It may be difficult to recall your life before the COVID-19 pandemic, but if you struggled with anxiety pre-global-crisis, then your stress response is surely turned up to 11 now. And if you have given birth in the last six months to a year, then your life already may have involved a lot of social isolation. If you’ve been experiencing intrusive thoughts (they can get pretty dark but are not suicidal) and overwhelming nervousness and irritability, you may be struggling with postpartum anxiety (or a Perinatal Mood and Anxiety Disorder, to use the most recent terminology). In case you aren’t aware of the statistics, as many as 6% of women experience anxiety during pregnancy, and around 10% of new mothers develop anxiety in the first year after giving birth. I would bet these numbers are even higher given the stigma around coming clean about the dark side of motherhood.

Reminding you that you aren’t alone is the main reason I even mention the data here. It’s validating when we find out other women are having a hard time. Women who are anxious tend to get distracted by details, so we aren’t going to start analyzing the statistics. Just know that you can stop googling “Is there something wrong with me?” Our cultural expectations of women and the lack of support for them is a huge part of the problem, not something that’s broken inside you. And even if you’re genetically predisposed to anxiety and depression, that’s not your fault. No one is to blame here. Let’s work on managing and coping with it instead of getting stuck in the weeds to avoid thinking about what we need to work on.

Moving on . . .

Postpartum Anxiety and What To Do About It

There is no secret cure for anxiety. The fear response is the key to our survival, and it isn’t going anywhere, nor should we want it to! Your brain is very good at keeping you safe from danger. And for millions of years, it has evolved to do even higher thinking than simply alerting you to run from that lion or leopard or killer kangaroo. But evolution is slow and lazy, so our lifestyles have outpaced our brains when it comes to managing modern day worries.

Anxiety is what happens when our brain perceives something harmless as a physical threat. The stress response is set off, and once that prehistoric process gets going, it’s difficult for our higher thinking brain parts to keep it in check. In Rewire Your Anxious Brain, Catherine Pittman explains that anxiety can be either top-down (starting in our prefrontal cortex, or PFC) or bottom-up (starting in that ancient “lizard brain” area, the amygdala). If you’re into neuroscience, check it out. It’s sciency enough to quench your geeky thirst for information on the origins of today’s problems but easy enough to understand that you won’t start beating yourself up for not studying more in that undergrad biology class (do I know anxiety or what?!?).

Now that you’re a mother, you are sleeping much less than usual, learning to breastfeed (or not, I’m certainly not here to advise you on that, and I strongly feel that fed is best. Period.), getting to know this tiny human who is both adorable and terrifying, figuring out how to stop feeling guilty when all you want to do is put this baby down and go pee, wavering manically between begging your partner to not leave your side and ordering them to get out of your face, and overall, wondering why no one told you the truth about motherhood. So, yeah, anxiety is kind of your whole existence. Toss in a global pandemic, and you’re all set.

The good news is that your brain has everything it needs to learn how to help you manage this shit storm of anxiety. The not-so-good news is that it takes practice and time. That’s right, at this most challenging time of your entire life, when you are already up to your eyeballs in learning new skills, you gotta make a few more changes. You are a mother now, though, so you got this! Let’s get started!

These tips are in no particular order. If I had to sort them, I’d probably put sleep first, but since this is an article for moms (and there’s currently a global pandemic), I’ll aim for realistic and start with the strategies that might be more doable than a good night’s rest.

1. Turn off the damn screen.

You do not need instagram making you feel worse than you already feel. Or that Wonder Weeks app making you obsessed with whether your baby skipped Leap 8 altogether or is still stuck on 7. Or that meditation app telling you to breathe. Oh, wait, that might be one exception. I’ll get back that one in a moment.

I’m not advising you to toss your iPhone out the window. I’m asking you to limit your screen time (especially at bedtime — or when you get to have a bedtime again) and be mindful about what you do on your screen, how long you’re doing it, and whether or not it’s contributing to your anxiety. If IG Stories really bring a smile to your face, then by all means, enjoy. But if you find yourself mindlessly scrolling and feeling completely numb, then maybe it’s time to take a break from it.

