Post-Partum Anxiety: The Intrusive Thoughts New Mothers Are Afraid to Share

Picture this. It is two in the morning and the baby is finally asleep. You should be sleeping too, but you are standing over the cot with your hand on her chest, checking that she is breathing. On the way back to bed a picture flashes into your mind of dropping her on the stairs, and you feel sick with fright.

If you have had thoughts like that and told no one, please know that you are far from alone, and that having them does not make you a bad or dangerous mother.

What post-partum anxiety looks like

Most people have heard of post-partum depression. Post-partum anxiety is spoken about much less, although many new mothers experience it, sometimes together with depression and sometimes on its own. It can begin in pregnancy or at any point in the first year.

It often looks like this:

• Constant worry about the baby's breathing, feeding, weight or safety
• Sudden, unwanted pictures or thoughts of something terrible happening to the baby
• Checking again and again, and still not feeling reassured
• Being unable to sleep even when the baby is sleeping
• A racing heart, tight chest, nausea or shaky hands
• Avoiding stairs, the bath, driving or being alone with the baby, out of fear

The frightening pictures are called intrusive thoughts. They are unwanted, they arrive uninvited and they horrify the mother who has them. That horror matters. It shows how strongly the thoughts go against what you actually want, which is to keep your baby safe.

Why a new mother's nervous system runs so hot

Several things happen at once after a birth. The hormones oestrogen and progesterone, which were very high during pregnancy, fall sharply after the birth. Both are thought to influence the brain's calming chemistry, so their sudden drop may leave the nervous system more reactive.

Then there is sleep. Weeks of broken nights are hard on any brain. Lack of sleep is linked with a more reactive sense of threat, and with less capacity in the calmer, reasoning parts of the brain to settle it.

Finally, a new mother is naturally tuned to watch for danger. That watchfulness is useful. It is what wakes you at the smallest cry. In an exhausted, depleted body, though, it can tip over into a state where the alarm rings constantly and everything looks like a threat.

A mother's worry is love with nowhere to rest.

Many mothers are also carrying a great deal with little help: a partner back at work, family far away, pressure to cope and look grateful. None of that is a personal failing. For more on the brain's own calming chemistry, see our article on GABA and calm focus.

When to see a doctor first

Please speak to your GP, gynaecologist, clinic sister or a psychologist if anxiety or low mood is making daily life hard. Post-partum anxiety and depression are medical conditions with good, established treatments, and some physical problems after birth, such as thyroid changes or anaemia, can cause similar symptoms and need to be checked.

If you have been prescribed an antidepressant or any other medication, do not stop or change it without the doctor who prescribed it. Your doctor can also advise you about medication and breastfeeding.

If you have thoughts of harming yourself, please contact your doctor or the South African Depression and Anxiety Group (SADAG) straight away. Get urgent medical help as well if you feel confused, are seeing or hearing things that others do not, or believe things that those close to you find strange. That is rare, but it needs immediate care.

How neurofeedback may help

Neurofeedback is a gentle, non-invasive form of brain training. Sensors on your scalp read your brain's electrical activity, and a computer gives feedback through sound or pictures when your brain moves towards a calmer rhythm. The sensors only read. Nothing is sent into your brain, and it involves no medication.

With practice, the nervous system may become better at shifting down from high alert and staying settled for longer. The hope is for small but meaningful changes: falling asleep more easily when the chance comes, worry loops that are easier to step out of, and a little more room to enjoy the baby. Neurofeedback has been studied for anxiety in general with mixed-to-encouraging results, but there is little research on post-partum anxiety specifically. Results vary, and no particular outcome can be promised.

Neurofeedback works alongside your doctor, psychologist or psychiatrist, not in place of them. It can sit comfortably next to therapy, medication where prescribed, and practical support at home. If you were an anxious person long before the baby came, our pieces on generalised anxiety and high-functioning anxiety may fill in more of the picture.

What sessions involve

Every client at Fix Your Brain in Krugersdorp begins with a 19-channel brain map, which takes about an hour and a half. A brain map is a recording of your brain's electrical activity, taken from 19 points on the scalp. Sessions after that are 45 to 60 minutes and start with a short check-in on how you are feeling. Our what to expect page has the details.

Common questions

Do intrusive thoughts mean I might hurt my baby?

Unwanted, frightening thoughts about harm coming to the baby are very common in new mothers, and the distress they cause shows that they go against your wishes. They are thoughts, not intentions. Please still tell your doctor or a psychologist about them, so that you can be properly assessed and supported instead of carrying them alone.

Can I do neurofeedback while breastfeeding?

Neurofeedback involves no medication and nothing is sent into your brain or body. The sensors only read your brain's own activity. Please still mention it to your doctor, who can also advise you about any medication you are taking while breastfeeding.

Does this replace seeing my doctor or taking medication?

No. Neurofeedback is a complementary approach that works alongside medical and psychological care. If your doctor has prescribed medication, keep taking it and discuss any change with them first. Brain training is best seen as one support among several, together with therapy, rest where possible and help from family or friends.

You are looking after a whole new person on very little sleep, and you deserve looking after too. If you would like to talk about whether neurofeedback could help your nervous system find some calm, please get in touch with Irine. A short message is enough to start.