Having a Baby Has Triggered Uncontrollable Anxiety

Reader’s Question

I am a 20-year-old woman with a 4-month-old son, and I have had severe anxiety problems for months now. I tried paroxetine and sertraline, and both made me act and feel very sick, confused and scared. I cannot take antidepressant medications without feeling not myself or “lost.”

This anxiety problem is affecting my everyday life and tearing me apart. I think I’m going insane because I worry over everything a thousand times all day and night. I have to remind my boyfriend about what to do with the baby over and over again, just because if I don’t it will eat at me, yet I know he knows how to take care of his own child. It gets so bad that my heart will race and I’ll start shaking so badly and feel like I can’t breathe. These episodes last about 30 minutes, sometimes longer.

I can’t breathe at night when I lie down, so I can’t sleep. I even have horrible thoughts just pop in my head at night when I’m trying to sleep, usually that someone is going to break in and hurt my baby. I’m so tired of worrying but it just won’t stop!

Psychologist’s Reply

Unfortunately, I think what you’re experiencing happens more frequently than people realize. I personally have known at least a few young mothers with stories very similar to yours. Each woman was generally an anxious person to start with, but the birth of their first child triggered intolerable levels of anxiety, with accompanying panic attacks and obsessive-compulsive symptoms. Of course other people suffer from panic disorder and obsessive compulsive disorder unrelated to motherhood, so we don’t know whether cases such as yours are triggered by hormonal changes or stress related to having and caring for an infant.

The predominant theories or explanations for both panic attacks and obsessive-compulsive disorder are biological: the brain’s normal and adaptive responses are being triggered in a faulty way. When there is a major threat to our safety, we should feel a sense of impending danger, and when that threat is imminent, our fight-or-flight system should be triggered, preparing us for the physical demands that may be required to preserve our safety. The problem with some people’s brains is that the sense of danger gets triggered without a rational cause (obsessive-compulsive disorder) or the fight-or-flight system gets triggered without an external threat (panic disorder).

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With such extreme anxiety as you described, and the assumption of faulty brain functioning, it’s important to start with medication. Although it’s true that the types of medications you mentioned are frequently used in a first attempt to treat anxiety, they are only a couple of the many options available. Especially for people who have tried psychiatric medication and not had a good response, it’s imperative to consult a specialist in brain chemistry (a psychiatrist). At this point in history, we have more options than ever for the safe and effective treatment of anxiety; you can take advantage of what’s currently available to return your life to normal.

In addition to medication, there are some behavioral things that can be very helpful. For example, when you experience a panic attack, it’s important to continually remind yourself that the symptoms you’re having are from that brain switch that was unrealistically triggered to the panic mode. You can remind yourself that the difficulty breathing is from anxiety, and not another medical condition, that the anxiety will pass (it always has), and so forth. To the best of your ability, try to focus on calmness, and attempts to relax both your mind and body. I realize that’s easier said than done. The good news is that practicing relaxation during non-panic times helps both overall and during those unpredictable periods of panic. Being able to relax is a skill that requires learning and practice to become proficient.

Additionally, it’s important to try not to give in to the temptation to “check” on the things that seem to be worrying you. One example is “checking” to make sure your boyfriend knows how to care for your child. At the time it feels like doing the checking or reassurance behavior will help, but instead it just feeds the tendency to turn to that same behavior the next time you feel the same way. As you know, the problem isn’t your boyfriend’s behavior, but that faulty trigger in your brain. So, the checking behaviors tend not to help and instead get worse if not reined in. Accomplishing these tasks I’m describing probably sounds impossible right now, which reinforces why it’s so important to get medical intervention as soon as possible. As the anxiety is lessened with proper medication, then you’ll be able to perform the behavioral steps to control anxiety when it arises.