POSTPARTUM RESOURCES

Managing Postpartum Anxiety: Ashley’s Story

Let's Thrive Postpartum | Postpartum Anxiety

New moms often experience a rosy picture of parenthood, but the reality can be far more stressful. Kelly Siebold and Ashley Moore discuss postpartum anxiety, using Ashley’s experience with her two children as a springboard for conversation. Ashley talks about the unrealistic expectations she had for motherhood and how this contributed to her anxiety. She also details the challenges she faced postpartum, including intrusive thoughts and sleep deprivation. Eventually, with the help of medication and a supportive network, Ashley was able to manage her anxiety and create a more positive experience with her second child.

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Managing Postpartum Anxiety: Ashley’s Story

Welcome back. I’m Kelly.

I’m Ashley. Thank you so much for being here. We’re going to be talking a little bit about postpartum anxiety. You, folks, are going to get to hear my story of working through postpartum anxiety, mostly with my first, but then still how it came up with the birth of my second child as well.

Can’t wait to hear.

The Ordeal

It was an interesting experience. I’ll start back at the beginning. I was very fortunate to have a wonderful pregnancy. I felt great. My skin looked amazing. My hair seemed to be doing these wonderful flowy things all the time and life was pretty good. It was everything. It was going along meeting the expectations that I had hoped for, which is a good feeling. I’m so fortunate that I had that experience.

It also set me up for having some perhaps unrealistic expectations of what life was going to look like after my son was born. I was one of those who had done tons of babysitting, the classic oldest daughter. We’ve all seen those memes and things on TikTok and felt like, “This is going to be just easy, fine, and normal.” It was not. I had already had anxiety and experienced anxiety for a little while in college and recognized that about myself and had thought it through.

I got pregnant while I was at the very end of grad school to become a therapist. I’m a therapist, by the way. Top of mind, I know that I already have experienced anxiety, managing it, and have some anxious tendencies. I probably need to keep an eye out for if this seems to get any worse like after the baby’s born. I was thinking through it. I thought a little bit. My son was born. His birth was fairly average for a normal birth, with fifteen-hour labor.

They did it up having to do some different medications to stop my labor, then restart the lit my labor. My heart rate was doing some strange things. His heart rate was doing some strange things. I don’t remember much of it. My husband will say he was scared for a little while because we didn’t know what was happening. Nobody was doing a great job explaining. That was the first experience for me. I was like, “Not what I thought. Not what I was expecting.” That creates fear and that was hard.

Once he was born, he was healthy. We came home and for me, within the first couple of days, I started noticing that he was born in December. It gets dark at like 4:45. I started noticing every time it would get dark, I could not eat. I had this like panic overwhelming sense of dread for anyone who’s experienced anxiety. You know what it feels like. I couldn’t eat and I couldn’t move around. I wanted to sit in one place and hold him or I don’t know.

I remember this frozen and mobile feeling. It would happen when it would get dark like every day. I remember telling my husband because he finally was like, “Are you okay? What is going on?” I was like, “I don’t want to talk about me,” which hello, therapist, red flag. It was this awful feeling. I remember texting friends and trying to say like, “I’m feeling nervous. I’m not sleeping a whole lot. I’m staring at him and his baths in it.”

A lot of people were like, “That happened. That was me, too.” Finally, my husband and I were talking. I was like, “I cannot sleep. I cannot fall asleep.” Some intrusive thoughts started coming in like, “I know that if I close my eyes, he’s going to stop breathing. I know that if I’m not looking at him, he’s going to stop breathing.” In hindsight, you think back and you’re like, “That makes no sense.” That is how it felt at the moment.

I would lay there and look at him. My husband finally, was like, “We need to get some distance. Let’s move the bassinet across the room.” The monitor will still be looking right down on him, but let’s move the bassinet away a little bit and see if that helps.” It did a little bit and he would start doing some of the night feedings trying to help me get more sleep, which wasn’t working.

My son also wasn’t the best sleeper as an infant. There was lots of bouncing in a dark closet on my yoga ball trying to soothe him at 2:00 in the morning. After I woke up one day, I was so tired that I was nauseous. Kelly, I don’t know if you know that feeling. You feel like you’re going to throw up because you’re so tired.

You also can’t sleep when you close your eyes and lie down to sleep.

