Anxiety in third trimester

Recognizing Anxiety During Pregnancy - Anxiety Canada

Pregnancy is an emotional time, and anxiety is just one of many feelings that pregnant women experience. A moderate amount of new fears and worries is normal and expected during this time of change. If you are experiencing quite a bit of anxiety, it can be helpful to first learn more about what anxiety is, and how it can show up during pregnancy.

“Late in my pregnancy I feel so panicky all the time, my heart feels like it is always racing and I can’t even take deep breaths. I’m so scared to have another panic attack, I barely want to leave the house.” – Susan

“I know it’s not rational but since I’ve become pregnant I keep having this constant sense of dread. Like something terrible is going to happen to my husband, and I will be left alone and pregnant. I text him several times a day to reassure myself he’s okay, but it doesn’t make me feel better for very long. I just hate being alone now.” – Anjali

What is Anxiety?

Anxiety is a natural, adaptive response we experience when we feel unsafe or threatened. We can experience many kinds of “threats” to the safety of ourselves and/or our loved ones. Sometimes we are anxious about something specific (e.g., waiting for the results of a diagnostic test). Some threats feel more vague, like a general sense that something bad will happen. We may also experience anxiety to a threat we are imagining in our heads, like picturing a loved one getting into an accident.

We can experience anxiety in these areas:

In our bodies (increased heart rate, sore stomach, tight chest and throat, shallow breathing, loss of appetite, difficulty falling or staying asleep, etc.)
In our mind (racing thoughts about the future; imagining the worst-case scenario; ruminating; worrying and obsessing, etc.)
In our actions or behaviours (avoiding certain situations, activities, places, or people; over-controlling; asking others for constant reassurance; checking things repeatedly; being extra careful and vigilant of danger, etc. )

Other possible signs of anxiety during pregnancy:

loss of appetite
difficulty sleeping
irritability
muscle tension (grinding teeth, neck and shoulder pain, back pain, muscle twitching)
difficulty concentrating and focusing
forgetfulness

How common is anxiety during pregnancy?

Anxiety is very common during pregnancy, and by some measures even more common than depression. Factors that could increase the chances of experiencing high anxiety during pregnancy include:

history of high anxiety and/or depression
perfectionism (believing you should not make any mistakes and do everything just right)
history of miscarriage(s)
high-risk pregnancy
major life stressors (such as marital or financial problems)

Anjali’s Story
Anjali is a 28-year-old married woman in her second trimester of pregnancy.

Anxiety During Pregnancy: Tips for Coping

Intro

A few months ago, you were thrilled to see that second line on your positive pregnancy test. Now? You’re feeling worried at every twist and turn that something might be wrong. It’s a feeling you just can’t shake, and it’s starting to affect your everyday life.

Isn’t pregnancy supposed to be a time of joy? If you suffer from anxiety, it can be complicated. Here’s more about anxiety during pregnancy and some ways you can cope.

You may have heard that postpartum depression is a major concern for women after delivery. But there are other mood conditions that may affect your pregnancy. More than 1 in 10 pregnant women experience anxiety at some point.

Some women experience a decrease in their symptoms during pregnancy, but your anxiety may get worse. After all, not everything that makes you feel anxious is under your control. Hormonal changes during pregnancy may affect the chemicals in your brain. This can cause anxiety.

Pregnancy is also a time of tremendous change. Some of these feelings and sensations are welcomed, while others are downright uncomfortable and scary. You may even have complications or other issues that arise that keep you up at night.

Some degree of worry is natural during pregnancy. After all, the process may be entirely new for you. You may have faced situations in the past, like miscarriage, that give you reason for concern. But if these worries start to interfere with everyday life, you may have anxiety.

Symptoms include:

feeling an uncontrollable sense of anxiousness
worrying excessively about things, especially your health or baby
inability to concentrate
feeling irritable or agitated
having tense muscles
sleeping poorly

Occasionally, bouts of anxiety may lead to panic attacks. These attacks may start very suddenly with the symptoms above, and progress. During a panic attack, your symptoms may be very physical in nature, which can make the experience that much worse.

Symptoms of a panic attack include:

feeling like you cannot breathe
feeling like you’re going crazy
feeling like something awful may happen

While anyone can develop anxiety during pregnancy, there are certain risk factors that may contribute, including:

family history of anxiety or panic attacks
personal history of anxiety, panic attacks, or depression
previous trauma
use of certain illegal drugs
excess stress in everyday life

Mild cases of anxiety usually don’t require any specific treatment, though it’s a good idea to mention your feelings to your doctor.

