Anxiety in pregnancy and postpartum: how it was born, how to face it, what symptoms and consequences it brings for the expectant mother and the fetus and how to cure it
Anxiety in pregnancy is a little in-depth disorder compared to other pathologies such as post-natal depression or general mood decreases but not for this reason less important. Anxiety disorders in pregnancy have received less attention than depression although they are equally common and studies are scarce, not very specific and methodologically not very rigorous. Anxiety in pregnancy is associated with negative consequences on fetal development and the possibility of experiencing depression in postpartum . One of the difficulties in detecting anxiety disorders during pregnancy depends on the overlap of physical and mental symptoms inherent in the pregnancy experience with manifestations of a specific anxiety disorder (Panic Disorder, Obsessive-Compulsive Disorder , Generalized Anxiety Disorder, Post-Traumatic Stress Disorder PTSD). Common and widespread fears among pregnant women can concern: the state of health of the woman and the fetus, the loss of the child, the fear of the change of the body, of the parental and social role and the fear of childbirth. It is important to know that stress hormones cross the placenta . The fetus therefore, is affected by the maternal situation, and the consequences can be significant. It has been verified in the data of the international literature that anxiety in pregnancy is associated with:
- greater risk of preterm birth
- greater risk of growth retardation
- lower circumference cranial in newborns, similarly to what happens for the administration of cortisone drugs
- anxious care of the newborn, with consequent anxiety also of the adult unborn.
But let’s see what are the symptoms related to anxiety disorder in pregnancy and how we can get out of it without damaging the fetus
Anxiety in pregnancy and postpartum: physical symptoms
Anxiety is a feeling of waiting for a imminent danger and represents an adaptive response in the animal world, which increases the effectiveness of the “attack or flight” reaction . I physiological signs include:
- increased sympathetic nervous system response, with accelerated heartbeats and breathing,
- increased adrenaline and stress hormones (cortisol).
- Is accelerated the release of glucose into the circulation, and the neoglucogenesis, that is the ability of the liver to produce glucose starting from amino acids.
- It increases the level of cortical alert, and the whole organism prepares itself in front of a dangerous situation.
- hyperemesis, vomiting, nausea, fatigue, asthenia, eating disorders, sleep disorders, phenomena such as “legs without rest” or heavy
The problem is when danger is imaginary and not consistent. In this case, the activation of the whole system can become chronic and lead to damage, first of all the worsening of the quality of life of those (or she, since we are talking about pregnancy) who expect catastrophic situations from moment to moment, without there being a real reason to think that this can occur. Anxiety disorders such as Generalized Anxiety, Phobia, Obsessive Compulsive Disorder, Adaptation Disorders, Panic Disorders and Agoraphobia, are as common in pregnancy as in postpartum as is depression. Anxiety disorders, as well as affecting women’s lives, can contribute to the onset of depression through concomitant sleep disorders and / or Puerperal psychosis: the most serious mental disorder for the new mother.
The anxious ideation expressed during maternity (eg: fear of death in a cot, of the sudden death of the child, fear of harming the child, etc.), if intensify reaching a psychopathological gravity, it can induce or reinforce, through dysfunctional behaviors stressed by anxiety, a worsening of the psychic attitude (eg: fear of cradle death with nocturnal hypervigilance, alteration of sleep-wake rhythm, depressive onset and puerperal psychosis
Anxiety in pregnancy and postpartum: Who is most at risk?
Risk factors for the disorder of anxiety in pregnancy and postpartum are attributable to those women who present:
- Past psychopathological history
- Psychiatric familiarity
- History of psychopathology in pregnancy
- Previous Postpartum Anxiety Disorder
- Traumatic childbirth
- Sexual and Psychological Abuse
- Recent stressful life events (eg, deaths, illnesses, abortions, domestic violence)
- Conflict relationship with the partner
- Lack of family / social support
- Unplanned or unscheduled pregnancy
- Hormonal vulnerability (eg: women with histories of Pre-Menstrual SPM Syndrome, Pre-Menstrual Dysphoric Disorder DDPM, previous post-natal depression)
- Medical pathology of the mother (eg, thyroid disorders , diabetes)
- Fetal complications (eg: primary and / or secondary malformations)
- Use of psychoactive substances (drugs, alcohol, doping substances)
Anxiety in pregnancy: it hurts the fetus?
Studies show that what we experience, whether they are positive or negative emotions, reach the fetus. The high levels of anxiety of a future mother can also become a risk factor in the possibility of completing the pregnancy itself, being a cause of preeclampsia and leading to a greater risk of premature birth . If pregnancy is accomplished, anxiety could cause a low body weight birth. It is also important to think about the gestation period and how anxiety during different periods of gestation can affect the fetus differently. If stress takes hold at an advanced stage, research shows that the child has a greater risk of developing neuropsychiatric and metabolic diseases. It is wrong to believe that the fetus, therefore, does not notice the anxious state of its mother. All the fault of cortisol a hormone excessively produced in case of stress. Cortisol may therefore have a negative impact, but it is not the only factor to keep under control. Also adrenaline and norepinephrine can cause an influx of busted blood to the uterus. Still l or stress in pregnancy can lead to risks of psychiatric disorders during the child’s life and the possibility that this may have difficulty in psychomotor development.