My husband finally said, “That’s it. Go to the guest room. Put on my noise-canceling headphones. Blast your favorite music or whatever it is. I’m taking the monitor, but I want you to be not able to hear anything.” That was triggering for me. His crying would send me into a spiral. I knew if I could hear him crying, I could not sleep. If a monitor is next to me, I cannot sleep because I was anticipating their cry.

Sleep Deprivation

He did that one night of me getting like a solid maybe 6 or 7 hours of sleep. Which is life-changing at that point. I woke up and I remember, my husband was in the military and he was like sleep deprivation is a tactic that they use for interrogation because it wears you down. He was like, “I don’t know that I’ve ever even been this tired, even through basic training.”

That’s when I remember thinking, “This is important.” We went to all the pediatrician visits. I remember at one visit, I filled out the Edinburgh-like scales and gave them to the pediatrician. She looked back at me and she said, “Some of these are a little concerning.” I said, “I realized that now.” She was like, “Are you going to reach out and talk to somebody?” I said, “I’m seeing my doctor.” This was getting close to that six-week mark.” I was like, “I’m going to see my doctor soon. I’m going to talk to her about it.”

The next visit, because you go so many times when they’re first born, I was having such a hard time breastfeeding. The whole feeding process was contributing and my anxiety was spiraling because I was convinced he wasn’t getting enough food. It hurt. I didn’t know what I was doing, but I was in that place of like, “I can ask for help.” I’ve gotten good asking for help, by the way. Even hearing me say this, I’m like, “Who are you? Who is that person?”

The pediatrician looked at me and she was like, “Have you ever given him a bottle of formula?” I was like, “No.” She goes, “I’m giving you a can. I want you to make a bottle and give the baby a bottle. Be happy that he’s fed. If you don’t want to breastfeed anymore, please stop. The most important thing is that you are happy and that you are feeling your best.” I broke down and started crying in this poor pediatrician’s office. I was like, “Thank you so much for saying this to me.” Again, no one was pressuring me. This was so much this internal dialogue and all the shoulds of what I should be doing or should be trying that I was so stuck in.

Give the baby a bottle. Be happy that he's fed. If you don't want to breastfeed anymore, please stop because the most important thing is that you’re happy and that you’re feeling your best. Share on X

Did you at that point start moving him to formula?

That day, I switched him to formula. I walked out. We were in Old Town Alexandria at the time. I walked down the street to the grocery store, the CVS, and I bought some formula. I was like, “That’s it. I couldn’t do this anymore.”

How did that impact your mental health when you made that?

Goodbye To Breastfeeding And Hello To Medication

It was huge. I don’t think I realized how much the stress of trying and what I felt like failing to breastfeed the pain, the difficulty, and the frustration of trying to figure out the timing and the engorgement. There was so much about breastfeeding that I realized I didn’t have a clue. Once I was able to say, “I don’t have to do this anymore.” It felt like a huge weight was taken off my shoulders. That happened pretty early on. That was like week four. That provided some relief but a lot of my anxiety was still so present.

At my six-week appointment with my OB, I had my son in the stroller right there next to me and she asked, “How are things going?” Again, total sobbing and she looked at me. This was the doctor who had delivered the baby. I knew her pretty well. She looked and nodded. I wish I could remember exactly what it was that she said, but it was something along the lines of, “The transition to motherhood seems to be super smooth for some. If it’s not, there’s Lexapro.”

She said nonchalantly that I was like, “Okay.” She goes, “We’re going to start you on some medicine to help with your anxiety. It’s okay. Here you go. Here’s the prescription. Let me know if you need anything.” Again, I had this internal dialogue or story of like, what are people going to think about me having to take medicine after when I’m supposed to be in this most joyous period of my life? I had a lot of shame and frustration.

The internal dialogue with myself was not very healthy. It was not very helpful, even though I did have these various outside people saying like, “It’s good. Let’s try this. Give him a bottle.” After all these things afterward, I was like, “This is good.” I started on the medication. Once that kicked in, it helped with a lot of my anxiety symptoms. We were moving at the time, which I was excited about. A new house that we were thrilled about.

I was getting ready to go back to work, which for me like it was for you, going back to work was a game changer. Being around adults again. It was such a big deal for me to feel like I had that piece of my life back. My relationship with anxiety, I always say, is still a work in progress. It gave me these insights that I didn’t know that I needed so that when I got pregnant again, I was like, “We’ve got to get a plan in place.”

Second Pregnancy

What did you do for that second one? What did you do to make it different? That would be hard to go back and say, “Let’s do this again,” having struggled the first one without some difference in your mind.

