Anxious about being pregnant
Anxiety and pregnancy | Pregnancy Birth and Baby
Anxiety and pregnancy | Pregnancy Birth and Baby beginning of content6-minute read
Listen
If you are extremely distressed or having suicidal thoughts call Lifeline on 13 11 14 for immediate support.
Key facts
- Anxiety during pregnancy is also known as antenatal anxiety. Antenatal anxiety is common, and it can affect either parent.
- If you have antenatal anxiety, you may feel very anxious about your baby’s welfare, and seek frequent reassurance that they are healthy and developing normally.
- Seeking professional help early, when you first notice symptoms, will allow you to get the support you need before your baby arrives.
- If you suffer from anxiety there is support available. Ask your GP, midwife or child healthcare nurse for advice, or call one of the support services listed below.
What is antenatal anxiety?
It’s natural to feel a little anxious when you’re pregnant, but for some people, anxiety can become a real problem. If you suffer from anxiety there is support available, so it’s a good idea to know the signs.
Anxiety during pregnancy is also known as antenatal anxiety. Antenatal anxiety can affect either or both parents.
Anxiety is more than feeling worried in a specific situation. It occurs when feelings of worry and stress come on for no particular reason, keep coming back and can’t be controlled easily. If left untreated, anxiety can have a major impact on your wellbeing.
Anxiety is a common mental health problem in Australia. It is even more common during pregnancy. Despite this, many people assume that their symptoms are a normal part of pregnancy and don’t seek help.
If you have antenatal anxiety, you may experience symptoms of any of these conditions:
- In generalised anxiety, a person feels anxious on most days.
- In panic disorder, a person has panic attacks. These involve attacks of overwhelming anxiety, that may include physical symptoms such as shortness of breath, chest pain and dizziness.
- Agoraphobia refers to an intense fear of open or public spaces.
- In obsessive-compulsive disorder, a person feels an intense need to carry out certain behaviours or rituals.
- In post-traumatic stress disorder (PTSD), a person’s anxiety relates to a past traumatic event. The person may have bad dreams, vivid flashbacks and find it hard to relax.
- In social phobia, a person may feel intensely worried about being criticised or humiliated in public.
If you had anxiety in the past, you have a greater risk of developing an anxiety disorder during pregnancy. If you already have an anxiety disorder, it’s important to seek treatment early in your pregnancy, so that you and your baby receive the right support.
How do I know if I have antenatal anxiety?
You might have antenatal anxiety if you are expecting a baby and you:
- feel worried, stressed or on edge most of the time
- have fears that take over your thinking
- have panic attacks
- have tense muscles when you are doing daily tasks
- have trouble sleeping because of your thoughts or feelings
These symptoms can develop gradually, or may come on suddenly and intensely. They can get worse over time if they’re not treated.
If you have antenatal anxiety, you may feel very anxious about your baby’s welfare, and seek frequent reassurance that they are healthy and developing normally.
What’s the difference between antenatal anxiety and antenatal depression?
Many people with antenatal anxiety may also have antenatal depression.
If you have antenatal depression, you may experience symptoms such as:
- low mood
- feeling hopeless
- finding it difficult to concentrate
- difficulty sleeping or eating normally
- losing interest in activities you previously enjoyed
How is antenatal anxiety diagnosed?
If you notice symptoms of anxiety or depression, talk to your doctor, midwife or child health care nurse. They may ask about your feelings, give you a questionnaire to complete and ask to speak to your partner, if you have one. They may also do a physical examination.
Try to answer as honestly as you can — this will make it easier for your doctor or nurse to give you the treatment and support you need. Remember, postnatal anxiety and depression are extremely common. There’s no need to feel ashamed.
How is antenatal anxiety treated?
If your anxiety is mild, it may be enough for you to get more support from your doctor or child healthcare nurse.
More severe anxiety may need treatment with psychological therapies and, sometimes, medicines. Your doctor will discuss what this means for your baby and whether the medicine will affect breastfeeding.
Having antenatal anxiety can affect your ability to enjoy the pregnancy and prepare for parenthood. Seeking professional help when you first notice symptoms will allow you to get the support you need before your baby arrives.