In severe cases, your doctor may recommend medication after weighing the benefits and risks.

Well-meaning friends may have told you that you need to stop worrying because it isn’t good for the baby. While their sentiment comes from a good place, you may feel like stopping the cycle is easier said than done. Still, research shows that there is good reason to get your anxiety under control.

High levels of anxiety during pregnancy are associated with a risk of developing conditions like preeclampsia, premature birth, and low birth weight.

1. Talk about it

If you’re feeling very anxious during your pregnancy, it’s important to tell someone. Your partner, a close friend, or family member may be able to offer support. Simply sharing your thoughts and feelings may be enough to keep them from taking over your everyday life. You may also ask your doctor to refer you to a therapist who is trained to help with anxiety. Some therapists specialize in helping pregnant women.

2. Find a release

Engaging in activities that help to lower stress and anxiety may be a good option for you. Physical activity helps your body release endorphins. These act like natural painkillers in your brain. Moving your body is one of the most recommended ways to manage stress.

Effective activities include:

walking
running
yoga

Don’t like to stroll, jog, or strike a pose? Do what you love! Anything that gets your body moving can help. Aerobic activity for as short as five minutes has been shown to have positive benefits. Always speak with your doctor before starting a new exercise routine during pregnancy.

3. Move your mind

You can try activities that help your body release endorphins without working up a sweat, including:

meditation
acupuncture
massage therapy
deep breathing exercises

The American Institute of Stress recommends deep abdominal breathing for 20 to 30 minutes per day to help with anxiety. Doing so will help provide more oxygen to your brain and stimulate your nervous system.

To try it, get in a comfortable seated position and close your eyes. Imagine yourself smiling inwardly and release tension in your muscles. Then visualize that there are holes in your feet. Breathe in and imagine the air circulating through your body. Exhale and repeat.

4. Rest up

It’s important to make sure you’re getting enough sleep. Though sleep may seem elusive during pregnancy, making it a priority may help significantly with your anxiety symptoms. Do you wake up often at night? Try sneaking in a nap whenever you feel the urge.

5. Write about it

Sometimes you may not feel like talking. All those thoughts need someplace to go. Try starting a journal where you can let out your feelings without fear of judgment.

You may find that writing down your thoughts and feelings helps you organize or prioritize your worries. You can track different triggers to share with your doctor, too.

6. Empower yourself

Tokophobia is the fear of childbirth. If your anxiety is tied to childbirth itself, consider signing up for a birth class. Learning about the different stages of labor, what your body does, and what to expect at each turn may help demystify the process.

These classes often offer suggestions for dealing with pain. They’ll also give you an opportunity to chat with other mothers who may be worried about similar things.

7. Ask your doctor

If your anxiety is affecting your daily life or you’re having frequent panic attacks, call your doctor. The sooner you get help, the better. Beyond referral to a therapist, there may be medications you can take to ease your most severe symptoms. You should never feel embarrassed about sharing your thoughts and feelings, especially if they concern you.

Don’t feel like you’re getting enough support? You can always explore changing providers.

Anxiety during pregnancy is common. It’s also highly individual, so what may work to help your friend may not alleviate your own worries. Keep the lines of communication open with the people you love, try some stress management techniques, and keep your doctor in the loop.

The sooner you get help, the sooner you’ll be able to gain peace of mind for your health and the health of your growing baby.

Share on Pinterest

Top — 9 fears of pregnant women - news from the clinic "Mother and Child"

The waiting period for a child is both exciting and disturbing. Let's try to understand some of them.

Dear pregnant women!

Some reasonable level of anxiety is good, but together with your doctor, you can overcome your level of anxiety and achieve your desired goal - the birth of a healthy baby.

Fear No. 1. Anxiety during the day and dreams at night, suddenly something is wrong with the child

A high level of progesterone during pregnancy makes a woman vulnerable, sensitive, and sometimes depressed. There is no need to be nervous, as this can provoke a threat of termination of pregnancy, use a simple auto-training: repeat to yourself that there is no reason to worry. If this does not help, you can use sedatives: motherwort and valerian are not contraindicated in pregnant women, discuss the use of these drugs with your doctor.

Fear No. 2. “On the day of conception, I drank a bottle of wine. I'm afraid the wine might hurt the baby. Maybe now I need to terminate the pregnancy?

