What can help New Mothers with Postnatal Anxiety

It’s natural to feel anxious when your new baby arrives. However, anxiety can sometimes become a real problem in need of professional help. postnatal anxiety, just like postnatal depression, can range from mild to severe. Symptoms can develop over time, or seem to linger after your baby is born. 

postnatal anxiety can appear in both mothers and fathers.  Even if you only have a mild case, there is a wide range of remedies and support services available.

Herbal medicine such as St John’s Wort, valerian, ashwagandha and passionflower, alongside key brain-building nutrients and psychological treatments, may help with postnatal anxiety by restoring balance to your brain chemistry.

Symptoms of postnatal anxiety

The postpartum period lasts a total of six months, although you may take more or less time. It is measured by the return of your muscle, connective tissue, metabolism and mind (hence postpartum anxiety) to their pre-pregnant state. 

During recovery from pregnancy and birth, many new mothers develop postpartum anxiety or depression as their hormones fluctuate, taking their brain chemistry along for the ride. However, as so many changes have happened in your life, it’s completely normal and natural to be anxious even without the physical recovery.

Anxiety is a natural response to feeling threatened or unsafe when there is a real reason to feel this way, for example if you are being followed or a cyclone is approaching.

Anxiety becomes a disorder when you start to feel an increasing sense of danger from imagined or vague threats.

Anxiety may have physical symptoms, such as:

• Racing heart rate
• Trouble breathing
• Tight chest
• Difficulty falling asleep
• Poor digestion.

These come from the fight-or-flight response, as stress hormones work to help you escape from the “threat”, real or imagined.

If you have an anxiety disorder, you may find yourself worrying and obsessing over the worst case scenarios that could happen to you or your baby. You may avoid certain situations and places, such as anything that reminds you of giving birth or hospitals. Some mothers constantly check on their babies and for any potential signs of danger.

If you are currently worried about whether you are feeding your baby enough, read:

•  How Can I Increase My Breast Milk Supply Naturally?

If you are bothered by having trouble with losing pregnancy weight, read:

•  The Best Teas To Lose Weight While Breastfeeding.

How long does postnatal anxiety last after having a baby?

There is unfortunately no defined timeframe where postnatal anxiety disappears after having a baby. The good news is that it does not last forever.

Summary Having anxiety differs from feeling anxious by having frequent and severe physical symptoms, and more reactions to imagined threats.

Difference Between Postpartum Anxiety And Postpartum Depression

Symptoms*	Postpartum Anxiety	Postpartum Depression
Uncertainty and isolation	✔
Feelings of worthlessness		✔
Desire to run away	✔
Self-harm and loss of interest		✔
Sadness and poor concentration	Temporary	Constant
Temporary or intermittent aches	✔
Racing Heartrate	✔
Fight-or-flight response	✔
Trouble eating		✔
trouble sleeping	✔	✔

*Despite our best intentions in providing you with this information, only your doctor can diagnose you with postnatal depression or postnatal anxiety. 

Postpartum depression receives far more attention than postpartum anxiety, even though both are common. Some of the symptoms overlap, but many contrast.

Although mothers can develop both disorders, there are several key differences between postpartum anxiety and postpartum depression.

• You are more likely to feel uncertainty and isolation with postpartum anxiety, while depression features a lack of interest in life, despair and feelings of worthlessness.
• Anxiety involves a desire to run away, that typically feels better when you are reassured or when a challenging situation is solved (such as difficulty breastfeeding). Depression can cause the urge to self-harm and loss of interest in your usual hobbies.
• Sadness and poor concentration are temporary in cases of anxiety, while they are constant in depression.
• Temporary or intermittent aches, racing heartrate and other fight-or-flight response symptoms are common symptoms of anxiety. Depression, however, commonly involves trouble eating or sleeping.

Summary Overall, you can think of anxiety being an overactive state of mind, while depression is more like a severe case of underactivity.

How do postpartum hormones affect you?

Postnatal anxiety has both biological and psychological causes, such as feelings of isolation and overwhelm. Postpartum hormones are the biological causes for postnatal anxiety.

When you are pregnant, oestrogen, progesterone, and the stress hormone cortisol rise gradually. There is also an increase in thyroid hormone production, as oestrogen boosts levels of a protein that binds to thyroid hormones, which affects the balance of postpartum hormones too. Read:

• How to balance Oestrogen and Progesterone during your period

Once you give birth, levels of oestrogen sharply fall back to normal. Laboratory research demonstrates that sudden falls in oestrogen can cause anxiety. A rodent model of hormonal changes in pregnancy found more signs of anxiety after oestrogen loss, but no changes to appetite that may signal depression.

