Anxiety during and post-pregnancy more common than we thought

Postpartum anxiety is more prevalent than previously thought, and needs greater attention, says one researcher.

According to University of British Columbia researcher Nichole Fairbrother, postpartum anxiety is not well understood, and stressed that it is more common that one might expect.

In a meta-analysis published recently in the Journal of Clinical Psychiatry, Ms Fairbrother found that one in five pregnant women experience at least one type of anxiety disorder.

Such maternal anxiety has been associated with a number of negative pregnancy outcomes, she explained, including miscarriage and high blood pressure during pregnancy, with strong evidence for pre-term delivery and low birth weight.

“There’s some evidence that when mothers are really anxious, it can impact the ways they communicate with their infant, that they’re a little less skillful or less responsive,” she said.

“Maternal anxiety is also associated with the infant not being as good at self-soothing. Children of mothers who score high for anxiety also have significantly increased risk of ADHD. It’s important to look at associations with caution, but that doesn’t mean that treating the mother for anxiety wouldn’t also have a positive impact on the child.”

On the question of how mothers can determine the difference between healthy levels of anxiety and problematic anxiety, Ms Fairbrother said it is completely normal and healthy for all of us to experience some degree of anxiety and some variation in mood.

“What we’re looking for is anxiety that is causing an individual a significant amount of distress or is interfering with that person’s ability to live their life normally. For example, someone with obsessive-compulsive disorder who is engaging in a lot of checking or washing behaviour might not be able to get to work on time,” she said.

“It doesn’t always need to be that extreme, but that’s what we look at when assessing the problem.”

When it comes to effective treatments for such anxiety disorders, she said that “the evidence is clear that for most anxiety and related conditions, cognitive behavioural therapy (CBT) is the first-line treatment”.

“It has been found to be as effective, or more effective than medication for the majority of anxiety and related disorders. What makes CBT so compelling is that when you receive a course of CBT, it offers protection against relapse, which means you can actually stop treatment,” she posited.

“There’s something really meaningful about receiving a course of treatment that leaves you with mastery and control and understanding.”