In the first 7 days after fertilization in the fallopian tube, the egg has not yet attached to the uterine mucosa, so the damaging effect of wine drunk on the day of conception is not necessary. If it happened that you drank 50–100 g of wine, champagne or beer at a later date, this is also not a reason to terminate the pregnancy. But for the future, remember - alcohol and pregnancy are incompatible. As soon as you find out about pregnancy - give up any alcoholic beverages. The constant or episodic use of pregnant alcohol leads to serious consequences for the child: from congenital alcoholism to serious malformations. Stop smoking as soon as you find out you're pregnant! But don't think about terminating your pregnancy if you smoked in the early days without knowing you were expecting a baby.

Fear #3. “My husband is 41, I am 39, and we don't have children yet. We would like a child, but I heard that if I decide to give birth, my baby will most likely be with some kind of deviation due to the age of the parents. Is it true?"

Indeed, with age, the likelihood of having a child with Down syndrome, Pattau, Edwards and other congenital diseases increases, but there is no direct dependence on the age of the parents. Many women over forty give birth to perfectly healthy children. There are a number of accurate genetic studies that make it possible to determine at an early stage that there are no congenital abnormalities in a child.

Fear No. 4. “My friend said that you should not treat your teeth, because after pregnancy and childbirth they will still begin to deteriorate quickly, then they will need to be taken care of. And she also says that during pregnancy you can’t take any medicines and I should be treated only with herbs. Is it so?"

Your friend is wrong. Preparing for pregnancy involves visiting the dentist in advance before pregnancy. Caries is a serious source of infection, bad teeth provoke tonsillitis, gastritis and other inflammatory processes that are doubly dangerous for a pregnant woman. To prevent tooth decay after childbirth, take calcium supplements, eat cottage cheese and cheese, and take good care of your teeth.

As for herbal medicine during pregnancy, it should be treated with caution. Not all herbs are harmless, for example, oregano can provoke a miscarriage. Secondly, there are conditions when traditional medicines cannot be abandoned. Of course, you should not drink painkillers for any tingling, but the harm that a sore throat with a paratonsillar abscess will cause to an unborn child is much more serious than the harm from drugs that cure it.

Fear No. 5. “I feel good and would not want to give up my usual active lifestyle because of pregnancy. For example, I want, as before, to roller-skate, to travel. And my husband says that all this is dangerous for me and for our child. Which one of us is right?

You are both right and wrong. From traumatic sports (rollers, skiing, cycling, equestrianism, diving) will have to be abandoned, because pregnant women need to avoid falls, bruises and any physical injury. However, this does not mean that you need to lie on the couch for all nine months if the pregnancy is proceeding normally. Swimming, gymnastics for pregnant women, walks are very useful - it is better outside the city, in comfortable environmental conditions. Long-distance travel is not contraindicated if the pregnancy proceeds physiologically, without complications. It is important to choose the right route and means of transportation. Kayaks, motorcycles, hot countries, conquering mountain peaks, direct sunlight are prohibited. It is better to choose a relaxing holiday with the usual food and climate close to Russian, without a big difference in time zones. When it comes to air travel, it is best to consult your doctor, as it requires an individual approach. One of the relatives or a friend should accompany you during the trip.

Fear No. 6. “At the beginning of my pregnancy, I ate chocolate bars. But recently I learned that mom's food habits affect the tastes of the unborn child. Now I am afraid to eat an extra cake or a piece of chocolate: because I can make my baby a sweet tooth!”

In this situation, there is a risk of giving birth to a child - paratrophy with overweight and a tendency to allergies, as well as realizing latent diabetes in the mother! Western publications publish information that the taste preferences of a pregnant woman determine the taste preferences of her unborn child. We can confidently say that proper nutrition during pregnancy and feeding is the key to the health of your baby. It is advisable to think over the diet to the smallest detail, include in it products that provide all the necessary nutrients, vegetable and animal proteins, vitamins and minerals, fruits and vegetables, and take carbohydrates in a limited way, including chocolate, which is a strong allergen.

Fear No. 7. “I was already in danger of miscarriage. Now, as the doctor says, she has passed, but I still am afraid of accidentally provoking a premature birth. For example, I read that it is necessary to prepare the nipples for feeding, but I am afraid that these measures would cause a miscarriage. Or maybe all these fears are unfounded?

You really shouldn't massage and stretch your nipples to prepare them for feeding. But you can use other effective and gentle methods. Sew canvas tabs from the inside to the bra, regularly wipe the nipples with a decoction of oak bark frozen in the freezer, take air baths. Stock up in advance with a special cream that soothes irritated and inflamed nipples after feeding.

