When the Worry Won’t Stop: A Therapist’s Guide to Postpartum Anxiety

Bringing a new baby into the world is often described as one of life’s most joyful experiences. But for many new mothers, it can also be one of the most emotionally overwhelming. While postpartum depression is now widely recognized and screened for, postpartum anxiety is still underdiagnosed and often misunderstood.

If you’re a new mom feeling constantly on edge, unable to sleep even when your baby is resting, or trapped in a cycle of racing thoughts and dread, know this: you’re not alone, and what you’re feeling is valid. In my work with postpartum clients, I often hear versions of the same phrase: “I should be enjoying this, so why do I feel terrified all the time?”

Let’s break it down together. We’ll explore what postpartum anxiety feels like, what causes it, how it differs from postpartum depression, and how therapy can support your healing and peace of mind.

What Is Postpartum Anxiety?

Postpartum anxiety is a type of perinatal mood and anxiety disorder (PMAD) that affects a significant number of women after childbirth. While a certain level of worry is natural for new parents, postpartum anxiety involves excessive, uncontrollable fears that interfere with daily life and bonding with your baby (ScienceDirect).

Symptoms can include:

  • Racing thoughts or persistent worry

  • Sleep disturbances (even when the baby sleeps)

  • Irritability or restlessness

  • Physical symptoms such as nausea, tight chest, or rapid heartbeat

  • Obsessive behaviors like constant checking or scanning for danger

Some women also experience postpartum anxiety attacks, which may involve sudden panic, difficulty breathing, or feeling detached from reality.

What Does Postpartum Anxiety Feel Like?

In my practice, many new mothers describe postpartum anxiety as a relentless loop of “what if” thoughts: What if I fall asleep and something happens to the baby? What if I’m not doing enough? This cycle is often accompanied by a physical sense of dread—even when things seem calm.

Often it’s not just a mental sensation, it can manifest physically and emotionally:

  • A racing heart or tight chest while your baby sleeps

  • Trouble sitting still or feeling unable to relax

  • Feeling trapped inside a loop of fearful thoughts

Many mothers in clinical interviews describe feeling unable to relax, even when their baby is sleeping, due to persistent thoughts that something might go wrong (PubMed Central).

It’s important to keep in mind that these thoughts don’t make you a bad parent, they are symptoms of a treatable condition, not a reflection of your love or capability.

Postpartum Anxiety vs. Postpartum Depression

Although postpartum anxiety and depression can occur together, they are distinct conditions.

Postpartum depression is often marked by sadness, hopelessness, fatigue, and emotional numbness. In contrast, postpartum anxiety is defined by heightened fear, worry, and hypervigilance.

It’s also possible to experience postpartum depression (PPD) and anxiety together—a combination of both sets of symptoms, which can make it even more challenging to navigate early motherhood.

Knowing the difference can be key to getting the right treatment. If you’re experiencing symptoms from both categories, a licensed therapist or psychiatrist can help you sort through what you’re feeling and offer targeted support.

When Does Postpartum Anxiety Start?

Postpartum anxiety can start anytime within the first year after birth, though it often begins in the first few weeks. Some women notice symptoms even before delivery, especially if they have a personal or family history of anxiety.

Without treatment, symptoms may continue for months or longer. According to the Pacific Post Partum Support Society, the duration of postpartum anxiety varies for each person, but early support and intervention can significantly reduce its intensity and longevity (postpartum.org).

What Causes Postpartum Anxiety?

Biological, Psychological, and Social Contributors

There is no single cause, but several overlapping factors increase the risk:

  • Hormonal changes: After childbirth, levels of estrogen and progesterone drop sharply, which can affect mood regulation (APA).

  • Sleep deprivation: Irregular or fragmented sleep can heighten anxiety symptoms.

  • Birth complications or trauma: Difficult labor experiences can trigger anxiety in the postpartum period.

  • History of anxiety or depression: A personal or family history raises the likelihood of developing postpartum mental health challenges.

  • Unrealistic societal expectations: Cultural pressure to be a "perfect mom" can make anxiety worse.

Understanding what causes postpartum anxiety doesn’t mean you could have prevented it, but it does help in finding the right path to healing.

Signs of Postpartum Anxiety You Shouldn’t Ignore

It’s easy to dismiss symptoms of anxiety as "normal new mom stress," but persistent and intrusive worry deserves attention.

Common postpartum anxiety symptoms include:

  • Constant fear that something will happen to the baby

  • Difficulty making decisions due to overthinking

  • Physical tension, digestive issues, or headaches

  • Avoiding activities or outings due to worry

  • Feeling "checked out" or overly alert

If these signs are interfering with your ability to rest, connect, or function, it’s time to seek support. You deserve to feel safe and stable in your own mind and body. And like a capable mom. 

How to Deal with Postpartum Anxiety

One of the most empowering things you can do is acknowledge what you’re going through and ask for help. How to help postpartum anxiety starts with breaking the stigma and understanding that you're not alone.

Therapy and often medication in tandem are very effective treatments for postpartum anxiety disorders. In therapy, you’ll learn how to:

  • Explore the roots of your anxiety

  • Learn grounding and self-regulation techniques

  • Identify unhelpful thought patterns

  • Rebuild self-trust and confidence as a parent

In sessions, I often help clients name their fears without judgment, practice nervous system regulation techniques, and reconnect with their values as new parents.

How Therapy Helps Postpartum Anxiety

Therapy provides a supportive, nonjudgmental environment to process difficult emotions and develop tools to manage anxiety. Many new mothers benefit from a blend of therapeutic approaches; strategies to challenge anxious thoughts, body-based techniques to calm the nervous system, understanding the roots of the anxiety, and supportive exploration of identity changes that arise after birth.

Therapy Techniques That Help New Moms

  • Grounding exercises to manage panic and stay present in the moment

  • Thought-challenging to address catastrophic thinking or "what if" spirals

  • Narrative therapy to explore shifts in identity and meaning after motherhood

  • Mindfulness and breathwork to regulate the nervous system and reduce reactivity

According to ScienceDirect, early psychological intervention significantly improves maternal outcomes, and can even benefit infant bonding and development.

Therapy doesn’t erase anxiety overnight, but it offers you a path forward—one step, one breath, one insight at a time.

Frequently Asked Questions About Postpartum Anxiety

What are common signs of postpartum anxiety?

Persistent worry, racing thoughts, physical tension, and sleep disruption even when the baby is calm.

How long does postpartum anxiety last?

It can last for months or longer if untreated, but early support can shorten its course (postpartum.org).

How can I help someone with postpartum anxiety?

Offer emotional support, reduce judgment, and encourage professional help when needed.

What does postpartum anxiety feel like?

Like dread, hypervigilance, and exhaustion—often coupled with guilt and physical symptoms like nausea or tightness in the chest.

Final Thoughts: You’re Not Alone

If you're wondering how long postpartum depression and anxiety last, or questioning whether your symptoms are "normal," take this as a sign to reach out.

There is help. There is relief. And there is nothing weak about asking for support. You deserve to feel calm, connected, and confident in motherhood.

If you’re navigating the emotional overwhelm of postpartum anxiety—or supporting someone who is—therapy can help. Contact me today to schedule a free consultation and learn more about how I support new mothers in finding relief, clarity, and compassion in this season of change.