoms of panic or anxiety
  • Irritability, or emotional depletion
  • A sense that you are “not yourself”

Seeking help is an act of care for yourself, your baby, and your family. I am passionate about helping parents shift from feeling like they need to “white knuckle” their way through anxiety in early parenthood to building skills so they can experience greater confidence in their ability to cope and feel steady again.

7. Frequently Asked Questions About Postpartum Anxiety

Is postpartum anxiety normal?

Postpartum anxiety is common and often underrecognized. Many people experience significant worry, emotional, and physical symptoms in the postpartum period. It is estimated that 1 in 5 women and 1 in 10 men experience anxiety disorders during pregnancy and postpartum, though I believe the numbers are much higher due to lack of screening and mental health stigma.

How do I know if I need therapy?

If anxiety is interfering with sleep, relaxing, decision-making, or daily life, therapy can help you understand what is happening and build tools to navigate and alleviate it.

Can postpartum anxiety include intrusive thoughts?

Yes. Intrusive thoughts are incredibly common aspects of postpartum anxiety and do not mean someone intends harm. Therapy can help people respond to them with less fear and greater agency.

Is online postpartum anxiety therapy effective?

Yes. Telehealth therapy provides effective support for anxiety and is often more accessible during early parenthood.

8. Further Reading

Jess Coleman, Ph.D.
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