Anxiety Attacks During Pregnancy: Causes, Symptoms & Treatment

Pregnancy can be a time of both excitement and anxiety for all women regardless of whether it’s their first time or another addition to their family. It’s natural for expecting mothers to fret about everything from eating to drinking to recurring thoughts and feelings or even panicking over trivial things. Anxiety is not only a part of being pregnant but also a part of being human in general. But it can become a serious issue if it becomes a part of a person’s regular thought process. Read on to understand the causes and effects of anxiety disorders that occur during pregnancy and how they can be treated.

What is an Anxiety Disorder during Pregnancy?

An anxiety disorder makes you worry or afraid of things more often. Although fear and worry are natural responses to threats and situations in people, an anxiety disorder would make those feelings much worse than what most people would feel in the same situation. If your anxiety is stopping you from doing things you would normally do with ease, then it could be that you have an anxiety disorder.

It is estimated that women are 60 percent more likely than men to experience anxiety disorders and 1 in 10 pregnant women suffer from anxiety at some point. Anxiety disorders are characterized by anxiety attacks that involve various physiological responses like sweating, racing heart, shakiness and restlessness.

1. Normal Anxiety Attacks

Anxiety attacks occur when feelings of intense fear or terror erupt without warning. They usually last between a few minutes to about half an hour and can be triggered by certain situations, places or people. They involve some or all of these:

• Heart palpitations or a racing heart
• Discomfort and chest pain
• Feeling dizzy and nauseous
• Shortness of breath and choking
• Feeling like you’re losing your mind or going crazy

2. Serious Anxiety Attacks

A serious anxiety attack can be much worse. The symptoms mentioned above are heightened in this case, and hospitalization might be necessary in order to control the situation. Patients report the following sensations:

• Having a heart attack
• Fear of dying
• A detached feeling from oneself

Types of Anxiety Disorders

Anxiety disorders come in different forms, and it’s not unusual to have more than one disorder at the same time. It often coincides with other mental health issues such as depression.

Some of the most common ones include:

• Generalized Anxiety Disorder (GAD): Women with this condition worry a lot about everyday situations which in turn interfere with their day-to-day activities. The common characteristics are irritability, inability to concentrate, tension in the muscles, difficulty in sleeping and a general sense of apprehensiveness.

• Panic Disorder: Recurring panic attacks that occur out of the blue without an apparent cause is a sign of a panic disorder. It involves an intense feeling of fear accompanied by physical symptoms such as sweating, dizziness, shaking, racing heart and nausea.

• Phobia: A phobia is a feeling of extreme fear and anxiety about specific objects or events which are harmless. Some of the phobias such as fear of heights or fear of poisonous insects relate to moderate risk, but the fear is exaggerated. People go to great lengths to avoid these things.

• Posttraumatic Stress Disorder (PTSD): Experiencing or seeing a traumatic or distressing event can cause PTSD which involves intense feelings of anxiety, flashbacks, nightmares etc. Losing a baby in a previous pregnancy can cause PTSD in some women and can bring back extreme fear and anxiety in a subsequent pregnancy.

• Obsessive-Compulsive Disorder (OCD): Women can sometimes experience OCD during pregnancy, and it can get worse after the baby is born. Women with OCD have recurring obsessions such as unwanted thoughts, sensations and ideas which lead to compulsions that are repetitive behaviours that relate to the obsession.

• Other Health Conditions: In a few cases a health condition such as a heart disease, hyperthyroidism or a respiratory illness can also cause anxiety.

What Causes Anxiety Attacks when Pregnant

The exact trigger for anxiety attacks is uncertain and is different for different women. The bodily changes that women go through during pregnancy may cause an anxiety attack in some women.

Some of the significant causes of anxiety attacks can be:

• The hormonal changes during pregnancy.
• Stress, worries and over thinking during pregnancy.
• Pre-existing anxiety issues that start to re-occur during pregnancy.
• The woman is at an age where anxiety attacks are common.
• Anxiety disorders can also be genetic, or hereditary.

How does Anxiety Affect your Baby?

There hasn’t been much research on effects of anxiety during pregnancy to tell conclusively about its impact on the child. However, it has been observed that women with high anxiety and stress during pregnancy have a slightly higher chance of preterm birth. Anxiety is also linked to complications such as slow labour, fast labour and forceps delivery. Some research suggests that children whose mothers have experienced anxiety disorders during pregnancy reach developmental milestones slower.