The other faces of Anxiety in pregnancy and post-partum
There are several manifestations of anxiety that constitute the following disorders:
- Generalized anxiety: or that excessive and persistent anxiety for most days for a duration of more than 6 months. It is more common in women during the postpartum period than in the general population. The symptoms of generalized anxiety are: excessive anxiety and anxiety, anxious waiting and difficulty controlling the worry (brooding). A strong muscular tension as well as a neurovegetative hyperactivity, cognitive vigilance at the highest levels, alterations of sleep, somatization of different organs, difficulty concentrating, easy fatigability. In postpartum anxious thoughts are organized more specifically on the health of the child. Anxiety can be structured up to the pathological fear of cradle death so that insomniac mothers can check the health of their baby while they sleep.
- Panic attack: The disorder is characterized by attacks recurrent and unexpected with severe anxiety (panic) for at least a month. At first, the apex generally lasts about 10 minutes and is often accompanied by a sense of danger and imminent fear. There are some symptoms in this case such as: concern about the meaning of the attack, concern about its consequences, concern about significant changes in behavior related to the attacks themselves. This period of intense fear is accompanied by at least 4 somatic symptoms and / or cognitive: Sense of fear, of terror, fear of dying, fear of losing control, shortness of breath, sense of suffocation, tremors, dizziness, sense of empty head, palpitations, pain or discomfort in the chest, tingling, paresthesia, numbness, sweating, nausea and abdominal disorders, depersonalization : that is the sense of extraneousness to itself, derealization : sense of extraneousness from external reality. In the post-natal period panic may worsen, leading to agoraphobia and social isolation in some women. Panic Attack Disorder affects approximately 10% of postpartum women
- Obsessive-Compulsive Disorder (DOC): this postnatal disorder can be extremely debilitating if untreated, since the mother, tried by obsessive thoughts and compulsive behaviors, has little time and energy to look after herself and her child. The DOC affects approximately 2-5% of new mothers. Frequently women who have experienced a post-natal OCD episode may resume an attack in subsequent pregnancies. It is characterized by obsessive and / or compulsive symptoms which cause marked suffering, wasting time to indulge obsessive thoughts or structured compulsions, (more than an hour a day), and interfere with normal daily activities. The disorder is diagnosed if it compromises the overall functioning of the woman (social, work, relationship) and if it is not better justified by other anxiety disorders or psychiatric illnesses due to general medical conditions. In obsessive disorder, the woman realizes that thoughts, images, impulses are the fruit of her own mind and so she tries (uselessly) to ignore them, suppress them or neutralize them, with other thoughts and / or behaviors ( compulsions ). The latter are repetitive mental behaviors or actions that the individual performs as a sort of stereotyped ritual to control obsessions. The compulsions can cover different themes such as: contamination, perfectionism, order, control. In postpartum may appear obsessive thoughts of damage to one’s child (fear of harming) often complicated by frequent, extreme and persistent feelings of shame and guilt accompanied by anxiety.
- Post traumatic stress disorder: Up to 25% of postpartum women occur in 3%. Disorder, another form of anxiety disorder, is typically associated with a catastrophic experience such as assault, rape or natural disaster. Women who experience trauma during pregnancy, labor or delivery or in Postpartum may show a Post Traumatic Stress Disorder. It is often an unrecognized and not properly managed complication of childbirth. For some women the birth of a child is not a satisfying event and becomes one of the most traumatic experiences of their lives. Experiences of extreme pain, loss of control and fear of dying for themselves and the child put women at a higher risk of PTSD. Suffering and stress resulting from a traumatic birth can affect a woman’s ability to breastfeed and negatively interfere in the mother-child relationship. A history of previous trauma can be a predisposing factor to further trauma or high levels of psychological distress in the perinatal period. Among the main factors predisposing are: domestic violence, sexual abuse, rape, migration, feelings of impotence, extreme pain, unexpected and unexpected outcomes of labor and delivery, including death or illness of the child, Perception of a careless and hostile medical staff, Loss of control, Lack of information, Previous traumatic parties.
Anxiety in pregnancy and postpartum: how to cure it?
First of all it is important recognize the problem. Both doctors and future and new mothers must be made aware of the risks of anxiety, in order to seek professional help in the cases indicated. The psychotherapy can help to control anxiety in pregnancy in milder cases, and, in selected cases, the psychiatrist may decide to start drug therapy. It is strongly advised against self-medication with herbal products based on herbs (valerian, hawthorn, etc.), whose safety during pregnancy is not established (generally speaking the rule that in pregnancy does not apply to pregnancy) it is cured with herbs ). complementary medicine comes in handy through other methods: relaxation practices, such as meditation and yoga should be practiced daily by those suffering from anxiety, for at least 20-30 minutes a day . acupuncture through the increase in endorphins, can be an excellent cure for anxiety, as well as undergoing therapeutic massages . Participating in accompanying courses at birth can be useful for sharing your anxieties in the peer group. Recognizing the same fears in others can help to reduce them and to live pregnancy with awareness and serenity. If you suffer from anxiety or unjustified fears about pregnancy, talk to your doctor. An advice for treating anxiety is to attend therapeutic support groups for pregnant women to be able to compare and not feel alone in this experience. Finding a solution could be simpler than you think, for example, Pamper yourself : every woman has to take a break from the daily routine from time to time. It must detach with the body and above all with the mind. And this applies even more during the 9 months of waiting. Changing haircuts, having your hair done, giving yourself a professional make-up session or doing massages are all valid alternatives to take care of yourself. Always remember that you are not alone and that anxiety is a disease that can be cured, it is enough to first want it! Rely on your partner, talk to him / her first. A final piece of advice is practicing a group support therapy for mothers in pre and post partum pregnancy can help a lot. It is valid not only during the sweet wait, but also after, when the changes will continue to be there and, above all because there is a puppy of a man at home, it is believed that they cannot be managed better.