I was scared that I was going to experience that same level of anxiety again. It shows I came out of it so much, my kids are three years apart, that I did finally get to a point where I said, “I can do this again. I think we can.” Once I was pregnant, I was like, “We’ve got to get a plan in place because now I’m scared that this could happen again.” I talked with my doctor early on and said, “I had horrible anxiety after the birth of my son. I want to talk about the medication options. What does that look like?”

She did a great job explaining. There are options for medication while you’re pregnant. There are options for medication after you give birth. There are various things that are safe for pregnancy and breastfeeding. She did a good job giving me a good level of information so that I could make a choice about what was going to be best for us.

Honest Communication

We decided that I would start medication after he was born, but literally right after he was born in the hospital. That was in place. My husband knew we were going to do that. I had also talked with my husband about, “You know me. You know that if I start shutting down if I seem closed off if I’m not eating, if I am saying I don’t want to talk about it.” I was like, “You know me. I need you to ask me. I need you to say, are you feeling okay? Are you feeling anxious? Do you need the help?’” I told him. I said, “I’ll be honest, I’m not going to volunteer the information.”

You knew that about yourself this time.

I knew that about myself. Even though I know that I’m not great in those moments of advocating for myself, I can advocate for myself by letting my support circle know, “Here’s what I need you to say to me. I’ll be honest with you, but I need you to ask me about it.” They have to take the first step. I also decided on the second one. I was going to spend a lot more time lying in bed and laying with her. Not trying to do laundry, get outside, and go on walks right away or do too much.

I can't advocate for myself by letting my support circle know, “Here's what I need you to say to me.” I'll be honest with them, but I need them to ask me about it. They have to take the first step. Share on X

We had lots of meals that were paired and ready to go. I tried to have this mini version of that lying-in period that is a common practice in many other countries that I wish they did more of in the United States. Her sleeping arrangements were different. It was like right beside me. I lay in bed. I watched a lot of TV. I did tons of skin-to-skin with her and I had pre-booked appointments with lactation consultants and other support people because I did want to try and breastfeed. I had it all in place before she was born.

It made so much of a difference. I remember medication takes a while to kick in. I had a couple of days postpartum where I remember telling my husband, “My anxiety is through the roof,” but I realized that. It’s not for whatever reason. It’s backed by lots of research. Skin-to-skin with my daughter completely calmed my nervous system. I would lay there for hours and she would lay on my chest. We lay there and I wasn’t trying to do anything else other than that. It started to pass. It was a completely different experience. I had a better success with breastfeeding and I wasn’t going back to work at the time. It was different but it was different because I had planned.

Let me ask this because at the beginning you said something interesting about when you had your first child. The expectations you had in your head of what this was going to be like were very different than reality. How did that play into anxiety? How did your expectations change for your second child?

Pregnancy Pressures And Expectation

Hugely so. I know for myself and probably for a lot of other people who have anxiety, I put lots of pressure on myself. You think that you’re going to do things the way that you see in the movies. We’ve talked about this before, Kelly, where did that expectation come from? What created this image of motherhood?

It’s people we see like friends and our own family. It’s also movies and social media. I had my little rose-colored glasses on thinking it was going to be great and when it wasn’t, the story I told myself is like, “There must be something wrong with you. You’re not doing something right.” That can cause a lot of anxiety, worry, and frustration because I have this whole story that I’m telling myself that it’s my fault.

You’re failing as a mom at that point.

That I’m failing. I’m not doing it right.

Even though as a mental health therapist, somebody who is certified, you know that that expectation probably is not reality going into it.

I know and I was fresh out of grad school. This all should have been top of mind. It wasn’t because it’s all-consuming.

If you can get it and go through those struggles coming right out of becoming a therapist, everybody else also makes sense to have those same struggles who don’t have that background and can easily identify, “These are red flags. These are things I should be paying attention to.” Even though it’s all-consuming, you have a little bit better knowledge than some of us.

Going into it with my daughter, I had the expectation, “This could happen again.” You could feel the same level of anxiety. What are you going to do about it? What can we do to mitigate it? What can we do to help move through it in a much healthier and more supportive way? With the second one, I would say it almost like, I wouldn’t say I lowered my expectations. My expectations were more grounded in reality than my experience matched and in some cases, some ways surpassed them because things did go much better in those initial weeks which was wonderful.

