1. Anxiety in Pregnancy and Early Parenthood

    July 1, 2013

    anxiety in pregnancy

    by Ngaire Stirling

    Anxiety Disorder is a blanket term for a selection of mental health issues widely believed to be caused by a deficiency in a neurotransmitter known as GABA and abnormal activity in the amygdala (flight or fight section of the brain) hypothalamus and cerebellum.  Anxiety Disorders tend to be genetically pre-determined to some extent but are also triggered by stress and worry.  This makes pregnancy and early parenthood a key period for anxiety symptoms in women.

    Anxiety in Pregnancy

    Around 10%* of women experience anxiety or depression in pregnancy and up to 40% in women diagnosed with fertility issues. Previous anxiety issues, poor coping skills, changed living arrangements, violence or abuse, poverty, discrimination, life changes such as giving up work, feelings of isolation, low self-esteem and unplanned pregnancy can all contribute to the likelihood of developing an ante natal anxiety disorder.  Treatment of anxiety disorders includes a number of pharmaceuticals including SSRI anti-depressants however these are not recommended in pregnancy.  Cognitive Behaviour Therapy is recommended for women who wish to avoid medication during pregnancy.

    Anxiety Disorders in Early Parenthood

    Diagnosis with post-natal depression often includes any one of many Anxiety Disorders. This can, unfortunately, leave women who aren’t depressed believing that feelings of panic and extreme anxiety are part of motherhood.   Around 16%* of women are diagnosed post-natal depression in the first year after the birth of their baby and triggers include adjusting to this major life change, sleeplessness, coping with the day to day stresses of motherhood and concerns about baby development.

    How Anxiety Disorders manifest during  Pregnancy and Early Parenthood

    Pregnancy Specific Anxiety

    Pregnancy Specific Anxiety is measured by a questionnaire that determines the level and classification of the anxiety disorder.  It’s been examined in depth as acute anxiety has been proven to have ongoing effects on the child, including pre-mature birth, difficulty concentrating and lower density grey matter.  Major triggers have been identified as fears of birth, fertility issues bearing a disabled child, marital problems, pregnancy complications, negative impact on career and being a younger mother to be.  Pregnant women can be assessed for the level of anxiety they’re experiencing and counselling may be recommended.

    Generalised Anxiety Disorder

    This is the most common diagnosed anxiety condition and is common in both pregnancy and early motherhood.  It manifests in excessive worry about the birth, living arrangements and parenting issues.  Symptoms may include lack of concentration, appearing “short tempered”, fatigue, insomnia and muscle tension.

    Panic Disorder

    Panic disorders can manifest in nausea, confusion, dizziness, racing pulse, extreme emotional state and difficulty breathing.  As some of these symptoms can also be attributed to pregnancy itself, women can feel panicked and be unaware of an underlying disorder.  Panic disorder is generally triggered by acute stress or fear making pregnant women especially vulnerable.

    Post-Traumatic Stress Disorder

    Post Traumatic Stress Disorder is surprisingly common in women who have had difficult births or a birth that did not go to plan.  Symptoms include “flashbacks”, panicked feelings, breathlessness and feeling faint when recalling various aspects of the birth.

    Situational Anxiety

    Situational Anxiety is the most common form of anxiety issue and is a direct response to a stressful situation – from a day to day situation to a major life change.  Most people experience situational anxiety at some point in their lives and early parenthood is one of the most reported periods.  A therapist may help identify periods where the anxiety is at its worst and recommend ways to manage it.

    Social Anxiety Disorder

    Social Anxiety Disorder is where the woman has an intense fear of public scrutiny or elevated levels of attention.  As pregnancy tends to increase a woman’s exposure to medical scrutiny and involves activity perceived as “humiliating” (such as constant weighing and invasive exams) it can heighten the symptoms of this disorder.  Similarly, a woman suffering post natal anxiety may feel as though she is being judged for her mothering skills.  This can lead to women withdrawing and isolating themselves, which can, in turn, lead to depression.

    Obsessive Compulsive Disorder

    Compulsive behaviour triggered by repetitive obsessions (intrusive and distressing thoughts and mental images) results from acutely stressful situations.  This is common after the birth of a child where a mother becomes fixated on preventing harm to the child.  The mother may experience “flashes” of disturbing images where her child is hurt or harmed and will compensate with a repetitive behaviour.   Early motherhood can trigger compulsive cleaning behaviours.

