Updated: Feb 3
Thinking back to my days when I was pregnant, I remember being struck by the reams of information readily available about postnatal depression and anxiety. I vividly recall how well it had been stamped across the NHS clinic hallways when I used to go for my pregnancy check-ups. The posters usually followed the similar motifs of black and white dramatic photographs; featuring a silhouette of a woman staring vacantly through a rain-washed window. The ‘warning signs’ would always be punctured in an appropriately aggressive bold font across the picture. It certainly drew the needed attention to the cause and that affirmed my belief that postnatal mental health was becoming more of a widely spoken-about issue. I remember thinking about how far we had come as now the critical attention and awareness was being raised on a very real issue.
However, it wasn’t until after the birth of my child that I realised there was so little information about prenatal depression and anxiety. This is an interesting paradigm as a study on just that had been conducted by the University of Cambridge titled ‘The Prevalence of Antenatal and Postnatal Anxiety: Systematic Review and Met-Analysis.’ The study declared that ‘The prevalence for self-reported trait anxiety was 29.1% for the first trimester, and 32.5% for the third trimester.’ **
Those are staggering figures that beg the question as to why information and support isn’t as readily available as there is about postnatal anxiety. In fact, I didn’t even realise I had experienced it at all until I spoke to a therapist and explained my symptoms. I even remember thinking, “prenatal anxiety, what is that?”
Pregnancy, childbirth and parenthood brings a littered trail of paradoxes and contractions. We experience pendulums of great joy and tortuous self-doubt. Pregnancy itself has its own delightful ingredients of sickness, nausea, a scattering of wistfulness and some meaty handfuls of mood swings all chucked into one messy soup of hormones. Of course, there is no doubt that it is a beautiful time for many of us. I mean, the mere concept of growing another human being inside your own body is certainly one that is utterly awe-inspiring. However, those mood swings can be horrendous for some of us, which is why it can be difficult to differentiate between the natural imbalance of pregnancy hormones and out-right prenatal anxiety.
We all experience different reactions to when we first discover that we are having a baby. For some of us it can be an exciting and blissfully joyous experience, while others have mixed emotions or just feel a constant flood of panic gradually crescendo in size in parallel to your growing baby too. It definitely makes you wonder; how are we supposed to cope with all of that in one body? Anxiety while pregnant can take the form of obsessive thoughts, worry, regret, panic and self-doubt. These are of course natural, especially if that protective instinct has kicked in early-on and we want to provide the best for our child. However, it is when those lows are more prevalent than the highs that we should consider that we could actually be suffering from prenatal depression or anxiety.
What causes prenatal anxiety? Although all of our reasons and lives are different, prenatal anxiety is often caused from circumstantial stress and unresolved traumas. Pregnancy can be an intensely stressful period. We live in a time where we are lucky enough to have the latest and greatest research on child development readily available for us on our phones to compare our fears of inadequacies whenever we should wish to. The need to strive for perfectionism has become a normal part of being an expectant mother. We are bombarded with conflicting advice and judgements from other parents, veteran mothers and social media. No wonder prenatal anxiety is so prevalent! Impending motherhood can be terrifying.
We have worries of eating right, eating wrong, ensuring we have a financially and emotionally stable permanent home for our little ones, all the little bits of crap that they will never use, have the best pregnancy multivitamins, are eating dairy-free, meat-free, gluten-free, paleo, vegan, keto GOD KNOWS WHAT! Oh, and not to mention exercising sufficiently enough, and balancing studying or a career too., knowing for certain how we will feed and receiving vitriol for our choices from either the breast-feeding mafia or the formula-feeding army. Also, if you already have children and extra demands, then you are actually looking at balancing the snot, trauma and stress on top of even more spinning plates.
All of those worries, mixed with the ticking clock of the 9 months until showdown can add extra pressure to say the least. On top of this, you also have a delicious, bubbling cauldron of hormones and pregnancy, not the greatest environment to harbour emotional balance – put it that way!
