What is it?
Anxiety disorders may exist prior to pregnancy or childbirth, or have their onset during pregnancy or postpartum.
Anxiety disorders exist without depression but are often not assessed for.
Failing to address anxiety leaves women vulnerable to depression.
Anxiety is a normal reaction to stress and some amount of anxiety can be good.
It helps you respond appropriately to real danger, and it can help motivate you at work and at home.
A reasonable level of anxiety is also expected in pregnancy and following childbirth as there are many new things to learn and adjust to during this period.
However, when anxiety becomes excessive and interferes with your normal everyday life then it may be that you have an anxiety disorder and some additional help could be needed.
Anxiety often goes hand in hand with depression and is more common than
depression. Up to 20 to 30% of women experience anxiety in pregnancy and after delivery.
Generalised Anxiety Disorder
People with Generalised Anxiety Disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is often little or nothing to cause it.
They anticipate disaster and may be overly concerned about health issues, money, family problems, or difficulties at work.
Women who experience this during pregnancy or in the postnatal period often find that they often also worry excessively about the baby. For example, they might constantly worry about whether the baby is gaining enough weight, getting enough sleep, or about the baby’s health.
Women in pregnancy might worry about the health of the baby, childbirth, or whether they will be a good mother. Of course, many of these worries are a normal part of becoming a mother. When the amount and the intensity of worrying is excessive, it becomes a problem if;
the mother feels very distressed by it
the mother is unable to function properly
it causes difficulties for others. For example, a mother keeps picking up her baby which interferes with the baby’s sleeping.
People with GAD can’t seem to get rid of their worries, even though they usually realise that their anxiety is more intense than the situation warrants.
They can’t relax, startle easily, and have difficulty concentrating.
Often they have trouble falling asleep or staying asleep.
These often accompany the anxiety and the most common are:
- easily fatigued
- difficulty concentrating
- muscle tension
- disturbed sleep
- muscle aches
Fortunately there are good treatment options for GAD.
I felt nervous and anxious about the baby’s health and well being. I wanted to overprotect my precious baby. I kept thinking, “What if…. Or what if this happened, how would I cope?” I wasted so much energy thinking of all the things that could happen and the reality of these things happening was so slim! Again I assumed these anxious feelings were experienced by most first time mothers?
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Abramowitz JS, Schwartz SA, Moore KM, Luenzmann KR. Obsessive-compulsive symptoms in pregnancy and the puerperium: a review of the literature. Journal of Anxiety Disorders 2003; 17:461-478.
Ayers S. Assessing psychopathology in pregnancy and postpartum. Journal of Psychosomatic Obstetrics and Gynaecology 2001; 22:91-102.
Bailham S, Joseph S. Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice. Psychology, Health & Medicine 2003; 8:159-168.
Levine RE, Oandasan AP, Primeau LA, Berenson AB. Anxiety disorders during pregnancy and postpartum. American Journal of Perinatology 2003; 20:239-248.
Matthey S, Barnett B, Howie P, Kavanagh DJ. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? Journal of Affective Disorders 2003; 74:139-147.
Wenzel A, Haugen EN, Jackson LC, Brendle JR. Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders 2005; 19:295-311.
This information originated from the Mothers Matter website
Human Expressions of Fear
Fight: For humans fear might be expressed in physical or verbal aggression. If we respond like this when it doesn’t seem appropriate to others we alienate people.
Flight: This might manifest itself by avoiding certain situations/places or by only staying for short periods of time.
Freezing: This might manifest itself as failure to express ones thoughts or wishes at important times, or by seeming to ‘cut-off’ or by not acting to protect oneself.
Why do we get anxious?
When animals, including humans, become frightened they respond in one of three instinctive ways:
- By fighting (fight)
- By running away (flight) or
- By becoming very still or immobilised (freeze).
Thus fear induces either a fight, or a flight or a freeze response.
Examples in the animal kingdom include:
- Fight: The lead wolf in a pack weakens. Other wolves will fight him for dominance, he will fight back. They will keep fighting until one is clearly the winner. This occurs in many animal male hierarchies and the fight may go on to the death or until one is seriously hurt.
- Flight: A lion chasing a deer. The deer runs away putting every ounce of energy into its effort to escape.
- Freeze: Possums when threatened keep very still, or ‘play dead’ thus encouraging the threat to loose interest in them. This is where the phrase ‘playing possum’ comes from.
You may be able to think of many other examples.
Parents (usually mothers) of virtually all mammal species will respond in one of these ways if their young are threatened.
When an animal is frightened the body reacts in certain ways:
- The heart beats faster
- Blood pressure goes up
- Blood goes away from certain organs and towards muscles
- Breathing becomes more shallow,
- The mind becomes aroused and focused on the danger (but at the expense of processing other information about what is happening, people can’t “think straight”)
- Shaking and sweating occurs
- Hair stands on end and the skin gets “prickly”
- The gut gets churned up
- Adrenaline and cortisol levels go up
Fear feels awful but it helps to protect us from danger by enabling us to take evasive action. In the animal kingdom we think of this fear being caused by either a predator or by something else in the environment that is life threatening and this also applies to humans.
However, because humans are more complex they can feel fear from a greater range of circumstances.
Furthermore what may cause fear in one person may not cause fear in another person. For example an experienced tight-rope walker may feel no fear walking on a high narrow ledge; where as most of us would be petrified. An adult may not be frightened by other adults shouting angrily at each other but a child may be quite frightened.
How frightened we are in any particular situation depends on what meaning we give to the event/situation and what memories (both conscious and unconscious memories) we have of similar situations in the past.5
The information and advice found on this website aims to reflect current medical knowledge and practice. However, this is not a substitute for clinical judgement and individual medical advice. The website authors accept no responsibility for any consequences arising from relying upon the information contained on this website.
We take the accuracy of the information we publish on our website very seriously, and updateregularly. Please check back for updates, or let us know if you think the information is out of date.