Struggling with anxiety in pregnancy

[toomanythoughts]

Hello,

Firstly I should say that I'm not sure what I'm looking to get out of posting here - whether it's advice on how to help myself get better, or just a bit of a catharsis in getting this all down in one place - apologies if what I write ends up being long or incoherent.

I'm 6 months pregnant and have been struggling with anxiety for the duration of the pregnancy, with my symptoms getting worse rather than better over time. I have always been a worrier and can't remember a time where there wasn't something I was worrying about, even if it wasn't at the forefront of my mind. Since being pregnant, my fear has focused on contracting toxoplasmosis (which you can catch from cat poo, raw or undercooked meat or unwashed fruit and veg), which would not be harmful to me but could leave the baby brain damaged or blind. This fear was sparked when I ate a medium rare burger, then realised I shouldn't have done - I got a blood test through my doctor which revealed that I had not caught toxoplasmosis, but also that I did not have immunity. Since then the risk of catching toxoplasmosis is on my mind more or less constantly, particularly at meal times when I am extremely thorough about washing veg and ensuring that meat is cooked through, and also that anything that has been in contact with the raw meat is not able to "contaminate" anything else in the kitchen. I do still eat out but tend to go for vegetarian options as meat is the biggest risk.

At home, my fears have led to me taking a long time to clean the kitchen and wash up after a meal, using countless dettol wipes and frequently changing sponges etc. As I mentioned, I feel that things have got worse over time - it's like the longer I have to think about things, the more risks I perceive and so the more I try to find ways to avoid or mitigate those risks. To give an example, because I have taken to frequent hand washing (and using lots of hand sanitiser gel), my hands get quite dry and sore - a few weeks ago I was washing up some items which had had raw pork on them, but I wasn't wearing any washing up gloves (I never normally do). It was only a week or so after that that I worried this may have left me vulnerable to toxoplasmosis - with the pink, sore bits on my knuckles perhaps being tiny little cuts, through which the toxoplasmosis could have entered my bloodstream. So since then I have been wearing gloves to wash up, but I have not been able to shift the fear that I contracted toxoplasmosis from that, despite not knowing if my hands were cut and not remembering whether they were even particularly dry or sore at that point. The irony of it is, something I'm doing to make me safe, has actually put me at risk. I feel so stupid for, as I see it, putting myself at risk like that and making such a stupid mistake. I have tried googling to get more information about the potential risk, but (unsurprisingly) there doesn't seem to be anyone else out there with the same worry!

I'm probably going far too much into detail here, I'm even boring myself, I suppose I'm just trying to give a flavour of how this is affecting me. It's not something I talk about beyond my immediate family as, being pregnant, people expect to hear that everything is going well, and also I am not comortable about the way I think or feel so prefer that people don't know what a struggle pregnancy is for me at the moment. I feel like I can never be free of this fear unless I have another test to see if I have caught toxoplasmosis (you don't usually get any symptoms with it), but then from what I have read part of my problem is not being able to live with uncertainty, so do I just have to grit my teeth and get on with it? Also, I know that in waiting for the results to come back I would be obsessing over them, and then if they are negative I think the relief from that result would only be temporary. I keep changing my mind on this though.

I worry that even when baby is here I won't be able to relax as I am aware that if he had been infected with toxoplasmosis the after effects don't always show up straight away and can only appear a few years later. These fears are taking much of the shine off my pregnancy and I don't want the pattern of worrying obsessively like this to continue after the birth.

I have contacted a clinic that offers CBT and had an initial assessment, but they say it could take a month or so to place me with someone - by that point I'll only be a few weeks away from giving birth! I did try some regular counselling but in the first session I felt that the counsellor was too directive and the interpretations of what I was saying that he fed back to me did not ring true, so I didn't pursue it - I had been looking for a more person centred approach. I wish that someone else could just sort me out with a counsellor, it's hard to make the effort to get help because I sort of resent having to do it, why do I have to have this problem and these feelings? It also makes me worry for the future because unless I can conquer this then I know that me and DH will be reluctant to go through another pregnancy any time soon.