There are safe ways to treat both anxiety and depression at the same time during pregnancy.
Where can I go for advice and support?
- Talk to your partner, or someone else you trust.
- Ask your GP or midwife for advice.
- Call one of these support services:
- PANDA (Perinatal Anxiety & Depression Australia) — 1300 726 306
- ForWhen — 1300 24 23 22 (Monday to Friday, 9.00am to 4.30pm)
- Gidget Foundation — online and telehealth support — 1300 851 758
- Beyond Blue — 1300 22 4636
If you are extremely distressed or having suicidal thoughts call Lifeline on 13 11 14 for immediate support.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
Beyond Blue (Anxiety), Beyond Blue (Types of anxiety), Beyond Blue (Anxiety and depression in new dads), Beyond Blue (Emotional health and wellbeing: A guide for new dads, partners and other carers), COPE Centre of Perinatal Excellence (Antenatal anxiety), Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Depression and Anxiety during pregnancy and following birth), The Parent-Infant Research Institute (PIRI) (Understanding Your Emotional Health - What are Postnatal Depression & Anxiety?), Perinatal anxiety and depression Australia (Antenatal anxiety: signs and symptoms)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: May 2022
Back To Top
Related pages
- Fathers and depression
- Postnatal depression
- Anxiety and parenthood
- Common worries and fears for parents
- Mental wellbeing during pregnancy
- Parental anxiety in the toddler years
Need more information?
Depression and Anxiety during Pregnancy and following Birth
It is widely thought that having a baby should be one of the happiest times of your life. However depression and anxiety are common for women during pregnancy and the first year of their child’s life, with as many as one in five women affected.
Read more on RANZCOG - Royal Australian and New Zealand College of Obstetricians and Gynaecologists website
Mental wellbeing during pregnancy
Your mental health and wellbeing during pregnancy is as important as your physical health. Learn how to look after yourself, how to know if you need help, and where to find it.
Read more on Pregnancy, Birth & Baby website
Common discomforts during pregnancy
Your body has a great deal to do during pregnancy. Sometimes the changes taking place will cause irritation or discomfort, and on occasions they may seem quite alarming.
Read more on Pregnancy, Birth & Baby website
Anxiety and Depression during pregnancy and the postnatal period
Read more on Black Dog Institute website
Exercise for Pregnancy - Exercise Right.
Exercise is important during pregnancy, do you know the facts? Read on and learn about pre and post natal exercise as well as important things to consider.
Read more on Exercise and Sports Science Australia (ESSA) website
Adjusting to change: expecting and new dads | PANDA
During pregnancy and after the arrival of your new baby, adjusting to the changes of parenthood can be pretty rough.
Read more on Perinatal Anxiety and Depression Australia (PANDA) website
Talking about mental health and parenthood
Mental health is something many new and expecting parents are afraid to discuss, but it’s important to be able to talk about it during pregnancy. Learn why here.
Read more on Pregnancy, Birth & Baby website
Depression and pregnancy
Pregnancy can have its ups and downs, but lingering feelings of helplessness, isolation or negative thoughts may be a sign of antenatal depression.
Read more on Pregnancy, Birth & Baby website
Common emotional problems in parents with new babies
A number of emotional problems can arise when you’re pregnant or have had a baby. Sometimes these emotional problems are all just called postnatal depression. This is not correct and can be misleading, especially since problems can arise during pregnancy too.
Read more on WA Health website
Anxiety & Depression in Pregnancy & Early Parenthood
If you are reading this, you may have concerns about your thoughts, feelings or behaviours, or those of your partner or someone close to you who is pregnant or recently had a baby.
Read more on Perinatal Anxiety and Depression Australia (PANDA) website
Disclaimer
Pregnancy, Birth and Baby is not responsible for the content and advertising on the external website you are now entering.
OKNeed further advice or guidance from our maternal child health nurses?
1800 882 436
Video call
- Contact us
- About us
- A-Z topics
- Symptom Checker
- Service Finder
- Linking to us
- Information partners
- Terms of use
- Privacy
Pregnancy, Birth and Baby is funded by the Australian Government and operated by Healthdirect Australia.