Fear No. 8. “Already in the second month of pregnancy, hair began to grow on my body, my stomach was covered with a dark fluff. I started to get better, and my friends unanimously say that after giving birth I will become completely fat. Is there really nothing that can be done, and will you have to pay for the birth of a child with an attractive appearance?

The appearance of hair is a temporary phenomenon, a consequence of hormonal changes during pregnancy, after childbirth it will pass. After childbirth, only those hairs that appeared during pregnancy fall out, so you are not threatened with baldness. Not all women get much better during pregnancy and lactation, while following a diet, weight gain can be influenced. The diet during pregnancy is determined by the doctor, taking into account concomitant diseases.

Fear No. 9. “Many women are afraid of childbirth, but I am not. I have attended maternity courses and have my own midwife, my birth is planned from start to finish. And since I know what will happen and how, I am not afraid at all.”

It is wonderful when a woman has knowledge and self-confidence. She knows how the birth process works and how to behave in order to help the doctor and the midwife.

Always with you, candidate of medical sciences, obstetrician-gynecologist of the Expert Center for Pregnancy Management of the clinic "Mother and Child - IDK" Romanova Elena Yuryevna.

Psycho-emotional disorders during pregnancy. The need for their correction | Tyutyunnik V.L., Mikhailova O.I., Chukhareva N.A.

Currently, more and more attention is paid to the influence of a woman's psycho-emotional state on reproductive function, pregnancy and perinatal outcomes [2,4,14]. In recent years, in developed countries, there has been an increase in the frequency of various mental disorders in women of reproductive age, the proportion of patients taking psychotropic drugs has increased, including among women who are planning a pregnancy and pregnant women [3,6,9].

