Why Pregnancy Can Make Your Anxiety So Much Worse

By definition, anxiety means worrying about the future or ruminating on the past — and many people spend the 10-month period of pregnancy doing exactly that. Bringing a human life into existence, along with figuring out all the logistics of becoming a parent, gives you a lot to think about. Some worrying or planning is an evolutionary skill that helps people prepare for a baby. But these thoughts can also take over and affect a pregnant person's quality of life in a major way.

There are a few reasons why people experience extra anxiety during pregnancy, explains Catherine Monk, PhD, director of the women's mental health program in Ob/Gyn at NewYork-Presbyterian/Columbia University Irving Medical Center. For starters, hormonal changes that occur during pregnancy are associated with increased anxiety, she says. There are also many psychological factors that can contribute to it, too. For example, if you had a past pregnancy loss or traumatic or sad childhood, that can raise concerns about how you will be as a parent, she says. Handling changes to your job, relationship, and financial situation can also throw you for a loop. "The ever-new experience of pregnancy that is out of one’s control is really disorienting and destabilising," she says. And finally, if you have a history of anxiety, your symptoms may re-surface during pregnancy, she adds.

Surveys from the Anxiety and Depression Association of America suggest that 52% of women who have been pregnant report feeling more anxious or depressed during pregnancy. As our awareness of mental health and postpartum depression increases, many Ob/Gyns are starting to screen for anxiety at routine appointments, Dr. Monk says. But if you're experiencing anxiety, it's important to see a mental health professional. "There are many, many effective approaches to successfully treating anxiety," she says. Here are some tactics that can help manage your anxiety in the moment:

Keeping a worry book to write down "worry thoughts" helps you compartmentalise, Dr. Monk says. Jot down whatever you're stressed about, and address it when you're in the frame of mind to problem solve. "Do not judge oneself in worrying again and again about the same thing; instead, observe oneself having that thought again and try to let something else engage your mind," she says.

Developing a mindfulness practice is a lifelong skill, but it'll be extra useful when you're juggling the stressors of parenthood. You don't have to start meditating if you're not into it, but find some way that allows you to "be in the moment for even a minute," Dr. Monk says. "Using sensory experiences to slow down, breathe deeply, and take a pause from the worrying can help push the reset button."

"Realise that anxiety can be an expression of the difficulty of not having ultimate control and knowledge of what is coming next," Dr. Monk says. Often when we feel an overwhelming sense of "what-if," it's because we're having trouble accepting that we don't control our futures the way we think we do, she says. Re-framing your worries, as such, can help you come to terms with your anxiety, which will serve you well beyond pregnancy.

If you know that certain situations tend to make you anxious — like having too many things on the calendar or missing your prenatal yoga class — then it can be helpful to identify and name them, Dr. Monk says. While you might not be able to control these circumstances, knowing that they are behind your anxiety can provide a small sense of relief.

Sleeping soundly and comfortably during pregnancy is a challenge in itself. But when you're not getting enough sleep chronically, it can make you feel more on edge, which can lead to anxiety spirals, Dr. Monk says. Prioritise getting enough rest, and you may have an easier time coping with your worries when they arise.