Pregnancy, Birth and Baby is provided on behalf of the Department of Health
Pregnancy, Birth and Baby’s information and advice are developed and managed within a rigorous clinical governance framework. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.
The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.
Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.
Support this browser is being discontinued for Pregnancy, Birth and Baby
Support for this browser is being discontinued for this site
- Internet Explorer 11 and lower
We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:
- Chrome by Google
- Firefox by Mozilla
- Microsoft Edge
- Safari by Apple
You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.
How can you manage anxiety during pregnancy?
Pregnancy is an exciting time. You will soon become a parent to an adorable, tiny human. You may expect to experience the rollercoaster of emotions during pregnancy, or emotions may catch you off guard. Some women feel joy at every flutter or kick, marveling at their changing bodies. For other women, pregnancy is hard, giving no reprieve as it brings severe fatigue, mood changes, and constant worries. You may notice that with every passing month, your thoughts are spiraling out of control, affecting your performance at work and your relationships at home. But how do you manage your anxiety, and should you treat it?
What causes anxiety during pregnancy?
Worries during pregnancy are universal. Hormonal changes of pregnancy, prior heartbreaking miscarriages, and sleep difficulties may all contribute to anxiety for mothers-to-be. You may worry about how a baby will affect your relationships with friends or family members, the health of your future child, the delivery experience, or the financial burden of an additional family member. All of these worries are completely normal. For humans, a certain amount of anxiety is protective; how else could we motivate ourselves to complete our work or run away from a bear?
What are the symptoms of anxiety disorders during pregnancy?
Although it’s normal to be worried about the health of your baby, in some cases this worry becomes debilitating and may require further attention. Thoughts about the health of the baby may become obsessive, even when doctors are reassuring. Worries may also appear as physical symptoms, such as a rapid heartbeat, difficulty breathing, or panic attacks. If this is the first time you experience a high level of anxiety, this may be frightening in itself. When anxiety starts to interfere with your day-to-day functioning, relationships, or job performance, it may be classified as an anxiety disorder — if your doctor picks up on it.
Anxiety can occur at any time during pregnancy, or it may first appear after delivery (perinatal anxiety is the term used for anxiety during pregnancy and after delivery). The rates of generalized anxiety disorder appear to be highest in the first trimester, likely due to hormonal changes. The most common symptoms of anxiety include constant worrying, restlessness, muscle tension, irritability, feeling dread, an inability to concentrate, and difficulties falling asleep due to worries. Some women also experience symptoms as a result of other anxiety disorders, including panic disorder, obsessive-compulsive disorder, or post-traumatic stress disorder.
Unfortunately, two of the most common mental health screening tools in pregnancy (the Edinburgh Postnatal Depression Screen and Generalized Anxiety Disorder 7-item Scale) are not great at detecting anxiety in pregnancy. Although underdiagnosed, anxiety disorders during pregnancy and in the postpartum period are common, and may affect up to one in five women. Many women suffer in silence.
What are the effects of untreated anxiety on the fetus?
When thinking about management of anxiety, it is important to consider both the risks of treatment as well as the harms of untreated anxiety. Although less studied than depression, research suggests that anxiety may negatively affect both the mother and the fetus. Anxiety increases the risk for preterm birth, low birthweight, earlier gestational age, and a smaller head circumference (which is related to brain size).
What are some treatments for anxiety during pregnancy?
Fortunately, there are many treatments that can reduce anxiety during pregnancy and help you feel better. For many women, anti-anxiety medication is not an option during pregnancy, as there is little information on the safety of such medication on the fetus. Some women who had previously taken medications for anxiety may wish to discontinue medications during pregnancy for personal reasons.
Therapies such as cognitive behavior therapy (CBT) demonstrate promise in the peripartum period (the period shortly before, during, and after giving birth). CBT focuses on challenging maladaptive thoughts, emotions, and actions, and it uses anxiety management strategies such as diaphragmatic breathing (adapted to pregnancy).