2. Breathe and be in the present.

You can do this one anytime anywhere, and even though it sounds completely obvious, a lot of us forget that taking a few deep breaths can help immensely with both physical tension and mental stress. And for people who suffer from anxiety, the panic or intrusive thoughts can take over pretty quickly, leaving you feeling like there’s no chance you could take a deep breath. If this happens, quietly tell yourself to stop and count slowly from 1 to 5. It’s likely that by the time you get to 5, you will be a little calmer and able to take some deep breaths. Inhale slowly through your nose to the count of five, and then exhale slowly through your mouth. Repeat three times. Counting from one to five before you begin is a grounding exercise that helps bring you back from being lost in worry to the here and now where your only task is to breathe.

Mindfulness is simply engaging your senses to bring attention to the present (as opposed to the past or future, where most worries reside).

If you can carve out ten minutes a day and you’re ready to try mindfulness meditation, check out the Waking Up app for iPhone or android. It’s a beautifully designed app with education on the theory behind the practice of meditation, as well as lessons (including some for children) that will gently guide you through the process.

3. Schedule your worry.

This is an old therapeutic technique to give you a sense of control. It’s unrealistic to set a goal to stop worrying. What would be the point in setting yourself up to fail? It’s much more effective to work on managing the worry. This way, you are in control of it, not the other way around. Here’s how it works: Schedule a recurring 5-minute long appointment with your worry. Yes, I’m serious. Put it on your calendar: ’10:00-10:05am - Worry!.’ Extreme worriers could even pencil in two of these appointments per day, one in the morning and one in the evening.

When the time comes for your worry session, set a five minute timer on your phone, and then worry it up! Write down all the things that have been driving you nuts, or think really intensely about them, or both. Take a look at your to-do list and your upcoming calendar events to be sure you haven’t missed anything. But don’t get distracted. This five minutes is all about worry, dread, and the worst case scenarios. When your timer goes off, you’re done (for now). Does this mean you will never, ever find yourself lost in anxious thoughts outside of your worry appointment? Of course not! But when those problems creep into your head, you have a place to put them. Think to yourself, “Not now, worry. I’ll see you at our next session.”

4. Express gratitude.

Research into wellbeing suggests that people who feel grateful report being happier and more satisfied with life. This research is fairly new, however, so I’m not saying, “Just be thankful for what you have and your problems will disappear.” I’m just saying that when we take time to acknowledge what’s going well in our lives and thank the people who make our world a better place, then it can benefit our mood and perspective. It’s another strategy for feeling a little more in control, too, and we know that’s a big deal for those of us struggling with anxiety. When I choose to reflect on the things I’m thankful for and express my gratitude through writing in a journal, talking to a partner, meditating on it, or passing it on by doing something kind of someone else, I’m training my brain to rationally see that life isn’t either one big shitstorm or one big ball of joy. Life is full of both pain and positivity, both sunlight and storms, both good and bad (and a lot of in-between). Now I have evidence that the worst isn’t all I can expect, regardless of what my anxiety is telling me.

5. Get that heart rate going.

A brisk walk with or without baby is good for you.

Humans need to move. When we don’t, our anxious brains start heating up with worry that something isn’t right. A great cure of this aimless, restless, and unfocused state of mind is exercise. It can be as simple as a brisk walk with baby in the stroller or as intense as a spin class. It’s totally up to you. If you’re new to exercise, start slow with a 15-minute walk once a day. You’ll likely discover that you want to keep going. Try out different activities to find something you really dig. There are YouTube videos, the Couch to 5K beginner running plan, workouts you can do with your baby, and video games that get you moving. You could simply crank up the tunes and have a good old dance party in your living room. There is no perfect exercise plan. Do your best to get moving any way that works for you.

6. Relax (your muscles).

Isn’t “just relax!” the #1 worst thing to say to someone with anxiety? You’ll never hear me tell you that. What I will advise, however, is to tense and relax your muscles. It’s called progressive muscle relaxation (PMR). You can even combine it with deep breathing. Here we go: Lie down or sit comfortably. You can close your eyes or leave them open, whatever feels better for you. Breathe in deeply and slowly. Exhale slowly. Now starting with your forehead, relax any tension you feel there. Raise and lower your eyebrows, squeeze your eyes shut and then release them, letting your whole face loosen and relax. It can help to open your mouth slightly and relax your tongue. Work your way down your body, focusing on each muscle group. Roll your neck and shoulders, squeeze and release any tension in your arms and hands, and on down. Many of us hold a lot of tension in our faces, particularly the jaw, and our lower back, so pay extra attention to these areas. This exercise can also be very grounding and mindful.

