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Postpartum Anxiety



Who knew? You may have heard a lot about postpartum depression, but postpartum anxiety or panic may have taken you completely by surprise.  Maybe you have had some of these thoughts or feelings:


What kind of mom am I if I am having these horrible thoughts?


Why can’t I relax and enjoy this time like I thought would happen?


What is wrong with me? Why am I fearful of being alone with my baby?


Who would understand this? I feel so alone.


If any of these thoughts sound familiar, I want you to know that you ARE NOT ALONE and THIS IS NOT YOUR FAULT.  Postpartum anxiety is just as common as postpartum depression (PPD) but isn't discussed as often. One in five WOMEN struggle during pregnancy or postpartum with depression, anxiety, and other mental health issues. With treatment, you will start to feel better.  I want you to know that IT WILL be possible for you to enjoy motherhood and accept (without judgement) those aspects of new motherhood that you may not be too fond of (and that’s okay too!)




Did you know that the exact cause is unknown? Experts theorize that postpartum anxiety and depression could be caused in large part due to the drastic change in progesterone and estrogen levels after delivery, along with sleep deprivation, the overwhelming sense of responsibility that comes with caring for a new infant, in combination with a whole host of other risk factors.  



  • History of anxiety prior to pregnancy or during pregnancy

  • Family history of anxiety or perinatal mental health symptoms

  • History of mood sensitivity to hormonal changes (ex. birth control methods, Premenstrual dysphoric disorder)

  • Endocrine dysfunction (thyroid imbalance)

  • Previous pregnancy or infant loss

  • Traumatic Birth/Delivery

  • Difficult Infant Temperament (Colic)

  • Difficult, or high risk pregnancy

  • Lack of support (friends, family)

  • Financial Strain/Crisis


Postpartum anxiety can present in the form of General Anxiety, surface in the form of Postpartum Panic Disorder (characterized by episodes of panic attacks) or be displayed as Perinatal Obsessive Compulsive Disorder (OCD). Perinatal OCD is characterized by having repeated intrusive or unwelcome thoughts. As a result of these thoughts, moms may experience intense guilt, shame, isolation, panic attacks and severe anxiety. In order to cope, it is common for some women to avoid triggering situations or to engage in certain rituals in hopes to “get rid” of the distributing thoughts


You may have experienced some of these physical symptoms common with Anxiety or Panic:

  • Increased heart rate

  • Shortness of breath

  • Insomnia

  • Muscle tension

  • Stomachache

  • Loss of appetite

  • Weight loss

  • Dizziness/Nausea

  • Hot flashes

  • Brain fog

  • Restlessness

If uncomfortable physical symptoms weren’t enough, often times distressing thoughts, feelings and behaviors arise from the anxiety or panic such as:

  • Racing thoughts

  • Feeling of dread about things you think may happen

  • Persistent feeling of being on edge

  • Excessive worry (often about baby's health)

  • Insomnia or trouble falling asleep

  • Intrusive or unwanted thoughts

  • Avoiding triggering situations

  • Irritability and mood fluctuations



Realize that having symptoms of anxiety does not make you a bad mom (In fact, just the opposite is true! You are incredibly fearful of something BAD happening)

Learn effective coping skills that you can use outside of the counseling room to help manage your symptoms

Look at your symptoms in a different way, a way that is less scary and distressing

Feel more in control of your thoughts, feelings, and actions

Help increase your partner or support persons’ awareness of postpartum anxiety and how they can best support you


What are postpartum anxiety counseling sessions like?

Sessions are 45-50 minutes and due to COVID19 safety, will be online therapy sessions (video tele-therapy). You can bring your baby with you to the session. 


What postpartum anxiety treatment modalities are used?

As a PMH-C, a therapist certified in perinatal mental health, I draw from four evidenced based treatments known to be effective in treating postpartum issues and anxiety, including cognitive-behavioral therapy (CBT), exposure and response prevention (ERP), Interpersonal Psychotherapy (IPT) acceptance and commitment therapy (ACT).


Is Medication Right For Me?

It very well could be! Counseling has proven to be incredibly effective in treating postpartum mood and anxiety disorders. However, if you find that your symptoms are not decreasing in frequency or intensity, I would encourage you (and will gladly help facilitate) a meeting with a physician (an OBGYN, primary care physician or psychiatrist) who is experienced in perinatal mental health. With your written permission, I will collaborate with any existing physicians or new providers, as we all serve as important members of your care team!

I don’t think I need therapy because these feelings will pass on their own.

In some cases, the emotional highs and lows can subside on their own. However, treatment with a trained professional gives you the opportunity to feel better sooner. You can also take the skills you acquire in session and use them for future challenges in your life.

I don’t have a budget for therapy.

I do accept United, Cigna, Aetna insurance plans. If you have another provider, please check to see to what extent they may cover out-of-network therapy. For those not covered by insurance, or without it, I also accept self-pay. Maternal mental health is one aspect of pregnancy that is easy to ignore but that is so crucial to the foundation-building of a mother or parent partner. Making an investment to care for your mental health can benefit everyone in your home.

If you are experiencing any of these symptoms, please know that you are not alone, and your symptoms are treatable. You do not have to continue to feel the way you do, and talking with a perinatal mental health trained therapist can help.

Interested in Postpartum Anxiety Treatment? 

If so, please contact me for a free consultation. My office is physically in Winter Park, Florida (Orlando)  I am licensed to provide online counseling services to anyone who resides in the state of Florida. 


Your maternal mental health matters. Please reach out soon


More About Sarah Courech, LMHC PMH-C

Sarah is a Licensed Mental Health Counselor, Certified Perinatal Mental

Health Professional and Owner of Moms in Mind Perinatal Counseling. She has expertise in treating mood and anxiety disorders during pregnancy and the postpartum period. Sarah helps new mothers cope with the transition to motherhood and successfully work through challenges that may arise during the early years. As a maternal mental health advocate and mother herself, Sarah understands the specific challenges women may experience during this life stage. Sarah proudly serves on the Board of The Tough Tough Fund, is a member of Central Florida Postpartum Alliance, Postpartum Support International, and the Mental Health Association of Central Florida 

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