If your anxiety is severe, medications may be an option for you. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety during pregnancy and after delivery. It does not appear that SSRIs are associated with an increased risk of major congenital malformations. However, SSRIs may be associated with transient neonatal symptoms such as jitteriness, tremor, crying, and trouble feeding, which resolve on their own in a few days.
The use of benzodiazepines such as lorazepam (Ativan) and alprazolam (Xanax) during pregnancy has long been a controversial topic. Although older studies showed an association between their use and an increased risk for cleft lip and palate, a more recent study looking at benzodiazepine use during pregnancy did not show this link when these medications were used alone (although there may be an increased risk when combined with antidepressants).
What else helps anxiety during pregnancy?
- Engage in regular physical activity. In general, it is safe to engage in physical activity during pregnancy. However, if you are at risk for preterm labor or have pregnancy complications, consult with your doctor first.
- Ensure adequate sleep. Whether it’s a calming bedtime routine, pregnancy pillow, or a few nights in a bed away from your snoring partner, now is the time to learn what works for your sleep.
- Practice mindfulness. Research shows that mindfulness may reduce worries about labor, and it may even prevent postpartum depression.
- Journaling. Writing about your worries may help you brainstorm potential solutions, and it allows you to reflect on your concerns.
- Schedule worry time. We often worry because we do not want to forget something. Setting aside 30 minutes toward the end of the day provides you with a time to worry productively, but it frees you from holding onto your worries the rest of the day (practice reminding yourself "I’ll get to these thoughts later").
- Yoga, massage, meditation, and acupuncture. Finding relaxation techniques that work for you may take some experimentation — but their benefits will continue even after the baby arrives.
Fears of pregnant women are overcome - nine useful tips :: Clinician
25 10.2017
-
Unfounded fears
-
Unnecessary alarms
-
Worries unsupported by arguments
-
Natural doubts
The time of pregnancy is nine months of happy expectation of a miracle, but sometimes the same number of months of fears and worries about the unborn child. In order to find joy and avoid unnecessary worries, to enjoy the gestation period, the necessary task is to get rid of the complexes, having determined the cause of the anxieties, to “quench” them. Mothers, husbands, relatives, of course, will help you (psychologically and physically), but the main mission to overcome your own anxieties lies with the pregnant woman.
The cause of anxiety is most often the physiological restructuring of the body, which leads to overwork, a weakened physical condition. This means that the expectant mother from the very beginning is predisposed to anxiety precisely in terms of physiological indicators. But understanding this phenomenon does not make it easier. The attending physician prescribes vitamins, trace elements, and in some cases hormones. It seems to be competent and according to plan, but ... it's still scary!
But what are these very fears and how to overcome them? How many pregnant women, so many fears. Not all have a logical background, some are based on myths and superstitions, and some are based on elementary ignorance.
Unfounded fears
A woman does not always plan pregnancy while leading a normal life. And when she finds out about an accidental pregnancy, she begins to count with horror the number of glasses of wine drunk, cigarettes smoked, what harmful food she ate during conception. Of course, the correctness of the recommendations indicating the need for timely planning of pregnancy sounds reasonable. But if everything has already happened, a decision has been made to give birth, then it is important to clearly understand that the wisest thing is to bring your psychological state into harmony and create favorable conditions for the development of the fetus.
Fear of miscarriage is an understandable concern. To identify the problem as early as possible, take tests every other day. The best arguments for well-being in this matter are indicators and numbers.
Futile worries
To drink coffee or not to drink - fans of aromatic grain drink exhaust themselves with this question, who cannot live a day without this drink. But every morning to tremble at this thought is definitely harmful to the unborn child. Let's look for an alternative. Is it better to spend the whole day at work sluggish and sleepy than to still dare to drink a cup of coffee with milk to cheer up?
Recent scientific studies have shown that a cup of coffee a day does not harm the child. Pregnant women are allowed to drink, but it is recommended to use it less often, in addition, use sparing options: instant coffee or no caffeine at all.
