Postpartum University® Podcast

How to Differentiate Between Postpartum Anxiety vs. Normal Motherly Worries | Kathryn Lopez EP 215

• Maranda Bower, Postpartum Nutrition Specialist

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Ever wonder if what a new mom is feeling is just "mom worry" or something more like postpartum anxiety? 

Maranda and Licensed Marriage and Family Therapist and perinatal mental health specialist, Kathryn Lopez, break it down in this episode. We're diving into how to tell the difference between those normal "mama" worries and when it might be postpartum anxiety – think physical feelings, constant unease, and those "what if" thoughts that feel way out of control.

We're tackling those sometimes scary intrusive thoughts that pop into a new mom's head – are they normal, or something to pay closer attention to? And what about feeling down about your old life? Is that just part of becoming a mom, or could it be something more? We even chat about that surprising link between postpartum rage and anxiety. If you're a postpartum pro, you need to hear this to help the moms you work with feel understood and supported.

Check out the episode on the blog: https://postpartumu.com/podcast/how-to-differentiate-between-postpartum-anxiety-vs-normal-motherly-worries-kathryn-lopez-ep-215/

Key Time Stamps: 

  • 01:58: What is Normal Mother Worry? Understanding Postpartum Anxiety vs. Typical Worry
  • 03:38: When Does Mother Worry Become a Problem? Recognizing Unhealthy Postpartum Stress
  • 05:47: How to Differentiate Postpartum Anxiety Symptoms from Normal Maternal Concerns?
  • 09:36: Understanding Intrusive Thoughts Are They Normal or a Sign of PPA?
  • 12:08: The Intent Behind Intrusive Thoughts in Postpartum
  • 15:50: Is It Postpartum Depression or Grief? Understanding Loss in Early Motherhood
  • 16:52: The Grief of Old Life in Postpartum
  • 21:00: How Does the Nervous System Impact Postpartum Anxiety? Understanding Hyperarousal
  • 25:48: Connection with Postpartum Rage and Anxiety
  • 29:43: The Sleep Deprivation Cycle and Postpartum Mental Health

Connect with Kathryn: 

Kathryn Lopez is a Licensed Marriage and Family Therapist (LMFT) and Life Coach who specializes in perinatal mental health and sex and intimacy therapy. She helps individuals and couples navigate the emotional and relational shifts of parenthood, from conception and pregnancy

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Speaker 1:

The postpartum care system is failing, leaving countless mothers struggling with depression, anxiety and autoimmune conditions. I'm Miranda Bauer and I've helped thousands of providers use holistic care practices to heal their clients at the root. Subscribe now and join us in addressing what modern medicine overlooks, so that you can give your clients real, lasting solutions for lifelong wellbeing. Hello, hello everyone.

Speaker 1:

Today we are going to be talking about mother worry versus postpartum anxiety and how to understand the difference, and today we have Catherine Lopez. She is a licensed marriage and family therapist and a life coach who specializes in perinatal mental health and sex and intimacy therapy. Hallelujah, she is helping individuals and couples really navigate the emotional and relational shifts of parenthood, from conception and pregnancy to birth and postpartum and beyond, and she is such a warmth, just brings so much warmth, and such an integrative approach and a safe space for clients to really explore these evolving identities and relationships and self-care. So, just to note, catherine is accepting new clients for online therapy in California and Florida and offers life coaching worldwide. Welcome, I'm so glad that you are here today, because this topic needs more depth and more understanding and you were just the person to share it. Thank you so much, miranda.

Speaker 2:

It's a pleasure to be here.

Speaker 1:

So tell us a little bit about why worry. I think the understanding is that it's such a natural and even protective part of motherhood. But when?

Speaker 2:

does it cross into something that's more concerning? Yes, it's really important to be able to you know, understand and distinguish between these two, because worry, as you mentioned, does serve a biological protective function, right. It has a very important purpose that we often don't think about. There's a reason that mama bear is such a popular term. So there we have something in our minds, after becoming a mom, called the survival biased towards worry, and so I like to kind of unpack that in in saying it's better to assume that a stick is a snake and overreact than to assume that a snake is a stick and underreact. Right, that might cause harm for you and your baby, but if you overreact, then it ensures more survival of the species. So that's a little bit of something that is just helpful, I think, for moms and for my clients to understand that propensity to. You know, maybe feel more hypervigilance, right. Maybe have more worry than they did before, and it can also help to normalize, feeling very different than they did, you know, mentally and physically, than before having baby. So, in terms of distinguishing the difference between the two, I like to break it down to that. Not all stress is bad, right. I've heard you talk about this too, in your various other podcasts. But I you know all there's stress that is positive stress or even good stress. So this is what I will refer to as like normal maternal worry is when we have, if you think of a graph, it's kind of like a sharp spike up and then it comes down pretty quickly. So it's short, lasting stress response that lasts up to about 20 minutes and then subsides. So this challenges our brain and body for short intervals to respond to something that's hard to do or an external stimuli right, that's very important to maybe overreact to or just react to. This could be, for example, studying for a test, kind of that stress you might feel oh, I need to get you know, studying for this test. Or if you're driving in a car and a car in front of you steps on the brakes, you have to respond quickly. So this is a really good and healthy stress response and actually it's good for you to have these stress responses. It can improve your immune system, it can prevent dementia, it improves blood sugar levels. So it's very healthy to have these positive or good stress responses.

