This post was written by Sarah Michelle Moore, CNM, PMHNP-BC, Parkview Behavioral Health Institute - Park Center.
Did you know that approximately 6% of pregnant people and 10% of postpartum people will develop anxiety? And those percentages only represent the people who did not have anxiety or an anxiety disorder before becoming pregnant. Research is recognizing that mental health concerns, such as anxiety, are quite prevalent during the perinatal (pregnancy and postpartum) period. Increased awareness, self-identification and increased screening practices in OB/GYN and midwife offices have helped to not only identify, but also increase treatment for those with perinatal anxiety.
While there are many different types of anxiety, for the purpose of this blog, we’re going to focus on Generalized Anxiety Disorder (GAD) and panic disorder. Let’s talk a little about what anxiety looks like, and then we’ll dive into some treatment options.
What does anxiety feel like?
Have you ever been so focused on a problem or concern that you feel like you literally cannot stop worrying about it? When you think about that problem, your pulse may increase, and your breathing may become shallower. Your mind goes to the worst-case scenario each time, and even when you try to distract yourself with other activities, such as spending time with your partner, children or friends, your mind continuously drifts to your worrying thoughts. This is a small taste of what GAD can look like.
Add in worrying about almost anything, including things that seem inconsequential, increased distress, feeling on edge, having muscle tension, trouble sleeping, and these thoughts interfering with your ability to do what you need to do in your daily life and that’s an anxiety disorder.
What is a panic attack?
A panic attack is abrupt and often feels like it appears out of nowhere. Symptoms include heart palpitations, shortness of breath, shakiness, chest pain, nausea, and feeling out of control or as if you are dying. Often, individuals experiencing a panic attack will go to the emergency room because they feel as if they are having a heart attack or some other health crisis. Panic attacks can occur with GAD or separately.
How to treat perinatal anxiety
If you’re experiencing anxiety or panic attacks during pregnancy and postpartum, the first treatment recommendation is individual psychotherapy (or counseling). Various types of therapy help, including Cognitive Behavioral Therapy (CBT). Group therapy and/or support groups are another great option.
Medication is also a treatment option, even in pregnancy and breastfeeding. Common medication options include SSRIs (such as Zoloft®), Alpha-2 Antagonist (such as Remeron), and low doses of second-generation antipsychotics (such as Seroquel, especially at night). If you are on medication and become pregnant, please talk with your provider before abruptly stopping your medication, especially if you are stable.
Treatment does not necessarily mean medication, though sometimes medication is a part of treatment to help you remain stable. Regular exercise/yoga, meditation/prayer, mindfulness and breathing exercises are also a way to keep your anxiety in check. Talk with your mental health provider about what will work best for you and your pregnancy and postpartum plans.
Overall, the goal of treatment during this time is to keep you stable and healthy because that helps with a healthy pregnancy and postpartum period. Untreated anxiety in pregnancy has been shown to increase the chance of preterm birth and low birth weight. And untreated anxiety in the postpartum period can interfere with breastfeeding and bonding with your baby.
Remember, you don’t have to suffer in silence. Actually, you don’t have to suffer, at all! There are treatments available to help you decrease your anxiety and reclaim your life.
Need an appointment?
We’re here to help. Call 260-481-2774 to schedule an appointment with me, Sarah Michelle Moore, (who specializes in maternal mental health) or any of our other Parkview Behavioral Health Institute providers.
National Maternal Mental Health Hotline
Call or Text 1-833-943-5746
American Psychiatric Association (APA) (2022). Diagnostic and Statistical Manual (DSM) (V-TR). Washington, DC: American Psychiatric Association Publishing.
Postpartum Support International (PSI) (2023). Postpartum and Antepartum Anxiety.
Massachusett’s General Hospital (MGH) (2023). Psychiatric Disorders during Pregnancy.