My DH and my mum are very supportive and I am able to talk to them about what I'm going through but I feel like a burden and feel particularly guilty about what I'm putting my DH through - he does a lot of the cooking and I'm quite paranoid about whether he has taken the "necessary" measures to avoid contaminating anything, so will quiz him about what he's done. He's mostly very patient but I'm just sick of being this way. I want to enjoy the rest of my pregnancy and look forward to the baby's arrival with excitement - at the moment I'm struggling to believe that everything's going to be okay and that we'll have a healthy, happy baby at the end of this. I feel stuck and I feel like a mess. I love my baby so much and would do anything for him - it frustrates me that I don't know how to be a healthier, happier me so that I can be the best parent I'm able to.

Thank you for reading, if anyone has any advice then I'd be grateful to receive it, but I know that really I'm the only one who can sort this, I just don't know how and I'm getting so worn down by it all. Sorry for such a long post.

I work with a lady that is a hypnotist and when I actually manage to get pregnant I'm going to get her to work on me... If you can afford it might be a quicker solution to therapy or CBT.
I'm hoping that she can help me not be anxious during both the pregnancy and childbirth. Maybe an idea? It sounds like you have some ingrained fears and habits and from my conversations with her, this is the kind of work she does a lot of and can be well treated using hypnosis methods.

Thanks stuck, that's not something I'd thought of - will have a quick google now. As you say, it may be a quicker solution, which is what I think I need right now. Wishing you an easy going, anxiety free pregnancy when your time comes.

Have you talked to your GP/midwife about how you are feeling? They may be able to refer you to someone who can help you with ante natal anxiety? I'm not a expert but I understand toxo and it's effects are incredibly rare but I also understand that stats won't stop you worrying at the moment.

By the way I found that when I got stressed out about something in pregnancy (listeria after eating cream one day past it's use by date being a memorable occasion that freaked me out much more than it should have) that reading one of my pregnancy books ie what to expect when you're expecting or the NHS website was much better than using Dr Google the results of which inevitably worried me more.

Hope you feel better soon

I had pregnancy anxiety, I know how awful it is. It is however recognised condition. I saw a maternal psychiatrist when I had it. It is to do with hormones and often hits out of nowhere.

I was on ad's for it which helped a lot, but I was very bad. It can be dealt with medically though. Good luck xx

Hi there
You sound very much like I was in my first pregnancy. I was diagnosed with perinatal OCD in my second pregnancy. Perinatal OCD is usually centred on health and wellbeing of you or the baby. I had the washing/contamination obsessions and compulsions you describe with my first but with my second I was more obsessive than compulsive.

I got the diagnosis when I pushed and pushed to be seen by perinatal mental health team, was seen at 28 weeks by psych and didn't get to start CBT until after the birth of my baby which was when I got CPN too. It has been quite a journey. CBT is directive enough but it is a proven therapy for this type of problem, I had some person-centred stuff privately in pregnancy and to be honest it was a load of codwallop. Unfortunately with CBT like all therapy the quality of the therapy will vary from person to person. They should be triangulating your "formulation" with you so if it sounds wrong you should be able to say... but you do really have to engage with it for it to work. To be honest, in pregnancy I was so convinced by my own fears that therapy wasn't very effective. Post-partum I started on antidepressants and that has made it much easier for me to be rational.

I didn't want to take ADs in pregnancy because I was too afraid but to be honest this was a mistake. By 36 weeks I was in a complete and utter state. Those last few weeks of pregnancy were hell. However, I will say that despite having a total freak out and booking an induction I didn't need because I couldn't cope with being pregnant anymore, I managed to hold off and have a spontaneous vaginal delivery with no pain relief that was just amazing as I got a lot of support from the supervisor of midwives who helped me write a plan and ensured that it was followed.

My ds2 is now 9 weeks old and things are immeasurably better.
Books that helped were:
Dropping the baby and other scary thoughts
The Pregnancy and Postpartum Anxiety Workbook

I am also doing a Mindfulness course online - www.mindfulmotherhood.com - which costs about £26 and have the associated book which I have downloaded on kindle. This has been the best tool I have personally used to start to build distance between my fears and reality and to stop the constant "what if's?"

