My 28-weeks-along reader (no name given so let's call her Sarah) wrote wondering what to do about anxiety, her doctor's unsupportive attitude about anxiety and her worry about taking anti-anxiety medication during pregnancy. Sarah, you and just about every American alive is feeling anxious right now. The economy, election and general state of our society is making everyone edgy. Add on a pregnancy and a predisposition for anxiety and you're right in step with the rest of the country. I get it. I've been there and I think I can help you out a little.
First let's talk about anxiety in general. Anxiety is a normal response to stress. It's actually a coping tool to keep you focused. If it's a normal thing designed to help us cope why are so many people suffering so much of the time that it's preventing us from coping at all? Because we're under way too much stress too often. The question each person has to ask is what's too much and too often for them? This isn't a judgment or competition. What amounts to a bearable load for one person is too darn heavy for another.
Our country is currently suffering an epidemic of generalized anxiety disorder (chronic anxiety, exaggerated worry and tension, even when there's little or nothing to provoke it). According to the Anxiety Disorders Association of America, more than 18% of the population is currently living with a diagnosed anxiety disorder. That's just the ones who've sought treatment for it. There have to be a whole lot more who aren't getting therapy or medical treatment for it. And why not? Lots of reasons. Lack of medical insurance is a big one. Some people, like Sarah, feel uncomfortable talking to their doctor about it. Some doctors are uncomfortable too and don't have the time, training or resources to give it much focus during their time-crunched appointments. Some people feel the stigma of being diagnosed with anxiety (classified as a mental illness) is just too great and potentially harmful. So what do people do? They reduce the amount of stress in their life, develop techniques for reducing anxiety, take medication and/or learn to deal with it. Or they don't.
I was driving my kids to school when a guy turned the corner and rode his bike up along side my car. He came out of nowhere and surprised me. I veered away to give him plenty of room but apparently that freaked him out (not sure what he wanted but I'm certain veering in to him would have been a bad plan). At the next stop sign, he pointed at me and yelled, "STAY." My dogs in the backseat plopped their butts down and stayed. The guy then rode through without stopping and veered into traffic again. Cars were dodging him like crazy. Next stop sign, there he was again yelling at another car and this time using plenty of foul language. My daughter asked what was wrong with this guy. My initial thought was "he's a jerk, that's what." Fortunately, I activated my edit button before speaking and told her, "I think he's anxious about riding his bike in traffic. He's afraid someone's going to hit him so he's freaking out." This guy could use some coping techniques.
So Sarah, honey, what are we going to do with you? First of all, let's take this problem off your OBs list of things to do. Clearly, he's not equipped to deal with this. He's probably anxious about it (heh heh). I want you to find a good therapist (if you don't already have one) and a psychiatric nurse practitioner or supportive family practice doctor. Call your insurance provider or go online to find one in your area. Tell them about your anxiety and how you've previously taken medication for it. You're going to start developing non-medicinal coping and stress reduction techniques with your therapist and your nurse practitioner or doctor will help you deal with the medications. They can talk to your OB if you don't feel comfortable with that.
The bottom line about anti-anxiety medications is, they're not a good idea during pregnancy. You don't want to take them at all during the first trimester. If you really have no other choice, and you're under the care of a nurse practitioner or doctor who's keeping your OB in the loop, then use them as infrequently as possible. We don't want you freaking out and screaming at cars either.
I want you to take a good look at your lifestyle to find ways to reduce stress. If you know what triggers your anxiety, you might be able to control it. I for one, come unglued in super-crowded stores without a lot of exits. Therefore, I don't go to Costco.
Sarah, I want you to eat really well to arm your body with everything it needs to protect itself from stress. You need to get a plenty of sleep and exercise. Take a good walk every day and sign up for prenatal yoga. Streamline your job to minimize stuff that overwhelms you. Do something fun every day. If you don't already practice meditation now's the time to start. It's not hippy-dippy, new-age, airy-fairy. It's a scientifically solid, practical tool for dealing with stress. I want you to reduce the amount of stimulation you take in: pull out the earbuds, turn off the iPod, computer and television. Avoid frightening imagery like the news, scary stories and movies. Ask your family and friends to help you out. Reach out and allow yourself and your baby to be cared for.
Once you've finished your pregnancy and have a newborn in your arms, you're going to need these coping techniques to deal with a whole new line-up of stressors. Babies deserve a calm, focused mother who's totally there. Good luck, Sarah. Oh, and one last thing: if your doctor can't "deal with anxiety," is too controlling or makes you feel uncomfortable about it; find a new doctor.
Got a question for Jeanne? E-mail it to firstname.lastname@example.org and it may be answered in a future blog post.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.