Written by Psychologist Nikolina Miljus
Anxiety during pregnancy is very common with 1 in 4 women facing moderate to severe anxiety while pregnant. We looked at the best treatments for anxiety in pregnancy starting from those that are completely pregnancy-safe, to therapies that can carry risks for your baby’s development.
Anxiety is an unpleasant feeling of worry, nervousness and fear of the threat that is not currently present in your surroundings. The fear ties to something that is about to happen in the future or something that potentially can happen right now.
Pregnancy, as one of the greatest life-changing experiences, is usually a source of anxiety, as well.
If you are a first-time mom, not knowing how the physical, emotional and the changes in your relationship will play out or how will your labor go and will your baby be healthy is a natural source of worry and anxiety in pregnancy.
If you have been trying to conceive for a while, have been through miscarriage or a difficult labor in your earlier pregnancies, your new pregnancy inevitably gives rise to anxiety. Worrying how will this pregnancy go and whether you’ll be able to carry the full term is a perfectly understandable source of anxiety.
Financial security, social support from friends and family and the quality of the support you might or might not have from your partner can all be additional roots of anxiety in pregnancy.
Given all the uncertainty pregnancy brings, it’s no surprise that up to 25% of all pregnant women experience moderate to high levels of anxiety.
When anxiety starts to interfere with your everyday functioning by creating uncontrollable worry-filled thoughts about potential adverse outcomes of pregnancy and labor, disrupts your sleep and appetite or makes you feel tense and unable to calm down for most days, it’s time to look into best treatment options for anxiety in pregnancy.
Here is the overview of best treatment options starting from completely pregnancy-safe to the anxiety treatments that carry an element of risk during pregnancy.
Healthy lifestyle choices to lower anxiety when pregnant
1. Balance your diet for pregnancy
Healthy nutrition is vital for the baby’s development. By including vitamins, minerals, and additional supplements, you can also boost your mental health and give your body more resources to handle the anxiety in pregnancy. Vitamin B, iron and zinc alongside omega-3-fatty acids are all beneficial for your optimal brain functioning.
If you’re encountering excessive anxiety in pregnancy, you also need to consider limiting your caffeine intake. Coffee and caffeinated beverages can make you feel twitchy and tense and this is the last thing you need when trying to manage anxiety.
2. Exercise to relieve stress and anxiety
Aerobic and cardio exercise, even in short intervals, boost the levels of the hormones called endorphins, also known as “the happiness hormone.” If you prefer walking, jogging or you’re into strength training, taking as little as 30 minutes daily can help you manage stress and anxiety in pregnancy. Yoga exercise can be especially beneficial since it combines physical activity with conscious breathing. An additional benefit of regular physical activity in pregnancy is keeping your body flexible and healthy. This way you have more resources at your disposal to tackle the anxiety.
3. Create Good sleeping habits
Worry, negative thoughts and tension can take a toll on the quality of your sleep. The less you sleep, the easier it is to become overwhelmed and stressed out by the symptoms of anxiety. By acting proactively and making sure you get a good night sleep, you are giving yourself a better chance to manage anxiety.
A way to ease into sleep is to make your own “sleep ritual.” For an hour before bedtime avoid loud and bombastic TV shows or spending time online and treat yourself to the relaxing bubble bath instead. Of course, you can choose any relaxing and soothing light activity you enjoy.
Anxiety and self-care in pregnancy
4. Making time for self-care
Self-care means acknowledging you are in a challenging situation and showing the same compassion for yourself as you would for your close friend or a partner if they were in a similar position. Self-care also means taking time for yourself and away from house chores, work responsibilities, relationship issues or ongoing stress for at least half an hour each day.
By making time for self-care when you’re anxious you’re allowing your body & mind to restore the natural resources you have at your disposal.
5. Managing worrying thoughts
Worry-filled negative thoughts and “what if” thinking create a self-sustaining cycle of anxiety. The more you think, the more anxious you get. Because there are so many uncertainties in pregnancy, uneasy thoughts never stop and only prolong the feelings of anxiety. A way to control thoughts like these is to have a compassionate conversation with yourself.
Reassure yourself you are doing the best you can in the situation you are inat the moment. You can’t control every possible outcome of your pregnancy. By making yourself worried sick you are not helping yourself or your baby.
6. Sharing your feelings and worries
Talking about anxious thoughts and worries you have about your pregnancy and labor is a very powerful treatment for anxiety. Just think how much better you felt after a friend comforted you when you were dealing with complicated emotions in the past. There is no reason you shouldn’t rely on the people closest to you now.
By including your partner in what you are enduring mentally during your pregnancy, you are creating a space to get comfort and reassurance. Hearing a different point of view or simply feeling loved and knowing you are not alone will help you ease the burden of anxiety in pregnancy.
For any medical concerns about your body, your baby or about the potential complications in pregnancy or during the labor, don’t hesitate to speak with your midwife or your GP. The more accurate and expert knowledge you have, less uncertainty you’ll face.
Relaxation techniques for managing anxiety
7. Calm your breathing
The unpleasant aspect of anxiety comes from physical changes it triggers, starting from the hyper-production of the stress hormones, the shortness of breath and chest tightness, to hyperventilation. By calming your breath, you can directly influence these changes and signal your body there is no immediate danger.
To calm your breath, you can start by inhaling deeply through your nose until you feel your stomach muscles tightening. Next, count to three and slowly exhale through your mouth. Repeat this pattern at least 10 times to feel your body completely relax.
8. Try guided meditation
With the assistance of a trained teacher, guided meditation or guided imagery meditation can be a very powerful tool for managing anxiety in pregnancy. Soothing atmosphere and a calm voice guide your imagination toward peaceful imagery and happy memories.