You have my sympathies btw. It is really tough and no one really understands how this can take over.

Pm me if you want x

Sorry for no links, computer is not playing ball!

Agree with thunksheadontable that it sounds like Perinatal OCD. This problem is thought to affect 2-4% of new mothers.

Here's a link about Prenatal and Postnatal OCD

Just to add though that we can't diagnose you on here, we can only make our best guess, so for a proper medical diagnosis I'd agree you should see your GP. Don't worry about telling them what you are going through, they've heard it all before!

Yes absolutely you need to have a proper diagnosis. GPs aren't always specialists but they can refer you to someone who can help work out the best course of action for you.

Thank you for all of your replies. Whilst I'm sorry to hear what you've been through, it's heartening to know that I'm not isolated in having these thoughts and fears.

I haven't spoken to my GP or midwife about what I've been going through - as I say, I thought I could get CBT more quickly by going privately, and I am worried that talking to them could have implications when my baby arrives - that I might be monitored or something like that? Also, I have previously had to sign things for work to say they can view my medical records and am worried about the stigma that could be attached to any entry relating to my mental health - I don't mean that to offend anyone, I have never been one to judge others with mental health issues or challenges, but I am acutely aware that others do, and I think this would be particularly so in my work environment.

thunksheadontable thank you for sharing your experience and the information about what has been working for you. It's been hard to find relevant reading material, the books I've been dipping into have been about OCD but I've found them a bit hard to relate to because they're not about OCD in pregnancy, which I guess is quite a particular strand! Like you, I don't think I would want to take ADs during pregnancy (I'm not sure I'd want to take them at all if I can help it, or certainly not until I have tried some alternative methods to deal with my problems) but I do worry about getting even worse as the weeks progress (I'm currently 30 weeks).

I think one of the hardest parts is just how real these fears are to me - I look back to the earlier weeks of my pregnancy, the things I would happily eat or do without thinking about it and I can't believe that's how I used to be. It's like I've forgotten what's normal. I also seek excessive reassurance from my DH, which I know is another OCD trait - it doesn't always do me much good but I do like to have a reference point as to whether to be concerned or not. Afterall, this is his baby too, so if he isn't concerned then I think I shouldn't be, knowing that I can't trust my instincts or perception of risk as they stand at the moment.

I was feeling more positive earlier and after reading these responses - CanoeSlalom thank you for the link, I hadn't come across the site before and there's something reassuring about seeing your fears and behaviours described in such a neat, succinct way that brings it home that it's in my head and that the risks I see everywhere are also in my head!

When I posted on Sunday I was feeling in a really bad way, definitely feeling like rock bottom and I booked a private test for toxoplasmosis because I wanted that relief, however temporary, that would come if I got a negative result. I subsequently decided that that wasn't a solution and wouldn't help me to overcome the problem long term so cancelled the test. However, in looking to see what test I needed, it has led me to doubt that my doctors sent me for the right test all that time ago (when I ate the undercooked burger that seemed to spark these fears off) as they were only testing for one type of antibody, which is the one that takes longer to appear, so my negative could have been a false one. I've now been obsessively googling about this with inconclusive results. I really want to believe that me worrying about this is unnecessary (I know it is obsessional) but I feel so stressed and scared that the reassurance I thought I had that I hadn't caught toxo in early pregnancy was false. I'm fed up with this hysteria and feeling this way - I can feel the panic rising and I feel guilty about how that might affect my baby, but I can only fight one battle at a time. The thing is, I'm finding it hard to muster the energy to fight that battle. Would antidepressants definitely help with this sort of problem? I need to do something but I'm struggling to know what. I do take your points about going to the GP though and will think hard about this, sorting myself out is more important than my work afterall.

Sorry for another extensive post, and thank you if you have read to the end.

Remember that if it is OCD, the doubt is part of it.
One thing you can do (though you won't believe in it necessarily) is say to yourself:

Toxoplasmosis is not the problem.
It is my worry that my baby might have toxoplasmosis is the problem.

Don't worry about being monitored. Are you having harm obsessions e.g. worried you will intentionally eat a contaminated food or do something to harm the baby? Even if you had the baby and were imagining things like throwing the baby out the window, this would not be something they would monitor you for. They will not take your baby away from you for perinatal OCD believe me.