    Phobias including Agoraphobia

    Because of the “medical” nature of pregnancy and birth, the most common phobia is a fear of medical interference, bodily fluids and of course, the pain of childbirth.  In the early parenthood period, irrational fears may become overwhelming, especially those related to safety of the child.  Visualising “worst case scenario” consequences of contact with the object of fear can trigger extreme panic in mothers with acute phobias.

    Agoraphobia is a fear of being in a situation where she cannot escape and result in avoidance behaviours such as staying at home or avoiding specific locations.  Agoraphobics may experience a panic attack in such a situation.  This is more common towards the end of pregnancies where women are overcome by fear of labour and shortly after birth where a simple trip with a baby seems overwhelming and fraught with danger.

    Anxiety is an extremely common mental health issue and pregnancy issue.  It’s a leading trigger of pre and post-natal depression and can impact greatly both the mother and the child.  It’s vital for parents who need help to seek it immediately.

    Image Credit: Trevor Bair


  2. Different Types Of Anxiety Disorders

    April 17, 2013

    anxiety disorders

    by Tsvetan Petrov

    Everyone feels anxiety at certain point in their life. It’s completely natural to feel anxiety in challenging or dangerous times. That can come when a person is just feeling uncomfortable or in real threatening danger. Spending too much time in that state of anxiety can mean that there is an underlying disorder. Different things can cause these anxiety disorders and each one has their one particular effects.

     Anxiety Disorders – Most Common

    Generalized Anxiety Disorder

    A person that consistently feels anxiety when there is no practical reason to remain in that state might have a generalized anxiety disorder. When a person with this disorder is asked why they’re feeling that way, they won’t be able to answer clearly. The typical bout will take around 6 months. It’s particularly common in women. The anxiety doesn’t go away and continues to eat away at the people suffering from generalized anxiety disorders. That can lead to a number of medical concerns like insomnia, heart palpitations, dizziness, and headaches.

     Phobia’s

    People with a phobia don’t have consistent anxiety without a trigger. They typically have a very specific trigger for their anxiety. They develop an overbearing fear of something or some situation. That fear can be something close to reasonable or something completely unnecessary depending on the severity. Whenever that fear begins to kick in, the person suffering may experience strong feelings of fear. That includes trouble breathing, heart palpitations, nausea, and shaking. Some of the most popular phobia’s that people have are blood, small areas, animals, and heights. Phobia’s can lead people to make poor decisions in an attempt to escape a high anxiety situation.

    Panic disorder

    People suffering from Panic disorders or agoraphobia will unexpectedly suffer from massive bouts of anxiety called panic attacks. They’ll often include chest pain, dizzy spells, fear, shaking, and discomfort with being alone. Many panic attacks are completely irrational and sufferers often even know that is the case. Often people will go out of their way to not be alone or in a public situation for that reason. Panic attacks can be minor or severe enough that someone may cause self harm.

    Social Anxiety

    Social anxiety is a phobia of social situations. People suffering from social phobia will often suffer symptoms like a panic attack when they’re exposed to public situations. They may become dizzy, shake, feel short of breath, and they may even have heart palpitations. This social anxiety can occur with strangers or close friends. It’s often most severe when the person becomes the center of attention of the group.

    OCD – Obsessive-compulsive Disorder

    OCD is an anxiety disorder that is caused by an obsessive feeling or thought. They often will manage their own anxiety by doing repetitive tasks that don’t allow anxiety to slip in throughout the day. One common example is someone that is OCD about cleanliness. They can feel anxiety at the sight of a little bit of a problem. That will lead to the person cleaning and reordering continuously without any logical end in sight.

    Post Traumatic Stress Disorder

    When a person suffers through a particularly damaging event in their life, they may end up suffering from recurring bouts of that anxiety and stress. That is Post-traumatic stress disorder. It can often be caused by a simple similarity between the damaging event and what is happening (familiar object or person.) The person may suddenly fall back into reliving the events that they suffered through. This can lead to panic attacks, loss of control, and crying. Often people suffering will have less obvious symptoms like avoidance of certain situations and trouble sleeping. Post traumatic stress disorder can start instantly after the event or it can start decades later.

    Anxiety disorders need to be understood to be treated effectively in a healthy way. Many of the methods used to work with an anxiety disorder, not only control the symptoms, but also aim to strengthen the natural mechanisms. A person must be diagnosed and treated accordingly to eliminate the anxiety that they feel.

    Image Credit: Daniel Horacio Agostini