How to cope with anxiety during pregnancy

The internal dialogue in my head kept telling me to be afraid, but I didn’t know what I was afraid of, and I felt stuck in a never-ending cycle of worry. It felt like my body was consumed with a constant energy that I couldn’t shut off and the only thoughts that seemed to consume my mind began with “what if.”

These paralysing feelings were not new to me, but the fear and sheer terror of something inexplainable happening to my unborn baby was. They seemed to spike when I became pregnant and the need to control every aspect of my life that could cause harm to this life growing inside of me took over.

What is antenatal anxiety?

We all know that it’s almost expected to feel anxious while pregnant, but for many women, this occasional feeling of anxiety can escalate and turn into a disorder, or worse, exasperate a mental health problem that already exists.

If your anxiety level seems to be more than just the normal worries about pregnancy and it's affecting your everyday life, you may have antental anxiety - a form of the condition experienced during pregnancy.

Research puts antenatal anxiety above depression, with prevalence ranging anywhere from 13 to 21% of pregnant women experiencing serious anxiety during pregnancy.

In fact, severe anxiety is three to four times more common than depression during pregnancy and early motherhood, according to research from the University of British Columbia. The study suggests that anxiety disorders in new mums are outpacing depression, yet health care professionals have given postnatal depression much more attention.

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Symptoms of antenatal anxiety

The severity of symptoms is experienced differently for each person. According to the PANDAS Foundation, some of the more common symptoms can be:

• Constant worrying

• Difficulty concentrating

• Difficult sitting still and/or relaxing — always on the go

• Racing thoughts

• Snappy or irritable behaviour

• Feeling that something bad will happen—imaging “worst case scenario”

• Tense, stressed, “on edge,” unsettled

• Panicky

• Rapid pulse tight chest, sweating, muscle tension, nausea, loss of appetite

Treating anxiety during pregnancy

If your anxiety begins taking a toll on your mental and physical health—affecting work, relationships, and your general quality of life—then it might be time to seek help from your doctor.

“Clinically significant anxiety in pregnancy can be addressed via multiple modalities,” explains psychiatrist Dr Carly Snyder. "The degree of severity of the anxiety in part determines the initial treatment approach."

She gives the following progression for treating anxiety during pregnancy:

• A woman with mild symptoms can try exercise, prioritising self-care, healthy diet, massage, acupuncture, and psychotherapy.

• Psychotherapy is the first line treatment for more moderate symptoms that are beginning to have a negative impact a woman's daily life.

• A combination of psychotherapy plus medication is the recommended approach for a woman with more severe symptoms.

How to manage anxiety

In addition to any treatment plan that involves therapy and/or medication, there are some self-care tips you can try in order to alleviate some of the symptoms.

Practice acceptance

Therapist Kimberly Hershenson advises making a list of what you can control about your pregnancy that may be causing your anxiety (eating balanced meals, getting adequate sleep, etc.). Now make another list of what you can’t control (when you deliver, the exact amount of weight you will gain, complications for the baby, etc.). Focus your energy on the things you do have control over.

Optimise and prioritise sleep

“No one feels good or is able to appropriately address fears when exhausted,” says Snyder. Ensuring a good night-time routine and obtaining adequate sleep nightly allows for a clear head and reduced overall anxiety.

Take time for yourself

Do things you enjoy such as meditating, exercising and get outside on a daily basis, and make sure you have at least one segregated time during the day to focus on your happiness.

Find your community

“It is common to feel isolated in the setting of experiencing anxiety or other mood symptoms during and after pregnancy. Talk to people you trust rather than keeping it all in,” says Snyder.

Whether it’s friends, family members, co-workers, or other pregnant women, let others know how you are feeling so you don’t have to cope with anxiety alone. Find a local group with other women who are due around the same time as you and meet up for social gatherings. Talking to other women who are in the same place as you can help to relieve concerns about your pregnancy. Self-help groups, such as a PANDAS Support Group, can offer you good advice and support on how to cope with anxiety as well as comfort to know that other mums are feeling the same as you.

Feed your body regularly scheduled, healthy meals

“Hypoglycemia or low blood sugar can lead to feelings that mimic panic,” explains Snyder. “This is compounded in pregnancy as hypoglycemia can also lead to increased nausea."

Eating small, high protein meals throughout the day can reduce the sense of panic that comes with extreme hunger and can also minimize nausea.

Try an alternative approach

Consider acupuncture for anxiety with a practitioner seasoned in working with pregnant women. Prenatal massage can also be helpful for relaxation. As can daily, guided mindfulness meditation practices. Mindfulness-based practices have become popular in the treatment and management of anxiety since it can promote healing in both the physical and emotional/psychological realms.

Mindfulness is about maintaining moment-by-moment awareness of your thoughts, feelings, emotions, bodily sensations, and your surrounding environment. Practicing mindfulness while pregnant can help you feel calmer and more connected to your body.

Avoid Dr Google

Yes, it can feel gratifying to google an answer, but, as Snyder explains, the internet is not regulated and much of the information is from biased sources and/or is inaccurate.

"Your situation is unique and you cannot rely on other people's accounts online to answer your questions,” she adds. “Ask your physician for trusted sites if you feel you must look things up rather than doing so without guidance.”

Seek professional help

If you are not already involved in a treatment plan for anxiety, you might want to consider professional help; if you are feeling more anxious than happy and your life is being dictated at least partially by your fears.

Additionally, it is a good idea to have handy the contact information of people you can call when you are feeling your worst. Include on this list a trusted family member, friend, doctor, therapist, and a helpline (such as PANDAS Helpline).

You are not alone

The most important thing to remember is that you are not alone. There are safe and effective ways to treat antenatal anxiety and the faster you get help, the sooner you will enjoy your pregnancy.