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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.

How can you calm down during pregnancy and stop being nervous?

Nervousness and irritability during pregnancy

Pregnancy is a wonderful time in a woman's life. However, it is often overshadowed by some unpleasant physical or psychological sensations, including increased anxiety. It leads to a change in the hormonal background, which occurs during the bearing of a child. Anxiety is also often accompanied by excessive sensibility, irritability and nervousness. nine0005

Nervousness during pregnancy is absolutely normal and is neither a disease nor a symptom of it. Such a state may be associated with the mental anguish experienced by a woman, for example, if the pregnancy was given to her after many years of waiting, or, conversely, was completely unexpected. However, women with a perfectly safe pregnancy, who have no apparent reason to feel irritated or tearful, can also experience increased anxiety.

Medical studies show that 73% of all pregnant women experience unreasonable irritation and anxiety. Meanwhile, a calm and peaceful state of mind of the mother is very important for the proper development of the fetus and delivery in time.

How to calm down during pregnancy?

To relieve nervousness and anxiety in pregnant women, most doctors recommend the usual relaxation techniques: massage, soothing exercises, aromatherapy, a light diet, simple sedative preparations. At the end of the 20th century, music therapy.

Not so long ago, the largest scientific journal Journal of Clinical Nursing published the results of a study on the removal of psychological stress in pregnant women with the help of music. After listening to music for 30 minutes a day for three weeks, the women experienced significant reductions in stress, anxiety, and depression. The most interesting thing is that a reliable result from listening was even when the women were doing other things during it, for example, housework. nine0005

The effectiveness of this therapy puts it next to well-known methods such as relaxing massage and herbal preparations. Meanwhile, the versatility and accessibility of music treatment will undoubtedly soon make it the most popular among all other ways to relieve stress in pregnant women.

Music Therapy for Pregnancy

Music Therapy is a simple and inexpensive method of reducing stress with almost immediate results. Just half an hour of music therapy a day is enough to reduce nervousness during pregnancy, calm down, eliminate signs of depression and get rid of increased anxiety. nine0005

Of course, not all music is suitable for therapeutic purposes. Scientists note that the greatest result is brought by the sounds of nature, especially water, lullabies, as well as folk chants . You can read more about this in the articles What kind of music to listen to during pregnancy? and The Wonderful Properties of Lullabies.

Music therapy is gaining more and more respect among doctors and midwives. The absoluteness and simplicity of this method allows you to quickly solve the problem of how to calm down during pregnancy and stop being nervous. Use the advice of experienced mothers and scientists to turn nine months of waiting into the most pleasant and peaceful time for you. nine0005

Pregnancy stress threatens the health of the unborn child - DW - 11/07/2013

11/07/2013 November 7, 2013

It is well known that severe stress is harmful. Now scientists have taken up the question of how the stress experienced by the mother during pregnancy affects the health of the child.

https://p.dw.com/p/1ADc4

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Pregnancy, even if it is not the first, in itself, of course, is a fair amount of stress. But even if this were not so, hardly any woman manages to avoid the stress caused by various events of everyday life for all nine months. And therefore, almost any expectant mother asks the question: how will the stress she experiences affect the child? Can the fear, pain, grief, irritation, or arousal of the mother be transmitted to the fetus in the womb? nine0005

Maternal stress hormone in fetal blood

Not only can they be transmitted, but they must be transmitted, although, of course, still not in full, doctors say. The placenta contains a number of hormones designed to protect the fetus from the harmful effects of cortisol, the mother's stress hormone. But it still penetrates into the blood of the embryo. True, there its concentration is about 10 times lower than the maternal one, however, it is also enough to have a significant effect on the fetal body. nine0005

And not just significant, but long-term, often even permanent. This conclusion was reached by a group of doctors led by Professor Matthias Schwab (Matthias Schwab) from the Hans Berger Neurological Clinic at the University Hospital of Jena. The scientists reported the results of their research at the 21st annual session of the German Somnological Society, which took place in Wiesbaden.

“Antenatal stress leads to a long-term increase in fetal cortisol levels and accelerates brain maturation,” says Prof. Schwab, who heads the Intrauterine Brain Development and Later Life Programming of Disease Working Group. “For this reason, the stress experienced by the mother during pregnancy , is a serious risk factor that increases the likelihood of a child developing later depression and other pathologies. nine0005

Dreaming of a lamb in the womb of a sheep

Professor Schwab and his colleagues conducted their experiments on sheep, since in these animals the course of pregnancy and the formation of the embryo have a significant similarity with the same processes in humans. Pregnant - that is, pregnant - sheep, the researchers injected betamethasone, a synthetic glucocorticoid drug related to cortisol, which is often prescribed to women with the threat of preterm birth. This drug speeds up the development of the lungs in the fetus, which increases the chances of a premature baby to survive. Betamethasone was administered to pregnant sheep at a stage corresponding in pregnant women to the period between the 25th and 32nd weeks. nine0005

At the same time, scientists monitored the intrauterine brain activity of embryos using electroencephalography. It turned out that betamethazole accelerates the maturation of not only the lungs, but also the brain, says Professor Schwab: “This is evidenced, first of all, by the early appearance of dreams. Usually, the formation of dreams occurs in the last third of pregnancy, and this development occurs very gradually. And betamethasone literally includes there is some kind of toggle switch in the brain, and dreams are formed in 2-4 days." nine0005

Brain development inhibits cell growth and division

Another consequence of the introduction of the hormone was an abnormally frequent alternation of the phases of REM and non-REM sleep. This fragmentation of sleep, if it becomes permanent, indicates a high risk of developing depression later in life and, according to Professor Schwab, is often diagnosed in newborns whose mothers experienced severe stress during pregnancy.

The problem is that the premature maturation of brain structures occurs due to a slowdown in cell division and body growth, the scientist says. This is confirmed by other doctors. "Children given injections to accelerate lung maturation showed a very significant increase in stress axis activity and had a markedly lower birth weight," says Thorsten Braun, a gynecologist at the Charité University Hospital in Berlin. nine0005

Therapy with betamethasone is fraught with behavioral disorders

In Germany, 8 to 10 percent of pregnant women receive betamethasone. The fact that this drug reduces mortality among premature babies by 31 percent has long been scientifically proven. However, animal experiments have shown that taking the drug also causes long-term side effects - in particular, hypertension - and also contributes to the development of cardiovascular diseases and diabetes in later life. nine0005

As for a person, here scientists have identified, first of all, an increased risk of developing depression and behavioral abnormalities. Recently, Professor Schwab and his colleagues examined 40 eight-year-old children who had previously undergone intrauterine therapy with betamethasone. Comparing the test results of these children with the test results of children in the control group revealed significant differences, the scientist emphasizes: ". Electroencephalography also showed that these children could not relax before testing, and could not concentrate during testing. nine0005

No reason to panic

Apparently, the increased content of the stress hormone in the blood at the stage of intrauterine development leads to the fact that the body of the embryo gets used to this situation and begins to perceive it as the norm. "These babies are already programmed in the womb to produce too much of the stress hormone later in life," says Professor Schwab.

The Dutch colleagues of the German scientist - doctors at the University of Tilburg - found that maternal stress affects the fetus most negatively between the 12th and 22nd weeks of pregnancy: its consequences make themselves felt even 20 years later.

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