Perinatal anxiety – what it is, and tips for how to manage it

Perinatal Anxiety

Pregnancy The Naked Truth by Anya Hayes


What is it, and why am I feeling it?

We’ve all heard of ‘postnatal depression’ and it looms large in your imagination as a scary ‘thing’ that might happen after the baby arrives. Increasingly being recognised, though, is the fact that heightened levels of anxiety or low feelings during pregnancy can increase the risk of developing postnatal depression. And perinatal anxiety is more commonly being diagnosed as a standalone condition, separate from postnatal depression. ‘Perinatal’ is the period which encompasses pregnancy and the first year into early motherhood. 

Figures released in 2015 by the Royal College of Midwives suggest that up to 20% of women experience perinatal mental illness during pregnancy and in the first year of their babies’ lives. It’s particularly common if you’ve struggled with fertility issues, or have had recurrent miscarriages. The new pregnancy guidelines published by NICE for healthcare professionals suggest that there should be ‘screening questions’ asked at regular pregnancy checks, to look out for warning signs, and support should be offered where needed.

Anxiety is the natural response to times of change: it is a normal human reaction, your brain is hardwired to perceive threats and respond to those threats by asking you to run the hell out of there, or fight, or freeze like a rabbit. When you’re pregnant, your future suddenly looks different, and your brain is physiologically changing to equip you for motherhood, which means that the area of your brain responsible for your fight or flight, the amygdala, actually grows during pregnancy, ensuring that you are more alert for dangers that could affect your baby. A wonderful and miraculous brain adaptation to ensure the survival of the human species… but less handy for modern motherhood when it’s work-related emails, financial worries or the stress of your commute which may be triggering this response day to day, rather than a predator in the bushes.

When anxiety comes out of balance in your emotional “team”, and begins to speak more loudly in your internal dialogue is where it can cause problems. Perinatal anxiety is an issue only where it reaches beyond regular normal ‘worry’, and into something that affects and influences your day to day behaviour and decisions – you’d have to be slightly unusual to sail through pregnancy without ever freaking out about your growing baby, your life ahead, the birth, the fact that you’ve run out of chocolate digestives … No, this is where normal worry tips into something that starts to control your life in a negative way and needs to be managed.

The Maternal Mental Health Alliance describes perinatal depression and anxiety as including constant symptoms such as ‘tumble-dryer mind’, insomnia, feeling tense and irritable, social paranoia, shakiness, blurred sight, racing heart and breathlessness. If you recognise these symptoms in yourself, make sure you chat to your midwife or GP, and please, you’re not alone and there is no shame in seeking help, so don’t suffer in silence.

‘I was surprised by how I seemed to change from being relatively easy going to suddenly very fearful and jittery about everything. I spoke to my midwife about it and apparently it’s quite normal. My GP referred me for a course of CBT (cognitive behavioural therapy) to try and deal with it before it became serious.’ Rosie, mum of 2

What can I do about it?

Question your thoughts – anxiety thrives in the space between your thoughts and your emotional response to them. So, tell yourself that THOUGHTS ARE NOT FACTS if your mind has gone into overthinking overdrive. Journal, when your thoughts seem to be overpowering your brain’s ability to temper their force. And meditate. Offer your thoughts a chance to shine – give them centre stage, and try to observe their acting as if on stage, removed with a curious distance, rather than listen within the emotional whirl.

Share the load and talk to someone about it. It takes confidence to speak up, but try not to feel scared to admit to feeling less than ecstatic if it’s clear that you’re feeling low or anxious most of the time. Even if you’re not able to confide in your partner or open up to your midwife, acknowledge to yourself that you’re feeling this way and try to incorporate managing techniques into your pregnancy – take a regular yoga or mindfulness class, or allow yourself some pampering time – or, simply take five deep breaths. Your breath is the surest way out of fight or flight, as deep breathing physically triggering the balancing parasympathetic nervous system to calm and soothe you. Anything that reduces tension in the body will help you to calm the mind. If you feel happy to, ask to be referred for counselling, which can give you some tools to keep your mental health on an upward trajectory.

‘I did worry about how parenthood would affect me. I’m not a fan of uncertainty and in lots of ways your first pregnancy is one of the most uncertain times of your life!’ Natalie, mum of two

Could it be serious?

If left unchecked and out of balance, perinatal depression can unfold into postnatal depression and really impact on your enjoyment of motherhood, so it’s really worth investigating and taking steps to improve your understanding of anxiety and learning how to soothe yourself into calm.

For more tips, pregnancy information and advice, have a look at Pilates for Pregnancy, or Pregnancy The Naked Truth.

Photo by Bryan Schneider on Pexels.com


Have you struggled with anxiety during pregnancy or into motherhood? Get in touch if you’d like to chat about ways through. xxx


#fightorflight #CBT #motherhood #mindfulmovement #Pregnancy #birth #breathe #restanddigest #pilates #anxiety #newmum #mindfulness #perinatalmentalhealth #perinatalanxiety #MBCT #selfcare

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