Make The Decision That’s Right For You
Many women prefer to avoid drugs entirely during pregnancy, but research is showing that having uncontrolled severe anxiety during pregnancy might cause problems for the baby, too. So, it definitely becomes a question of weighing the risks and benefits. Some women prefer to seek out cognitive-behavioral therapy or other non-drug anxiety treatments instead of pharmaceuticals.
In any case, the choice of whether or not to use anxiety medication during pregnancy is up to you and your doctor. If you are suffering from severe anxiety after a miscarriage, this is an important discussion to have.
Tips For Managing Panic Attacks During Pregnancy
If you are worried about pregnancy and panic disorder, these tips on how to manage panic attacks while pregnant may help you.
If you or a loved one are struggling with panic attacks, contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Have A Postpartum Plan
You may have heard of postpartum depression, a term used to describe when women experience depression symptoms, such as feelings of hopelessness and worthlessness, after the birth of her child. Similarly, women diagnosed with an anxiety disorder are at risk for increased anxiety after childbirth. Feelings of nervousness, fear, and isolation are common for new mothers.
Fortunately, heightened anxiety and panic-related symptoms may be prevented with some preparation. Even though postpartum is typically a busy time for most women, it is important that you follow up with your doctor and/or therapist about your panic disorder. Continue to work on your treatment plan goals, such as managing anxiety, coping with panic attacks, and dealing with loneliness. Having a postpartum plan can help you to maintain progress on your path towards recovery.
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What Can Be Done During Pregnancy To Deal With Anxiety
About 10% of women develop anxiety symptoms during pregnancy. Following the steps below will definitely help them to deal with the situation in a better way.
- ·Seek advice from your doctor about your plans to either become pregnant, or that you already are. The doctors instructions and medications will help you to deal with your anxiety and pregnancy strategically.
- ·Bond with your partner in a more strong and intimate way. This would ensure support and love which would help in dealing with the situations in a better way.
- ·Relax. Pursue hobbies according to your liking. Talk to your friends, go for walks, practice gardening. All these activities will divert you mind and keep your stress under control.
- ·Open up to your husband or partner and close friends and discuss your causes of stress. This will definitely help.
Drugs And Pregnancy Side Effects
The medications that are most often used to reduce anxiety in pregnancy fall into two classes: the benzodiazepines and the SSRIs .
Here are the assessments of the risk involved with taking specific benzodiazepines as evaluated by the FDA and the American College of Obstetrics and Gynecology. Each medication is given a grade that tells you what the risk is in taking it. Here is the meaning for each grade: A = controlled studies show no risk B = no evidence of risk in humans C = risk cannot be ruled out D = positive evidence of risk X = contraindicated in pregnancy.
Alprazolam = D
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What Are Some Symptoms Of Anxiety During Pregnancy
Since there are different types of anxiety disorders, the symptoms vary. Speak with your doctor about any symptoms you experience so he or she can accurately diagnose and treat you. Some common symptoms of anxiety disorders include:
- Feeling nervous, anxious or on edge frequently
- An uncontrollable sense of anxiousness
- Worrying excessively about things, especially your health or your baby
- Finding it difficult or impossible to relax
- Feeling restless and hard to stay still
- Feeling irritable and agitated
- Tension, pain or trembling in your muscles
- A numb or tingling feeling in your limbs, fingers, toes or lips
When these symptoms come on quickly and intensely, you may be experiencing a panic attack. People with anxiety experience the same symptoms and panic attacks regardless of whether they are pregnant or not. However, when you are pregnant, your concerns about the health of your child can increase the effects of your anxiety attack dramatically. That level of anxiety, and the physical effects of anxiety, can have potential risks for your health and your babys health.
What Are Some Causes Of Anxiety During Pregnancy
Most women experience some anxiety during pregnancy, and just about any woman can develop a severe anxiety disorder during pregnancy. However, there are some risk factors that can put a woman at greater risk for developing severe anxiety during her pregnancy. These include:
- A previous diagnosis of an anxiety disorder, panic attacks, or depression
- A family history of mood disorders or panic attacks
- Anxiety during a past pregnancy
- Previous pregnancy loss or fertility struggles
- Complications during pregnancy
- Stress at home or work
- History of abuse or trauma
- Stressful life events, like the death or illness of a loved one
- Lack of a partner or social support during pregnancy
- Relationship problems, including domestic violence
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What Anxiety Medication Is Safe For Pregnancy
Most drugs that treat anxiety fall into the same class of pharmaceuticals as antidepressants, which means that some can be tricky to prescribe during pregnancy. The American College of Obstetricians and Gynecologists cautions that prescribing these types of medications during pregnancy should always include a careful risk-benefit analysis.
