Postpartum Anxiety & Hormones: What Your Doctor Might Not Know
Postpartum Anxiety (PPA) is extremely common in new moms, and also under-treated. PPA is a perfect storm of hormone changes, nutrient depletions, and stress. Learn all about how nutrition can make you feel like yourself again.
February 4, 2025
We hear a lot about postpartum depression, but postpartum anxiety? Not so much. While both involve mood struggles, postpartum anxiety feels more like your brain is stuck in overdrive—racing thoughts, constant worry, and sometimes a chest-tightening dread that makes it impossible to relax.
If you’re in crisis, first things first: you are not alone, and help is available. If your anxiety is making it hard to function, or you’re experiencing intrusive thoughts that scare you, reach out to your doctor, a therapist, or a crisis support line ASAP. You deserve support.
But if your doctor dismissed your concerns with a casual “welcome to motherhood” or a “sleep when the baby sleeps” (excuse me, what sleep?), or gave you a prescription you’re not quite ready to fill, stick with me. Because postpartum hormones, nutrition, and lifestyle factors all play a massive role in how you feel, and there are real solutions that can help.
What is postpartum anxiety?
Postpartum anxiety (PPA) is an excessive, often irrational fear or worry that can interfere with daily life. While some level of anxiety is expected after childbirth (because, you know, you’re suddenly responsible for keeping a tiny human alive), PPA goes beyond the typical "new mom worries." It’s the difference between “I should check on the baby before I go to bed” and “I physically cannot sleep because I need to watch my baby breathe all night.”
Symptoms of postpartum anxiety
Racing or ruminating thoughts, constant worry
Feeling like something bad is going to happen (even without reason)
Physical symptoms like a racing heart, nausea, dizziness
Panic attacks
Insomnia (not just because of the baby waking you up —your brain literally won’t turn off)
Hypervigilance (needing to check on the baby constantly)
How PPA differs from PPD
Postpartum depression often includes sadness, low energy, feelings of hopelessness, and trouble bonding with your baby. Mom rage, irritability and extreme fatigue fit this diagnosis as well.
Postpartum anxiety is more about excessive worry, restlessness, and a constant feeling of being “on edge.” This can also look like insomnia, panic attacks, obsessive thoughts or behaviors, and extreme overwhelm.
Many moms actually experience both at the same time. Because why have one when you can have both, right? 🙃
What causes postpartum anxiety?
A diagnosis of generalized anxiety pre-pregnancy (or even a tendency towards running anxious) is a risk factor for PPA.
While every mom’s experience is different, there are four major physiological contributors to postpartum anxiety:
1. Hormonal shifts: The postpartum rollercoaster from hell
Your postpartum hormones take a massive nosedive immediately after birth. Estrogen and progesterone levels, which were sky-high during pregnancy, plummet in the first 72 hours postpartum to menopause levels. Yikes.
This drop directly impacts:
Serotonin, your brain’s “feel-good” neurotransmitter, which regulates mood.
GABA, a calming neurotransmitter that prevents overactivity in the brain (aka, prevents anxiety and helps you settle into sleep).
Cortisol, your stress hormone, which keeps you in hypervigilent fight-or-flight in response to sleep deprivation, postpartum recovery, and the stress of parenthood.
Postpartum hyperthyroid is under-diagnosed but happens in 5-10% of new moms. Anxiety and insomnia are two of the common symptoms.
For many moms, this sudden withdrawal of hormones leaves them feeling emotionally unhinged, panicky, and unable to regulate stress properly.
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2. Blood sugar crashes: The anxiety trigger no one talks about
OK you’re postpartum, so chances are you’re skipping meals, living on coffee, and forgetting to eat real food—all of which can trigger blood sugar instability.
When blood sugar crashes, your body releases cortisol and adrenaline, two stress hormones that can mimic anxiety symptoms: racing heart, dizziness, irritability, and even panic attacks.
I typically see these crashes happen in the late afternoon (3pm-ish) or even overnight.
Stable blood sugar = more stable mood and energy.
3. Sleep deprivation: The anxiety amplifier
Lack of sleep makes everything harder, including anxiety. Chronic sleep deprivation increases cortisol levels and reduces your brain’s ability to produce serotonin and dopamine, two key neurotransmitters involved in mood stabilization.
This means:
Less ability to handle stress
More exaggerated emotional responses
Increased anxiety and irritability
And no, your body doesn’t just “adjust” to sleeping in 2-hour increments. The longer we go without uninterrupted sleep, the worse this gets.
4. postpartum Nutrient depletion: Because making a whole human takes a LOT out of you
Pregnancy and breastfeeding drain your body of key nutrients like magnesium, B vitamins, omega-3s, and iron, all of which are essential for mental health. We have tons of research data showing deficiencies in these can make anxiety significantly worse postpartum.
Let’s talk more about this.