You said you’re first crying was a trigger for you. When you would hear him cry, it would set it off. Was that the same reaction that you had with your second?

It wasn’t. I don’t know if it was I’m taking care of an older child and a baby. My focus was on two. I don’t have all of my focus going into this one child.

That’s a great point.

With her later, the feeding and stuff became another trigger in its own way making sure she was getting enough to eat. Her growth curve started going down a little bit then that was its own journey more like the six-month mark where I experienced another huge spike in anxiety when we were trying to figure out how to switch to a bottle. She was refusing to take a bottle. I bought all the cups, every single cup that exists, and every single bottle that exists trying to figure it out. I later learned in other countries, there are not nearly as many options, which would be great. It’s great when you go into a store and they’re like, “These are the two bottles,” and that’s it. There’s not 500.

We have every bottle you can imagine.

Recognize What Your Anxiety Looks Like

Through the experience, I learned a lot about myself. I learned how to recognize what anxiety looks like and feels like for me, which is so important. When I can recognize it, I become aware of it then I can figure out what I need to do about it. Before and even back thinking my younger self, I don’t think I had that level of awareness of what it feels like and how to recognize it early on to say, “This doesn’t feel good. This doesn’t feel right. We need to make a plan.” That is what going into the second pregnancy and even now.

Let's Thrive Postpartum | Postpartum Anxiety

My symptoms of anxiety are often related to sleep, lots of racing thoughts, and worst-case scenario kinds of things. If it starts to happen, I know. I do a lot of mindfulness and breathing. I lean into that then it passes. That was something so important for me. It is learning how it feels in my body and what to do about it.

That’s great that you know you have that. I’ve said, “This is a trigger. I feel this way. I’ve got tools that I can use mindfulness, meditation, and things that are going to help bring me back so it doesn’t continue to spiral out of control.”

Let's Thrive Postpartum | Postpartum Anxiety

It’s informed my work as a therapist. I worked at a school for a number of years and that was where I worked when I had both my kids. Transitioning into private practice decided like, “I want to work with postpartum moms and families to help them feel better and help them navigate through all of this.” Especially even when I’m working with families, talking about how to create a healthy family dynamic and how for parents, how your mental health often can become your kid’s mental health and affect them. It’s just been a big driving factor for what I’m doing in my work now and I love what I do. I can’t imagine doing anything else.

I love that you can use the experience and what you went through to help other parents not suffer as much, and understand and improve their family outcomes.

Get Educated

What you said to, Kelly, the education piece of it is reducing the stigma through education and through telling people how frequently this happens and how many moms go through this. I forgot to ask you this question. Did any of your friends have a good understanding or idea of what you were going through?

Your mental health can often affect your child's mental health. Share on X

It was COVID, so we didn’t see a lot of people. If you saw me, it would have been very evident. I also didn’t know how to say, “Here’s what I’m feeling and what I’m struggling with.” I didn’t share a lot. I also don’t know that I had an immediately close friend who’d experienced something similar to be checking on the mental health part of it but that was 100% on me. I kept my mouth shut, isolated, and did everything I probably shouldn’t have done. The education piece that you’re talking about, learning here things that will help you is so key in stopping that.

That’s why conversations like this are so important because again, I didn’t say anything to anybody. If you think about most women probably have several people they would consider close friends and good friends. We all know that we’re not talking to each other about it. It’s hard to talk to your doctor about it. Hearing conversations like this and getting more information out there and trying to normalize it is so important.

It is, but I want to come back to something you said at the very beginning. In your experience when you went to your pediatrician for your first child’s checkups and you did the Edinburgh depression scale. They talked to you about your results. I didn’t have that experience. Never. I hope I’m not saying anything wrong because some parts of it are blurry, but you take it 500 times. Every time you go for a first year, you do it. I don’t know that I ever had a single person talk to me about my results. I know my results weren’t great, but also, I probably lied a little bit because I wanted to look better than I felt.

You never put the 100% truth, but it was a good 80% truth. That should have been a flag. I don’t remember anybody ever talking to me about it. In South Carolina, they’re not required to. They’re required to give it to you but not talk to you about it. Maybe I fell through the cracks in certain situations. I love that at least you had a discussion. Somebody in Virginia was saying, “This is a little worrisome.” That gives me hope.