Taking medicine or suffering pain (discomfort)? Pregnant women are usually extremely distrustful when even doctors prescribe pills to them. Even after the time spent at the consultation with a specialist, some “pregnant women” discuss the medicines prescribed by the doctor on women's forums for greater reliability. In order not to panic and not look on the Internet for advice from pregnant alarmists whose competence you are not sure, it is wiser to find a doctor who you can trust 100%! The field of gynecology in our clinic is one of the most developed and intensive areas of work.
Anxiety unsupported by arguments
Does it seem to you that your belly is growing slowly or, conversely, is it too big? This is not a serious cause for concern. The main thing is that the ultrasound confirmed that the fetus develops according to the deadline. Also, pregnant women worry that they are gaining weight rapidly or are malnourished. Eat a balanced diet and get enough (again, with the permission of your doctor) to move, then the weight will be within the normal range.
When the baby pushes hard, it is scary at first, and if the pushes are weak, perhaps even more scary. Indeed, both may indicate hypoxia. Share your concerns with your doctor, a toned uterus is a solvable problem. Just in case, study the so-called "method 10", based on the calculation of the fetal heart rate. So you will participate in the process not passively, but meaningfully. By the way, it is in your power to actively help the cub: walk daily in the fresh air, sign up for an oxygen cocktail course. Most likely, this is how the child simply shows temperament. But if the reason is more complicated, remember that medicine can cope with such problems. Hypoxia (if it is not chronic) is amenable to medical adjustment, as a result of which the tension of the walls of the uterus decreases, and blood circulation improves.
Childbirth is delayed, and this is fraught with the fact that a woman is daily absorbed in listening to herself and looking out for harbingers in fear of missing the start of the long-awaited process. On the one hand, vigilance does not seem to interfere, but one thing is clear - it is impossible to miss childbirth, there is no turning back. Perhaps the day of birth is simply incorrectly determined, because pregnant women do not always know the day of conception exactly.
Natural doubts
Are you afraid of natural childbirth, scary and surgical intervention? Remember that most panic plans (not related to pregnancy) are implemented in a completely different way than your imagination draws, so fantasizing, winding yourself up is not a good idea. Even if the child is born as a result of a caesarean section, this sometimes happens. The main thing is that the birth is safe for the baby and the mother. To give confidence in this matter, it is useful to attend childbirth preparation groups with your husband.
The fear of not being able to cope with a new role is familiar to everyone who has “passed through” pregnancy. Long before the birth of a child, a woman begins to "try on" motherly cares. And a common misconception here is to make demands on yourself based on the image of your own mother. After all, you are unique, you have your own ideas about care and upbringing, dreams and dreams. Anxiety is unproductive, they take away strength, depress energy, instead read a book about the development of the baby. When he is born, there will be much less time for reading.
In preparing for childbirth, it is important not only to follow the doctor's recommendations, but also to overcome fears. Psychologists believe that awareness of the causes of fears and knowledge help to cope with problems, especially for women - “courageous”, thinking and hardy beings.
Pregnancy - manage emotions
Pregnancy - manage emotionsRemote consultations with a doctor are available in our center! DETAILS
8 812 380 02 38St. Petersburg
Make an appointment
Pregnancy - manage emotions.
When a woman comes to a gynecologist's appointment and, being worried, says I want to have a baby, I am always happy for her. Expectant mothers are special, one might say, our most beloved patients. Among the many questions that arise when planning and bearing a child, there are not only medical ones, and often we have to become a little psychologists. I want to talk about the influence of the emotional factor on the course of pregnancy and the health of the unborn baby in this article.
It's good when pregnancy starts with planning. It is possible to solve health problems before conception, get tested for potentially dangerous infections. If treatment is required, the drugs used will not harm the unborn baby. It would seem that there are only pluses, but one tiny minus of responsible planning still exists. This is fear and excitement, “what if it doesn’t work out to get pregnant.” For women who are emotional, suggestible, with an increased level of anxiety, this can become a real problem. If every month menstruation is experienced as a tragedy, the body is in a state of chronic stress, which prevents the onset of pregnancy. There is a completely scientific rationale for this: for any stress, the level of the hormone prolactin rises, which, in turn, blocks the regulatory function of the ovaries, and the likelihood of pregnancy decreases.
