How to Manage Anxiety During Pregnancy: Tips from a Therapist
It’s common to experience anxiety during pregnancy- especially for those who have a history of anxiety. You may be feeling worried about your baby’s health and development, your own health, or just about this significant transition in life. But, just because many feel anxious during this time doesn’t mean you can’t do anything about it.
I’m Kayla Estenson Williams- a therapist who specializes in perinatal mental health as well as a mom who experienced anxiety during pregnancy and postpartum. I love supporting individuals and couples as they are growing their families, and often work on symptoms of anxiety during these transitions in life.
In this article, we will talk all about:
What causes anxiety during pregnancy
Signs and symptoms that you are struggling with perinatal anxiety
as well as some therapist-approved tips for managing anxiety during pregnancy
What Causes Anxiety During Pregnancy?
Life transitions and identity shifts
Whether this is your first baby or your fourth, growing your family is a major life transition. It’s perfectly normal to feel a bit worried or anxious amidst significant change. In small amounts, this worry helps us to think about what’s coming next and adequately prepare for change. It’s our brain doing what it’s meant to do! But- we live in a world that our brain’s weren’t necessarily designed for. We are exposed to so much more media and information- which can at times be helpful, but also can give our brains more fuel for that anxiety during pregnancy.
Hormonal changes
As your body changes to grow an entire human (!!!), your hormones shift in some major ways. Estrogen and Progesterone significantly increase during pregnancy and fluctuate throughout the trimesters of pregnancy. These changes in estrogen and progesterone impact how you regulate your mood- and many notice that these fluctuations throughout pregnancy and postpartum contribute to anxiety and depression.
Cortisol, which is a stress hormone, naturally rise during pregnancy to support fetal development. This increase in cortisol can lead to feeling more stressed and overwhelmed during pregnancy. Oxytocin and serotonin levels also increase during pregnancy and postpartum- which can have an impact on mental health. Our hormones are wired to change during pregnancy and postpartum to support both fetal development and our bonding with baby. We are literally wired to care more and be more cautious during this time- which is a protective factor that can also lead to symptoms of anxiety in many.
Past trauma
Significant life transitions, such as pregnancy and growing your family, tend to bring up our past wounds. For those who have experienced challenges in fertility, such as infertility or pregnancy loss, it makes sense to feel heightened anxiety during pregnancy. There may be more fears about something happening to this pregnancy, an already higher level of stress due to what it took to grow your family, or some unresolved trauma from the process.
Past attachment or relational trauma can resurface during pregnancy as well. Those who may have attachment wounds from their upbringing or a difficult childhood may feel fearful of repeating old patterns. Past trauma, especially if it hasn’t been worked through, may have lingering impacts on self-talk or feelings of self-worth. During pregnancy, these unhealed parts may lead to feelings of anxiety or depression during pregnancy.
Existing mental health conditions can be exacerbated
Those who have previous diagnoses or symptoms of mental health conditions, such as Generalized Anxiety Disorder or Major Depressive Disorder, are at a higher risk for prenatal mental health conditions. So, if you had anxiety prior to pregnancy, there’s a chance your anxiety will feel a bit more intense during pregnancy or postpartum.
Signs You Might be Struggling with Anxiety
While anxiety can look different for everyone, here are some common symptoms of prenatal anxiety:
Frequent worry or racing thoughts
While it is normal to have thoughts like “How should we set up a safe sleep space?” “What pump should I buy?” “What’s it going to be like when I take my leave from work?”, if you find yourself frequently worrying about the to-do list, or feeling these worries at a high intensity, you may be experiencing some anxiety.
Anxiety during pregnancy might look like racing thoughts about all of the “what-ifs”, frequently doubting and rethinking your choices, and frequent worry about you or your baby’s health.
Difficulty sleeping
Okay, yeah, about everyone during pregnancy could check the box off for difficult sleep! But, sleep disruption due to physical discomfort will show up a bit differently than sleep disruption from anxiety. If you are having difficulty sleeping due to racing thoughts before bed or difficult dreams- this may be a symptom of anxiety.
Physical symptoms associated with worry
A normal or minor worry thought likely isn’t associated with physical symptoms. Anxiety, however, can be accompanied with physical symptoms such as a racing heart, shallow breathing, sweaty palms, muscle tension, headaches, or digestion changes.
Avoiding triggers for anxiety
While avoiding certain triggers for anxiety such as traumatic birth stories, excessive parenting advice, or too much social media can be healthy- avoiding things in your daily life because they are associated with worry can be a sign of anxiety. Common things to avoid due to prenatal anxiety may be doctors appointments, going out in public, driving, or things that generally remind you of pregnancy or parenting.
Excessive checking or reassurance-seeking
Some who experience anxiety during pregnancy may seek reassurance as a coping skill. This can look like frequently checking baby’s heart rate, fixating on baby movements (more than just the observing that doctors recommend), excessively googling things about pregnancy or symptoms, or frequently asking others for reassurance when you’re worried. While all humans need some reassurance and support from time to time, once this becomes excessive it can be a symptom of anxiety.
