Anxiety itself is not a disorder. If it were not for anxiety, we would not survive for long. Regular levels of fear or anxiety is essential throughout our lives for guiding us to recognise the anticipated problem and work out an appropriate way to cope. Problems arise when our assessment of the threat is mistaken, exaggerated, denied, and therefore our coping (survival) strategy is inappropriate, e.g. irrational, excessive or prolonged.
Women+ are thought to be much more likely to experience anxiety, at least in part because they are socially evolved to feel responsible for the welfare of others, to have low self-esteem and seek approval from others rather than from themselves, to readily blame themselves and feel guilty if things go wrong.
As pregnancy is a hugely important (whether we wanted it or not) event in our lives, a degree of anxiety is appropriate. Even if things seem to be going well, we do not know what the outcome will be, and most of us know someone who has had serious problems.
To manage this situation, we want support from our partner and family, GP, mental health clinician, midwife and/obstetrician – to name a few. We may also want to write a birth plan with our support team. Health professionals also can be anxious and some find it difficult to cope with worried women carrying pages of requests and decisions that may be unrealistic. What is required here is mutual respect, trust, validation and willingness to be flexible – from both parties.
The main anxiety-related mental health concerns over the perinatal period include:
- Phobias – specific (e.g. of sharp objects) or social (social situations where you will be observed and possibly criticised by other people)
- Panic Disorder
- Agoraphobia (fear of being out in public alone or out in enclosed places or on public transport etc)
- Generalised Anxiety Disorder (excessive anxiety or worry about a number of events or activities: restless, easily tired, unable to concentrate, irritable, unable to sleep).
Closely related to the above anxiety disorders is the category of Obsessive-Compulsive and Related Disorders. OCD refers to the presence of obsessions and/or compulsions. Obsessions are persistent and recurrent thoughts, urges or images that you consider intrusive and unwanted. Compulsions are repetitive behaviours that you feel you must do in response to an obsession and the activity has strict rules about how exactly you must carry it out.
Postpartum OCD is very common and often relates to serious or even fatal harm befalling the baby (or partner), including harm by the mother herself. Naturally, having such thoughts and feelings is extremely distressing for the mother.
Remember, there are a range of treatments available for all of these conditions, so make an appointment promptly to discuss the situation with your GP.
If you can, it helps to tell your partner about your distress and, if possible take your partner along to see your health professional too. Partners can be a key aspect of the treatment plan.
