Postpartum Anxiety: Symptoms, Causes, and Treatment
Postpartum Anxiety in Texas and Connecticut: What it looks like and how to treat it
It doesn't always look like falling apart. Sometimes it looks like competence.
If you're still getting everything done, the appointments, the feedings, the laundry, but you feel like you're one thing away from unraveling, that doesn’t mean you don’t have the right systems in place. That's what postpartum anxiety can look like in a woman who doesn't know how to stop performing calm.
What is postpartum anxiety?
Postpartum anxiety is persistent, excessive worry, dread, or physical tension that develops during pregnancy or in the year after having a baby. It can show up as constant "what if" thinking, trouble sleeping even when the baby is asleep, a racing heart, irritability, or a sense that something bad is about to happen when reality says otherwise.
Postpartum anxiety is different from the baby blues, which usually fade within two weeks. It also often gets confused with postpartum depression, though the two can exist separately. Anxiety tends to show up as worry and physical tension rather than sadness, and it's frequently the one that goes unnamed because worry has been normalized as part of Motherhood.
Why Postpartum Anxiety Gets Missed
Most postpartum screening tools, including the one most commonly used in OB and pediatric offices, were built to detect depression, not anxiety. If you don't feel sad, and you're still functioning, high-functioning even, it's easy for a checklist, a partner, or even you to miss what's actually happening.
That's the gap I specialize in closing. The moms I see most often aren't falling behind. They're doing everything right and still feel terrible underneath it, and that mismatch is exactly why it goes unnamed for so long.
Common Symptoms of Postpartum Anxiety
Constant "what if" or worst-case thinking
Difficulty sleeping even when you have the chance to
Racing heart, tight chest, or other physical tension
Irritability or a short fuse
A sense that something bad is about to happen
Checking on the baby repeatedly, even when everything is fine
Difficulty relaxing or sitting still
Feeling like you have to keep everything under control
If several of these sound familiar, that's worth taking seriously, even if you're looking productive on the outside.
Treatment That Actually Works
Cognitive Behavioral Therapy is considered a first-line treatment for postpartum anxiety. In my practice, sessions aren't about handing you another checklist. We work on what's actually driving the anxiety, not just how to manage the symptoms better. Once physical symptoms are under control, then we can work on the root of the anxiety.
Hannah Castle, LCSW, Texas LCSW #58184, CT LCSW 58.016119
MSW University of Pennsylvania, Certified PCIT Therapist, Circle of Security-Parenting Facilitator.
Last Updated: September 2026