Perinatal Anxiety - a Different Take

[Betsie86]

Hello Mumnet!

This is my very first post and I’m looking for some advice from you all.

My husband and I are planning on trying for a baby later this year.

For many years I’ve struggled with OCD and generalised Anxiety, I’m now at a point where I’m not on any medication and haven’t been for a good 5 years, however, I still have really good days and some bad days I think I’ve learned as to how to cope. The OCD in particular is more pressing, I have considered going back on Meds but at the same time feel that 80% of the time I cope quite well and can get myself out of it.

My fear is that when I fall (hopefully) pregnant is that me managing to cope currently will be go through the roof! So effectively I’m worrying about worrying!

I’m not worried about the birth etc or anything pregnancy related is purely having that anxious feeling and then my mind taking over and coming up with many ridiculous things that I should then worry about.

Has anyone been through this with a similar background and how did they find it? Did you find your anxiety went a little crazy?

I have booked an appointment with a perinatal psychiatrist next week to discuss with her before it happens for tips but I’m really interested to hear from you too.

Please help!

Thank you

Anxiety about anxiety is a really tricky vicious cycle to be in. Have you had CBT before?

I know it's so frustrating. I have tried some CBT but only once and I didn't find it that helpful however that's not to say it couldn't be and that maybe the instructions I had were not the best! I was advised to do things different and set tasks like tidying my desk drawers when I first got to work

Please keep us updated with how your visit with the perinatal psychiatrist goes. DH and I plan to TTC next year and I've been referred at this stage as I suffer from PMDD (I have HRT treatment and won't be able to use my regular medication at the beginning of a pregnancy when my consultant says my oestrogen levels may be too low for me to function). This had made me super anxious.

So I saw the therapist today.

The decision has been to go on to some medication now to keep me level throughout . The risks and benefits were discussed at great lengths.

I feel quite relieved in a way and I'm glad I chatted everything through with them. Unfortunately I fall into the high bracket for a reoccurrence as well as genetic loading from anxiety perspective.

I'm also going to do some CBT

X

I have anxiety as well. But CBT works really well for me.

I think, personally, you should try it before the meds and then book a follow up with your psych. If they still feel meds are the best in terms of balance of risks then fine. The issue isn’t so much the side effects on the fetus, but what would you do if you got pregnant and the prescription isn’t renewed - which is a real risk as medical care during pregnancy is usually referred to maternity medicine.

I'm not overly concerned about not having the meds, my psychiatrist is a perinatal Anxiety specialist working with the Ob/Gyn team I'd like to think they wouldn't allow someone to go cold turkey once started, they have a duty of care surely.

However I am actually starting CBT in two weeks so I may get on really well with that

This is the NHS advice. I find CBT works well for me. But my sister needed meds too - she was forced to stop them (despite also seeing a perinatal specialist) when she got pregnant and really struggled. The same specialist then told her she should have tried harder to CBT work so don’t expect them to treat you the same before and during pregnancy.

I think personally get a second opinion / ask why they have chosen the medical route first, and then decide.

www.nhs.uk/conditions/generalised-anxiety-disorder/treatment/

I've had anxiety and OCD all my life, from the first sort of conscious memories I have. I've had a lot of therapy, meds and psychiatrists in the past.

I fell pregnant in 2016 when I was 31 and initially my mental health was okay, I'd had a long stint of being relatively stable. Around the 4/5 month mark I got progressively worse and by the end I was a wreck. I'd come off all meds which I think was the problem (at my GPs request). I was passed onto the perinatal mental health team and had a lot of involvement from them for about a year which was a blessing.

My anxiety continues to trouble me now. I have health anxiety and germ phobia and the two are quite difficult when you have a baby who can't tell you what's wrong, and then a toddler who picks up everything going. I get obsessed with bugs, fevers mainly. I also struggle now I have a toddler to have that down time that was so crucial to me in my stable times - although I get evenings as he more often than not sleeps through (unless ill) I find the day passes slowly sometimes when I at home with him and I do sometimes wonder whether I was mentally healthy enough to have a child.

It's something you really have to weigh up. Having a child has made my mental health x 10 worse, but that's not to say it'll be like that for you. It sounds as if you've been super proactive about it going forwards which was opposite to me (who wrongly assumed I'd be fine as I had for a long while beforehand).

Some tips I'd recommend;

• make sure duties (particularly with a newborn) are split as much as possible - housework mainly, but if you're breastfeeding, that your husband does everything he can to make sure you get rest. My anxiety was noticeably worse when I was sleep deprived.
• go back on medication if you feel you are feeling worse, there are lots of very safe SSRi to take
• involve perinatal mental health as much as possible - they were invaluable
• get out and about as much as you can, it does make a difference
• if you career/job makes you happy, do look to go back. I'm a SAHM now due to circumstances beyond my control, but going back to work really allowed me some time to feel like me, which was really important
• find a group of mums who maybe suffer from anxiety too, or an antenatal group (I have a fantastic bunch that I met on Mumsnet and we talk on FB now) that you can sound off on if you have any fears
• don't entertain feeling guilty if you have bad days - everyone has them, and we're all human

Thank you for the tips they are really helpful.

It’s so hard as I have a long history of mental health on and off meds, my anxiety was horrific almost sucidal. So I really do understand how it can make you feel.

Once I’m in Meds I will be categorically be refusing to come off them until after the baby is born. If my current psychiatrist refuses (although given this is her advice) I can’t see it happening I will go else where I’m definetly not going to allow them to refuse to treat me.

Btw teddybear I have tried CBT before and I didn’t get on with it that well if it works well for you then that’s great. I’m not planning on getting a second opinion.

@Betsie86 is your anxiety rooted towards anything or is it very non specific?

I've recently been in treatment with EMDR which has made a huge improvement in things. I think the waiting lists can be long (I went private) and they normally are given to those with a trauma based background (abuse, PTSD, etc) but it might be worth looking into it. I've found it far more effective than CBT which never worked for me.

Another treatment I had years back which helped massively at the time was CAT therapy which again, was more intense than CBT (usually over 6 month period) but that dealt with my issues pre-children.

If they know you are planning a pregnancy they should put you on medication that is safe to take. I doubt that anyone will try and stop it during pregnancy - that is generally the last thing they will do as it’s better to be on medication and stable than risk having your mental health deteriorate.

I have been diagnosed with prenatal depression (30 weeks pregnant) and the support I have received has been incredible.
I have CBT once a week and as of next week I will be having perinatal home visits from midwives who deal with depression and anxiety around pregnancy.

Its not an ideal situation to be in, but the support is there and it is fantastic, when I reached out for the help I was seen as soon as possible and feel very supported honestly if you feel you need it reach out

Thanks all. I feel comfort knowing I’m not alone but also feel for all of us going through this. I’ve not heard of EMDR but will look into that too.

I’m so glad you are being supported well samfaa