It's not the baby blues and it's not postpartum depression—so what is it? If you're feeling overly worried after giving birth, you may be suffering from postpartum anxiety disorder. Here's what you need to know.

Postpartum anxiety disorder is a cousin to postpartum depression (PPD) that affects about 10 percent of new moms, according to the American Pregnancy Association. The telltale signs are excessive worrying, racing thoughts, and feelings of dread.

"Some worry is adaptive. Anxiety is a natural response to protect one's baby, and often that's expressed with hyper-alertness and hyper-vigilance," says Margaret Howard, Ph.D., director of postpartum depression at Day Hospital at Women & Infants' in Providence. That's why, according to the Mayo Clinic, 89 percent of new parents find their minds racing: What if the baby suffocates? Or slips under the water during a bath? What if someone breaks into the house and snatches her?

"For most parents, this is just mental noise," says Jonathan Abramowitz, Ph.D., associate chairman of psychology and director of the Anxiety and Stress Disorders Clinic at The University of North Carolina at Chapel Hill. "They learn to dismiss it, so the thoughts stop cropping up."

On the other hand, if your worries are irrational (say, you have an intense fear that your baby will get hurt if you don't hold him), and you can't get them out of your brain, you may be suffering from postpartum anxiety (PPA). This diagnosis becomes a problem when it affects everyday situations (like driving with Baby), if panic attacks come out of the blue, or if it interferes with your ability to function. "Anxiety is a problem when it overshoots reality," Dr. Howard says.

Read on to learn more about how long postpartum anxiety lasts, as well as the causes, symptoms, and treatment options.

Postpartum Depression vs. Postpartum Anxiety

Unlike PPD, which can cause mothers to experience extreme sadness or even disinterest in their newborn, postpartum anxiety symptoms manifest themselves mainly in the form of worry. "You constantly feel worried and on edge," says Sarah Gottfried, M.D., author of The Hormone Cure. "I think of postpartum anxiety as the loss of the normal sense of balance and calm, and postpartum depression as a loss of heart."

Unfortunately, postpartum depression is the disorder that's talked about most, so many moms aren't sure what to think once they start experiencing intense worry. "We call postpartum anxiety ‘the hidden disorder’ because so few moms recognize it and it goes undiagnosed," says Dr. Abramowitz. "It hasn't been discussed or studied much, even though it's a lot more common than postpartum depression."

In a study that tracked 1,024 women during the first three months after they gave birth, researchers from the University of Heidelberg in Germany found that more than 11 percent fell victim to postpartum anxiety disorders, while roughly 6 percent developed postpartum depressive disorders. The two often go hand in hand too—about half of women who have PPD also have anxiety. "If you're anxious and it's getting in the way of your life, you may begin to feel depressed about that and vice versa," Dr. Abramowitz says.

Postpartum Anxiety Symptoms

Like postpartum depression, which can make women feel tired all the time, PPA might also involve physical symptoms. Here are some common signs of postpartum anxiety:

Excessive worry

Feelings of dread

Racing thoughts

Lack of concentration

Changes in eating and sleeping patterns

Dizziness

Hot flashes

Rapid heartbeat

Nausea

For the majority of women, these symptoms kick in sometime between birth and Baby's first birthday—but in some cases they begin much earlier.

"Twenty-five to 35 percent of postpartum anxiety cases begin during pregnancy," says Ann Smith, CNM and President of Postpartum Support International. Smith also notes that, while most women start feeling on edge shortly after giving birth, a particularly stressful life event—or even weaning—can trigger PPA months later.

Postpartum Anxiety Causes and Risk Factors

Postpartum anxiety often results from a variety of triggers, experts say. For starters, "there's a huge hormonal shift—estrogen and progesterone levels increase 10- to 100-fold during pregnancy, then fall to essentially zero within 24 hours of delivery," explains Elizabeth Fitelson, M.D., director of the Women's Program at the Columbia University Department of Psychiatry. In the days that follow, you're dealing with sleep deprivation, changes to your relationship, and new schedules and responsibilities, including round-the-clock care of a newborn. Add to that society's expectation that this should be one of the happiest times in your life, and it's no wonder so many mothers start to come unglued.

While any new mom can develop postpartum anxiety, there are some factors that might increase your risk. These include:

A personal or family history of anxiety

Previous experience with depression

Certain symptoms of PMS (such as feeling weepy or agitated)

Eating disorders

Obsessive-compulsive disorder (OCD)

What’s more, women who have had a miscarriage or stillbirth are more susceptible to postpartum anxiety and depression with a subsequent healthy delivery, according to a study by the University of Rochester in New York, because they're so worried something else might go wrong.

Personality may also come into play: "Moms with postpartum anxiety often describe themselves as Type A, sensitive, or easily worried," says Sherry Duson, a family therapist in Houston who specializes in treating those with pregnancy and postpartum mood and anxiety issues.

How Long Does Postpartum Anxiety Last?

Unlike the baby blues, which last about two weeks, postpartum anxiety doesn't always go away on its own. It's crucial to seek help if anxiety is disrupting your sleep or you're constantly preoccupied with worries. "In moderate to severe untreated cases, postpartum anxiety can last indefinitely," Smith says. "Perinatal mood disorders don't always disappear on their own. In fact, in some cases, if left untreated, they can set women up for a lifelong bout with mental illness."

Fortunately, there are a number of postpartum anxiety treatments out there, but the onus often falls on you to bring it to a doctor's attention. When researchers at Massachusetts General Hospital in Boston screened 491 mothers for postpartum anxiety or depression six weeks after they gave birth, 17 percent had one or the other; yet the majority of them had not been diagnosed.

Postpartum Anxiety Treatment

If you're feeling overwhelmed with worry, tell your OB-GYN or pediatrician. "In mild cases of any perinatal disorder, the first thing that should be tried is a combination of support and therapy," Smith notes. "Sometimes just having someone to talk to or give you a break from baby duties makes a big difference."

You should also ask your healthcare provider for a referral to a therapist who has experience with perinatal mood disorders or a psychologist who specializes in cognitive behavioral therapy (CBT). "It gives you the skills to change the thinking and behavior patterns that lead to anxiety," Dr. Abramowitz explains. For instance, if you tend to think the baby has a serious illness at the first sign of a sniffle, CBT can help you develop a more realistic outlook (could be a cold!). "This isn't about positive thinking," says Dr. Abramowitz. "It's about being rational."

An expert can also teach you relaxation techniques, such as meditation, progressive muscle relaxation, and mindfulness training. Done before bedtime, they can set you up for a good night's sleep. Exercise can also relieve anxiety by helping you feel more empowered, Dr. Howard says. Six weeks of resistance training or aerobic exercise led to a remission rate of 60 percent and 40 percent, respectively, among women ages 18 to 37 with generalized anxiety disorder, found a study done by The University of Georgia.

Do I Need Postpartum Anxiety Medication?

For more severe cases of postpartum anxiety, your doctor may recommend therapy, support, and medication—even if you're nursing. "The use of medications needs to be determined on a case-by-case basis," Dr. Fitelson says. "Your mental health—and your ability to take care of and bond with your child—are so important. At some point they take precedence over the low or theoretical risk to your baby of taking an antidepressant."

If you've taken an antidepressant or anti-anxiety medication in the past and it worked, you might consider starting it again. "Don't try to reinvent the wheel," Smith says. Always talk to your doctor about how a particular medication may affect your baby.