The positive sensations you visualize while meditating can later serve as your “safe place” to recuperate when you feel overly anxious. These days, you can get guided meditation recordings for free online, so you can practice whenever you find it convenient.
9. Try progressive muscle relaxation
Progressive muscle relaxation (PMR) is somewhat comparable to the guided meditation. The goal of this technique is to relieve muscle tension, an unpleasant and frequent side effect of anxiety in pregnancy. PMR can be applied to specific muscle groups (e.g. neck and shoulders) or to the whole body, one muscle group after another.
In the first phase of PMR, you tense the muscle as much as you comfortably can. Next, you relax the muscle and perceive the sensations in the relaxed area. As an added benefit, PMR can also assist with the back pain many pregnant women struggle with during their pregnancy
Psychotherapy choices for anxiety in pregnancy
10. Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is a brief, actionable and effective psychotherapy choice for managing anxiety in pregnancy. In as little as six weeks CBT can assist pregnant women significantly reduce anxiety and prenatal depression-related symptoms.
The focus of CBT is to encourage you to understand how your thoughts and perceptions can shape the type and the intensity of your emotional reactions. Next, the CBT sessions focus on helping you strengthen the skills necessary to manage worrying and “what if” thoughts. By learning how to address the uncertainty in pregnancy, you have a higher chance of successfully reducing the anxiety, as well.
11. Interpersonal therapy
Interpersonal therapy (IFT) is routine psychotherapy choice for managing antenatal depression and anxiety, the two frequent mental health concerns in pregnancy. Similar to CBT, IFT is a comparatively short-term treatment, confirmed to be useful in helping pregnant women to manage anxiety. Unlike CBT, the focus of IFT is on interpersonal relationships, earlier and present ones.
The IFT can cover re-examining your feelings about your original family, your relationship with your partner, as well as processing the emotions arising from any prior unsuccessful pregnancies and pregnancy-related losses.
Pregnancy-safe alternative anxiety treatments
12. Hypnotherapy
Hypnosis involves a trance-like relaxed state in which you are more receptive to suggestions. When a professionally trained hypnotherapist guides you to a hypnotized state, he or she can assist you with managing concerns you have about your pregnancy or a life with a new baby.
Modern hypnosis is very much different from waving the watch and hypnotist issuing instructions to do specific actions. Today, the focus is on self-hypnosis and empowering you to guide yourself to a relaxed state. The self-hypnosis can assist you to handle anxiety in pregnancy more effectively, and support you during the labor pains when prepared with a verified practitioner.
13. Acupuncture
The 2500 years old Eastern practice of acupuncture is a pregnancy-safe alternative treatment for anxiety in pregnancy. The acupuncture includes the precise insertion of very fine needles with the goal of redirecting Qi into physical and emotional healing processes.
When a reliable practitioner performs acupuncture, it can assist in managing the anxiety in pregnancy. Additionally, as an integrative practice, acupuncture can relieve morning sickness, back pain or pelvic girdle pain in pregnancy.
14. Homeopathy
Homeopathy has been around for more than 150 years as an alternative healing practice. Homeopathic remedies can be used in pregnancy because they contain microscopic amounts of active ingredients. And, two homeopathic medicines called Argentum nitricum (or the “What if medicine”) and Arsenicum (completely unrelated to the poisonous arsenic) can be useful in treating symptoms of the anxiety in pregnancy.
As with other alternative healing practices, homeopathic treatment for anxiety in pregnancy should be used only when supported by a verified homeopathic practitioner.
Anti-anxiety medications in pregnancy
15. Antidepressants
Even though their name suggests otherwise, antidepressant medications are frequently used medication choice for managing moderate to severe anxiety. Most commonly used antidepressants in pregnancy are SSRI (brand names: Zoloft, Prozac, Lexapro) and SNRI (brand names: Venlafaxine, Cymbalta ).
The current evidence on the safety of their use in pregnancy is overall inconclusive. Instead, your mental health professional alongside your GP and midwife can help you consider all potential risks of untreated severe anxiety in pregnancy and the potential risks for the health of your baby.
16. Benzodiazepines
Medications like Xanax, Valium or Lorazepam are some of the most common benzodiazepines, also known as sedatives or anxiolytics. These medications are used specifically to treat anxiety. If you encountered generalized anxiety disorder or panic attacks before your pregnancy, chances are you received benzodiazepine treatment at some point. In pregnancy, the anxiety treatment with benzodiazepines is used only when it is absolutely necessary due to the potential risks for the baby.
The benzodiazepines are addictive. 40 percent of people taking them for more than six weeks become addicted and encounter withdrawal symptoms upon stopping the medication. What this means for you in pregnancy, especially if you are on benzodiazepine treatment in your third trimester, is that your baby can become dependent on benzodiazepines and experience neonatal withdrawal syndrome. The addictiveness is one of the main reasons why most health professionals will advise the use of benzodiazepines as a treatment for anxiety in pregnancy only after careful consideration.
Anxiety in pregnancy is feeling almost all pregnant women encounter. Alongside life-changing transformation pregnancy brings, your current life situation or your mental health history can make the anxiety worse in any particular moment of your pregnancy.
What you can do if you feel anxious most of the time during your pregnancy is to seek help. Effective and pregnancy-safe treatments for anxiety in pregnancy are available. Sharing your worries and feelings sometimes can be enough to help you get through this. In other cases, you might need a professional help.
Keep in mind that anxiety and feelings of sadness and depression are common in pregnancy. You do not need to feel guilty or ashamed if you are feeling anxious when you’re pregnant.