Almost all pregnant women are subject to sharp emotional swings, since the expectation of a child is associated with changes - both physical and emotional. Hormonal changes during pregnancy lead to the fact that the mood of a pregnant woman changes dramatically almost every hour.
A future mother can get rid of such emotional swings and feel calm during pregnancy by observing the rules of emotional health. Emotional balance and physical fitness are equally important for a pregnant woman, they equally help her prepare for motherhood. Due to the lack of maternal experience, a pregnant woman may experience sudden emotional outbursts. The first pregnancy is a new experience that is quite difficult to comprehend. Ignoring the fact that the emotions of a woman who is expecting a child is much more complex and sharper than usual, can lead to a number of problems, including in relations with her spouse. Acceptance of this fact is the basis of emotional health during pregnancy [1,5,11].
Also, if a woman is pregnant for the first time, she experiences many fears, which include fear of childbirth and untimely termination of pregnancy, concern about the health of the unborn child and her own health, fear of labor pains and inevitable pain, fear of partner / spouse disappointment due to changes occurring with body. Modern women have to worry about careers, financial problems, and many additional costs associated with the appearance and upbringing of a new family member.
All these fears can lead to many negative emotions, such as anxiety, depression, irritation, anxiety, stress, anger, feelings of loneliness, confusion. Most often, changes in the psycho-emotional background during pregnancy lead to the development of depressive and anxiety disorders. Until the end, the pathogenesis of these changes is unclear, several theories are discussed, it is believed that changes in the hormonal background during pregnancy, including a significant increase in estrogens, and especially progesterone, in the blood serum can exacerbate existing emotional disorders [5,7,15]. As a rule, minor manifestations in the form of irritability, tearfulness, resentment accompany manifestations of early toxicosis in the first trimester of pregnancy - nausea, vomiting, etc. [6,10]. After the disappearance of these symptoms, the neuropsychic state of pregnant women usually improves. At the same time, an important role in the development of anxiety states is played by certain physical discomfort and psychological factors, which include forced changes in lifestyle, communication in the family and with work colleagues, concern for the health of the unborn child, financial difficulties - all this contributes to the appearance or exacerbation of psycho-emotional disorders during pregnancy. For some women, the onset of pregnancy is unexpected and not always desirable, however, due to the circumstances, a decision is made to prolong this pregnancy, which can lead to a further increase in stress and anxiety [5,8,12]. It should be noted that additional psychotraumatic factors may appear during pregnancy, such as the occurrence of pregnancy complications requiring hospitalization, or the detection of congenital malformations in the fetus, which can cause negative images and feelings [1,10,12].
The state of psycho-emotional stress with the presence of anxiety of various levels is observed in 40% of women with a normal pregnancy [2,7,11]. Borderline neuropsychiatric disorders can be presented in the form of hypochondriacal and hysterical syndromes. However, there are other forms of gestational borderline neuropsychiatric disorders, their features are the invariable inclusion in the clinical picture of certain psychopathological phenomena directly related to pregnancy: various fears for the successful course of pregnancy, obsessive fears for the fate of the fetus, expectation of childbirth, conditioned reflex fears associated with unfavorable past pregnancies and childbirth [5,6,8]. A study of pregnant women who do not have signs of borderline neuropsychiatric disorders showed that character accentuation was established only in a quarter of women. The first trimester of pregnancy is usually characterized to some extent by the sharpening of existing character traits. Soft, vulnerable, insecure women become even more impressionable, sometimes excessively tearful, and anxious (those women who have had miscarriages in the past or this pregnancy are not going well, in this case, the fear of another abortion can become simply obsessive) ). Powerful women with a sharp character can become even more aggressive, irritable and demanding. In the third trimester of pregnancy, emotional swings may begin again in connection with the expectation of childbirth, and with them fear - especially women who have to experience this event for the first time are susceptible to it [5,6,11].
Anxiety disorders may first appear during pregnancy, there may be a change in the course of already existing disorders. In one retrospective study in women with panic attacks, 20% of cases showed a decrease in symptoms during pregnancy, 54% remained unchanged, and 26% worsened the course of the disease [12]. The detection of depression in pregnant women is difficult. Many symptoms, such as emotional lability, increased fatigue, changes in appetite and cognitive decline, are often found in physiologically normal pregnancy. Under stress, the hormones of the adrenal glands of the mother release catecholamines (stress hormones) into the blood, and during the experience of positive emotions (joy, calm, etc. ), the hypothalamic structures produce endorphins, which, penetrating through the placental barrier, directly affect the fetus. Consequently, mother and child are a single neurohumoral organism, and each of them equally suffers from the adverse influence of the outside world, which is recorded in long-term memory, affecting the entire subsequent life of the child. Positive maternal emotions cause an increase in the growth of the fetus and an increase in the level of its sensory perception.
According to the literature [2,5,11,15], a significant effect of anxiety disorders on the course of pregnancy and perinatal outcomes has been noted: the frequency of placental insufficiency, fetal growth retardation, premature birth, the birth of children with low body weight, which subsequently affects negatively on long-term forecast for them.
Thus, emotional swings are dangerous not only for the woman herself, but also for her unborn child. When a pregnant woman experiences stress, her body produces more of the hormone cortisol, the main “stress hormone”. Cortisol increases blood pressure and blood sugar levels, negatively affects the strength of the immune system - which, of course, adversely affects the health of the child.
Stress during pregnancy is dangerous for a variety of reasons. Chronic stress experienced for several weeks can slow down the development of the cells of the body of the embryo, the growth of the fetus. This increases the risk of miscarriage or spontaneous abortion or premature birth. Elevated levels of stress hormones can damage the brain of an unborn baby and lead to parenting problems later on.
Psychological stress in the perinatal period brings with it a whole range of problems that require serious attention to the psychological sphere of a pregnant woman in order to avoid obstetric and other complications. However, diagnostic criteria for the transition of the stress syndrome from the link of adaptation to the link of pathogenesis of various diseases have not yet been found [2,4,15].
Emotional control is necessary to maintain normal emotional balance during pregnancy. A pregnant woman who successfully manages her emotions is aware of the changing emotional balance and is ready to accept what is happening to her.
There are several basic rules that will help to cope with emotional imbalance:
• You must come to terms with the fact that physical and emotional changes are an inevitable part of the pregnancy period. You need to understand that this is a temporary stage that will last only a few months and end a maximum of 1-2 months after the birth of the child.
• Each trimester of pregnancy brings new changes, both in the body and in the emotional state. The main source of information about pregnancy is special literature and the experience of women who have recently given birth, who can share their feelings and experiences.
• A pregnant woman is responsible for the emergence of a new life. Taking care of yourself means taking care of your child. Proper nutrition, rest and self-indulgence are essential.
• A pregnant woman should be open to dialogue and not be afraid to discuss her problems with a gynecologist, partner or friends - anyone who can provide emotional support. You should not keep fears and worries in yourself - this will only aggravate internal tension.
• Changes associated with pregnancy can lead to low energy and, as a result, rapid fatigue. You need to slow down, re-prioritize your work, and give yourself a break.
• Emotional tension and negative emotions can be overcome by being distracted by pleasant activities or hobbies. When emotions overwhelm you, try to analyze what is bothering you, and then find an adequate solution.
• Engaging in certain physical activities designed specifically for expectant mothers will help improve both physical and emotional health.
• The main components of emotional health during pregnancy are rest and comfort.
However, unfortunately, during pregnancy, a woman cannot always cope with nervous tension, irritability, anxiety, excitement and other symptoms of stress on her own. Therefore, in some situations, she needs medical help.
The relative risk of using drugs during pregnancy makes it difficult to choose therapy, therefore, for the correction of psychoemotional disorders that occur during pregnancy, herbal drugs that have practically no side effects can be considered as highly safe therapy.
The basis of anti-anxiety complex herbal remedies is valerian. It has been used in traditional medicine for many years for its hypnotic and sedative effects and remains a highly sought after remedy to this day. The mild hypnotic effect of valerian makes it possible to use it for the relief of shallow insomnia caused by anxiety. In addition, the vegetotropic effect of valerian is well known, its ability to have a uniform effect on both mental and somatic (vegetative) symptoms of anxiety. Valerian preparations also have anxiolytic and neuroprotective effects. The spectrum of side effects of valerian is very narrow and practically limited only to allergic reactions. Although valerian extract is metabolized by the cytochrome P450 system, it has virtually no effect on the metabolism of other drugs, and thus unwanted drug interactions are excluded.
Among the phytopreparations used by clinicians for the treatment of psycho-emotional disorders, Persen, a modern combined sedative preparation of plant origin, is widely used to relieve stress symptoms (anxiety, irritability and emotional stress) without causing drowsiness. Along with valerian, the composition of the drug includes dry extracts of medicinal plants with pronounced anxiolytic activity - peppermint and lemon balm (Table 1). The additional antispasmodic effect of peppermint makes it possible to successfully use the drug in patients with a pronounced somatic component of the anxiety syndrome. In addition, lemon balm has a nootropic (increased concentration and speed of problem solving), antioxidant effect. Persen is administered orally to adults and adolescents over 12 years old, 2-3 coated tablets, 2-3 times / day, Persen forte - inside to adults and adolescents over 12 years old, 1-2 capsules 2-3 times / day.
The advantages of Persen over other sedatives are:
• the preparation contains only natural ingredients;
• the effectiveness and safety of herbal ingredients Persena are well studied;
• does not contain alcohol and bromine;
• can be combined with any psychotropic drugs, including antidepressants;
• effective as a fast-acting symptomatic remedy when it is necessary to stop the symptoms of anxiety, agitation, and during a course of treatment for stress conditions, anxiety and phobic disorders.
Due to the natural components of plant origin that are part of Persen, this drug can be used during pregnancy. In each case, the doctor must evaluate the benefits and risks of taking Persen and other drugs, depending on the severity of the symptoms of the disease.
Thus, to prevent possible development, as well as to treat psycho-emotional disorders in pregnant women, it is advisable to use sedatives, the effect of which softens the damaging effects of psychogenic factors.