A healthy couple has only a 15% chance of getting pregnant in their first cycle. You need to give yourself time, at least six months, to calmly wait. Gynecologists believe that there is a problem if pregnancy does not occur within a year. Tune in to the good, enjoy each other's company with the future dad, regardless of the day of ovulation. After all, the positive side of the planning period is that you can finally not worry about protection, there is time for yourself and for your spouse. The psychological situation directly affects the possibility of becoming pregnant.
One of the first questions that women who are planning a pregnancy ask at the appointment is “How?”. And so, it is worth getting out of a stressful state - the body itself begins to fulfill the main program laid down in it.
“When I found out that I was pregnant, I was delighted and was so delighted that many asked, what lottery did I win a million in? But after a certain time, the euphoria passed, and after studying articles on pregnancy in smart books and the Internet, it became scary - there are so many dangers for my unborn baby. Of course, I began to take care of myself more - eat right, rest, not take medicine, but still I constantly worry about the child, am I doing everything right, what if something goes wrong? - pregnant women often come to us with such questions.
I would like to answer: you are doing everything right, except for one thing - you constantly worry. Of course, pregnancy, especially the first one, is a cause for countless worries: fear for the health of the child, fear of changes in appearance, fear of the upcoming birth, can be listed for a long time. It is worth considering the changing hormonal background, which makes women more vulnerable and emotional. All this cannot but affect the well-being of the expectant mother and baby. With stress, toxicosis is more pronounced, the risk of developing complications of pregnancy increases: anemia, high blood pressure, preeclampsia.
“Smile and wave!” this should be the attitude of a pregnant woman to all troubles. It is not easy to maintain this attitude, due to the changed hormonal background during pregnancy, any little thing can unbalance. It is impossible to remain calm and unperturbed for all 9 months, but if these situations arise periodically and do not last long, they practically do not affect the child.
Strong and constant anxiety, prolonged chronic stress is harmful. Under stress, we begin to breathe incorrectly, and together with you, your baby “breathes” incorrectly and suffers from a lack of oxygen. As a result, there may be a delay in the development of the fetus, problems with the respiratory system immediately after childbirth. If the mother is calm, the blood circulation is normal, the baby receives enough nutrients and oxygen. If the mother is tense, agitated, the child begins to worry, he actively moves, moves, reacting to the mother's condition. Such a seemingly intangible thing as emotions directly affect the physical condition of the baby. In addition, the level of cortisol, the stress hormone, increases, which, passing through the placenta, can affect the development of the nervous system, laying in it a negative perception of the world.
Constant anxiety can lead to insomnia, which prevents you from enjoying your position and does not allow the body to recover. It depresses the immune system, and no magical kefirs to help the immune system will help while you are in a nervous state.
Stress, especially in the first weeks after conception, is one of the causes of premature birth. Doubts - “Do I need this pregnancy?”, “Am I ready to become a good mother?” and the experiences associated with it can already negatively affect the fetus. So we begin to rejoice from the very first weeks, do not hesitate to share our condition with loved ones, ask for help.
Light physical exercises, gymnastics for pregnant women, swimming, yoga are very useful for a positive mood. At the same time, this will prevent your muscles from losing shape, prepare the body for childbirth, and speed up recovery after them.
An active cultural life also helps to distract. If health allows, it is good to attend exhibitions, concerts, travel out of town. In general, do everything that brings pleasure to you and your baby, of course.
The impact on the development of the child of various factors, including emotional ones, depends on the duration of pregnancy:
- At the very beginning of pregnancy, in the first 2 weeks, a fertilized egg (and this is not a baby yet) migrates to the uterus. Since the egg does not yet have a common blood circulation with the mother, external factors have almost no effect on it. During these weeks, the process goes in 2 ways: 1) the fetal egg attaches to the uterus and begins to develop 2) if something goes wrong, the fetal egg dies. Usually at this time, the woman does not yet know about her pregnancy.
- The first trimester, (3rd - 13th weeks of pregnancy) is a critical period when all organs and systems of the fetus are laid and formed, so the impact of various harmful factors can cause malformations. So at this time it is necessary to take care of yourself as much as possible.