Speaker 2:

Now, when it shifts into unhealthy or negative stress responses is when it's more of a pattern of worry or an ongoing chronic worry bit. So if you think of a graph again, instead of a spike up and then down, it's more like a squiggly line. It just goes up and down and up and down, uh, where there's not one identifiable threat that you're responding to, and then you come back down to baseline, rather a constant state of worry, and so we're not meant to be in a constant state of worry. This is where it's not good for us anymore. So you know, this could look like, for example, reading the news and then a coworker is mad at you and you get not a great text, and then you forget to pay a bill and you remember it and you're just under kind of this constant feeling of stress. Other ways, you know.

Speaker 2:

Other things I like to point out in terms of a healthy worry versus more of an anxiety sensation is that worry tends to reside in our minds versus anxiety affects both our body and mind. Worry is very specific about one thing versus anxiety is more general and can be vague. Worry is grounded in reality often, while anxiety is marked by catastrophic thinking. Worry is also quite temporary, right? Whereas anxiety is more long lasting. Right, whereas anxiety is more long lasting.

Speaker 2:

And then, lastly, worry doesn't impair our function, whereas anxiety does, and so these are pieces to make note of and to reflect upon your experience. And then the last thing around how to distinguish between the two that I do want to point out is a good way to kind of decipher this is if you're trying to make a decision and you're wondering am I coming from a worried state that's useful and serving me, or actually an anxious state is pausing for a moment, getting curious about where's this coming from, and then then noticing am I trying to set a healthy boundary with something which is more indicative of worry, right, such as, maybe you're worried to cross the street without holding your child's hand, so you're gonna hold their hand because it feels safe to you, and then the worry away? Or is your decision being made more from an avoidance standpoint? Right, that's more indicative of anxiety driving that decision. So these are just some pieces to think about when trying to decipher the difference.

Speaker 1:

There's so much to unpack here. I am so grateful for this conversation because it seems like to me, you know, anxiety seems to kind of fly under the radardiagnosed. Because? Is it because of this misunderstanding of the difference between worry and actual anxiety?

Speaker 2:

That's a good question. You know, they often say that postpartum anxiety is the little cousin to postpartum depression. Right, I think postpartum depression or postpartum OCD has gotten a lot more hype, a lot more attention, whereas I think it's been challenging for some people to differentiate. Is this just normal maternal worry? A lot of more anxious tendencies in postpartum, I find, get incorrectly normalized, right? It's that that dynamic between is something common or is it normal?

Speaker 2:

And very often, when working with clients, they'll think that certain you know, anxious tendencies and feelings that are interfering with their quality of life are just normal when they're not. But they are very common in our culture and in this day and age, when, for me, I really see it come back to a lack of support for new moms, right, and when it all lands on them and when they believe and see, especially through social media, that the norm is do it all and be perfect at it, and if you're not, something's wrong. So I think there's been an incorrect kind of example put out there and I think that contributes a lot to it.

Speaker 1:

I'm really glad that you said this, because I talk about, you know, the difference between commonality and what's normal in our society all the time, and I wasn't expecting to ask you this. But I'm really curious because that falls under the same line of intrusive thoughts. Right Over 80% of women in the US experience gut-wrenching, awful intrusive thoughts that feel so out of control. What is your take on that and how does that fit into this conversation?

Speaker 2:

Yes, take on on that. And how does that fit into this conversation? Yes, so intrusive thoughts are one of those things that I think is very important to unpack when working with your clients, especially during postpartum, it can be something. So there is an element of intrusive thoughts that are normal for new moms to feel because of that, you know hormones shifting drastically, often sleep deprivation, unfortunately. But then those neurological shifts right, the pruning that's happening with the prefrontal cortex and and making space for the bonding and attachment with baby and that protective function of the negativity bias towards worry.

