Living with an anxiety disorder while you are pregnant adds stress to a challenging time of your life. In the case of generalized anxiety disorder (GAD) , chronic anxiety related to the disease can prevent you from experiencing the pregnancy – from the time you find out until long after your baby is born.
If you find that you are experiencing chronic anxiety that is out of control, consider mentioning how you feel about your doctor or other health care professional.
Occurrence of GAD during pregnancy
We know that about 6 percent of the population experiences GAD over their lifetime, and during any year, about 1 to 3 percent of individuals will live with GAD. The disorder is twice as common in women as men, making it particularly relevant to pregnancy.
The rate of GAD during pregnancy has been shown to be between 8.5 and 10.5 percent. However, the disease tends to go undiagnosed and can be difficult to dispense with normal concern. At the same time, a woman who is always a worryer may develop GAD during pregnancy, possibly related to changes with hormones, state of mind and social obligations (e.g. leaving work, preparing to raise a family).
A 2011 study showed that anxiety symptoms tend to be highest in the first trimester and decrease during pregnancy. However, many women have GAD overlaps with other disorders such as depression, which can make them, and their unborn children, extremely vulnerable.
What are the risks of GAD during pregnancy?
A 2015 longitudinal study of women with major depressive disorder and GAD showed that those with GAD, in addition to depression, had a poor quality of life and experienced more persistent anxiety.
Untreated GAD can lead to pregnancy complications such as low birth weight, premature delivery, high blood pressure, problems with the baby’s neurodevelopment, and failure to progress during labor.
Once your baby has arrived, you may also have difficulty dealing with the demands of a newborn baby and developing a bond with your baby.
Treatment options for GAD during pregnancy
Treatment of GAD during pregnancy may include psychoduction, therapy and / or medication. Typically, the treatment will be tailored to the unique situation of the mother, taking into account your severity of symptoms and history of anxiety:
- Psychoducationis important in the early stages and during diagnosis, to help reduce denial and stigma and lead to successful treatment.
- Therapiessuch as cognitive behavioral therapy (CBT) are most often used in mild cases of GAD or in combination with medication in worse cases. CBT can include cognitive restructuring, exposure, relaxation training, and mindfulness therapy.
- Medicationmay be used in more severe cases. Typically, a selective serotonin reuptake inhibitor (SSRI) (e.g., Prozac, Cipralex) will be prescribed. Benzodiazepines can be used for short-term management of anxiety.
- Supportis also an important component of coping. If you have GAD and are pregnant, seek support from family, friends and the community to help you cope.
Can I take medicine for GAD while I am pregnant?
If you have GAD and are pregnant, you may be wondering if it is safe for you to take medication.
While this decision is best left to your doctor, typical medications are prescribed when the benefits are thought to outweigh the risks. In other words, if you are suffering from crippling anxiety that will almost negatively affect your pregnancy, medication may be a good option.
SSRIs cross the placenta, but are considered fairly safe during pregnancy. Babies of mothers who took SSRIs during pregnancy may suffer from neonatal adjustment syndrome, with symptoms such as jitters, problems with nutrition, and irritability. This problem is seen in about 10 to 25 percent of newborns who are exposed late in pregnancy, but it should resolve within 3 to 7 days.
If you regularly took benzodiazepines during pregnancy, your baby will also be monitored for side effects from the medication.
You may also be wondering about breastfeeding. Certain SSRIs have a low concentration in breast milk – such as breastfeeding, while these medicines may not be contraindicated. However, the long-term effects of these drugs on the developing child are not yet fully known. You should weigh the potential benefits and risks with your doctor.
A Word From
You may be wondering if it is responsible to get pregnant if you have GAD. When successfully treated, there is no reason why a woman with GAD should not have children. Make a plan with your doctor about how to manage symptoms if they occur and contact on a regular basis to keep your anxiety under control.