Postpartum Anxiety Treatment

Written and Fact-Checked by: Jenna Carberg

Postpartum Anxiety Is Treatable

If worry, racing thoughts or panic have taken over since your baby arrived, you don’t have to just push through it. Postpartum anxiety responds to treatment, and there are effective options whether or not you want to take medication and whether or not you are breastfeeding.

This page covers what the evidence and the American College of Obstetricians and Gynecologists (ACOG) say about each treatment. If you haven’t been screened yet, the GAD-7 takes a few minutes.

Treatment Options at a Glance

Treatment Best for Evidence
Therapy (CBT, mindfulness-based) Mild to moderate anxiety; anyone who prefers not to take medication Medium effect in a meta-analysis of perinatal anxiety trials
SSRIs (sertraline, escitalopram) Moderate to severe anxiety, or when therapy isn’t enough ACOG’s first-line medication; evidence comes mainly from non-postpartum adults
SNRIs Alternative to SSRIs Reasonable alternative per ACOG
Benzodiazepines Short-term bridge while other treatment starts working ACOG recommends avoiding or using sparingly
Hydroxyzine Short-term help with anxiety-related insomnia Add-on option per ACOG
Exercise Alongside other treatment Small benefit, limited studies

Therapy for Postpartum Anxiety

ACOG notes that therapy is often a first-line treatment for mild to moderate anxiety, and that therapy has a stronger evidence base for anxiety than benzodiazepines do.

  • A meta-analysis of 22 studies found psychological treatments reduced perinatal anxiety with a medium effect compared with control groups. Results were strongest for cognitive behavioral therapy (CBT), behavioral approaches and mindfulness-based therapies.
  • Treating anxiety also improved depression symptoms.
  • Online CBT works too. In a trial of new mothers with postnatal depression, an internet CBT program called MumMoodBooster cut depression and anxiety scores roughly in half compared with usual care and in-person CBT by 21 weeks.

CBT for anxiety typically helps you notice anxious thought patterns, gradually face feared situations and reduce checking or reassurance-seeking, which can keep anxiety going. If anxiety is keeping you awake even when you can sleep, CBT for insomnia may help; see postpartum insomnia.

Therapy isn’t always easy to access. Online therapy, telehealth and support groups can help fill the gap. Learn more about types of therapy, or look for a therapist with PMH-C certification in perinatal mental health.

Find a therapist who treats postpartum anxiety

Medication for Postpartum Anxiety

SSRIs Are First-Line

ACOG strongly recommends selective serotonin reuptake inhibitors (SSRIs) as the first-line medication for anxiety during pregnancy and after birth, with SNRIs as reasonable alternatives. If you haven’t taken these medications before, sertraline (Zoloft) or escitalopram (Lexapro) are reasonable first choices. If a medication worked for you in the past, that one is often the best choice.

Some important details:

  • The evidence is borrowed. ACOG acknowledges that no trials have specifically tested medications for perinatal anxiety disorders. The recommendation is based on strong evidence in adults with generalized anxiety disorder and on safety data in pregnancy and breastfeeding.
  • Start low. Most experts start at half the usual lowest dose to avoid early side effects like jitteriness or insomnia, then increase.
  • Anxiety may need a higher dose than depression.
  • It takes time. SSRIs usually take several weeks to reach their full effect.

Benzodiazepines

Benzodiazepines such as lorazepam work quickly, but ACOG strongly recommends avoiding them or prescribing them sparingly because of side effects and the risk of dependence.

  • When used, they should be a short-term bridge, typically for 2 to 4 weeks until an SSRI or therapy starts working, followed by a gradual taper of 25% to 50% per week.
  • If one is needed, ACOG prefers lorazepam, oxazepam or temazepam. Alprazolam (Xanax) should be avoided because of its high addiction potential and withdrawal risk.
  • Avoidance is especially important for anyone with a history of substance use disorder.
  • Don’t stop a benzodiazepine suddenly.

Hydroxyzine

Hydroxyzine, a sedating antihistamine, can be used as an add-on, particularly for short-term help with insomnia related to anxiety.

What About Zurzuvae?

Zurzuvae (zuranolone) is approved for postpartum depression, not anxiety. In trials of women with postpartum depression, anxiety symptoms also improved, so it may help if you have both.