I remember how I worried about everything. At one point, I developed a tiny rash on my stomach and I was not able to sleep until around 3am because I was convinced that it would somehow pass through to the baby and harm it. Similarly, whenever I had a cold or a fever, I thought I was harming the baby too. The worry of sustaining such a fragile life by myself terrified me, so everything seemed to trigger my anxiety. Anything could go wrong and it felt like it would always be my fault as the walking life support system of my growing baby. I remember how I kept prodding my stomach to check the baby was still moving enough, waking the poor little thing up while he was sleeping and trying to grow. Whenever cramps would occur, the feeling of sheer panic that I was going to miscarry would flood my thoughts. I even remember anxiously going to the toilet to check for blood or any signs that I might start to miscarry.
The worst symptom had to be the constant paranoia. I was paranoid that people had negative intentions around me and that I needed to protect the baby from those feelings at all costs. The curtains were drawn, a limit of only two close friends were ever allowed around and I cut myself off from most of my acquaintances or colleagues by withdrawing from social media completely. I found their constant pregnancy-related questions to be invasive and predatory and subsequently blocked out most of the people I used to regularly come into contact with. In hindsight I can see that these were the actions of someone clearly acting out of fear, a natural response to feeling understandably vulnerable. Now that I can reflect on it, it is clear that I felt scared and threatened. Those people may not have actually intended to seem intrusive. What I didn’t understand at the time is that it is an intriguing curiosity to see a pregnancy develop from a distance. I have learned that it is all about perspective and that our vision can be easily clouded through assumptions made when we feel threatened – a very common symptom of anxiety in general.
Here is a list of the most common symptoms of prenatal anxiety. If you find that any of these apply to you.
Symptoms of Prenatal Anxiety Physical Symptoms:
Feeling light headed or nauseous
Feeling restless/ wanting to move around
Needing to go to the toilet more
Tingling in fingers and toes
Thoughts and Feelings:
Unable to keep calm/ tense
Worrying about the worst
Feeling like time is going to quickly or too slowly
Paranoia that people are staring at you
Worrying that you are being irrational
Feeling disconnected from the world or the people around you
Worrying about the anxiety or depression happening
A constant feeling of dread
If you have found that you have noticed that a number of these have applied to you then you might be suffering from the symptoms of prenatal anxiety. Don’t panic though as there are a whole array of effective treatments that could help.
Talking to a therapist – Cognitive Behavioural Therapy (CBT) can be quite helpful. Sometimes just talking to a trained professional can help as they will endeavour to find the root of your anxieties and find ways to help you. This might also help as a form of support throughout the postnatal period too.
Group Therapy Sessions - Talking to other mums-to-be can be really helpful because you will realise that you are not alone in this. Prenatal affects an average of 25% of pregnant women, remember. Also, you never know, by sharing your own experience might help another woman suffering from the same feelings.
Self- Help Guides – There are loads of books, leaflets, audio books, podcasts, YouTube videos and blogs that can all help you. I would recommend that you speak to a licensed therapist or a doctor about recommended guides because some may contribute to your worry about perfectionism if they have not been articulated properly.
Speak to your Doctor – Don’t panic, this does not necessarily mean that you are going to be put straight onto medication. Even if you are offered it, a lot of medications are safe to take while pregnant without harming your baby. Also, speaking to your doctor or midwife might help in that they could refer you to local support groups that specialise in perinatal mental health. This does not mean that you are going to be seen as a threat to your baby either. These groups are there to help you and support your journey as a mother with your baby. I remember being terrified that someone would think I was crackers and take my baby away from me. These thoughts actually prevented me from reaching out for help, which was actually making it even harder to cope with everything.
Self- care – It is so important to take time out to do the things you enjoy; this will help you relax and take your mind off what is causing your anxieties. Even running a warm bath or talking to a friend can help.
The crux of the matter is; healthy mother – healthy baby! You need to look after yourself and prioritise your mental and physical wellbeing in order to provide a safe environment for your baby. More often than not we can lose self-compassion along the way of prioritising the needs of our baby too, so be kind to yourself, you are growing a PERSON inside of you, remember?
It is easier said than done to try not to think about all the material things you need to have and achieve by the time the baby arrives, but honestly, all the baby will want is your unending love and comfort. Yes, it can be difficult to shift your focus but the support is out there and there is help. Prenatal anxiety is more common than most of us realise so it is important to know that you are not alone. Reach out for help.
Jimi D Katsis is a Bristol based consultant psychotherapist at jimikatsis.com specialising in recovery from trauma, depression, and anxiety