Understanding anxiety as a mum to be
In this section of the site we will examine what anxiety is, how it can manifest itself, and look at some simple ways you might be able to gain more control over it.
Before you learn about some strategies for managing perinatal anxiety, it is important to understand what anxiety is, and what symptoms is can produce. This is because better understanding your anxiety is the first step towards learning how to manage it.
NB – if your anxiety symptoms are so intense they interfere with your normal day-to-day life, we recommend that you seek help from your GP or another healthcare professional (if you haven’t already done so). It may be that you require more support than this site is able to provide.
What is anxiety?
In many ways, anxiety is helpful. From an evolutionary stand point, fear and anxiety have helped us to survive. When faced with a situation where our safety or wellbeing was on the line, our fear or anxiety would kick in, activating the regions of our brain that control our body’s fight or flight response; those primitive, automatic reactions that prepare us to fight or flee from a predator. Our breathing and heart rate increase, our muscles tense, we experience nervous sensations in our body… all in preparation for survival. And while effective in situations where your survival is on the line, our bodies don’t know the difference between being faced by a sabre tooth tiger or the anxiety we feel as a result of modern day stressors. Whether the object of our anxiety is real or imaged, the biological response is essentially the same.
Sometimes the things we are anxious about are obvious – a fear of childbirth, the health of your baby, or a visit to the doctor to discuss test results. But sometimes people feel anxious all of the time, without any specific trigger or perceived threat that they can point to.
Anxiety is a perfectly normal and useful response when it protects us and is not out of proportion to the threat. However, it becomes a problem when we start to overreact to the normal stresses of everyday life.
Anxiety consists of three types of symptoms: thoughts, physical symptoms and feelings, and behaviours.
- Physical symptoms and feelings might include: Rapid or irregular heartbeat, feeling breathlessness, hyperventilation, butterflies in the stomach, tense muscles, shaking/trembling, nausea, dizziness, feeling overwhelmed, clammy hands, tingling in hands or feet.
- Thoughts refer to the inner speech (or images) that we have going on in our own heads. When we are anxious, these thoughts can often be unhelpful, focusing on the object of our anxiety. These anxious thoughts may be occasional, or sometimes they may be racing, repetitive and intrusive; imagining worst-case scenarios, or ruminating, worrying and obsessing.
- Behaviours are the things that we do to manage our anxiety, but as we’ll see, can often make symptoms worse. This might include avoiding anxious situations, activities, places, or people; constantly checking things you are worried about, or repeatedly asking others for reassurance; being overly cautious and hyperaware of potential threats or dangers, etc.)
Each type of symptom feeds into the others, and can exacerbate the anxiety.
Cognitive Behavioural Therapy
One therapy that is really effective in the treatment of anxiety is Cognitive Behavioural Therapy (CBT). This therapy is built on the premise that dysfunctional cognitions (thoughts) are directly linked to emotional distress, which in turn can lead to behaviours that can maintain or escalate anxious feelings. The aim of CBT is to alter these problematic patterns of thinking and behaviours, and as a result, change the way they feel.
Some perinatal examples:
NB don’t worry if you don’t relate to the examples here… no two people are the same, and people experience anxiety is very different ways. These are just examples that cover some of the experiences women with perinatal anxiety report.
Activity : How do you experience anxiety?
Before you can treat your anxiety symptoms, the first thing you really need to do is understand how your anxiety manifests itself, as people can experience anxiety in very different ways. Take some time to think about your own experiences with anxiety in terms of the CBT type of model. What are the Thoughts, Physical Symptoms & Feelings, and Behaviours associated with your anxiety?
Physical Symptoms & Feelings
Thinking about how you experience anxiety may initially feel a bit uncomfortable, and may even make you feel anxious. Don’t worry if this happens – this is a totally normal reaction to facing your worries and anxiety head-on. Understanding your symptoms is part of the process, and hopefully the more you understand how your anxiety works, the more your anxious feelings will reduce.
Understanding the triggers behind your anxiety
Now we’ve looked at how you experience anxiety, it can also be useful to get a better understanding of when your anxiety symptoms occur. For example, are there certain people, places or activities that may you feel more anxious? Being aware of how triggers set off your anxiety is a critical step in learning to manage it.
To identify possible anxiety triggers, ask yourself:
- WHERE were you when you last got anxious: does anxiety only happen in certain places; or certain types of places?
- WHO you were with: is there a certain person or people that make you feel anxious?
- WHAT happened just before the anxiety episode: were there any specific cues? Was it something you were doing? Or was it a physical cue, like feeling dizzy or palpitations? Perhaps it was your friend telling you how they ‘sailed through their pregnancy without any problems’, seeing an episode of ‘call the midwife’ or ‘one born every minute’, or being woken up in the middle of the night.
Let’s use a simple example to spot anxiety triggers with a scenario you may be familiar with:
Andrea is 4 months pregnant and is anxious something bad will happen to her baby. In the evening she comes home, and spends a lot of time on her computer, looking up symptoms of miscarriage and other birth complications, and reading forum posts about other women’s experiences. Whenever she reads about the symptoms, her hands go clammy, her heart beats faster, and she feels like she can’t catch her breath properly. She gets a general feeling of impending doom, which only really goes away once she has finished with the computer, and shared her fears with her partner.
Andrea’s situational triggers
- She was at home at the end of the day
- She was alone, on her computer
- Searching for symptoms
Linking these triggers up to her experience of anxiety, Andrea could see that her thoughts and fears were driving her internet searching behaviours, and this was leading her to think “What if this happens to me?”… This helped her to recognise that her exposure to negative information wasn’t making her feel better, but it was feeding into her initial negative thoughts, and making her anxiety worse. She decided to actively cut down on the amount of internet searching she is doing, to see if it helps reduce her anxiety.
Activity: Understanding your anxiety
Now it’s your turn. Next time you feel anxious, notice:
- Where you are
- Who you are with
- What is happening and what you are thinking
This can help to identify potential patterns that may be triggering your symptoms. You may even find it helpful to keep a note of this in a Thought Diary, as tracking your thoughts and feelings can often be therapeutic in of itself, and help you to see your anxiety in more objective way. By observing these things while you experience anxiety, patterns may start to emerge and you will better understand your own anxiety response. Once you understand what is making you anxious, and what your symptoms actually are, you will be in a better position to deal with them.
Now that you understand your anxiety a bit better, the next page will teach you some simple techniques that can help you to better manage your anxiety.