Speaker 2:

There's a piece of if you have intrusive thoughts that are occasional and fleeting, that's normal and that makes sense to keep your baby safe and healthy and responding to them Right. But it's when, when they become more associated and connected with anxiety is when the frequency and the distress of them is so intense that it's interfering with your daily life and sometimes even triggers intense fear or physical anxiety symptoms like racing heart, nausea, panic I hear these things come up in regards to intrusive thoughts. This is when it's important to you know, seek help to work on that more. So it's really to work on that more so it's really once again turning inward and getting curious with if you're the new mom or if you're a professional working with new moms, exploring what's underneath these intrusive thoughts. Where are they coming from? How intense are they? How frequent are they?

Speaker 2:

Another piece that I rarely hear being talked about regarding intrusive thoughts is around the intentionality behind them. Right, so there's ego-syntonic intrusive thoughts, which means the intrusive thoughts are in alignment with what you want to do and in alignment with what you want to do and you know your beliefs. This is a big red flag, right? If a new mom is talking about intrusive thoughts and that you know they're kind of appealing in a in a weird way and she doesn't understand that, that's something to really you know, get clear about and help her get further help.

Speaker 1:

Is this? Is this still like for those and I've seen this fairly frequently and I'm not trying to call out anybody, but I see those who have like Instagram posts where they're they develop a whole persona around being this mom who experiences X, y, z and they're they become really attached to it. Is that very, very similar?

Speaker 2:

I'm not quite sure. I haven't seen that myself, but that sounds like something I would definitely if that was my client. I'd want to explore further. Right, like is the response to that? Helping them and serving them, or is it coming from this kind of anxious place? Is it interfering with their quality of life? It's a good, good indicator.

Speaker 1:

Usually what I've seen in that is like these moms and I've seen so many over the last years of you know, 15 years plus working with moms, especially in social media and all of the things and they have like, well, this is what I'm experiencing and nobody's gonna help me. I'm in it all by myself. This is what I'm experiencing and nobody's going to help me. I'm in it all by myself. No matter what you do, no matter what you give me for free, I will not accept, because this is who I am and this is how I've built my entire identity and how I connect with other people. Like it's a whole thing. And so when you said that, that, that egocentric kind of aspect, it really made me think of that, and, of course, I feel like that's definitely not always the case. Obviously, it's a very minute um, uh, you know population but I also believe that like we have to be careful and watchful of things like this.

Speaker 2:

We do.

Speaker 2:

And it's interesting you talk about that identity piece because another component that is a big part of my work with clients and new moms is around that identity shift into new motherhood Every single time you have a new baby of matricence right, it's the signal it's, it's like adolescence but in a shorter amount of time, where you have intense hormone, physical, mental, emotional, neurological shifts that are happening and there's kind of maybe if some people are identifying with this new version of themselves right, a mother is born when a baby is born as well, and kind of take it and run to try to feel a sense of control or mastery over it. Yes, yeah, it can be very nerve wracking and feel like you're kind of floating and alone and who am I now? And that is something that takes time and postpartum I'd say at least a year, if not two, to get to know the new you and to grieve the old you that is no longer here.

Speaker 1:

Okay, let's talk about grief. Did not expect to talk about this. You know a lot, a lot of the times when I was working with moms back in the day. There was a very subtle yet distinct difference between I'm experiencing postpartum depression and I'm experiencing the process of grieving, grieving my relationship with my partner that is now different. Grieving the fact that I am not able to enjoy the things that I used to now because I have a baby and it's harder to go to, you know, photography class or harder to go paint, or, you know, whatever the case may be grieving. You know your old life and who you felt you were before as you made this transition into motherhood. Can you speak a little bit about the difference between the two? Like, let's unpack this. Oh my gosh, I'm so excited.

Speaker 2:

Yes, me too. No, it's very important. So grief is not only very healthy and important for us to do, it is a natural process, right, of growth and change. And you knowhood, becoming a mom, whether it's the first time or another time, you know, second, third time it's a new phase of life where the phase that you were coming out of is done right.

Speaker 2:

With anything, there's a beginning, a middle and an end, and it's hard for us to feel that, right, it's hard to experience these, the change. Um. So, but to answer your question, more, around postpartum depression, I think I really look for a sense of hopelessness. That sense of hopelessness is often very thick within postpartum depression. It's not just grief I wouldn't say is necessarily indicative of postpartum depression, right, grief is, it can correlate and it can lead to if it's not processed correctly. But grief is important to make space for and it takes as long as it takes, right, and it's incredibly common for moms to grieve their old life, to grieve, oh man, on a Friday night at 9 PM, I used to be doing different things than burping the baby at home. Right, and that's okay, right, but really coming to peace with that being a process of being a mom is, in my opinion, to be expected.

