Perinatal distress is an umbrella term that describes various emotional and psychological challenges women may face before, during, and after childbirth. These experiences might include:

• Depression
• Anxiety
• Stress

It's crucial to recognize that perinatal distress can also encompass issues stemming from pregnancy complications. These might involve pregnancy loss, premature births, miscarriages, stillbirths, terminations, or having infants with disabilities or other complexities.

Defining Anxiety

Anxiety disorder refers to a spectrum of mental health conditions characterized by persistent feelings of fear and anxiety. Historically, these emotions served an essential evolutionary function, safeguarding our ancestors. Today, while they still hold value, excessive and prolonged anxiety can diminish one's quality of life.

When anxiety evolves into a disorder, it's typically due to obsessive anxieties about future events, whether real or imagined. When such anxiety accompanies intense, debilitating fear, daily life can become challenging. This could manifest as panic attacks, separation anxiety, situational anxiety (like a fear of leaving home), post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD). Often, these conditions co-occur with depression, bipolar disorder, eating disorders, or substance abuse. Substances like caffeine, alcohol, recreational drugs, and certain medications can exacerbate feelings of anxiety for those with an existing disorder.

Take a screen to gauge if your anxiety is within normal range.

Anxiety Diagnosis Process

Your medical history is pivotal in diagnosing anxiety disorders. Often, symptoms surface in childhood, and they may run in families. Moreover, specific traumatic events can trigger these disorders. For example, PTSD is frequently found in combat veterans, sexual assault survivors, and natural disaster survivors.

If you suspect an anxiety disorder, clinical screening questionnaires provide an effective way to confirm a diagnosis or indicate the need for further assessments.

If a parent has an anxiety disorder, their children face a six-fold increased risk of developing a similar issue compared to peers without parental anxiety disorders. Traumatic childhood experiences can also predispose individuals to anxiety, potentially due to enhanced sensitivity to perceived threats or dangers.

In adults, heightened stress can precipitate anxiety disorders. Though often associated with significant traumatic events, like those causing PTSD, stresses such as financial hardship, job instability, or marital discord can also act as triggers. Additionally, the stress accompanying chronic illness or age-associated dementias is linked to anxiety disorders.

Managing Anxiety Before and During Pregnancy

Many effective, medication-free strategies exist to manage anxiety during pregnancy, fostering better overall well-being. Begin by considering these approaches, as medication isn't always the initial recommendation, especially during pregnancy unless beneficial and necessary. If already on medications, consult your physician before any changes. The gold-standard Cochrane Library suggests mind-body interventions, like yoga and autogenic training, may help alleviate anxiety in pregnant women.

• Practice mindfulness. Research indicates that mindfulness training, instead of medication, can reduce anxiety related to fertility, pregnancy, and labor. It might even fend off postpartum depression.
• Explore yoga, massage, meditation, and acupuncture. Find relaxation techniques tailored to you; their benefits will extend well after childbirth.
• Cognitive Behavior Therapy (CBT) has shown promise by addressing maladaptive thoughts, emotions, and behaviors, employing anxiety management strategies like diaphragmatic breathing, adapted for pregnancy.
• Engage in regular physical activity. Generally safe during pregnancy, physical activity can support mental health, but always consult with your physician, especially if you're at risk for preterm labor or other complications.
• Ensure sufficient sleep: Develop a calming bedtime routine. Whether it's using a pregnancy pillow or occasionally sleeping separately from a snoring partner, pinpoint what aids your rest and stick with it.
• Consider journaling. Writing about anxieties can spur problem-solving and assist in reflecting on your concerns.
• Designate "worry time." Allocate 30 minutes towards the day's end for productive worry. This technique can help compartmentalize concerns, enhancing focus and reducing stress throughout your day.

Impact of Anxiety Disorders on Pregnancy

Some anxiety medications might not be appropriate during pregnancy and breastfeeding. Discuss with your healthcare provider whether your medications are suitable when trying to conceive or during pregnancy. Never discontinue necessary medications without professional guidance. Alternative therapies or dosage changes might be advisable for optimal pregnancy outcomes. Moreover, if prescribed anxiety medications during pregnancy, discuss these treatments with your prenatal medical team, ensuring they are informed of all prescriptions.

Understanding the Prevalence of Anxiety

Globally, 4.5% of people suffer from an anxiety disorder, with women being twice as vulnerable as men (5.2% compared to 2.8%). In the United States, about 29% of the population is predicted to encounter an anxiety disorder at some point in their lives.

Aside from substance abuse, anxiety disorders are the most prevalent psychiatric conditions in the US. They constitute a significant portion of workplace disabilities, highlighting the substantial impact these disorders can exert.

Further Insight: National Institute of Mental Health on Anxiety Disorder. National Institutes of Health. No date. Accessed Oct. 6, 2014.
Explore more: Anxiety Disorders by the American Psychiatric Association. American Psychiatric Association. No date. Accessed Oct. 6, 2014.