Therapist-Approved Tips to Manage Anxiety During Pregnancy
Mindfulness or grounding techniques
Developing a mindfulness practice can be a great way to manage anxiety during pregnancy. When we are feeling anxious, we are typically focusing on the past or future- rather than the present moment. Practicing mindfulness can help us bring our focus back to the here and now by observing our thoughts, breath, or physical sensations. Guided meditations or breath practices can be a nice way to begin developing a mindfulness practice- here is a free guided breath practice to get you started.
Connecting to the present moment in any way is a nice coping skill for anxiety as it helps us to ground ourselves. The 5-4-3-2-1 skill is a helpful skill to ground you in the here and now. For this skill, you tune into 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Don’t worry about getting the order down right- just check in on whichever sensations are easiest to identify first.
Create a restorative routine
One of the best ways to support our resilience to difficult emotions is to create a routine that supports us. Sometimes the simplest things make the biggest difference. Connecting to a restorative routine before bed so that you can get better and more sleep, making sure you are eating meals and snacks throughout the day that feel good in your body, spending some time outside, moving your body in ways that feels good, and having time to connect to your loved ones and pets are some good foundation pillars for a supportive routine. There’s no need to overhaul your routine all at once- in fact, striving for the “perfect” routine can fuel anxiety. Meet yourself where you’re at and start with one small shift in your routine at a time.
Explore and challenge anxious thoughts
Getting curious with how your anxiety plays out can be helpful in figuring out how to address your anxious thoughts. For many, there is a general theme of anxiety. It may be anxiety about your baby, anxiety about relationships, or health anxiety. Get curious about what thoughts show up when you are feeling anxious and work to create some helpful challenges to anxious thoughts that you can come back to when you need. For example, if you are feeling anxious about the health of your baby, a helpful challenge statement may be “my doctor said that everything is looking well at my next appointment, and so I am working to trust in that.”.
Better navigate anxiety triggers
While we can’t and shouldn’t necessarily avoid all triggers to anxiety, there may be some things that are helpful to avoid if they are increasing your anxiety. A common one that I see show up is content on social media. For many, the influx of information on what you “should” do as a parent as well as content on what could go wrong can be a huge trigger for anxiety. Get curious with what influences your anxiety and see if there are ways that you can add in boundaries for those triggers.
On the other hand, there may be triggers for your anxiety that are important for you to continue exposing yourself to and learning how to navigate. These triggers may be going out in public, driving, or going to doctors appointments. Rather than avoiding these important activities, explore what ways you can support yourself as you navigate them. This may be by having a support person come with you, practicing mindfulness or grounding techniques, or giving yourself gentle reminders along the way.
Lean into support
Life transitions, including growing your family, need support! Identify who in your support system you feel you can rely on- this may be a spouse, family member, friend, or therapist. Opening up about your experiences and asking for support can feel vulnerable and overwhelming- and is the best way to let someone know how they can support you. If you feel that your support network is lacking, you might look into local pregnancy or parenting groups, or join a free Postpartum Support International virtual group.
Get professional help
I often recommend working with a therapist through any significant life transition. Meeting with a therapist who specializes in perinatal mental health can help you explore your own experience, learn and practice coping skills, and feel a strong sense of support throughout all of your family changes. You can check out Postpartum Support International’s Provider Directory here to find a therapist with training and experience in supporting those throughout pregnancy and postpartum.
For some, anxiety may be difficult to manage during pregnancy with coping skills alone. If you feel like you’re trying all of the things and it’s just not working, don’t hesitate to talk to your doctor about medication for anxiety. There are medications that are safe for pregnancy that can support you in navigating anxiety during pregnancy and postpartum.
When to Talk to A Therapist
Don’t feel like your discomfort has to be extreme before seeking professional support. Any perinatal therapist sees the importance of getting support through the transitions of pregnancy and postpartum- even if you are not experiencing perinatal anxiety or depression. If you’re considering working with a therapist during this time- then now is the time!
If you are noticing a significant increase in worry, difficulty navigating or coping with anxiety, or urges to avoid parts of your everyday life due to anxiety- now might be the time to take the next step towards therapy. If therapy is newer to you, know that most therapists offer a free 15-minute consultation so that you can check out if they would be a good fit for you. It’s understandable and completely okay to be hesitant about starting therapy if it’s not something that you’ve done before! Rest assured that your therapist gets it. They’re there to help you hold space for meaningful change during this time in your life.
We’re Here to Help
At Minnesota Attachment Collective, we hold space for those in the tender seasons of growing their family. We specialize in fertility challenges (such as infertility or pregnancy loss), pregnancy, postpartum, parenthood, and healing attachment wounds. We have current openings in Minnesota for individual and couples therapy- both virtual as well as at our Eagan, MN office location. Learn more about us and our services to see if we would be a good fit for you!