This Isn't What I Expected

Notes on healing postpartum depression

Having Another Baby: How Much Anxiety is Okay?

Anxiety can be a natural, normal response. But when is it not?

Women with a history of postpartum anxiety worry tremendously about having another baby. Sometimes, anxiety is difficult to get support for because, well, everyone gets anxious. Thus, responses are often condescending or worse, totally dismissive. 

Women with anxiety disorders need to keep this in perspective, so they know when it's okay that they are anxious and when it is not.

Will you get anxious again if you have another baby?  Unequivocally yes.  You will.  Most definitely.  In fact, you will get anxious again whether you decide to have another baby or not.  Anxiety and motherhood go hand in hand.  It’s not possible to be good mothers without worrying about how life impacts your babies and how the choices you make influence everything else along the way. Welcome to the world of motherhood, the good, the bad, the ugly, and the anxious. 

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Accepting a certain amount of anxiety is not only a healthy, adaptive response, it will prepare you to cope with the anxiety that feels out of your control from time to time. Actually, you will feel better if you presume that some anxiety will be present and learn to accept this as best you can. The last thing you want to do is to worry about the worrying, which is guaranteed to intensify the anxiety. If anxiety feels excessive, that is, if it interferes with your ability to experience pleasure, or if it becomes the focus of your day, then that’s too much anxiety and that’s when it’s time to look for support tools or interventions. Thus, it is the degree to which the distress interferes with your ability to get through the day, which is a marker for when anxiety should be treated. Everyone has difference tolerance levels. Frankly, some women can operate very well with high degrees of anxiety, while others find it gets in the way of optimal functioning very quickly. What bothers one person may not bother another. 

Laurie was always a worrier.  After her baby was born, her worry took on new dimensions.  All new moms worry, she would think.  Did the baby have enough to eat? What if the baby missed her nap?  What if she gets exposed to someone’s cold if they go the shopping center? Or worse, what if something terrible happens while they’re out? Will she be safe in the car?  Laurie could hear her worrying thoughts spinning around in her head.  Uh-oh, this isn’t good.  Why am I thinking these things? Does this mean something bad IS going to happen?  Is it normal to worry like this?  Maybe something else is wrong with me.  Is this what happens when mothers hurt their babies?  Is that why my head is so cluttered with worry? 

Laurie is quite right about one thing.  It is normal for mothers to worry about their babies.  Anxiety is an exaggeration of a normal healthy response.  That’s why it can be hard to distinguish, sometimes, even for healthcare providers.  If all mothers worry, to some extent, how does one know how much worrying is okay?  When does it become a problem?  Worry and anxiety can take on a life of its own, it can feed itself and grow larger and more troublesome. Worrying thoughts can slide down that slippery slope without you really knowing what’s happening until you find yourself consumed by agonizing anxiety. Depending on your personal and family history, obsessive thoughts can, and typically do emerge during the postpartum period, cascading down that slope with fierce determination. Make no mistake, obsessive thoughts can feel terrifying.

You have more power over your anxiety than you might think you have. Think of an anxiety scale of 0-10.  It’s an anxiety check.  Remember that anxiety is fluid, it can go up and down, back and forth, better or worse, any time of day or night. You cannot always control the events that triggered the original anxiety, but you can control how you respond to the anxiety and do things to make it better or worse.  You can, for instance, learn how to move it from a 7 down to a 6 or from a 9 to an 8.  Some people find relaxation or breathing exercises helpful to accomplish this.  Other people prefer to distraction techniques.  The trick is to understand and expect that anxiety will be there, but watch it move up and hopefully down, so you are the one controlling it, rather than it controlling you.   Any incremental change you can make or power you can claim over your anxiety is great.  Belief in your ability to adjust the anxiety even a little bit can bring enormous relief. 

The key here is to be able to determine what degree of anxiety falls within normal limits and how much is too much.  That’s not always an easy distinction to make, not for anyone, but certainly not for someone who’s hyperfocusing on how they feel or is super sensitive to anxiety in the first place. 

If anxiety feels excessive, that is, if it interferes with your ability to experience pleasure, or if it becomes the focus of your day, that’s too much anxiety and it’s time to look for support tools or help from others. If you are ever not sure whether what you are feeling is okay or not, that’s a good enough reason to check with your healthcare provider or therapist to get some perspective on your emotional state.

Remember this:

1) All moms worry.

2) Try to accept the fact that you worry. This will help you let some of it go.

3) Worry does not make bad things happen.

4) Surround yourself with people who understand you and can help you maintain perspective.

5) Allow yourself to make mistakes.

6) Exercise, find a hobby, distract yourself, play, laugh.

7) Trust your instincts if your anxiety feels out of control. Seek help.

 

copyright 2013  Karen Kleiman, LCSW

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Karen Kleiman is founder and director of The Postpartum Stress Center, a treatment and training center for prenatal and postpartum mood and anxiety disorders. more...

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