Anxiety Disorders and Pregnancy

What is perinatal distress?

Perinatal distress is a general terminology used to describe several conditions and symptoms that women may experience before, during, and after birth which include:

  • depression
  • anxiety 
  • stress 

Perinatal distress may also include issues associated with pregnancy complications such as pregnancy loss, premature births, miscarriages, stillbirths, terminations, and infants born with disabilities or other issues.

What is anxiety?

The term anxiety disorder represents a family of mental disorders associated with fear and anxiety. Both mental states — anxiety and fear — are thought to be important evolutionary mechanisms that enhanced chances of survival in a once-primitive world. In today’s presumably safer world, anxiety and fear still serve a purpose but when these feelings linger or are experienced with intensity, quality of life suffers.

Anxiety that reaches the point of a disorder is the obsessive worrying about real or imagined events expected in the future. An unhealthy fear, or phobia, creates difficulty when facing challenges of everyday living. When these symptoms are present at the same time, anxiety disorder is diagnosed. The disorder can take form as panic attacks, separation anxiety, situational anxiety (fear of leaving home, for example), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). People suffering from depression, bipolar disorder, eating disorders, and substance abuse are often diagnosed with anxiety disorders, too. Caffeine, alcohol, recreational drugs, and some prescription medications can heighten one’s sense of anxiety when a disorder is present.

How is anxiety diagnosed?

Medical history is an important diagnostic tool for anxiety disorders. Symptoms often begin in childhood and the disorder frequently runs in families. Certain traumatic life events trigger anxiety disorders, too, as is the case with PTSD and combat soldiers, rape victims, and survivors of a natural disaster.

When an anxiety disorder is suspected, clinical screening questionnaires often confirm the diagnosis or identify the need for further testing.

What causes anxiety?

When a parent has an anxiety disorder, his/her children are six times more likely to develop similar disorders than children whose parents don’t have any form of the disorder. Children who experience traumatic childhoods, regardless of parental diagnosis, are more prone to develop anxiety disorders due, perhaps, to a heightened sensitivity to threats or danger.

In adulthood, extreme stress can trigger a diagnosis. Violent or traumatic events are often associated with PTSD but financial, employment, and marital strife can trigger anxiety disorders. The stress of chronic illness can lead to anxiety disorders; the condition is closely associated with age-related dementias.

How is anxiety treated?

Lifestyle changes that resolve the stress triggers and cognitive therapies are the first approaches to treating anxiety disorders. Medications can help but are easily misused, especially during episodes of high anxiety. If the disorder is caused by substance abuse, the patient is urged to stop its use.

How can anxiety disorders affect pregnancy?

Anti-anxiety drugs may not be safe during pregnancy and nursing. Women taking these drugs before pregnancy are urged to discuss their medication regimen with their Ob-Gyn before conception or at the first signs of pregnancy. Alternative options or dosage adjustments may be needed for the safest pregnancy possible. When anti-anxiety medications are prescribed during pregnancy, it is important to notify one’s prenatal medical team of these and all new prescriptions.

How prevalent is anxiety?

Estimates indicate 4.5% of the global population suffers from an anxiety disorder, with females being twice as likely as men (5.2% and 2.8%, respectively) to develop it. Approximately 29% of the US population is expected to experience an anxiety disorder at some time in life.

Except for substance abuse, anxiety disorder is the most common psychiatric condition in the US population. Anxiety disorders account for more workplace disabilities than any other cause.

Read More:
Perinatal Distress in Women in Low- and Middle-Income Countries: Allostatic Load as a Framework to Examine the Effect of Perinatal Distress on Preterm Birth and Infant Health
Pregnancy Depression
Mood Swings and Emotional Changes During Pregnancy
How to Manage Bipolar Disorder During Pregnancy

What is Anxiety Disorder? National Institute of Mental Health. National Institutes of Health. n.d. Web. 6 Oct. 2014.
Anxiety Disorders. American Psychiatric Association. American Psychiatric Association. n.d. Web. 6 Oct. 2014.