Support for Prenatal and Postnatal Anxiety

There are several things which can help manage an anxiety disorder in pregnancy. One of the most important things that a woman with anxiety should do is take care of herself. This is one task which should be given priority by the woman, even when the care of her family requires much time and effort.

Mild anxiety may be treated effectively with no more than adopting self-care measures, but more severe anxiety may require both medication and psychotherapy, or various forms of counseling.

Psychological Support

Various techniques are used in psychotherapy, including:

Cognitive Behavioral Therapy (CBT)

CBT is thought to be very effective in helping a patient to recognize anxious thoughts, identify the abnormal responses to these worries, and deliberately seeking to change their behavior by altering their responses. CBT is especially helpful when combined with medication. The problem-solving component of CBT is of assistance to women who feel incompetent to deal with the changing demands of life during pregnancy and following childbirth.

Emotion-Based Therapy or Psychodynamic Therapy

This focuses on talking with the patient so as to uncover the underlying roots of anxiety, which may have been due to an early trauma. This form of therapy may take more time, but patient bonding may be deeper.

Group Therapy

This type of treatment has multiple benefits, such as:

• Providing psychological therapy
• Giving the patient a wide exposure to other people who are experiencing various difficulties as well as finding solutions to them, which helps create social connections. Many groups meet informally but formal group meetings are also available.
• Helping to educate expectant and postpartum mothers as well as to treat their anxiety.
• Meetings which include the father or relevant family members for at least some sessions will help the family understand the woman’s feelings and stresses better,  as well as to improve the marital relationship by teaching and promoting the use of communication skills within this relationship. This is an especially important aspect because poor social support contributes largely to the development of anxiety during this period.

Grief Counselling

When a couple has lost a baby or suffered a miscarriage, they may find it difficult to carry succeeding pregnancies without anxiety. This may be because the previous loss experience was not given closure. Denial or false consolation may deprive parents of the chance to deal with their grief properly. Discussing this with the parents, and formulating a pregnancy and postnatal plan which will allay such anxieties, as for instance by more frequent check-ups, may be of great help in such situations.

Medication

Some drugs are of use in mitigating the symptoms of anxiety.

All treatments should be decided upon by both the healthcare providers and the parents, in order to optimize the level of control the anxious woman has over her condition. Various aspects of each approach should be discussed before any technique is chosen and initiated.

Lifestyle Changes

Women who suffer from pregnancy-related anxiety should tailor their lives as far as possible to reap the maximum support for their emotional and physical well-being. This may include:

• Dropping unnecessary chores or activities which drain too much time or energy.
• Eating healthy appealing food at the right times.
• Regular exercise and sleep.
• Taking the time to unwind with a book or a friend.
• Drinking enough water.
• Sharing problems with friends who are mature enough to have a good perspective on your situation.
• Asking for help from those who love one most, including one’s spouse, family, and friends. Women should not try to do everything themselves – they should tell others of their anxiety and ask if they can share some of the work for some time. These people will also be able to see if one is slipping further down and urge them to seek medical help.
• Joining a support group if required.
• Stopping drinking or smoking, with the help of a good program if needed.

References

• http://umm.edu/health/medical/reports/articles/anxiety-disorders
• http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/mentalhealthinpregnancy.aspx
• http://www.nhs.uk/conditions/pregnancy-and-baby/pages/mental-health-problems-pregnant.aspx
• https://www.healthdirect.gov.au/anxiety-treatments

Further Reading

• All Postnatal Anxiety Content
• Pre- and Postnatal Anxiety
• Treatment for Pre and Postnatal Anxiety
• Symptoms of Pre and Postnatal Anxiety

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.