Speaker 2:

You know it's more for some than others, and that's okay. But it is a healthy phenomenon. That doesn't mean that you have postpartum depression at all.

Speaker 1:

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Speaker 1:

I see so many moms who struggle with oh my gosh, I'm, I'm crying a lot, I I feel frustrated, I I feel like I'm thinking about my old life and it makes me wonder if, why am I being, why am I a mom, and is this really what I wanted? And then they start there's and I see this too with intrusive thoughts. Right, all of a sudden, there's these thought patterns that emerge and these questions that we were asking. And then, all of a sudden, those additional thoughts that we have to it. Is this really what I wanted? Am I even really a I wanted? Am I, am I even really a good mom? Maybe I wasn't cut out for this? Uh I, I really miss my old life.

Speaker 1:

And then you start to panic a little bit. Oh my gosh, I can't believe I'm asking myself these questions. And then you, what happens is that nervous system starts to go into overdrive, right. And the same thing happens with intrusive thoughts. You're like oh my gosh, I can't believe. I just had that thought I'm a terrible human being, how in the world? And then it just spirals out of control.

Speaker 2:

Yeah, I think it does spiral out of control, and partially because we're not moms. Don't hear about these pieces that are a part of motherhood. Right, it's not necessarily sunshine and rainbows which is often the picture that's painted, and if it's not sunshine and rainbows, something's gotta be wrong. No, I would say that elements of intrusive thoughts and grief whether it's a small amount or intense, or questioning did I make the right decision? This is so intense, Can I do this? That's all to be expected, and I see that come up more than less.

Speaker 2:

And one thing with that I think it connects back into the importance of having support, whether that's from your family and the women in your family, or friends or mother's groups. I have found to be so helpful to just sit with other moms who are going through these same phases of new motherhood and matrescence and navigating it. You know, seemingly it feels like you're blind navigating through it because it hasn't been normalized and talked about enough, right? So if you can surround yourself by people who've done it before, who are in it with you, or even you can just help lighten the load of all the new responsibilities and roles that you are doing, the better.

Speaker 1:

Hmm, isn't it interesting how I feel like from new moms, we kind of paint this picture of like, oh, this is going to be such a beautiful period and, you know, enjoy it while it lasts and motherhood is fabulous. And then you get into the throes of motherhood and you're like, whoa, how come no one had told me I'm feeling all of these things. And then it's kind of like a gotcha now, like, and everybody's, everybody's like, yeah, of course. Well, you're a mother, you can expect to feel like crap. You, you know, expect to feel awful. Isn't it such an interesting shift that we have in our society where it's like, once you're in it now, it's like, oh, of course, this is just normal and how motherhood goes. But before it is, it's like, oh, it's such a beautiful thing and you're going to love it.

Speaker 2:

I know, I know it's. I think that is a great disservice to people and that's a big reason I love to be able to have the opportunity to work with you. Know, expecting moms or couples during pregnancy or even preconception. Right, Thinking about family planning to really demystify those ideas. Right To talk about, you know, the good, bad and ugly or different experiences that many people have. Right To speak to that, because then it's less of a shock. Another piece, though, that comes up while you were saying that is the paradoxical nature of parenth shock. Another piece, though, that comes up while you were saying that is the paradoxical nature of parenthood right, there's so often it is so beautiful and amazing and there are pieces that are sunshine and rainbows and simultaneously it is so hard and so messy and so raw and we just want to break right. But it's that both, and almost all the time, almost all of it, at least in my experience.

Speaker 1:

Yes, yes, that is motherhood. And also, I think, you know, if I look back at life in general and the things that I have thought and experienced and have gone through, and what other people have as well, Like, I think it's a sign of maturity to be able to hold two opposites in one space. Right, and we use that as a means of um determining whether or not somebody is mature and in a professional sense. Right, Like, and I think it just motherhood, like takes that level of and that ability to, to weigh above and beyond what we have ever been, you know, used to in the past. So I have a quick question for you, because I know this, it comes up so often and you know, as providers, like we are very well aware of how much rage is connected to anxiety. Can you tell us what's happening here? Why are those two so connected?

Speaker 2:

Yes, so postpartum rage isn't always indicative of anxiety, but when rage stems from chronic stress, hypervigilance and a constant sense of overwhelm, it's a good indicator that it is connected right.

