I can’t seem to shake the emotions from my baby’s time in the NICU. What can I do?

Answer by Sarah Best, LCSW

There's no way around it: Having a baby in the NICU impacts your experience of early parenthood. From the intensity of the hospitalization to the vulnerability of bringing your baby home, parents of babies who began life medically fragile often think, feel, and parent differently than parents whose babies were born full-term and healthy. And that's understandable.

But sometimes the experience leads to more than mild overprotectiveness. NICU stays – and the complicated pregnancies and deliveries that can lead to them – are associated with an increased risk of perinatal mental health concerns, including post-traumatic stress disorder, postpartum depression, and postpartum anxiety disorders.

If you notice changes in your thoughts, feelings, or behaviors after a NICU experience, it can be difficult to tell whether the changes represent a typical reaction or signal the development of a perinatal mood or anxiety disorder. If you or a loved one is concerned about how you're feeling, know that the following signs suggest you could benefit from professional support.

You can't stop thinking about the experience, even when you want to.

It's normal to replay all sorts of significant events – especially difficult ones – in our minds long after they're over. Some psychological theories maintain we do this to feel a sense of mastery (because now we know what happens next) over an experience in which we initially felt helpless. Others suggest that we replay the event in order to find meaning in the experience – emphasizing what we learned about ourselves or the world through the process, for example. In these instances, thinking (and even rethinking) about the difficult experience can be healthy and adaptive because doing so helps us feel better and offers a greater sense of authority.

Sometimes, however, thinking about a difficult experience only makes us feel worse. Whether we find ourselves re-experiencing the distress we felt initially or feeling a new range of negative emotions, being unable stop the instant replay can be a sign of clinical trauma or of a mood or anxiety disorder. If you find that you can't keep yourself from thinking about your baby's NICU stay – and feeling bad when you do – let your ob-gyn or even your baby's pediatrician know you how you're feeling. It's especially important to talk to a mental health professional if rumination interferes with your ability to care for your baby, meet your other responsibilities, or fall and stay asleep at night. 

You're afraid for your health and baby's safety, even when you know everything is ok.

After your baby has faced medical uncertainty, it makes a lot of sense to feel cautious. So it's common for NICU parents to be especially vigilant about their baby's health and safety, even after their baby has been discharged from the hospital. Many find themselves in the pediatrician's office with every cough or sneeze, and some have a hard time letting anyone else hold their baby. Others avoid unnecessary activities – like large social gatherings – to avoid coming in contact with germs. Most of the time, this early cautiousness fades with time. As their baby grows and thrives, moms and dads feel more confident and less restricted in their activities.

But some NICU parents find themselves feeling hypervigilant, on edge, or scared even when they know there is nothing to fear. If you find yourself experiencing physical signs of fear – like a racing heart, an exaggerated startle response, or a sense of foreboding – even in situations where you know there's no real threat to your baby's safety, it's a good idea to reach out for help. Somatic, or physical, symptoms like these are associated with post-traumatic stress disorder and other anxiety disorders, and they can get worse without proper treatment. The good news is that they're very treatable with psychotherapy, medication, or a combination of the two, so you can feel better and more comfortable with your baby – in your home and out in the world.       

Your reaction to the NICU causes lasting problems in your relationships.

It's very common for parents whose babies have been in the NICU to feel like no one understands their experience. They feel frustrated when their own family members don't understand their cautiousness and can't relate to friends who seem to have had picture perfect births and "babymoons." Feeling different when your experience has been different is understandable. So setting boundaries or keeping your distance from those people you feel just don't get it can be a good self-care strategy, especially when your emotions from the experience still feel raw.

But if you find yourself feeling increasingly distanced from important friends and family members weeks and months later, it's a good idea to talk things through with a mental health professional. Social withdrawal and avoidance can both be symptoms of mood and anxiety disorders, and social relationships can heal when the disorders are treated. But if therapy helps you see that a particular relationship no longer serves you, you can actively plan to set boundaries and to build other, healthier relationships. This way, you can be sure to get the support you need when caring for a new baby.

If you've lived through a difficult NICU experience and are concerned about its impact on your thoughts, feelings, or behaviors, reaching out for professional support can help you feel better. A licensed mental health professional can help you make sense of your experience, manage difficult feelings, and move forward in your parenting with confidence.

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