Scary Thoughts Postpartum

Trigger Warning: In the following article examples of disturbing thoughts or scenarios are described. These may be triggering to some, and have been distinguished by the use of italics. If you are concerned about reading these examples, we encourage you to read the rest of the article to find information about ways you can get support.

My 3 week old daughter is cradled in my arms as I make my way out the door and down the stairs to where my car is parked. As I’m walking down the stairs, I look down at her, and an image of tripping and falling on top of her at the bottom of the stairs flashes in front of me. A wave of panic flows from the pit of my stomach to my hands, and I have to stop because now I’m actually afraid I might lose my grip. 

It’s the middle of the night, and my newborn son is finally asleep after a particularly rough night-time feeding. I lay in bed, close my eyes, and try to force sleep to come because I know I probably have an hour or two before the next feeding. The thought “what if he stops breathing” pops into my mind. I’m exhausted, and desperately try to push the thought away. I recall how I had fantasized about escaping to a hotel room just the other night, to leave my baby and the relentless cycle of feeding and soothing, and shame envelops me.  I sit up and stare at my son, and glance over at my sleeping partner. I feel the pit of resentment settle into my chest.

Our mind is complex and powerful. It can help us plan for the future, learn from the past, and make sense of our experiences. With our mind, we can imagine all sorts of scenarios, and the imagination has been the birthplace of many human accomplishments and developments!  In addition to our mind’s creative ability to imagine literally anything, it can also take our thoughts to scary or disturbing scenarios. While scary thoughts can be rooted in serious mental health disorders, they can also be a very normal human experience. In fact, these thoughts or images can be our brain’s way of protecting ourselves and the ones we love.

Becoming a mother drastically increased my sense of vulnerability. I felt a deep desire to keep my baby safe, while also feeling completely exhausted and overwhelmed by the new role and the tasks of caring for a newborn. While I knew that scary thoughts that seemed to come out of nowhere were a common human experience, the shame and fear of letting anyone know that I was actually experiencing them in postpartum kept me silent for far too long. Fortunately, I eventually opened up to a friend who had also recently had a baby. She shared her own experience with these types of thoughts, and through the power of connection I was able to take steps in shifting the impact of these experiences.

Scary thoughts and images during the postpartum period are a very common symptom that can be experienced by both moms and dads. The word symptom is critical here. They are not YOU, they are a symptom. Our brain’s job is to protect us, and sometimes it does this by identifying the worst case scenario, focusing on horrible stories or situations, and/or ruminating over ways that you, your baby, or your loved ones might get hurt. Most often they are NOT an indicator that you are going to hurt your baby, but you still deserve help and relief is absolutely possible. 

Tips for Overcoming the Overwhelm of Scary Thoughts

Here are some things you can do to find relief:

Develop a new relationship with your thoughts.  

Thoughts are simply that, thoughts. They are a part of our human experience that allows us to make sense of the world around us. Giving birth to a baby can put a mother’s system on high-alert, which makes sense from an evolutionary perspective! The mamas who were on high alert had a higher chance of protecting themselves and their baby. Yet, sometimes this elevated alertness or anxiety can surpass its level of helpfulness, producing an intrusion of scary thoughts, potential scenarios, or images.

With this in mind, we want to begin to develop a new relationship with our thoughts. Just because you have a thought, does not make it true or realistic. Getting hooked by our thoughts and spiraling isn’t productive and can pull us out of being present with what actually matters most to us. Begin to look at thoughts as data or information that your mind is trying to share with you. 

Name it to tame it.

One step you can take to develop a new relationship with your scary thoughts is to name and externalize the thought. Dr. Dan Siegel, author of the book “The Whole Brain Child,” has identified that when we name our emotions or thoughts, we can tame our physical response. 

“Ok, I’m having the thought that ______.” 

“Alright Anxiety, I see you’re trying to tell me that I value safety and security.”

Create mental space.

Breathe. Taking a moment to breathe can help us create space and a pause between the triggering thought and what we are going to do next. By creating some space between the triggering thought and how you choose to respond, you give yourself a chance to reclaim agency over HOW you are going to respond. Instead of being driven by your thoughts and the emotions that come with them, taking a pause puts you back in the driver’s seat.

Identify the data the thought is offering.

Feelings, thoughts, images…they are not FACTS. They are data. It’s very possible that the data the thought or image is offering you is that you want to keep your baby safe, or that you’re feeling out of alignment with your values or that you thought the experience of becoming a parent would be different. Maybe it’s just offering data that you need better boundaries with watching the news, or scrolling social media. It’s also probably offering you data that you may need rest, a break, or help. 

Respond to the thought or image with compassion.