I hear that from so many friends who are like, “I feel this thing out.” I was honest maybe the first time. They’re like, “I was honest,” and nobody said anything. Nobody asked about it, which itself is hard because it takes a lot of being vulnerable on that form when you are in a pediatrician’s office where they’re examining your baby and now they’re evaluating you is what it feels like.

It does. It’s probably also not their specialty. They went to medical school for children. Not your mother’s mental health, but you are vulnerable and you’re saying, “I need help.”

No one says anything. That’s hard. I did have this one pediatrician, I remember she like looked at it and was like, “This is a little concerning.” I said, “I know, I work in mental health.”

That gives me so much hope that there are people out there who do look at it.

Maternal Mental Health

I know. It’s interesting. I interview everywhere I go now. Anyone who touches the world of maternal mental health is better working with babies, I’m always like, “How do you do this? What does this look like in your practice? What questions do you ask?” It’s been interesting just hearing the responses but everyone seems to agree. There is so much more work to be done in this field that people are trying. They’re working on it. People like you but there’s still so much more to do.

There is but I feel like we’re starting somewhere, it can only get better and more normal. That’s even the thing that we can get from this, it’s normal and people don’t talk about it. It reminds me back in the ‘80s before Susan G. Coleman passed away and her sister started the nonprofit. You didn’t talk about breast cancer. It was very taboo, hushed, and shameful.

When they started that nonprofit and it went to the marketing side of, “Let’s normalize this. We should be supporting women.” Your perception of breast cancer and being a survivor and what happens to families in the female all changed drastically. I know it’s a huge way down vision, but that became something for mental health and motherhood depression. All of that where people were saying, “This is real. This is impactful. It is not shameful.” It’s something we should celebrate when we get through it because it’s very normal. More normal than breast cancer. That is one day that people could say, “I survived that and it wasn’t shameful.” It would be amazing.

It is treatable with the right support and whatever that support looks like for an individual person. It is very treatable. We hope that through this show and the work that you’re doing is trying to reach as many people as possible to share the stories, get the word out there, and have some real talk about the not-so-pretty parts of motherhood. There are lots of pretty not pretty parts that people don’t tend to focus on.

It’s the best of the best and the weirdest of the weirdest all at one time. Ashley, thank you for sharing this and getting vulnerable, and walking through what happened. Is there anything that you didn’t ask or what you learned that you would want someone to know from your experience?

Learning for me what I would wish for other moms to know is honest communication with your partner or support network or whoever it is for you. Talking ahead of time and saying, “This is what I want you to ask. This is how I want you to check in with me.” It could be different for everybody, but what do you need to be honest with one person about how you’re feeling? Again, it can be anyone but thinking through, what do you need to be honest with one person? When you’re honest with them, then you’re able to make a plan about how to get more help.

Be honest with your partner or support network so you can make a plan about getting more help. Share on X

You mentioned from the honesty side telling your husband, “I need you to ask me this. I need you to make the first step when you notice this.” Is there anything else that helped you be honest with him or another support person?

Having him ask me.

You knew I couldn’t make the first step. I need you to take the first step.

I will be honest with him, but I needed him to make the first step and to be the person to ask me and check in on a regular basis, how are you feeling? Are you feeling okay? Do you need to go outside? Do you want to go for a walk? Do you want me to hold the baby for a while?

What was a regular basis? Was that once a day? Did he check in once a week?

A couple of times a day. If it’s too much, I’ll say, “You’ve asked me five times. I’m good. It’s good.” I told him to ask me multiple times a day, and especially in those first weeks postpartum, how are you feeling or anything you need? What’s going on? It was so helpful because then I could say like, “I’m not feeling great. What do you want to do? Do you want to hold the baby? Do you want to go on a walk?” I love being outside. Being outside helps me feel better all the time.

For your mental health, it’s so great.

It’s so important. Figuring out how to be honest with one person and having somebody intentionally asking, “How are you?” It feels good. Lots of people ask about the baby. Not a lot of people ask about the mom.

Things I wish I had known when I had friends having babies. Ask about the mom.

Same.

Thank you for sharing this. That’s a huge takeaway for all of us reading how do you start to recognize what this feels like in you? How do you start working on having that open and honest communication with one person? Step one, I need help. Ashley, thank you so much. This was wonderful.

Thanks, Kelly.

Thank you folks for reading. We will see you back here next episode as we keep going on board with other stories and tips and ways you can start preparing and helping support your mental health as you’re going through post-partum depression and anxiety. Hope you have a great week. Thanks. Bye.

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