Anxiety During Pregnancy

Anxiety is feelings of worry, stress or fear, and is a normal part of life. However, if these feelings are persistent and strong enough to interfere with your daily life, this may be an anxiety disorder, a type of mood disorder.

Feeling anxious while pregnant is completely normal. It’s natural to worry about whether your baby is healthy, have fears about being a good parent, or stress about how your relationship with your partner will change. The changes in your hormone levels that come with pregnancy can also affect your mood and emotions, making you more prone to worry and stress.

However, there is a difference between normal worries and a more serious anxiety disorder during pregnancy, also called antenatal anxiety. If these anxieties become all-consuming, are difficult to control and regularly interfere with your ability to function day-to-day, you should speak with your doctor to find better ways of managing those feelings. Long-term, severe anxiety can increase your risk of preterm labor or of delivering a low birth weight baby, and increase the chance a child will later develop emotional or behavioral challenges.

It is important to seek out help and speak with your doctor if you experience signs or symptoms of anxiety during your pregnancy.

How Often Does Anxiety During Pregnancy Happen?

Antenatal anxiety is a very common experience. More than 1 in 10 women experience anxiety at some point during their pregnancy.

What Are Some Symptoms of Anxiety During Pregnancy?

Since there are different types of anxiety disorders, the symptoms vary. Speak with your doctor about any symptoms you experience so he or she can accurately diagnose and treat you. Some common symptoms of anxiety disorders include:

• Feeling nervous, anxious or on edge frequently
• An uncontrollable sense of anxiousness
• Worrying excessively about things, especially your health or your baby
• Finding it difficult or impossible to relax
• Feeling restless and hard to stay still
• Feeling irritable and agitated
• Feeling afraid, or thinking that bad things will happen
• Inability to concentrate
• Difficulty sleeping

You may also experience physical symptoms with antenatal anxiety, including:

• Racing heartbeat and rapid breathing
• Dizziness
• Lightheadedness or feeling faint
• Shortness of breath
• Excessive sweating
• Tension, pain or trembling in your muscles
• A numb or tingling feeling in your limbs, fingers, toes or lips

When these symptoms come on quickly and intensely, you may be experiencing a panic attack. People with anxiety experience the same symptoms and panic attacks regardless of whether they are pregnant or not. However, when you are pregnant, your concerns about the health of your child can increase the effects of your anxiety attack dramatically. That level of anxiety, and the physical effects of anxiety, can have potential risks for your health and your baby’s health.

What Are Some Causes of Anxiety During Pregnancy?

Most women experience some anxiety during pregnancy, and just about any woman can develop a severe anxiety disorder during pregnancy. However, there are some risk factors that can put a woman at greater risk for developing severe anxiety during her pregnancy. These include:

• A previous diagnosis of an anxiety disorder, panic attacks, or depression
• A family history of mood disorders or panic attacks
• Anxiety during a past pregnancy
• Previous pregnancy loss or fertility struggles
• Complications during pregnancy
• Stress at home or work
• History of abuse or trauma
• Stressful life events, like the death or illness of a loved one
• Lack of a partner or social support during pregnancy
• Relationship problems, including domestic violence

How Can Anxiety During Pregnancy Be Treated?

Mild cases of anxiety during pregnancy typically don’t require specific treatment. However, if you experience any symptoms of anxiety, inform your doctor so he or she can help you learn to manage the symptoms safely and effectively. Some treatment methods your doctor may recommend include:

• Counseling or therapy: You will discuss your thoughts and feelings with a counselor or therapist, who will help you understand your feelings and cope with your anxieties. You may learn to practice specific techniques such as cognitive behavioral therapy and interpersonal psychotherapy.
• Support groups: These are groups of people going through similar circumstances who meet in person or talk online to share their feelings and experiences about specific topics.
• Medication: If your anxiety is severe, your doctor may prescribe one or a combination of medications. Your doctor should discuss the benefits and risks of taking medication while pregnant, so you can make an informed decision about your treatment. Your doctor will prescribe the safest medication at the most appropriate dosage. If you were taking medication for anxiety before you became pregnant, or begin taking them while pregnant, do not stop taking them without first talking to your provider. Stopping medication can pose potential health risks to you and your baby.

Making changes at home may also help you manage your anxiety symptoms. Speak with your partner, family, or friends about your issues and ask for support. Allow yourself to relax, slow down, cut down on chores and tasks, and put your health and well-being first. Taking care of yourself is vital to taking care of baby. Some other changes that may help manage anxiety symptoms include:

• Exercise: Exercise is a natural way to increase serotonin levels and decrease cortisol levels. Speak with your doctor to find the best workouts that would be safe and appropriate for you. Exercise classes designed for pregnant women may be available to you.
• Eating a healthy diet:  Many foods have been shown to affect mood, the ability to handle stress, and focus. Caffeine, sugar, processed carbohydrates, artificial additives and lack of protein can negatively affect your mental and physical health.  Ask to speak with a registered dietitian to determine an individualized healthy eating plan that would most benefit you.
• Get enough sleep: A lack of sleep can greatly affect the body’s and mind’s ability to handle stress and cope with day-to-day challenges. Although anxiety can affect your ability to sleep, try to establish a sleep schedule routine so you go to sleep and get up at the same time each day.
• Meditate and breathe: Activities such as meditation and deep breathing practices can help your body release endorphins without working up a sweat. It is recommended to do deep abdominal breathing for 20 to 30 minutes daily to help with anxiety. It will help provide more oxygen to your brain and stimulate your nervous system. Meditation can help you refocus, calm down and clear your mind of intrusive anxieties to better cope with any issues.

When Should I See My Doctor for Anxiety During Pregnancy?

Even if you experience only mild symptoms of anxiety, it is important to inform your doctor. They can recommend the best methods for you to manage those symptoms, and can then monitor you throughout your pregnancy for signs of worsening anxiety.

If your anxiety is affecting your daily life or if you’re having frequent panic attacks, you should call your doctor right away. Only they can diagnose you with an anxiety disorder and recommend the best, most effective treatment options for you.

Seeking help is the best step you can take to ensuring that you and your child stay safe and healthy.

Learn more about Multidisciplinary Obstetric Medicine Service (MOMS) at Brown University Health