A spike in oxytocin and the immune system reacting to its heightened presence may be one way that losing oestrogen leads to anxiety.

Clinical studies show that the loss of oestrogen may affect mood after giving birth. Some demonstrate relief of depression with oestrogen replacement therapy, or prevention of relapses. Others have found that thyroid hormone dysregulation is more common after birth, especially in women who develop postnatal mood issues.

On the other hand, all of these links between temporary hormonal imbalance and postnatal mood issues have mixed results.

It is possible that there is no clear biological cause, as other research shows that stresses such as poor social support and unemployment contribute to postnatal depression and anxiety.

To read more about how hormonal fluctuations can contribute to anxiety, see: 

• Why Is My Anxiety Worse Right Before My Period?
• Can Lemon Balm Help with Anxiety?
• Which Herbal Teas Should I Drink for Stress and Anxiety?

Does breastfeeding cause anxiety?

Even though the bonding experience of breastfeeding may relieve stress and anxiety, it is possible for breastfeeding to make you feel more stressed and less motivated. For prolactin to rise and trigger milk production, dopamine must fall. As dopamine is essential for motivation, focus, learning and an upbeat mood, loss of the brain chemical can leave you feeling flat, stressed and worried about where your real self went.

Summary Postnatal anxiety has unclear biological origins. It likely involves a sudden fall in oestrogen, heightened cortisol and, as a result, reduced serotonin.

What herbal remedies can I take for postnatal anxiety?

TEA	CUPS / DAY	BREASTFEEDING SAFE
St John’s Wort	1-3	YES
Valerian	1-3	YES
Passionflower	2-4	NO
Skullcap	2-3	NO
Rhodiola	1-2	NO
Ashwagandha	2-3	YES

If you wonder what herbal remedies you can take for anxiety, many can help, whether it is generalised or a specific manifestation such as postpartum anxiety.

Herbal medicines that you can take for anxiety after giving birth work by restoring levels of serotonin and/or dopamine; reducing cortisol; and improving energy and cognition.

Stopping Postpartum anxiety with St John’s Wort

St John’s Wort (Hypericum perforatum) is a popular herbal medicine to calm mood issues, including postnatal anxiety. It increases levels of the neurotransmitter serotonin, often known as the “happy” brain chemical. However, serotonin also has a relaxing effect.

Multiple studies show that St John’s Wort is effective in relieving mild to moderate levels of anxiety.

However, it can take four to six weeks to show its full benefits, so it’s important to be patient if you choose this remedy. As its dosage is quite standardised compared to other herbs, a dose of 300mg of extract, three times a day, is recommended.

Valerian for postpartum depression

Valerian (Valeriana officinalis), like passionflower, is most commonly used to promote sleep. This is because it boosts GABA, one of the main calming brain chemicals, but it doesn’t affect your energy or concentration during the day, unlike conventional sleep aids. Read:

• The best sleep teas in Australia and New Zealand
• Valerian Root: My Best Natural Supplement for Anxiety

You must still avoid taking valerian alongside other sedatives as this increases your risk of side effects.

The standard recommendation for valerian when treating anxiety is 200-400mg of extract per day.

Passionflower is a great remedy for anxiety

Passionflower (Passiflora incarnata), may be an effective remedy for anxiety if it appears alongside trouble sleeping.

It is known in the herbal medicine world as a nervine, meaning that it has a calming effect without causing drowsiness. This is even more beneficial when you have to get up at night to feed your baby.

Some research shows that passionflower is as effective as antianxiety drugs. A trial comparing the powerful drug midazolam to passionflower extract before a dental surgery found that they were roughly equal in terms of relieving anxiety. However, passionflower had far fewer side effects.

While midazolam caused memory impairment, with 20% of patients remembering nothing, everyone taking passionflower remembered the majority or all events that happened.

Skullcap may help relieve stress 

Skullcap (Scutellaria baicalensis), belongs to a category of herbal medicine known as the nervines. Like passionflower, it helps to relieve stress, anxiety and trouble sleeping without being too sedative.

The benefits of skullcap relate to the protection of dopamine production. This may restore your motivation, mood and ability to focus that can be impaired for months after pregnancy.

So far, the published evidence for skullcap and anxiety is limited to lab studies.

Clinical research does show that the herb significantly boosts cognitive performance. If you have “baby brain” and are worried that your old self won’t come back any time soon, skullcap may resolve the issue.

Rhodiola for postpartum depression

Rhodiola (Rhodiola rosea) is an adaptogen, another category of herbal medicines that increase our resilience to stresses.

Multiple studies show benefit of Rhodiola extract in improving cognitive performance and energy levels, while relieving depression and anxiety. It is able to raise serotonin and dopamine, while reducing production of cortisol.

