• Dr. Saru Bala

The best ways to combat postpartum stress and anxiety


Did you just have a baby and feel:

  • Overwhelmed?

  • Can't relax?

  • Racing thoughts that are keeping you from sleeping?

  • Constant sense of worrying or dread?

  • Brain fog (new onset)?

  • Constantly irritated?

  • On edge/restless?


You may be dealing with postpartum anxiety. And while this is different from postpartum depression, about 25-50% of new moms who have postpartum anxiety may develop postpartum depression in addition, if these issues aren't managed.


Tools to manage postpartum stress and anxiety


WALKING AND MOVING DAILY

This may seem simple and you may brush it off, but I'm telling you, don't! How many times have you felt in a funk and got up, moved around, went somewhere, and your mood shifted?


Movement is crucial for your health, your hormones, your cortisol regulation, and circulation (this can help with hair loss!). Don't discredit the small things like going for a walk.

Ask your friend, family, neighbor, etc to watch your baby, or take your baby with you, and spend some time OUTSIDE (weather permitting) for 20 minutes taking a leisurely walk. It doesn't have to be for a certain number of steps or a specific cardio goal. Just move your body, get some blood flow, increase your endorphins, and see if this helps you shift your mind a bit.


Make sure to LEAVE YOUR PHONE AT HOME. Or at the very least, put it on do not disturb, and avoid looking at it while you're on your walk. Instead, pay attention to what you're seeing in front of you.

  • What colors do you see?

  • What sounds do you hear?

  • What can you smell?

This technique can really help to pull you out of your mind (especially if you struggle with racing thoughts and worry) and get you into the moment.


PACED BREATHING

This is a great technique that can be used anytime, anywhere. In the car, in a meeting, while you're breastfeeding, pretty much anywhere you go, you can do this!


Paced breathing is a great and very effective way to increase your parasympathetic tone. Your parasympathetic nervous system is your "rest and digest" nervous system.


The sympathetic nervous system is your "fight or flight." This is the state most people are in on a daily basis and without consciously tapping into that parasympathetic state, constant sympathetic activation can cause a lot of issues with stress and anxiety. Sympathetic activity looks like:

  • Increased heart rate

  • Sweating

  • Decreased blood flow to organs (including your gut- so you may not feel hunger, you'll feel bloated after meals, indigestion, etc)

  • Higher blood pressure

  • Reactive to small things

There's tons of research for paced breathing and anxiety, and most of it states that 10 minutes of paced breathing twice per day can significantly help to lower symptoms of stress and anxiety.


When you breathe slowly, it signals to your brain that you're not in danger, you're not running from a bear, and that you're safe. It pulls you out of that sympathetic response. So you can have more circulation back to your organs, your blood pressure returns to normal, and your heart rate can slow down again.


"Slow breathing techniques act enhancing autonomic, cerebral and psychological flexibility in a scenario of mutual interactions."

How do you do paced breathing?


There are several ways to do this, so find what works best for you. My initial go-to recommendation if you're new to the paced breathing or deep breathing world is a 5 second inhale, with 5 seconds exhale. No breath holding.


If you want to use a visual aid, this is helpful for many people. This website is free and an excellent resource. You can set the pacer to your desired inhale and exhale and just watch it. If you have a watch that has a pacer, that's great to use. The calm app also has a breathing section that is wonderful to use.


If you find that you're feeling overwhelmed with following a pacer and having a hard time taking air in within the 5 seconds, or find that you're feeling more stressed about following a certain number, then start with just slowly inhaling for as long as you can, then slowly exhaling for as long and slow as you can. Don't worry about the time. Keep your hands on your diaphragm (bottom of your ribs), and notice your hands move out and in.


ESTABLISHING A ROUTINE

This one too seems simple and like one you can overlook, but trust me when I say, your body craves routine. Just like your new babe needs a routine, your adult body does too.


Establishing a good morning and bedtime and routine, even if you're up later throughout the night, can be really helpful for your nervous system. It helps to set your circadian rhythm, and it helps your body and mind know that when you do this series of events, we're going to sleep, or we're waking up. After about a week, it really starts to make a difference and you'll notice more energy and an easier time with falling asleep.


Morning:

  • Once the sun has risen, go outside and get morning light in your eyes for 10 minutes. This helps trigger your cortisol awakening response (CAR)

  • Get in some gentle movement. Doesn't have to be a full workout. Some gentle yoga, walking, a few jumping jacks, etc to get your blood flowing can be the little boost you need to again, get that CAR jump started (no pun intended)!

Evening:

  • In the morning we need bright light to trigger a cortisol response, but in the evening, we need darkness to shut down the cortisol and bring in the melatonin. These two hormones work inversely. When one is active, the other is suppressed.

  • Get your house as dark as you can- no overhead lighting. Use candles or dim lamps throughout your house.

  • Avoid using any screens 30 minutes before you plan to go to sleep. Even if it's a show that's on in the background, or one you've memorized the words to (I'm talking to you, Friends fans), your mind is still actively tuning in even if you may not realize it and it's stimulating to your nervous system.

  • Include paced breathing right before falling asleep. This is a great way of settling your nervous system and getting into the parasympathetic nervous system before falling asleep so you can get more restorative sleep (even if the hours of that sleep are fragmented and shorter).


HERBS AND SUPPLEMENTS

On top of adding in lifestyle pieces like movement, breathing, and a routine, supplements can help push the needle a little further if you're still noticing some lingering symptoms.


But keep in mind, herbs and supplements are the cherry on top of making those other changes! Don't expect these to suddenly make a huge difference if you haven't focused on the other pieces, they will not work.


Ashwaghanda

  • This is a great one for anyone at anytime that is dealing with stress, and can be especially helpful in the postpartum period to help regulate your nervous system, your cortisol, and your HPA axis.

  • It helps to improve energy levels and your memory, while also helping to reduce anxiety

Rhodiola

  • This herb is particularly useful for physical and mental endurance

  • It's helpful for reducing inflammatory levels, boosting your immune system, lowering stress levels and improving your anxiety as well.

Magnesium glycinate

  • This form of magnesium is particularly helpful for metabolism and energy, along with relaxing your muscles if you're experiencing cramping or tension.

  • Unlike the citrate form, this doesn't affect your bowels, so if you've tried magnesium and you were sensitive to it in the past, this form shouldn't be an issue.

  • It's also known as "bisglycinate" or "chelated" magnesium.

Eleutherococcus

  • Best for chronic stress with low energy levels

  • It helps improve mental alertness, but for some it may be over stimulating, so start with a lower dose and work your way up

  • AVOID if you have a history of high blood pressure


WORKING WITH A PROVIDER TO CHECK LABS

Hormonal imbalances do occur in that postpartum period. It's always best to work with a provider to check in on any imbalances that might be popping up. Things like:

  • Thyroid disorders (a FULL thyroid panel- TSH, T3, T4, and thyroid antibodies)

  • Iron panel (including ferritin levels- especially if hair loss is excessive)

  • Hormonal panel (if you've started cycling again)

Disclaimer: As with ANY supplements or herbs, please check in with your doctor before adding in any new products or changing your routine. This is not medical advice.

If you're looking for more support in the postpartum period, whether that's getting your period regular (post breastfeeding), addressing lactation, or needing more support for stress, schedule a free consult below to see how we'd work together to solve your issues!










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