Postpartum Anxiety: When You Can't Stop Worrying

Everyone tells you to sleep when the baby sleeps. But you can't. You lie there, heart racing, listening for every breath. You check constantly. You run through everything that could go wrong. You Google symptoms in the middle of the night, convinced something is terribly wrong even though nothing is.

 You thought this was just being a good mother. Being vigilant. But it's consuming you. You can't rest, can't eat, can't enjoy anything. The worry is constant, exhausting, and completely out of proportion to any actual threat.

 This is postpartum anxiety, and it's more common than most people realize.

 What Is Postpartum Anxiety?

 Postpartum anxiety is often overshadowed by postpartum depression in public awareness, but it may be even more common. Research suggests it affects up to 15-20% of new mothers, and many cases go undiagnosed because the symptoms look like "normal" new mom worry, just more intense.

 The signs include constant worry about the baby's health and safety, racing thoughts that won't quiet, inability to relax or sit still, physical symptoms like heart pounding, chest tightness, or shortness of breath, difficulty sleeping even when exhausted, changes in appetite, irritability or feeling on edge, and intrusive thoughts.

 When Frightening Thoughts Won't Stop

 Intrusive thoughts deserve special mention because they're often the most distressing, and the least discussed.

 These are unwanted, disturbing thoughts that pop into your mind, often about harm coming to your baby. They might involve accidents, illness, or even you hurting your baby. These thoughts are terrifying, and women often don't mention them because they're afraid of what it means.

 Here's what the research shows: intrusive thoughts are extremely common in new mothers. A study published in the Journal of Reproductive and Infant Psychology found that over 90% of new parents experience intrusive thoughts about their infants. They don't mean you're dangerous or that you want to act on them. They're a symptom of an anxious, hypervigilant brain trying to anticipate every possible threat. Women with intrusive thoughts are often the least likely to harm their children because the thoughts are so distressing to them.

 If you're experiencing intrusive thoughts, please tell someone. A therapist, your doctor, or us. The shame of keeping them secret makes them worse. Bringing them into the light usually brings relief.

 Postpartum Anxiety vs. Postpartum Depression

 Anxiety and depression often occur together, but they can also occur separately.

 Postpartum depression tends toward flatness: sadness, emptiness, disconnection, lack of interest or pleasure. You might feel like you're moving through fog.

 Postpartum anxiety tends toward activation: racing thoughts, hypervigilance, inability to rest, physical tension. You might feel like you can't turn your brain off.

 Some women have both. Some have one or the other. Both respond to treatment. For more on depression specifically, see our article on postpartum depression.

 Why Does Postpartum Anxiety Happen?

 Postpartum anxiety has multiple causes, and they often overlap.

 Hormonal shifts after birth affect neurotransmitters, including those that regulate anxiety. Sleep deprivation heightens anxiety responses. The physical demands of recovery and feeding create stress on the body. Biology is part of it.

 But there's also an evolutionary component. Your brain is wired to protect your baby. Some degree of vigilance makes sense. But for some women, this protective instinct becomes dysregulated, stuck in high alert even when there's no actual threat.

 Personal history matters too. Women with a history of anxiety, trauma, or OCD are at higher risk. Previous pregnancy loss can make the postpartum period particularly anxiety-provoking, as you wait for something to go wrong.

 And lack of support increases anxiety. When you're managing everything alone, hypervigilance makes sense. Your brain doesn't feel it can relax because there's no one else watching.

 In the United States, new mothers are expected to manage largely on their own. Partners return to work quickly, extended family may live far away, and the cultural message is to bounce back, to be independent, to handle it. This isolation isn't just emotionally hard. It's physiologically activating. Your nervous system registers the lack of support as a threat, and it responds accordingly.

 When Birth Itself Was Traumatic

 A difficult or traumatic birth can trigger postpartum anxiety. If you felt out of control, if there was an emergency, if you feared for your life or your baby's, your nervous system may still be responding to that threat.

 Women who experienced birth trauma often have heightened vigilance afterward. The body learned that danger was real, and it stays on alert. Intrusive memories of the birth, nightmares, and avoidance of anything related to the delivery are signs that trauma may be contributing to your anxiety.

 This is why we work somatically. The nervous system needs to complete what it started during that experience. When it can, the hypervigilance often settles.

 Your Nervous System on High Alert

 At its core, postpartum anxiety is a nervous system state. Your body is stuck in sympathetic activation, the fight-or-flight response. This made sense during birth. It doesn't serve you now.

 When your nervous system is on high alert, your body behaves as if danger is present even when it's not. Your heart races. Your breathing becomes shallow. Your muscles tense. Your mind scans for threats constantly. This isn't a choice or a character flaw. It's physiology.

 The problem is that the nervous system doesn't respond to logic. You can know that your baby is fine and still feel terrified. You can tell yourself to calm down and find that nothing changes. That's because anxiety isn't primarily a thinking problem. It's a body problem.

 This is why we work somatically. Changing your nervous system state requires working with your body, not just your thoughts.