The broad effects of Rhodiola make it our top pick if you need a cognitive boost.

Whether you are worried about “baby brain” or feeling tired all the time; are a busy professional and need a sharp mind; or have ADHD and notice your symptoms got worse during pregnancy, Rhodiola may be the remedy for you.

Ashwagandha for postpartum anxiety

Ashwagandha (Withania somnifera), is a popular herbal remedy for debilitating fatigue and poor immunity. However, preparations of the herb can be effective for anxiety too.

Multiple studies on ashwagandha for anxiety show significant improvement, with one finding a 44% reduction in symptom severity compared to 5% in the placebo group.

Another comparing naturopathic care with an ashwagandha prescription to psychotherapy saw a 56% drop in anxiety scores, compared to 30% for psychotherapy.

To learn more about herbal remedies for anxiety, check:

• Which Herbal Teas Should I Drink for Stress and Anxiety?

Summary Effective herbal remedies for postnatal anxiety, and related issues such as fatigue and baby brain, include St John’s Wort, passionflower, valerian, skullcap, Rhodiola and ashwagandha.

Postpartum Massage therapy to start feeling better 

Massage therapy is a relaxing way to relieve muscle pain and tension, nipping minor muscle and connective tissue problems in the bud to help you start feeling better postpartum. It may be the same situation for your mental health too.

Booking a massage therapy session can be an important self-care practice for anyone. It may be especially important as a new mother to start feeling better postpartum.

A study on 100 mothers who had just given birth compared slow-stroke back massage to no extra interventions, to see if it had mental health benefits in this situation.

The slow stroking was similar to continuous effleurage and light petrissage, Swedish massage techniques that provide relaxation. Women receiving massage had a small but significant decrease in anxiety, from an average of 35 to 30 points, while there was no improvement in the control group.

The massage techniques used in this study were simple enough for partners to learn for the mothers once they returned from the hospital. Therefore, this could be an effective way to help your loved one if they request it.

Summary Relaxation massage can significantly relieve postpartum anxiety, and you may benefit whether you seek out a professional therapist, or your partner learns basic massage for home use.

Aromatherapy to relieve postnatal anxiety

Aromatherapy may be an effective way to relieve postnatal anxiety, without having to add more pills, powders or teas to the supplements and medications you may already be taking. One of the most popular essential oils to diffuse into the air is lavender, which may still be effective for you just as it is for “regular” anxiety.

Research shows that aromatherapy with lavender essential oil may relieve postnatal anxiety for months after use. It is possible that starting aromatherapy soon after birth may give you longer-lasting results.

A trial with 140 women in hospital after giving birth assigned them to either inhaling lavender oil three times a day for one month, or routine care only. Two weeks into aromatherapy treatment, the mothers’ anxiety levels were 2.19, compared to 3.63 in the control group. At four weeks, these results were 1.27 and 4.46 respectively – the treated group continued to improve, but the women only receiving usual care got worse.

It was two months after their treatment ended that the results started to get interesting.

The mothers who used aromatherapy maintained their improvement, with an average anxiety score of 1.23.

The usual care group had an average anxiety score of 4.43. They weren’t getting worse but weren’t any better either.

Lavender oil can help to correct the imbalance in brain chemistry that underlies postnatal anxiety. It increases serotonin production and reduces cortisol, while helping you to bond with your baby.

Summary Aromatherapy with lavender essential oil can reduce anxiety back to normal levels by boosting serotonin and relieving stress, at least when started soon after birth.

Caring for Someone with Perinatal Anxiety & postpartum Depression

You may be reading this because you are caring for a partner who is pregnant, and they already have anxiety or depression.

It is an overwhelming experience to see someone we love suffer from mood disorders, but it’s important to avoid taking anything personally as anxiety and depression are real illnesses. They are responding to their feelings, not to you.

As for what support you should give your partner, be guided by what type of help they need and how much.

Offering gentle emotional support can help them through the difficult period of pregnancy and birth.

Some people want to have a companion or patient advocate with them at medical appointments to discuss treatment options. Both appointments with conventional and natural therapists can benefit from a support person, as they are in a vulnerable position by sharing personal information in front of a stranger.

Summary How to care for a partner or family member with perinatal or postnatal anxiety depends on their individual needs, but gentle support is most important.

Conclusion

Postnatal anxiety is more common than we may think but can severely impact your quality of life and enjoyment of new motherhood.

Fortunately, there are herbal medicines and other remedies, such as massage and aromatherapy, that can significantly relieve symptoms.

If you are currently suffering from severe symptoms, however, it is best to seek medical advice as soon as possible.