Though some anxiety meds are considered relatively safe during pregnancy, you’ll need to work closely with your practitioner to determine which ones are right for you if medications are necessary to ensure your well-being and/or your babys.
Your doctor and a qualified therapist can work with you to decide which drug offers the most benefits for the fewest risks . If youve been on a medication for panic attacks, anxiety or depression pre-pregnancy, you may need to change or adjust your dose, too.
Pregnant Women Report Taking Medicines For Anxiety And Other Mental Health Conditions
Many women need to take medicine to stay healthy during pregnancy, including medicine for mental health conditions. Two studies from the Centers for Disease Control and Prevention found that a small number of women reportedtaking benzodiazepines or atypical antipsychotic medicines during pregnancy. Benzodiazepines are medicines used to treat anxietyexternal icon and atypical antipsychotics are medicines used to treat schizophreniaexternal icon, bipolar disorderexternal icon, and other mental health conditions.
Women should discuss options for managing their mental health conditions with their doctors if or when they start planning for pregnancy.
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Antiepileptic Therapy For Bipolar Disorder
Several antiepileptic drugs are used in the treatment of bipolar disorder, including valproic acid , carbamazepine , and lamotrigine . However, data on the fetal effects of these drugs come primarily from studies of women with seizures. It is not clear whether the underlying pathology of epilepsy contributes to the teratogenic effect of these drugs on the fetus.
Exposure to valproic acid during pregnancy is associated with an increased risk of neural tube defects, craniofacial and cardiovascular anomalies, fetal growth restriction, and cognitive impairment. Carbamazepine exposure during pregnancy is associated with facial dysmorphism and fingernail hypoplasia. It is unclear whether carbamazepine use increases the risk of neural tube defects or developmental delay. Although these drugs are superior to lithium in the treatment of patients with mixed episodes or rapid cycling, they should be avoided during pregnancy.
The use of lamotrigine during pregnancy has not been associated with any major fetal anomalies and is an option for maintenance therapy in women with bipolar disorder.
Valproic acid use during lactation has been studied in 41 maternal-infant dyads only one infant was adversely affected with thrombocytopenia and anemia. The American Academy of Pediatrics and the World Health Organization consider valproic acid safe in breastfeeding women. Carbamazepine is ruled probably safe rare side effects include transient cholestatic hepatitis and hyperbilirubinemia.
How Is Antenatal Anxiety Treated
Anxiety is treated with psychological therapies such as relaxation training, cognitive behavioural therapy or using mindfulness. You might also be encouraged to modify your lifestyle to reduce stress, exercise more and eat healthily.
In more severe cases, your doctor might prescribe medication. They will discuss with you what medicines are safe to take during pregnancy.
Remember, anxiety during pregnancy is common its nothing to be ashamed of but without treatment, it can get worse. You should talk to your doctor or midwife to get on top if it as soon as you can.
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Symptoms Of Antenatal Anxiety
- Worrying thoughts that keep coming into your mind like worrying that something may be wrong with your baby.
- Panic attacks which are outbursts of extreme fear and panic that take over your body and feel out of control. Sometimes this leads people to start avoiding situations for fear it may reoccur.
- Constantly feeling restless, on edge and irritable.
- Feeling tense in your muscles and tight in your chest.
Some of these symptoms affect us physically , while others affect us mentally . In turn, these thoughts and feelings can impact on our behaviour , such as checking to seek reassurance or avoiding people or situations that have made us feel uncomfortable. Living with the constant symptoms and trying to manage the intrusive, anxious thoughts can be exhausting.
Symptoms Of Anxiety During Pregnancy
Some degree of worry is natural during pregnancy. After all, the process may be entirely new for you. You may have faced situations in the past, like miscarriage, that give you reason for concern. But if these worries start to interfere with everyday life, you may have anxiety.
