Anxiety after having a baby
The arrival of a new baby is one of the most momentous occasions in your life. It is frequently a time of great joy, love, wonder and gratitude. From the images you would have seen and books you may have read, it certainly seems like these emotions are the ones that will be most prominent.
However it is also common to feel other emotions that perhaps you may think you are not supposed to feel.
Feeling blue, down, sad, depressed or overwhelmed is common at any stage of life, and is particularly common in the days, weeks and months after having a baby.
Post natal depression is a well-recognised syndrome, and even has its own acronym (PND).
You may not know anxiety is even more common than depression in this period, and new mums frequently experience a mixture of feeling low and anxious.
Anxiety is a normal emotion that is vital in protecting us from danger. When we perceive a threat our body reacts with physiological changes including the release of large amounts of adrenaline and an increased heart and breathing rate. These changes prepare the body to fight or take flight from the threat. If you think about how fragile and defenceless a baby is, then it makes perfect survival sense for the mother to be constantly on the alert for threats to its wellbeing.
Our brains are still wired like this to detect bears and tigers that may harm our babies, or poisons in the environment that may make them ill. In modern times though such fears may take the form of feeling scared to go outside with your baby, doubting whether you have fed your baby enough or too much, or repeatedly checking that your baby has not stopped breathing. You may feel restless, fidgety and constantly on edge. Your sleep and appetite may be affected. You may find yourself constantly thinking ahead to plan and organise to shield off any potential problems. You may constantly look for the perfect response to every situation. So many “what if” and potentially catastrophic scenarios run through your mind that you may not be able to make any decisions at all. You may feel guilty and your mind may tell you that you are not a good mum, that you should know what to do, that everyone else except you can handle the situation.
You may respond to these emotions in a way that makes the problem get bigger rather than smaller, such as withdrawing from your family and friends, stop doing the things that normally give you pleasure, work harder in setting rules and schedules in order to get a sense that you can control the danger.
These strategies work well when there is a tiger outside about to eat your baby. But when the source of danger is diffuse and cannot be eliminated, such as worrying thoughts, these strategies actually teach you that you need to worry harder and exert more routine and control. And the potential sources of worry are endless, so a vicious cycle is set up. Reading multiple parenting books and websites can often increase the doubts that perhaps you are not doing things right and that you need to work harder.
This is not because you are in any way abnormal. This is just how your brain, and most of our brains, work. For a combination of reasons that may include your usual thinking style, the ways of coping you have observed around you, past experiences, your current situation, responses of others, and the temperament of your baby, you have inadvertently found yourself in this vicious cycle.
ACT (Acceptance and Commitment Therapy) is a modern form of CBT (Cognitive Behaviour Therapy) that is very effective for anxiety.
ACT helps you to become aware of your anxious thoughts and emotions, not as automatic cues of danger but as events occurring in your mind and body. In that way you don’t have to automatically react to your thoughts and emotions, but be able to step back from them and see them for what they are. This frees you up to act in a way that is more in keeping with how you want to be as a parent and as a person. It allows you to experience your unique baby as he or she really is from moment to moment, a concept known as mindfulness. In this way you can notice all the subtle cues that your baby uses to communicate. This more than any set rules or routine, forms the basis of the sort of interaction and care that will allow you and your baby to thrive together.
An added benefit is that you can apply this to all other areas of your life on an ongoing basis. So ACT is so much more than a treatment for depression or anxiety. You gain a whole set of skills that help you to live a richer and more vital life, and can dip into this tool box time and time again throughout your life.
Dr Nga Tran
Psychiatrist and ACT therapist
The Possums Clinic
07 3036 4081