7. Eat.

While this one may seem obvious, I have often been guilty of pushing through my hunger or grabbing something quick to eat only to notice a half hour later, I’m incredibly sluggish, grouchy, and blah, leading to anxiety about not being productive enough. Personally, I know I need to snack throughout the day so my blood sugar doesn’t plummet, avoid processed carbs, and be sure to include whole grains and some protein. If I’m really pressed for time, I always have a pantry stocked with nuts that I can easily grab by the fistful on my way out the door (or more commonly these days, on my way up the stairs to do a virtual session with a client). I have little ziplock bags of nuts or granola and these delicious mini Clif bars stashed everywhere so there are no excuses for getting hangry in the afternoon! For you, accessible snack options may look very different. Spend a few minutes right now jotting down some yummy whole food items you can have available so at least your tummy will remain satisfied enough to not contribute to your anxiety. And, like everything else on this list, it’s something you are in control of!

8. Go to bed.

While baby is tiny, you won’t be getting much sleep at all, of course, so this one will vary greatly depending on what’s going on. BUT you may be able to manage a four hour stretch of uninterrupted z’s if your partner or other supportive person in your home can take care of baby for awhile. There are many variables at play during the first few months of life with baby, so just do your best here. Never ever discount the value of sleep. It should be a priority, so even during those challenging times when you can’t get as much as you need, keep it up there on your list. This baby will eventually sleep through the night, and you want to be ready with a brain that is fully trained to wind down at a decent hour so it can heal and do its thing to prepare you for the next day. A sleep-deprived brain will not be helpful at all when it comes to managing your anxiety. It will definitely struggle with any sophisticated rational thinking, taking that kind of processing offline in favor of survival instinct. And we know how that turns out. So talk to your partner about how you can work together so that each of you can get a little more rest than you’re getting now. And if you’re beyond that newborn stage and your baby is consistently napping and down for bed by 7pm, GOOD JOB, YOU!!! Think about trying to relax a bit earlier in the evening, starting a nice bedtime routine (taking a hot shower or bath, enjoying a cup of tea, reading a book, whatever floats your boat) that will teach your brain to recognize the signal that it’s time to slow down and prepare for snoozing. Just like when sleep training your baby, you need to optimize your environment for calm and relaxation. A rested mother is a less anxious mother.

9. Talk to a professional.

You knew this was coming, didn’t you? Motherhood is incredibly difficult and overwhelming and a unique blend of conflicting emotions that seem like they’re changing by the minute. And although more and more women are opening up about postpartum depression and anxiety, there’s still stigma around the topic. People tend to have a hard time knowing how to acknowledge the reality of how challenging and exhausting life is with a new baby. They don’t want to bring up anything to upset you, and they seem to think if they ignore uncomfortable conversations, things will magically be ok. There are therapists who are trained in helping new mothers. They know all about the hormonal shifts that are happening, common experiences and emotional changes, and strategies for helping with the symptoms. It takes time to adjust to this new role, and you don’t have to do it alone. A therapist will listen, offer tips and guidance if that’s what you need, give you permission to feel what you feel, and connect you with local resources, including a specialist who can prescribe medication if necessary. I’m one of these therapists, and I’m happy to help. You can schedule a consultation call here or send me a message here. Visit PSI’s directory for an entire searchable list of therapists trained in perinatal mood and anxiety disorders. And don’t wait until post-pandemic. You can get started with virtual counseling now and then transition to in-office later.

10. Make some mom friends.

We all need a village. The size of that village can be up to you. You don’t have to be a social butterfly. Who has time for that? But having a few other women to chat with about mom life can be incredibly helpful. Many communities have meetups especially for new moms or support groups. Here in the Raleigh area, there’s a wonderful organization called Triangle Area Parenting Support (TAPS). They have groups for first-time parents and second time arounders, for moms of newborns and moms of toddlers. During the current COVID-19 crisis, they are even offering their groups virtually. Ask your pediatrician or OBGYN for resources local to you. You won’t immediately click with every new mom you meet, so don’t give up. Push yourself to step out of your comfort zone to build a support network of people who get it. Postpartum Support International is currently offering online support groups, too, so check out their web site no matter where you are.

Comment below and let me know which of these strategies you feel you could put into practice today. If you have any questions about maternal mental health, or if you’d like to talk about working together, send me a message. It’s private and secure, and I’ll get back to you within 24 hours.

Ten Realistic Strategies For Managing Postpartum Anxiety (Even During A Global Crisis)