The link between nutrition, inflammation & postpartum mental health
Your brain requires certain nutrients to function properly. If you’re low on key vitamins and minerals, your body physically cannot regulate neurotransmitters and hormones effectively.
How nutrient deficiencies impact inflammation & anxiety
Low magnesium → Increased stress, poor sleep, and heightened anxiety
Low omega-3s → Reduced serotonin production, leading to low mood
Low iron → Fatigue, brain fog, and increased panic symptoms
B vitamin depletion → Nervous system dysfunction, irritability, and depression
The gut-brain-inflammation connection in postpartum moms
Fun fact: 95% of serotonin is produced in the gut. If your gut health is off (thanks to stress, antibiotics, or a poor diet), your mood and anxiety will suffer.
Chronic inflammation damages gut bacteria, further disrupting serotonin production and contributing to postpartum anxiety.
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Top nutrients for postpartum anxiety
What you eat in postpartum matters! I know this season is a time of “barely scraping by” - but at a bare minimum, eating 3 large meals per day and including the following foods whenever possible can dramatically improve your PPA. As a dietitian who works with new moms, I have seen dietary changes work even better than anxiety medications on many occasions. That doesn’t mean you should throw out your prescriptions (more on that later) - but it’s important to know that food can be medicine too.
Blood sugar balance & anxiety: Why stable glucose matters
Blood sugar crashes are a common anxiety and panic attack trigger.
If you experience more anxiety in the afternoon (around 3pm), this is something to consider.
Prioritize protein, slow-digesting-starches, and healthy fats at every meal.
Avoid ultra-processed snacks that spike and crash blood sugar. Or at least pair those cookies with some protein.
Omega-3s for brain health: How DHA & EPA support mood
Omega-3s are needed for baby’s growth and development, both during pregnancy and breastfeeding. So if you are not getting enough from diet, you become quickly depleted.
Found in fatty fish, grass-fed meats, fish oil supplements.
Supports serotonin production and reduces inflammation in the brain.
Magnesium for stress & sleep: The calming mineral
Magnesium helps regulate GABA, the brain’s natural calming chemical.
Found in fish, nuts and seeds, dark chocolate (you’re welcome), and leafy greens.
B vitamins for energy & nerve health: Why B6 & B12 are crucial
Needed for serotonin production and nervous system regulation.
Found in eggs, meat, and leafy greens.
Iron & postpartum fatigue: How low iron can worsen anxiety
Low iron levels can make you feel wiped out, anxious, and mentally foggy. Iron deficiency anemia also can worsen panic attacks.
I have seen many cases of postpartum depression actually be undiagnosed iron deficiency. Always get this tested.
Best sources: grass-fed beef, liver, dark meat poultry. Supplements are often needed.
Foods that help vs. foods that make PPA worse
Best foods for postpartum anxiety
Fatty fish (salmon, sardines)
Leafy greens (spinach, kale)
High-quality protein (chicken, eggs, beef)
Nuts & seeds (almonds, pumpkin seeds)
Probiotics (yogurt, kefir, sauerkraut)
Foods to avoid or limit for postpartum anxiety
Too much caffeine (or coffee on an empty stomach) - this fuels cortisol surges and exacerbates anxiety.
High sugar foods – leads to blood sugar spikes, and then crashes. If you need a treat, always pair with a high protein + fiber food to limit the blood sugar activity.
Ultra-processed snacks – we all know we shouldn’t have too much of these! For anxiety in particular they are nutrient-poor and inflammatory, and displace more nutrient dense foods.
Should I do medications, nutrition, or therapy for postpartum anxiety?
Ah, the question that makes the most people angry on Instagram.
Instead of thinking in ors, let’s think in ands.
I’ve seen nutrition and supplements be life changing for moms with anxiety. These work even better when we are also doing talk therapy with a perinatal therapist to work through the more “external” causes of anxiety.
And I’ve seen medications pull moms who are really struggling out of the depths so they can breathe again.
Some patients start with meds, and then implement nutrition changes with the intention of weaning off (with their prescribing provider’s support).
Some patients start with nutrition and supplements and realize they need something stronger; some start their nutrition protocol and realize they feel better.
There is no right answer, just the answer that works right for you, right now. And know that the right treatment can evolve and change over time.
Just like we don’t get a prize for laboring without medications (still waiting for my medals 9 and 7 years later), we also don’t get any prizes for suffering through anxiety and depression if meds, nutrition, and/or therapy are the right course for us.
The big picture
If you’re struggling with postpartum anxiety, know this: it’s not in your head, you’re not failing, and you’re not alone.
Inflammation, hormone shifts, and nutrient depletion all play a role in how you feel. The good news? Small changes—like balancing blood sugar, reducing inflammation, and getting the right nutrients—can make a huge difference. Sometimes that’s all the difference we need, and sometime it’s part of a bigger treatment plan.
📩 Need personalized support? Let’s get to the root of your postpartum symptoms. Work with me.
xo
Alison
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