Is it Anxiety or Baby Blues?

Baby blues occur in all women after they give birth due to the sudden change in hormones following the stress of delivery, sleep deprivation, stress and fatigue. Women often feel tearful and emotionally overwhelmed. This typically starts a few days post delivery and reaches its peak at about one week and tapers off eventually by two weeks postpartum. On the other hand, anxiety is characterised by panic attacks, thoughts and physiological symptoms that interfere with their normal functioning.

Symptoms Of Prenatal Anxiety

The symptoms of prenatal anxiety are often excessive and seemingly uncontrollable. They include:

• Constant worry and a feeling that something terrible will happen
• Uncontrollable thoughts
• Difficulty in sitting still
• Physical symptoms such as heart palpitations, hot flashes, dizziness and nausea
• Disturbed sleep and appetite

Available Treatments for Anxiety Disorders

Non-Medicinal Approaches

There are a few approaches to treatment that do not involve the usage of medications.

1. Psychotherapy

Guided by a  skilled therapist, techniques such as Cognitive Behavioral Therapy (CBT) are used. The therapist teaches new ways of looking at the stress factors and how to come up with better responses.

2. Omega 3

The Omega 3 essential fatty acid acts as a natural mood booster and is found in foods such as walnuts and oily fish.

3. Light Therapy

Light therapy is a method where an artificial source of bright light resembling the sunlight is used on the patient. Sitting by the side of the light at specific times of the day or having it set up in the living room can relieve depression symptoms.

4. Acupuncture

This is an ancient Chinese practice that involves placing tiny needles on specific points on the body. The meothod is used to influence mood and treat stress.

5. Talk Therapy

The method where a patient talks to a therapist or a counsellor about the thoughts and feelings that generate anxiety is called talk therapy. It acts as a release and helps find new ways to think about the anxiety triggers.

Medications For Prenatal Anxiety

Since anxiety medications can cross the placenta, doctors are always cautious about prescribing them during pregnancy. Prescribed medicines include:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Similar to their usage with depression, they are used to treat anxiety in pregnancy. Some of the commonly used ones are; Fluoxetine, Sertraline, Citalopram, Paroxetine etc.
• Benzodiazepines: These drugs are used to manage severe anxiety and panic attacks but are known to cause congenital disabilities in babies when taken during pregnancy. If you are already on benzodiazepines, your doctor would slowly lower the dosage and switch to a different drug once you’re pregnant.

Herbal and Home Remedies

Kava is a commonly used root to alleviate anxiety but isn’t recommended during pregnancy as it can weaken the muscles of the uterus. There is very little research on herbal remedies, and since they are unregulated, it’s advisable to stay away from them.

Who is at Risk?

While anxiety is normal during pregnancy, there are risk factors that put a few women at higher risk. These include:

• Having a family history of mood disorders
• History of Premenstrual dysphoric disorder
• Being a young mother who is single, having poor support or low income
• Living alone or divorced, separated or widowed
• Pregnancy complications
• Having experienced stressful or traumatic events before

Preventing Anxiety during Pregnancy

• Talk to your partner or a trusted friend about your feelings often
• Learn simple relaxation techniques and maintain a regular practice
• Look after yourself and read a self-help book for better understanding
• Try not to feel embarrassed or guilty. It is not your fault.

FAQs

1. What will Happen if my Anxiety is Left Untreated?

Both you and your child are at risk in this case. The baby might be preterm with low birth weight and score low on APGAR. The baby might also have problems with adaptation outside the womb. Risks to you include pregnancy termination, postpartum depression, substance addictions etc.

2. Will Anxiety Result in Depression?

Anxiety disorders often coincide with other conditions such as depression. About half of the women who develop postpartum depression start noticing early signs during pregnancy.

3. Where Can I Get Help?

If you are pregnant and start having symptoms of anxiety, it’s best first to consult your ob-gyn or midwife.. There are international groups such as Postpartum Support International (www.postpartum.net), Women’s Mental Health Consortium (http://womensmentalhealthconsortium.org/), and The MGH Center for Women’s Mental Health (www.womensmentalhealth.org)

Anxiety need not hold you back from experiencing the joys of early motherhood. With a better understanding of your condition, the appropriate treatment can be prescribed, thereby making it possible for you to enjoy your pregnancy to the fullest.