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Tuesday 7 July 2015

When Pregnancy Brings On Panic Attacks

Anxiety and stress during pregnancy are more common than you might think. Even women who have never had a panic attack before may experience one while they're expecting.

Though many women might think of pregnancy as a magical time, it is not always nine months of bliss. Stress and anxiety may run high. And panic attacks during pregnancy are actually quite common. “Up to 10 percent of pregnant women struggle with panic attacks,” says Gina Hassan, PhD, a licensed psychologist in Berkeley, Calif., who specializes in perinatal health.

The symptoms of a panic attack during pregnancy are no different from a panic attack at any other time:

Rapid heartbeat
Chest pain
Shaking or trembling
Breathing difficulty

“People feel like they’re having a heart attack,” Hassan says. “Some women feel like they’re going to die.”

Women who have a history of panic attacks are more likely to experience panic attacks when they are pregnant. However, women who have never had a panic attack in their lives may find themselves experiencing them during pregnancy, Hassan says. On the other hand, some women who get panic attacks may find they subside when they are pregnant.

The diagnosis of a panic attack is based on a woman’s description of her symptoms. She may complain of being nauseated, having difficulty breathing, and feeling like she might die. She may go to the ER, where doctors may order tests. “To some degree, diagnosing a panic attack is ruling out other causes for these symptoms,” Hassan says.

Researchers believe panic attacks during pregnancy may be associated with a woman’s hormone levels. “It could be that the way their body responds to hormonal shifts is more dramatic,” Hassan says.

Research also shows that people may have a genetic predisposition to panic attacks — you’re more likely to experience panic attacks if a family member has had them. Stress or anxiety can bring on panic attacks, and some women find being pregnant and suddenly worrying about the health and well-being of their unborn child can trigger panic attacks, Hassan says.

Feeling the Stress of Pregnancy

Buffalo, N.Y.-based Jodi Hitchcock, a social worker who specializes in mood disorders, says that when she was pregnant with her third child, “crazy” thoughts would pop into her head, such as “Okay, now I’m going to have three kids under the age of 5. How do you have diapers for that many?” From there it would snowball: “It would go out of the normal,” she remembers, “and I’d start thinking, ‘What if one of them gets leukemia?’” Then she’d feel as though she was going to black out. “I’d be dizzy, sweating, feeling like I’m going to have a heart attack,” she recalls.

Like Jodi, Amy A. of Indiana doesn’t remember having panic attacks before or with either of her first two pregnancies. But when she was pregnant with her third child, she says, the panic attacks were constant. “I felt certain that I was going to die in childbirth. I was so certain that I wrote my husband a letter and gave it to his best friend so he could give it to my husband when I died,” she says. The panic attacks she was having lasted 15 to 30 minutes and were so bad they interfered with her ability to function.

Panic attacks during pregnancy can be a cause for concern because they can impact the fetus. “Blood flow to the fetus is reduced when their mothers are experiencing high anxiety, which can lead to low birth weight and premature labor,” Hassan says. Also, major panic attacks can affect the mother-child relationship and a mother’s ability to cope in the postpartum period.

Help for Panic Attacks During Pregnancy

What are the best treatments for panic attacks in a pregnant woman? In most cases, a combination of cognitive and behavioral therapies will help. Cognitive therapy can help people replace negative or frightening thoughts with more realistic, positive ones. Behavioral therapies, such as mindfulness exercises, also may help. Mindfulness teaches you to focus on what’s happening right now in the present, rather than worry about the future or dwell on the past. “It can help reduce stress during pregnancy,” Hassan says.

Amy says cognitive-behavioral therapy helped her to exert more control over her thoughts — it attempts to stop the anxiety before it escalates into a panic attack and to control anxiety in general.

Pregnant women who know what might trigger a panic attack — such as drinking coffee or stepping into an overheated room — should avoid those situations whenever possible.

Relaxation techniques, including deep breathing, can help calm someone who is having a panic attack. Amy says breathing is an important part of her therapy. Anti-anxiety medications can also be used, under the supervision of a physician. Medications may be necessary because women who have panic attacks during pregnancy are more likely to struggle with them postpartum, Hassan says.

Hitchcock, who has since had a fourth child, found that counseling and medication helped her deal with panic attacks. “Some women are afraid to admit that they are having panic attacks when they are pregnant,” says Hitchock, “but I can tell you just because you’re experiencing it during this time doesn’t mean it’s a permanent diagnosis or state of being.”

If you are pregnant and are having panic attacks or feel overwhelmed by stress, you should talk to your doctor and get appropriate treatment.

By Beth W. Orenstein | Medically reviewed by Cynthia Haines, MD


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