How to Cope with Postpartum Anxiety, Panic, & OCD By Dr. Carissa Gustafson

Unlike postpartum depression (PPD), many people are unaware of postpartum anxiety (PPA). This is true despite the fact that research shows it impacts approximately 10-15% of women. 

Whereas PPD is characterized by feelings of sadness, PPA is associated with excessive worry that is difficult to control, restlessness, and difficulties relaxing. Research suggests that 30% of the time PPD and PPA cooccur.  

Some women with PPA will experience panic attacks, which can be described as the sudden onset of intense fear that peaks within minutes and involves a number of physical symptoms such as shortness of breath, chest pain, chocking sensations, dizziness, trembling, rapid heartbeat, hot or cold sensations, numbness, tingling, and fears of losing control, going crazy, or dying. 

Sometimes, worry is the result of disturbing and intrusive thoughts, most often of harm coming to the baby. In this case, anxiety may be due to postpartum OCD (PPOCD). 

Here are a few ways to cope to PPA, panic, and PPOCD:

  • Practice self-care. While it is difficult during the postpartum period, it is imperative to try and prioritize self-care including sleep, eating a healthy diet, engaging in physical activity as able, abstaining from substances, and utilizing your support system. 

  • Practice relaxation and grounding techniques. When it comes to anxiety, doing things that help you reconnect to the present moment and “what is” rather than being lost in “what if” thoughts, can make a huge difference. This could include deep breathing, tuning into your senses such as listening to sounds in the environment, taking in a fragrant scent, touching an item and noticing the texture, savoring a drink such as coffee or tea, etc. 

  • Know that intrusive thoughts do not mean you want these things to happen. Many women who experience intrusive thoughts feel not only distress, but also guilt and shame. If you are experiencing intrusive thoughts know that these thoughts do not mean that you want these things to occur. In fact, it is quite the opposite. It is as if you brain is trying to tell you, watch out this could happen. Furthermore, these types of thoughts are not the same as those experienced in postpartum psychosis (PPP), which is associated with hallucinations, delusions, and disorganized thinking. PPOCD can be distinguished from PPP in that women with PPOCD are disturbed by these thoughts and take steps to avoid harm. 

  • Don’t fight intrusive thoughts. If you are experiencing intrusive thoughts, know that fighting the thoughts by trying to suppress them or engaging in a behavior, otherwise known as a compulsion, in an attempt to neutralize them, will likely only increase the frequency and intensity with which you experience them. Instead of trying to get rid of them, recognize that they are involuntary mental events and allow them to pass without judgment.

  • Seek therapeutic support. If you are experiencing symptoms of PPA, panic, and/or PPOCD, you may benefit from attending a support group, such as the perinatal (pregnancy & postpartum) Mood Support for Moms or the perinatal (OCD Support for Moms offered by Postpartum Support International (PSI) and/or finding a therapist in your area through their online directory, both of which you can at the PSI website

  • Consider medication. Depending on your level of distress and the degree to which it is interfering with your ability to function, you might also consider medication. Even if you are breastfeeding, there are many medications that are safe to take. You can find a psychiatrist who specializes in reproductive psychiatry at the PSI directory.

  PSI has a helpline available at 1-800-944-4773 (4PPD).

The National Maternal Mental Health Hotline is available 24/7 at 1-833-852-6262.

If you are experiencing thoughts of suicide the Lifeline can be reached 24/7 via text or phone at 988. In the event of a mental health emergency call 911 or go to the nearest ER. Please note that this information is intended for informational purposes only. It should not be used as a substitute for psychological or medical care. 

Dr. Carissa Gustafson works with people throughout the state of California to help them learn skills, such as mindfulness and compassion, to cope with difficult thoughts and feelings, and to find freedom from suffering. Carissa has a special interest in working with high-achieving women who are struggling with stress, depression, and anxiety, as well as pregnancy and postpartum issues. You can learn more about Carissa at www.drcarissagustafson.com and find her book on Amazon.