Medication and Breastfeeding

You don’t have to stop breastfeeding to treat postpartum anxiety. ACOG recommends against stopping mental health medication just because you’re breastfeeding, and says people with mental health conditions shouldn’t be discouraged from breastfeeding. According to the NIH’s LactMed database:

  • Sertraline is considered a preferred antidepressant during breastfeeding by most authoritative reviewers.
  • Lorazepam has low levels in breast milk and has not been shown to cause problems in breastfed babies at usual doses. Watch for sleepiness or poor feeding.
  • Hydroxyzine in small, occasional doses is not expected to affect breastfed babies, but larger or prolonged doses may cause drowsiness or lower milk supply. Other options are preferred with newborns or premature babies.
  • Propranolol, sometimes used for physical anxiety symptoms like a racing heart, reaches babies in small amounts not expected to cause problems.

If a medication kept you stable during pregnancy, ACOG advises generally not switching after birth, because your baby’s exposure during pregnancy was far greater than through breast milk. See antidepressants during pregnancy and breastfeeding.

Exercise and Self-Care

  • A 2025 meta-analysis found postpartum exercise reduced anxiety symptoms, but the effect was small and based on only two trials, compared with stronger evidence for depression.
  • For depression, benefits appeared at about 80 minutes a week of moderate activity such as brisk walking.
  • Exercise is a helpful addition to treatment, not usually enough on its own for significant anxiety.

Other steps that can help: protecting sleep where possible, limiting caffeine, accepting practical help and connecting with other parents.

Natural Remedies and Supplements

No supplement has been shown in controlled trials to treat postpartum anxiety. If you’re considering a supplement or herbal product, check its safety while breastfeeding with LactMed, your pharmacist or your doctor, and be wary of products marketed as a cure.

Support Groups and Helplines

Talking with other parents who have been through postpartum anxiety can make a real difference. See postpartum support groups, including free online options.

Postpartum Support International runs a HelpLine at 1-800-944-4773 that can connect you with local support. It does not handle emergencies.

How Long Does Treatment Take?

  • Therapy often involves weekly sessions over a few months.
  • SSRIs take several weeks to work and are usually continued for months after you feel better. When it’s time to stop, a gradual taper over 2 to 4 weeks is recommended.
  • Benzodiazepines, if used, are typically limited to a few weeks.

When to Get More Help

Ask for a referral to a perinatal psychiatrist or specialist if:

  • Your anxiety isn’t improving after several weeks of treatment
  • You’re having panic attacks, intrusive thoughts that frighten you or trouble caring for yourself or your baby
  • You also have depression, or symptoms are getting worse

See how to find a perinatal psychiatrist.

Call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), 24 hours a day. If you have thoughts of harming yourself, call or text 988, or call 911 in an emergency.

Frequently Asked Questions

What is the best treatment for postpartum anxiety?

Therapy, especially CBT, is often first-line for mild to moderate anxiety. For moderate to severe anxiety, ACOG recommends an SSRI such as sertraline or escitalopram, often combined with therapy.

What medication is safe for postpartum anxiety while breastfeeding?

Sertraline is a preferred choice while breastfeeding. Several others, including escitalopram and short-term lorazepam, have low levels in breast milk. Talk with your prescriber.

Can postpartum anxiety go away without medication?

Many people improve with therapy alone, especially with mild to moderate anxiety. Anxiety that is severe or not improving usually benefits from medication too.

Is Xanax safe for postpartum anxiety?

ACOG recommends avoiding alprazolam (Xanax) because of its high addiction potential. If a benzodiazepine is needed short-term, lorazepam is preferred.

Are there natural remedies for postpartum anxiety?

No supplement has been proven to treat postpartum anxiety. Exercise, mindfulness, sleep and support can help alongside treatment.

How long does postpartum anxiety treatment take?

Therapy typically lasts a few months. Medications take several weeks to work and are usually continued for several months after you feel better.

PostpartumDepression.org Team
Written by:

Jenna Carberg was diagnosed with postpartum depression following the birth of her daughter in 2016. It was a healthy birth but in the following days, Jenna's mood changed quickly. Doctors suggested that it might be the "baby blues", but her husband Chris suggested she seek a second opinion. Jenna was diagnosed with postpartum depression and began a journey that lasted 9 long months with significant ups and downs. Jenna's mental health care and her experiences became a passion for her to share with the world. She and her husband Chris founded PostpartumDepression.org as a support website designed to help women suffering in silence and their loved ones.

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