Worry about the stigma is also part of the problem. I was so ashamed that I wouldn't tell the taxi driver that I was going to the street where the psych hospital where my psychiatrist was based, I pretended I was going to an adjacent street. No one cares as much as you think, even work. Perinatal mental illness in particular really doesn't carry as much stigma as you imagine. Certainly if I were in my home country they would have diagnosed me with PND rather than OCD and most people know tht PND etc are time limited. It is rare even with the disclosure you have signed that anyone would actually requisition your records and I suspect it would be on a need to know basis that couldn't be shared out of HR etc.

I understand why you don't want the ADs because I was there but I do regret it. The dangers to you and your baby from untreated mental ill health are much greater than the dangers posed by ADs and the risks to both your happiness, even if just in the short term, are grave. I deeply regret the time I lost with my eldest son to these damned obsessions. I will never, ever have that time over. ADs worked in a matter of weeks and I am now happy and feeling blessed and absolutely compulsion free at the moment. You will need to discuss all of this with any professionals you meet if they suggest it but if I were offered them again in pregnancy I would take them and if I have a third I intend to take them from early on in the pregnancy. I don't believe I could have accessed and benefited from therapy quickly without them, with the obsessions still raging. They have given me back my life and my time with my precious baby.

Thank you for the quick reply thunk, you're right about the doubt being part of it - it's so overwhelming, and all too easy to give in to.

I don't have any thoughts around doing something intentionally to put the baby at risk, only ever that I will unwittingly cause him harm by eating something I'm not supposed to - though to be honest it's gone much further than this where I imagine that any surface/cupboard/thing could be contaminated - hence feeling the need to wash my hands so often, and also developing all sorts of odd behaviours to avoid the risks that I see. This has included throwing a lot of food away. And you're right about the likelihood of work looking at my records being slim.

If you don't mind me asking, in your case did the OCD carry on once your baby was here? That is another worry I have, I don't want these fears about toxoplasmosis to transfer onto things to do with him when he's here, at the moment it's the thought that he'll be here in around 10 weeks and I can see he's okay that is acting as something of a comfort (with the caveat I mentioned before that I know even if he had been infected it wouldn't necessarily be discernible at birth), so perhaps that is a false comfort.

Argh! Wish I could just switch my brain off sometimes! :)

With my first pregnancy I didn't get any help. In pregnancy my predominant fear where yours is toxoplasmosis was swine flu and I had similar issues with decontamination. I stopped taking public transport and forced my husband to drive me to work (45 mins from our home and back for him) because I was convinced I would be contaminated . I really believed it, just as you do now. I also had to clean and wash my hands etc and wouldn't touch door handles etc.

I got the swine flu vacc at about 32 weeks and it all just stopped. However, it very quickly jumped to obstetric cholestasis as I had been itching a lot in pregnancy and I was convinced that they had missed the diagnosis and my baby would die as he wouldn't be induced.

After he was born, the obsession quickly switched to metabolic disorder (he wasn't gaining weight while breastfeeding) and then when he started to gain weight, it became about cot death. I would sit up watching him breathe and if I fell asleep on "watch" would have to check he was still breathing with a mirror under his nose or by feeling him breathe with my hand for increasingly long periods of time. It was just like a really stark exaggeration of normal new mother fears.

It started to reduce after about six months post-partum but there were echoes of it still until I went back to work at about a year after he was born.

That is the problem with OCD. It can very, very quickly change focus.

I would say that until I started the AD's, the therapy that I had (mindfulness and CBT privately, two sessions a week!!!!) really didn't do a whole lot of good. When I started the ADs and CBT after birth, I probably started to feel normalish within 3-4 weeks and now at 9 weeks postpartum I really feel fine most days and at most times.

You're right about that being the problem with OCD (one of the many I guess!) - it's no use getting the certainty you crave that your fear won't come true because something else will just take its place when you do. Mind you, all the while I'm fixated on making sure that the most recent thing I've done or feared isn't really a risk, I seem to forget that that isn't really the answer. If I put as much effort into getting help then maybe I'd be getting somewhere.