Speaker 2:

So it's really important to kind of unpack where is this coming from? When is it triggered? So, for example, when someone is feeling constantly on edge and easily triggered by small things, right, that's something I I noticed comes up when I'm working with clients who are struggling with postpartum rage. It's like they snap so kind of, they feel so easily right and so quickly where it doesn't seem to match what's going on or a strong need for control that when they feel out of control it leads to frustration when things aren't going as planned, things right, or even racing thoughts and a difficulty to calm down where it can just escalate and escalate and become so overwhelming that you know just kind of your lid bursts, right, that feeling. And then postpartum rage also can. There can be physical symptoms the racing heart, shortness of breath, muscle tension, right, all these pieces. So, yeah, it's often a reaction to feeling overstimulated, under supported or out of control.

Speaker 1:

Yeah, yeah, so true, so true. I remember distinctly having this experience myself. I remember being in the kitchen and I was listening to music and I was actually having like a really good time. And so I thought I was having a really good time and you know just like life was happening, and I was cooking a great meal and then my toddler spilt a giant cup of water that somebody left on the floor next to a toddler Right, and I lost my mind and it felt so out of control I I didn't know how to stop myself. And then, of course, the guilt and the shame that comes from.

Speaker 1:

You know, after going through that experience of rage, I think that was a really defining moment in my motherhood of recognizing okay, it's time that I need to do something about this.

Speaker 1:

This is not okay when I'm affecting my entire family. You know, and I and I know so many moms who've experienced things that are very similar, and one thing that I recognized through that process is that, although I felt like everything was fine, it was because my nervous system was already so heightened that I couldn't even tell that it was so heightened because that was a normal state for me, that that was like a constant. I'm operating with my nervous system on edge so much that I don't even understand that there is a level below that and more peace and ease and and rest that comes after that. Um, and it's interesting, like when we're so stressed and we that becomes a normal in our life that it's hard to understand what it means to not be stressed, that we think we're not stressed when really we are just like we are on edge, right right, and then, as new moms, the the propensity, the the ability to be more on edge or more stressed is greater.

Speaker 2:

Right, because those pieces of hyper vigil, it's that kind of negativity bias towards worry. It has that biological function that back in the day it served us very well, but in this day and age we have to be very careful that that doesn't kind of take over, right? So being very mindful of you know, while having a good day and feeling I'm feeling normal, I'm feeling good, and then it can just hit you right From seemingly nowhere, yeah, right, it. Also, when you were saying that it makes me think of something I like to provide a lot of psycho education around with my clients is around the sleep deprivation cycle.

Speaker 1:

Yes, tell us all deprivation cycle?

Speaker 2:

Yes, tell us all, because that's one thing that you know.

Speaker 2:

Within new motherhood and the early days with a baby, it's so challenging with feeding baby, changing diapers, all these pieces, with getting enough sleep. But when we miss, when we miss sleep, we don't get adequate sleep. Our body increases alert or stress hormones, like adrenaline and cortisol, to be able to carry us through the next day right, not fall asleep on the job. But that gives us then a heightened sense of agitation, which then can just feel normal when we have day after day or night after night without adequate sleep. It's that kind of wired feeling or over caffeinated feeling where you know you're not feeling great but you're managing right and you can get through.

Speaker 2:

This. Like increased alert hormones can cause insomnia, whether that's a difficult time falling asleep that next night or staying asleep that next night, right. So you have often a startle response that really clicks on quite easily. I say all this because it can be a vicious cycle that can repeat itself again and again and kind of unknowingly put a lot of moms into a deeper hole of sleep deprivation and of heightened agitation and can lead to more postpartum rage behaviors.

Speaker 1:

Right, yes, yes, yes, thank you. Thank you for this. This has been such a beautiful conversation and I am so grateful for you. Where can people reach out and find you?

Speaker 2:

Of course. Yes, my website is the best place to find me. It's katherinelopeztherapycom, and Catherine is spelled K-A-T-H-R-Y-N, and I have a contact sheet on there, so that's the best place to find me at this time. And you know, I love working with individuals and couples going through the postpartum period, whether it's preconception, pregnancy, right around birth or even postpartum Um. So, whether it's just for a few sessions or longer term, I really support new moms and families to talk to people because we're social beings. Right, we need that support. We need that help. So I hope to be a support to anyone out there who is feeling that need.

Speaker 1:

Thank you. Thank you so much. Thank you, miranda. Thanks so much for being a part of this crucial conversation. I know you're dedicated to advancing postpartum care and if you're ready to dig deeper, come join us on our newsletter, where I share exclusive insights, resources and the latest tools to help you make a lasting impact on postpartum health. Sign up at postpartumu the letter ucom which is in the show notes, and if you found today's episode valuable, please leave a review to help us reach more providers like you. Together, we're building a future where mothers are fully supported and thriving. Thank you.

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