How to Manage Your Anxiety Disorder During Pregnancy and New Motherhood

By Dr Natasha Bijlani

Dr Natasha Bijlani, a consultant psychiatrist at Priory Hospital Roehampton with a specialist interest in women’s mental health issues and pregnancy-related mood disorders, has outlined the steps women can take to manage the impact anxiety has on themselves and their baby during pregnancy and new motherhood.

Read on for her advice to all expectant new mums suffering with anxiety…

If you have an anxiety disorder or have had one in the past, it is likely that you’ve thought about the possible effect it will have on you and your baby during pregnancy and beyond.

While it is completely normal to feel some stress and worry at this time, it’s important that you don’t shrug off and ignore any excessive concerns that you may experience. 

I would advise that you spend time talking to your doctor or another knowledgeable professional such as your midwife to ensure that you can get access to the right level of support and treatment. It is important that your mental health is well-managed and monitored so that you are able to function well and look after both yourself and your baby.

Speak to your doctor about your anxiety medication

Before you make any changes to your prescribed medication, book an appointment with your doctor to discuss it in more detail. They will be able to provide you with updated information about your medication during pregnancy and help you to weigh up the pros and cons of continuing or discontinuing your treatment, working with you to help you decide on the best way forward.

You may receive reassurance about the relative safety of the medication that you are already on, or you may be advised to gradually discontinue it. Typically, doctors tend plan ahead and prescribe medications with a safer evidence base in women of childbearing age.

Never stop taking your medication without speaking to your doctor, as this can cause you to experience unpleasant discontinuation symptoms. It can also cause you to re-experience the symptoms of anxiety that you were being treated for.

Take steps to monitor and manage your anxiety symptoms 

If you are worried about any particular symptoms, or find that some symptoms start to appear or worsen during your pregnancy, speak to a medical professional right away. 

Discussing any symptoms that you are concerned about with a knowledgeable professional such as a midwife, general practitioner, psychiatrist or psychologist can provide you with reassurance as well as practical coping strategies such as relaxation methods or sleep advice. 

If pharmacotherapy is needed, your doctor will usually aim to prescribe the lowest dose required of the most appropriate medication, for the shortest, clinically appropriate time.

Women are at their greatest risk of mental ill health following childbirth and the risk is greater if they have a past or family history of mental illness. Therefore, it is advisable for all pregnant women and new mothers to be well-monitored throughout their pregnancy and in the first few weeks following childbirth so appropriate management can be provided as soon as possible.

Make time to look after your physical and emotional health 

Maintaining a healthy lifestyle throughout your pregnancy can be beneficial for managing anxiety symptoms.

Eat a balanced diet, get enough sleep, do appropriate exercise and drink adequate amounts of non-alcoholic fluids. Also make sure that you find the time to unwind from your daily commitments, engaging in activities that you find pleasurable whether that is socialising, reading, or going on a daily walk. Additional benefits can be obtained from formal relaxation techniques, such as diaphragmatic breathing, progressive muscle relaxation and meditation.

It is also helpful to read factually accurate information about pregnancy, childbirth and motherhood so that you are reliably informed about changes to expect, and don’t spend time worrying about the unknown. 

Don’t attempt to go it alone 

The most valuable piece of advice I can give new mums struggling in any way is to communicate and share their feelings and problems with someone they trust.

Ignoring distressing anxiety can lead to an excess of damaging stress hormones and result in unhealthy coping behaviours, such as poor sleep habits and a disordered dietary intake.

So, talk to your partner, your mother or a close friend and don’t hesitate to consult your health visitor, midwife or general practitioner for advice and help.