How to Create New Thought Patterns to Prevent Prenatal Anxiety:
(Guest Post) By Dawn Kingston, RN, PhD
Some of the most common – but unspoken – questions that pregnant women have are:
- Is this worry normal?
- What’s wrong with me? I’m anxious all the time.
- Do other pregnant women go through this worry, too?
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Anxiety in Pregnancy: Debilitating and Common
Prenatal Anxiety is one of the most debilitating and common complications of pregnancy. It affects one in every four pregnant women, making it one of the most common complications of pregnancy. And, it’s debilitating.
Anxiety often shows up as a constant sense of dread or an underlying, vague feeling that something is wrong and something bad is going to happen.
It robs us of our joy, which is distressing when we begin our pregnancy looking forward with excitement, hope and anticipation at the new future before us. It holds us back from being who we want to be and doing what we want to do.
The biggest problem is that most pregnant women – and their doctors – don’t know that prenatal anxiety is common. Therefore, we don’t talk about it, look for it, or treat it. So, let’s talk about it.
What to Look For
We’ve talked about one sign of anxiety – that sense of dread or vague feeling that something bad is going to happen and you just can’t shake it.
Here are other signs of prenatal anxiety:
Physical
- You feel tense, a feeling you may experience in your stomach, or as muscle tension in your neck or shoulders
- You may find yourself tightening your jaw or clamping down on your teeth, even just while sitting, watching television, or reading a book
- You may experience heart palpitations while you are sitting resting
Emotional
- You feel restless, keyed up, on edge
- You have a hard time controlling your worry
- Your worry is out of proportion to the event e.g., you react with a great deal of worry and anxiety over something that normally wouldn’t bother you much
- You feel irritable
- You might have a hard time falling asleep, or wake in the night because you have thoughts circling around in your mind
- You have a hard time concentrating
- You are worn out – physically and emotionally – from being keyed up all the time
Is it Just Hormones…and It Will Go Away on Its Own?
No… and likely not. Hormones are not the major cause of anxiety. Many women who feel anxious during pregnancy came into their pregnancy with anxiety. For most, it’s something they’ve struggled with even before they became pregnant.
For some, they didn’t realize they’d struggled with anxiety for a long time until it became troublesome in pregnancy. In this case, women often feel relieved because for the first time they understand what is going on for them.
Anxiety is not likely go away on its own. Like diabetes and asthma, people tend to have anxiety across their lives. But, also like diabetes and asthma, it can – and needs to be – managed in order for you to live your life happily and successfully.
Prenatal anxiety can run from mild to severe. But all can rob you of the joy of your life. And, all have this in common: you can manage anxiety.
Ease your Mind
The key to managing anxiety is to manage your thoughts. A breakthrough in recent years has shown that emotional regulation is at the heart of controlling prenatal anxiety and depression – to feeling better.
We’ve learned about the cognitive triangle: thoughts, feelings, and actions are all related.
What you think generates feelings, and your actions follow. Here’s an example: think about the last time someone gave you a piece of unsolicited, unwanted pregnancy advice.
- Thoughts: What were your thoughts? You might have (even without paying attention) had a stream of thoughts, such as: Am I doing something wrong that she is giving me advice? Who is she to tell me what to do? Why didn’t I think of that – how could I have missed that? Doesn’t she see this bothers me?
- Feelings: Your thoughts automatically triggered emotions. Do you recall what you felt at the time? It might have been hurt, shame, anxiousness, embarrassment, anger, irritable, worried, discouraged, or put-off.
- Actions: Then, what did you do? You might have to think back because the stream of thinking-feeling-action can be quite automatic and take just seconds or minutes to act out. You might have blurted out words you regret, been polite to simply extricate yourself from the uncomfortable situation, eaten a large piece of chocolate cake or a hot fudge sundae, or called a friend to rant?
Can you see that your thoughts in the moment resulted in your actions? You are living the “cognitive triangle.”
Turn the situation around now. Imagine if your thoughts in response to that unwanted advice were: She’s just trying to help. Everybody gives pregnant advice because they want to share their own experiences.
Your emotions that flowed from those thoughts would have been different – more positive, such as grateful, amused, curious, calm, or patient. And in response, you might have thanked her – and not eaten the hot fudge sundae.
This switch in thinking:
- Happens in the moment and in a fraction of a second.
- Requires you to notice the thought in the moment.
- Changes the trajectory of your emotions and actions that follow.
- Is very hard work at first, but gets easier over time.
It’s almost like flipping a light switch, turning dark, distressing, disturbing thoughts into thoughts of growth, opportunity, possibility, and creativity.
Lower Brain versus Upper Brain
The switch we’ve been talking about has a physical and physiological basis. When you, in the moment, flip the switch from distressing thoughts to those of opportunity and possibility, you are switching your thinking from the lower brain to the upper brain.
This switching creates new neural brain pathways.
That’s why it gets easier over time to flip the switch. Your brain is building new pathways and as you use them your thoughts naturally use the new pathway (upper brain thinking) versus the old (lower brain thinking of threat and anxiety).
Your lower brain becomes activated when you are in a situation of threat and you move into survival mode. You become defensive (argue, say things you regret) or you withdraw (leave, don’t respond to the email, don’t talk to your partner). But in each case, you are thinking about self-preservation and protection.
Can you recall a situation at work or with family where you felt the need to protect yourself? Where you didn’t feel emotionally safe? That’s the lower brain operating.
When you are thinking from your upper brain, you see opportunities and possibilities. You are creative and can generate explanations and reasons for others’ behavior. You feel safe and secure. Your thinking is clear. You see the good and positive things that could come from the situation.
Moving Forward
Sometimes anxiety is severe and your doctor may recommend medication (typically an antidepressant) to “take the edge off.” Medication can be helpful to get you to a point in which you can ease your mind as we’ve talked about.
Whether you take medication or not, anxiety cannot be managed without managing your thoughts.
Sometimes we can’t change the situation that contributes to our worry. But, we can change the inner sanctum of our thinking. Learning to manage your prenatal anxiety has added benefits in that you can teach your child how to manage his or her thoughts, too. This is a powerful way of helping your child to build resilience.
We hope this post has given you some tips that will help you manage and even prevent prenatal anxiety.
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More About The Author:
Dr. Dawn Kingston and her team are passionate about helping women and their families have the best start to life by improving maternal mental health. She is Canada’s only endowed research chair in perinatal mental health, and also holds the prestigious national New Investigator Award from the Canadian Institutes of Health Research.
Her research focuses on approaches to screening and treating women who struggle with depression and anxiety during pregnancy. She and her team are leading the field in using e-technology for screening and therapy in pregnant women so that women can get help whenever they need it, wherever they are.
Dawn’s work also aims to understand the consequences of early adverse childhood experiences, particularly poor perinatal mental health, on child mental health and development.
To read more about Dawn’s work, visit her website at https://www.drdawnkingston.com
