Insomnia and severe anxiety

[magentadaisies]

Hi all,
27 weeks pregnant and I am currently dealing with a terrible panic/insomnia flare. Had general anxiety disorder pre pregnancy but the past few weeks this is manifested into physical panic attacks. This included waking up in the middle of the night having panic attacks and heart palpitations which after a few nights of very broken sleep I guess made my brain associate bedtime with having these panic attacks. On Sunday night I literally had zero sleep at all. Went to gp on Monday who noted my high heart rate and said if this continues to go to a&e. She gave me a short term prescription for promethazine which worked and knocked me out on Monday night however didn’t work last night. I ended up in a&e with again terrible racing heart and another night of zero sleep at all. Doctors in a&e just advised breathing exercises which I feel I’m way beyond the point of. I’m now an anxious mess as I’m worried I don’t sleep and how dangerous this must be for me and baby’s development. I’m so desperate for some sleep! My brain won’t even let me nap, it’s like it’s stuck in fight or flight. Any ideas would be very welcome as im just knackered and very tearful at this stage and feel totally in despair .

Are you under the care of Mental Health midwives? Also, are you seeing anyone to help with your anxiety?

I am similar, 28 weeks, with anxiety and insomnia, but was already regularly seeing a therapist and so mental health midwife is more of an extra for me (they would have referred me for counselling if I wasn’t already getting help privately).

I’m on Amitriptaline to help with my sleep, again it predates pregnancy and they said they’d rather I keep taking it than not sleep and become more anxious. (It generally helps get me some sleep most nights which is a lot better than before).

I really would recommend you urgently request to see GP and midwives- whoever can get you help sooner. Definitely get signed off work until you are more stable, if you’re working.

A couple of things I’ve been told before that have helped me- firstly that resting, eg being laid down with eyes closed breathing slowly, while not as good as sleep, is better than being up panicking. There’s a thing called radical acceptance, where you accept things you can’t control- so sometimes I have to “accept” it’s a bad night and try to make the best of it by at least resting and focusing on staying calm.
Similarly, I’ve been told that I’ve got through days after not sleeping the night before, so again- remember it is not the end of the world (the panic is exhausting and upsetting).

Also, I’ve been told by medical professionals that the baby will be fine and I can’t think what examples they’ve given me but the gist is that women have been in absolutely diabolical situations and given birth to healthy happy babies, so try not to overly focus on that.

That said, I have also gone to my hospital more often than most as I do get anxious about the baby/reduced movements/other symptoms- but the midwives have always been lovely and told me it’s better to go in and be checked out than to be at home worrying. I hope you feel you can do the same at your hospital?

I hope you have a supportive partner and that you can try to get proper support from gp/midwives as soon as possible.

Hey, thanks so much for your message. I’m sorry that you’ve experienced similar struggles. It’s totally debilitating.
I haven’t seen anyone re my mental health during pregnancy, it’s more of a chronic anxiety I suppose I’ve been used to living with that’s escalated in recent weeks to acute panic attacks. This is in part why I’m so unsettled, as up to a few weeks ago everything was ok.
This pregnancy was after a 2 year infertility struggle though, with previous losses prior too so I do think that’s added to my stress. Luckily I feel able to call triage and be seen whenever, however unless baby isn’t moving or I have pain/bleeding etc in this instance they are not concerned.
It’s reassuring what you’ve said re effects on baby. I think this fuels my anxiety more. The acceptance I also resonate with - that’s pretty much my approach tonight. If I don’t sleep I’m going to gp tomorrow anyway so no point in putting myself under pressure.
My husband is a fantastic support and is also concerned and luckily has tomorrow as a day off so I will bring him along to help emphasise the issue.

That’s great that you can go to the GP tomorrow with your husband. I have found it helpful having my partner present for things like this as it can be easy to minimise things with health professionals and I’m less likely to do that in front of him.

I actually had a panic attack in my first midwife appointment which I think is why I was signposted to mental health midwives. I do think you can/should ask to be referred as there is still a while to go until baby arrives and they may be able to offer you some support.

I’m not sure if you’ve had similar but I’ve found the last few weeks much more physically challenging than earlier in 2nd trimester and that’s been physically, emotionally and mentally exhausting and ramped up my anxiety and sleep problems.

I have also had a long fertility struggle and this is an IVF pregnancy, I do think having had fertility problems adds a layer of stress and fear, and of course so would previous losses (I’m sorry you’ve been through that).

I don’t know if you’ve ever had therapy for anxiety but I would strongly recommend giving it a go. It’s really helped me through a difficult few years but also can just help you through a rough patch if you are in crisis.
GP/Midwives may be able to signpost you but if you’re able to go private for a while, you can find therapists on BACP directory - you can filter for people specialising in fertility, anxiety etc.

Be gentle with yourself! And I hope tomorrow goes well (and tonight).

So sorry to hear you’ve also walked the road of infertility. It is soul destroying and I absolutely believe it plays into these anxieties. I think my fight or flight is just constantly activated and now this is why these episodes of panic are happening. Yes it’s physically a lot more challenging now and as you’ve said lack of sleep amplifies everything more.
I could use all the support I can get so I’ll be asking about mental health midwives too.
Thanks so much for reaching out to me , although I wish it were different for us both and we are in such a difficult position especially being pregnant with much wanted and loved babies, it does help to know I’m not alone.

Put some Vicks under your nose and listen to an audiobook or podcast. The Speakman have a lot of good things online to help with anxiety.

I absolutely know what you mean about there being some comfort in not being the only one going through this stuff. Whilst of course not wishing it on anyone!

Infertility is a super isolating place to be, and then it’s very strange when you are flipped into the place you have desperately wanted to be in- but with a whole new set of worries and fears that you couldn’t possibly have fully anticipated.

Re fight or flight response, I completely get that too. I’ve really found dialectical behavioural therapy has helped me being able to slow down and regulate my emotions better, as well as learning to tolerate distress better. (Sorry it’s all such therapy speech, but it really has helped me so much).

I have had a break from therapy for a while because of holidays and really have felt the absence of that space for expressing everything.

Do let me know how you get on, sending best wishes.

I think the perinatal mental health team could really help - please ask GP or midwife for a referral xx