I guess the next step is to make an appt to see the doctor... I have never seen the same GP twice at my surgery so think I'll struggle to articulate things because I'm quite a private person, but I guess I'll just have to grit my teeth and get on with it, might take DH for support. Another thing I find hard is that I just crave a solution to this problem that isn't full of struggle and hard work - from what I've read of others' experiences with OCD, progress has come after lots of effort and hard work, I just keep putting that off, trying to muddle through. It's not a realistic approach and not what I'm like in other aspects of my life, I don't know why I'm finding this so hard. I feel like a bit of a failure.

I suspect that's just another symptom too. I think everyone just wants relief from this and I would guess it's the nature of the thing to be a very driven person who is used to being able to control thoughts and feelings... though I have no evidence for this.

I think I felt like you on my first pregnancy, I didn't really admit it to myself and I minimised it a lot, kept it to myself. I bought that anxiety workbook but I never did any of the exercises in it, I would read them thinking "oh I'm not that bad" etc. And I did find ways of dealing with it that first time that meant that in pregnancy at least I had lots of good memories.. we went on lots of weekends away once I'd had the vacc and I did a lot of swimming and tried to empty my mind and sometimes it worked.. but it was immense effort if I was honest and I was doing really bizarre things. I suppose because I didn't feel "depressed" in the way I imagined depression to be I just thought it was relatively normal even though I knew not that deep down that it was beyond the usual.

I found telling the GP the first time virtually impossible. I was six weeks pregnant. I could barely look at her and I just sort of blurted it out and I think I tried to minimise it... I think I said "a little bit of anxiety" or something like that, certainly not enough for her to actually suggest anything.. and she wasn't great at eliciting more info either. I also tailed it onto a request for something else, a repeat asthma prescription rather than presenting it as my main issue. I practically felt like I was choking and she didn't really do anything about it.

I told my midwife at about 12 weeks pregnant and she sent me to a pregnancy support midwife who was really lovely and very reassuring as she was just so normal and sane about it and she later told me she had had postpartum psychosis.. so it was reassuring to see her being so with it, made me feel less ashamed.

The second time I went to the GP it was on her recommendation and I must have been about 16 weeks along (like you it was someone different). I was a bit better. I said "I suffered anxiety in my first pregnancy and I am having a lot of intrusive thoughts" and I described how I would see my son crashing through the windscreen of the car as though it were a movie in my mind. He wrote a referral to the perinatal mh team but he was a bit pants too, he said he wouldn't advise ADs in pregnancy but really it wasn't his call to make, it should really be a specialist I think.

Finally at 28 weeks pregnant, I went to the midwife and just broke down in tears, just sobbing "I can't cope" and they got me a crisis appointment with the psychiatrist in the mother and baby unit next day. I had my assessment and got my diagnosis and arranged therapy from the following week which I continue until 38 weeks pregnant and it took the edge off but I was still very engrossed with my "stories" and I don't think either of the therapists had the skills or experience I needed to move me along, they just sort of went along with all my self delusions really. When it stopped I was instantly worse and the next three weeks before delivery were, as I said above, HELL. I felt like a total waste of space. Failure really sums it up...

Just remember when you are beating yourself up about this, a lot of what you feel is just this illness. It will peak and rise and fade away, you won't be like this forever. The sooner you get help the better, so if you can have your OH come and be very forthright about your symptoms and not allow your sense of shame to override the need to be bold and brave and tell the truth about what it's really like, how much it really occupies your mind and how much doubt rules every day, it will be very helpful!

Thank you thunk, I really appreciate you taking the time to share your experience with me, I'm glad things are looking up for you now and that you're enjoying your DCs :)

DH is out this evening but I'll talk to him when he gets home about going to the docs together; I know he'll be supportive, just need a bit of a strategy for what we'll say, when/how he should step in!

Thanks again - I was saying to my mum the other day that at least if I had a physical illness I wouldn't feel guilty about it and I'd feel like it was okay to let other people know, I think the secrecy around mental health issues makes it all feel a bit shameful. Just goes to show that you never really know what's going on for someone.