Flexing the mindfulness muscle by noticing and naming the thought can help create enough space for you to respond in a more productive way. Try saying: “I’m having the thought that _______. Thank you brain for this data, some pieces are helpful, some of it is unrealistic or not helpful. The way you’re delivering this data is probably going to lead me to spiral and suffer. So, I’m going to take what’s helpful and move forward.” 

I know this might sound weird/awkward at first, but externalizing the thoughts/images and creating space between you and them has been proven to be highly effective at changing the way we respond in really meaningful ways. You will also get to a point where creating the mindful space between thought and response will be easier and happen quicker.

Talk to someone. 

Identify someone who you feel comfortable with and who can hold space for you. Talk to them, bring these thoughts out of the shadows and into the light. Spend some time with your social support circle…who has earned the right to hold space for your vulnerable experiences?

Prioritize sleep.

Research shows that sleep deprivation can heighten symptoms of anxiety and depression in postpartum women. Getting restorative rest is a huge protective factor. Make a plan with your support system to try and get at a 4-5 hour stretch. If you’re needing more support, reach out to a lactation consultant or baby sleep consultant that feels aligned with you and your needs.

Get professional support. 

Speaking of support….you may need more support if these thoughts or images are experienced with other symptoms such as hopelessness, difficulty concentrating, changes in appetite and difficulties with sleep (beyond the newborn sleep patterns), hypervigilance, stomach aches/headaches, avoidant behaviors, suicidal thoughts, numbing behaviors, disassociating or disconnecting from those around you, and more. 

These are treatable experiences, you are not alone, and you deserve to feel better. There are so many wonderful professional support resources out there to help you. Postpartum Support International (PSI) is an amazing organization and website with resources, a helpline, and a directory to find providers and support groups in your area. You can also visit Psychology Today, a website with a directory where you can find therapists, psychiatrists, and support groups based on your insurance and presenting issues. If you’re looking for a therapist that offers a lower fee, Open Path Collective is a great resource where you can find clinicians that offer low fees for counseling (between $30-$60/session).

When are scary thoughts potentially a symptom of a Perinatal Mood and Anxiety Disorder (PMAD)?

While many new parents are likely to experience the occasional scary thought or disturbing image, there are some cases when these symptoms are pointing to something more serious. Scary thoughts can be a symptom of Perinatal Mood and Anxiety Disorders and PTSD connected to trauma from pregnancy, birth, or the postpartum experience. Here are some examples of scary thoughts that can be associated with Depression, Anxiety, and PTSD:

• Depression example: “I keep imagining driving to my in-laws house and handing the baby over, because she would be better off.”

• Anxiety example: “I can’t stop picturing the nanny walking down the stairs and falling on my baby.”

• PTSD example: “I keep having flashbacks of pulling my baby out during the birth, and feeling like I was choking him.”

When are scary thoughts potentially a symptom of Perinatal Obsessive Compulsive Disorder (OCD)?

OCD is a diagnosable mental health condition that falls under the umbrella of Anxiety Disorders and can be experienced in postpartum. According to Postpartum Support International (PSI) around 3-5% of new parents experience symptoms of OCD during the perinatal period (pregnancy and postpartum). You do not need to have a prior diagnosis of OCD to experience perinatal OCD, but a prior diagnosis does put you at higher risk. OCD includes disturbing thoughts or images that can feel like they come out of nowhere. These thoughts or images are highly disturbing to the parent, persistent, repetitive, and can be paired with compulsive behaviors such as rituals, avoidant behaviors, and behaviors that are connected to control such as cleaning, checking, and counting. If any of these symptoms resonate with you, it’s important to seek support from a professional so that you can better understand what you are experiencing and so that relief can be found.

When are scary thoughts an emergency that calls for immediate action?

If the thought is disturbing to you, feels inconsistent with your values, and you are afraid of the thought or image happening, these are real protective factors for both you and your baby and indicators that what you are experiencing is not postpartum psychosis. According to Postpartum Support International postpartum psychosis occurs in approximately .1-.2% of deliveries and typically occurs in the first 2 weeks postpartum. In this situation the delusions or beliefs make sense to the parent, and can lead to real safety issues or dangerous actions. This is a life-threatening emergency where immediate help is indicated (such as telling someone what is happening and that it is an emergency, calling 911, going to the nearest emergency room, or calling a local crisis line). 

More Resources

Many times these scary thoughts can make us feel tremendous guilt or shame. Guilt is the feeling of “I’ve done something wrong,” whereas shame is the experience of believing “There is something deeply wrong with who I am.” If these feelings sound familiar, consider a resource like this Mom Guilt Workbook.

Interested in learning more about scary thoughts in postpartum? Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood by: Karen Kleiman, MSW and Amy Wenzel, PhD. is an informative and authentic book that dives deep into this experience.