 How We Support Postpartum Anxiety

 We address postpartum anxiety at the level where it lives: the nervous system.

 Acupuncture for Anxiety

 Acupuncture is remarkably effective for anxiety. It activates the parasympathetic nervous system, the "rest and digest" response that counteracts the stress response. Many women feel calmer within minutes of the needles being placed.

 Research supports acupuncture for anxiety, including during the postpartum period. A study published in the Journal of Affective Disorders found that acupuncture was as effective as medication for postpartum mood disorders, without the side effects. It reduces cortisol, increases heart rate variability, and helps the nervous system find its way back to regulation.

 For breastfeeding mothers, acupuncture offers relief without the concerns that come with medication. Nothing passes through your milk.

 Somatic Work

 We work with your body to help shift your nervous system state. This might involve noticing where you hold tension, tracking sensations as they change, learning what helps your body feel safe.

 This is different from talk therapy, which can help you understand your anxiety but often doesn't change how your body responds. Somatic work goes to where the pattern lives and helps create lasting change. Over time, your baseline shifts. You're not just managing anxiety. You're actually less anxious.

 Breathwork and Regulation Tools

 Your breath is a direct pathway to your nervous system. We teach specific techniques you can use when anxiety spikes, not to suppress the feeling but to give your body a different signal.

 These tools are simple but powerful. A particular way of breathing. A grounding practice. Something you can use when your mind is racing. We want you to have resources between sessions, not just during them.

 Chinese Herbs and Supplements

 Certain herbal formulas calm the spirit and settle the mind without sedating you. Oat straw is one we often use, a gentle nervine that's safe during breastfeeding unless you have a gluten or oat allergy. We prescribe other herbs based on your specific pattern.

 Magnesium glycinate supports the nervous system and is often depleted in new mothers. B vitamins support neurotransmitter production. Omega-3 fatty acids have research support for mood and anxiety. We assess what you need rather than giving everyone the same list.

 What This Looks Like in Practice

 A woman came to us six weeks after her second baby, who had arrived at 32 weeks. Her first postpartum experience had been manageable. This time was different.

 The premature birth had been frightening, and her son spent four weeks in the NICU before coming home. Those weeks had been their own kind of trauma. She'd watched him through the glass of the isolette, unable to hold him when she wanted. She'd listened to monitors beeping, learned to read the numbers, panicked when they dipped. She'd gone home without her baby and returned every day to sit beside him, willing him to grow stronger. When he finally came home, she thought the fear would end. Instead, it intensified. Now she couldn't stop worrying.

 She checked on him constantly, even setting alarms to wake herself at night to make sure he was breathing. She'd been told he was healthy now, but she couldn't believe it. Every time she put him down, her mind went to the worst-case scenario.

 She also had intrusive thoughts, images of terrible things happening that she couldn't control. She was horrified by them. She hadn't told anyone, not even her husband, because she was afraid of what people would think.

 When she told us about the intrusive thoughts, she cried with relief. Just hearing that they were common, that they didn't mean she was dangerous, that they were a symptom of anxiety rather than a sign of her character, changed something for her.

 We talked about what she'd been through. The early delivery, the four weeks of NICU, the days of not knowing if he was okay. Her nervous system had learned that danger was real, and it hadn't gotten the message that the danger had passed. This wasn't irrational. Her body was doing what it had learned to do.

 We started with twice-weekly acupuncture. The first session, she couldn't settle. By the third, she could relax more. Her nervous system was starting to learn that it could rest.

 We added magnesium, oat straw, and Chinese herbs to support her postpartum recovery. We did somatic work, helping her process the trauma of the early delivery and the weeks in the NICU, and notice what happened in her body when the anxiety spiked. She learned that if she could feel the anxiety in her body without fighting it, it would peak and then settle. It wasn't permanent. It moved.

 We also talked about support. Her husband traveled for work. Her mother wasn't nearby. Even with a nanny, she felt like she was managing alone. No wonder her nervous system was on high alert. She increased her help, adding weekend coverage, and asked her husband to take the night shift when he was home.

 After two months, the constant checking had stopped. She still worried, but it was proportional. She could enjoy her baby. She could sleep when he slept. The intrusive thoughts had faded to almost nothing.

 She said the biggest shift was understanding that her anxiety made sense given what she'd been through, but that it didn't have to stay this way. Her body had learned danger, and it could learn safety again.

 Read stories from women we've worked with →

 Your Next Step

 If you're caught in the grip of postpartum anxiety, know that this responds to treatment. You don't have to wait it out, and you don't have to white-knuckle through this alone.

 We've helped many women find their way back to calm. Not a forced calm that requires constant effort, but a genuine settling of the nervous system. The kind that lasts.

 Learn more about our Fertility & Health path or contact us at 212.432.1110 or info@fafwellness.com.

If you're having thoughts of harming yourself or your baby, please contact the National Maternal Mental Health Hotline at 1-833-943-5746 (available 24/7) or go to your nearest emergency room.