Symptoms include:
- feeling an uncontrollable sense of anxiousness
- worrying excessively about things, especially your health or baby
- inability to concentrate
- having tense muscles
- sleeping poorly
Occasionally, bouts of anxiety may lead to panic attacks. These attacks may start very suddenly with the symptoms above, and progress. During a panic attack, your symptoms may be very physical in nature, which can make the experience that much worse.
Symptoms of a panic attack include:
- feeling like you cannot breathe
- feeling like youre going crazy
- feeling like something awful may happen
While anyone can develop anxiety during pregnancy, there are certain risk factors that may contribute, including:
- family history of anxiety or panic attacks
- personal history of anxiety, panic attacks, or depression
- previous trauma
- use of certain illegal drugs
- excess stress in everyday life
Mild cases of anxiety usually dont require any specific treatment, though its a good idea to mention your feelings to your doctor.
In severe cases, your doctor may recommend medication after weighing the benefits and risks.
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Managing Panic Disorder And Generalized Anxiety Disorder During Pregnancy
Pregnancy is a time of great emotional change for women, often producing increased stress and anxiety. Gonadal steroid levels have been reported with as much as a 100-fold variation in serum estrogen levels and a 1000-fold change in serum progesterone levels during pregnancy. These changes can exacerbate such emotional difficulties.
Psychological factors may also have an important role to play in the development of anxiety disorders at this time. Often the expectant mother has concerns over the health of the child, the change in lifestyle likely to occur in her own life after the birth of the child, her own ability to be a good mother, and finances. There are also instances where the pregnancy is unexpected or unwanted, which may further increase stress and anxiety. For some women, pregnancy may bring to mind painful events in their lives with their own parents.
The Right Medication At The Right Dose
Kimmel suspects that some women may not respond well to antidepressants, because they are not taking enough or not taking the right one. Due to changes in blood volume and metabolism during pregnancy, women already taking antidepressants may have to take a higher dose to maintain the same effect.
While she generally does not recommend benzodiazepines for pregnant women, she warns that abruptly halting them is not advised.
And she stresses that some medications come with more risks than others.
For instance, one recent study found that while paroxetine and fluoxetine were strongly linked to birth defects, including cardiac defects, sertraline was not.
If you do need medication, our objective is to use the right medication and the lowest effective dose to get you well, she says.
Her advice to those mulling this tough question: Talk to your doctor about it and keep talking with your doctor about it. Different decisions can be made at different times to be sure you are doing all you can for your mental health.
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Can I Take Medication For Gad While Pregnant
If you have GAD and are pregnant, you may wonder whether it is safe for you to take medication. While this decision is best left to your doctor, typically medication is prescribed when the benefits are thought to outweigh the risks. In other words, if you suffer from crippling anxiety that will almost certainly negatively impact your pregnancy, medication may be a good option.
SSRIs cross the placenta but are considered reasonably safe during pregnancy. Babies of mothers who took SSRIs during pregnancy may suffer from neonatal adaptation syndrome, with symptoms such as jitters, trouble feeding, and irritability.
If you’ve taken benzodiazepines regularly during pregnancy, your baby will also be monitored for side effects of the medication.
You may also wonder about breastfeeding. All SSRIs have a low concentration in breastmilk and are compatible with breastfeeding. There is also ample data supporting the long-term safety and a lack of negative neurocognitive effects.
What Good Can Come Out Of It
Other than harboring some negative thoughts the expecting mother makes preparations to deal with anxiety and pregnancy. Several bodily changes take place during pregnancy.
One of the major concerns during this time is that whether their anxiety disorders will affect the unborn and worsen the pregnancy conditions and also after the baby is born whether they will be able to take care of the baby properly or not. Obviously, a great concern is whether or not the symptoms of their anxiety disorder will worsen during the pregnancy, and if they will be able to care for the baby after it is born. Whether intake of different medicines will affect the baby or not is also a cause of concern. All these thoughts however can elevate the levels of stress in the expecting mother.
The following facts can offer some hope for anxiety and pregnancy:
- ·During the pregnancy period and breast feeding period the medicines for anxiety disorders are quite safe for the baby.
- · About 40% of women experience a precise decrease of the anxiety pattern during pregnancy. However during postpartum the set of anxiety symptoms may return.
- ·The intake of medicines for anxiety disorders by the expecting mother can actually help in preventing the development of anxiety disorders in the baby later in life. If the mothers symptoms are not treated properly then however it may result in lower birth weight of the baby.
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