Literature
1. Abramchenko V.V., Kovalenko N.P. Perinatal psychology: Theory, methodology, experience. Petrozavodsk, 2004. 350s.
2. Avedisova A.S. Anxiety disorders // Alexandrovsky Yu.A. "Mental disorders in general medical practice and their treatment". M: GEOTAR-MED. 2004, pp. 66–73.
3. Voznesenskaya T.G., Fedotova A.V., Fokina N.M. Persen-forte in the treatment of anxiety disorders in patients with psychovegetative syndrome // Treatment of nervous diseases. 2002. No. 3 (8). pp. 38–41.
4. Vorobieva O.V. Psychovegetative syndrome associated with anxiety (issues of diagnosis and therapy) // Russian Medical Journal. 2006. V.14. No. 23. S. 1696-1699.
5. Grandilevskaya I.V. Psychological features of women's response to the identified pathology of pregnancy: Abstract of the thesis. dis. ... cand. psychol. Sciences. SPb., 2004.
6. Kasyanova O.A. Socio-psychological factors in preparing women for pregnancy, childbirth and motherhood: Abstract of the thesis. dis. ... cand. psychol. Sciences. Yaroslavl, 2005.
7. Kovalenko N.P. Psychoprophylaxis and psychocorrection of women during pregnancy and childbirth: Abstract of the thesis. dis. … doc. psychol. Sciences. SPb., 2001.
8. Filippova G.G. Psychological readiness for motherhood // Reader on perinatal psychology: Psychology of pregnancy, childbirth and the postpartum period. M., Izd-vo URAO, 2005. 328 p.
9 Davidson J.R.T. Pharmacotherapy of generalized anxiety // J.