Pregnancy & beyond

Anxiety disorders

Having an anxiety disorder as well as being pregnant or just having had a baby can make life unbearably hard. You may have had anxiety before, or this might be new to you, but it feels awful and it feels like it will never end. It is easy to get panicky at this time of your life. There are so many changes, so many things out of your control and it is hard to know if people are there to support you or because they want to cuddle your baby. With little sleep and little time to yourself it is also hard to know if you will ever get through this time. There is a lot of help out there.

LEARN Consider the different stories and pictures below, listen to a podcast or watch a video. 

THINK Then, to understand more about what causes anxiety you can explore the different social, psychological and physical causes that can increase anxiety. In this section you will find questions to ask yourself about each cause to see if it affects you.

DO Once you have explored the causes of your anxiety then it is time to do something. Go to the ‘Toolkit’ to find a range of different tools to help yourself try and reduce anxiety.

View the causes of Anxiety Disorders for Pregnancy & beyond

Do you relate to these?

Panic – yes
Fear – yes
Scared – yes
Anxious – yes
Can’t breathe – yes

In control - NO

Helpless

I wash my hands after everything I do – after I take my jacket off, drink my tea, fold the washing. I have hand sanitizer next to every chair, in every bag and on every counter. I am petrified I am going to give my baby germs and she will get sick. I could never forgive myself.

Panicked

Unlike all the movies and glamorous pictures of having a new born I did not bond straight away with my baby. It took me a long time actually – and even longer to admit this. I feel a failure as a mother because I didn’t love my baby from the minute she was born. You have no idea how anxious I felt thinking I would never love this new ‘thing’ – it was terrifying.

I thought my own mother would understand and help. But she was too busy having panic attacks herself. Suddenly her own daughter was a mother and she couldn’t cope. What hope do I have?

Frightened

Alone

Causes of anxiety disorders for Pregnancy & beyond

What happens

Some personalities are more prone to anxiety. You might really like to have a sense of control about your life. Pregnancy and/or a new baby can pose a serious challenge to your ability to have any sense of control as your body, the baby’s needs and your newness to these things create a sense of chaos. If you are someone who is uncomfortable when things don’t go right, or you have rigid ways of thinking about things, you may feel anxious because you find uncertainty difficult to cope with or tolerate.

Questions to ask yourself

Is it in my make up to be anxious?

How much am I a perfectionist?

How much do I over think things?

Do I find uncertainty difficult to cope with?

Do I get anxious that I am losing control because of all the changes that are happening in my life?

What happens

One third of women who have had a prior episode of depression or anxiety can experience depression and/or high anxiety after the birth of their baby. If you have had panic attacks before, there is a higher chance you may experience anxiety after the birth of your baby rather than while you are pregnant.

Questions to ask yourself

Have I had depression and/or anxiety before?

Have I had panic attacks before?

What happens

Distressing and faulty thinking such as:

  • catastrophising - thinking the worst possible thing will happen
  • jumping to conclusions - thinking you can predict the future (and it is bad) 

create a negative cycle. Distressing thoughts cause physical symptoms such as a racing heart, feeling sick causing you to want to run away. Your self-talk remains negative - “I am hopeless” - and the whole cycle starts again. If you find it hard to challenge your thoughts or if you avoid situations that cause anxiety you don’t get the benefit of facing your fear and working through the anxiety – this can lead to anxiety disorders.

Questions to ask yourself

Think of a recent time when you felt anxiety and ask yourself – in what ways were my thoughts unhelpful or faulty?

For example, do I

  • jump to conclusions about what people are thinking about me?
  • think something really bad is about to happen?

What is the evidence to support my thoughts?

What is the worst thing that could happen? How likely is this?

What happens

Having a constant and significant negative attitude can increase the levels of anxiety you can feel. The negative thoughts and feelings may be about your life in general, how your life is changing, or they may be focussed on your performance as a mother and your ability to cope with a new baby.

Questions to ask yourself

How negative do I feel about the things that happen in my life?

What happens

The physical changes that happen with pregnancy and having a baby can change how you feel about your body. Pregnancy weight gain can be hard to lose, your body shape changes and you can be anxious your body may not look the same again. Being pre-occupied with your weight or the appearance of your body can increase anxiety levels, particularly if it interferes with your day to day living.

Questions to ask yourself

How anxious am I about how my body looks?

How anxious am I about the weight I have gained with pregnancy?

What happens

When you are pregnant or have a new baby it is easy to become anxious that people are judging you or you may begin to judge yourself because you are doing things differently to the way you imagined. The things you question and doubt or feel judged for can be about what you eat, how much you work, whether you breastfeed, your baby crying or sleeping or not sleeping or a thousand other things. You can be anxious because you feel you are in the spotlight of people’s opinions and in constant fear of judgment.

Questions to ask yourself

How anxious am I about what others think of me?

How anxious am I that I might be doing the wrong things while I am pregnant or as a new mum?

How anxious am I that I will not be a good mum?

What happens

Physical, emotional, mental and sexual abuse can significantly affect your mental and emotional health. Ever having felt neglected, threatened or that you may be harmed in some way increases the risk of you experiencing an anxiety disorder. With maltreatment you learn you can’t trust that people will do the right thing by you – even sometimes those you thought loved and cared about you. With abuse you may lose the idea that everything in your world will be okay in the future and you may no longer feel safe.

Questions to ask yourself

Have I felt

  • neglected?
  • threatened?
  • that I might be harmed at any time during my life?

Has abuse put me more at risk of anxiety?

How much can I trust others?

How safe do I feel?

What happens

Having roles that give you meaning are important to your mental and emotional health. You might be used to your roles as a best friend, a daughter, a student or an employee but not to your role as a pregnant woman and a new mother. The role may or may not be what you expected. A new baby delivers a complex experience. With your happiness, you might feel a sense of loss - for the life you once had or you might feel trapped or burdened because your baby is totally dependent on you and that was not a role you were prepared for. These feelings can interfere with your sense of confidence about who you are and this often creates anxiety.

Questions to ask yourself

What roles do I have?

How anxious am I about the roles I have?

How anxious am I about my new role of mother?

Social causes →
What happens

Problems with your family can include lots of things. It might be that your relationship with your partner has changed with your pregnancy or adding a new baby to your family. Your relationship with your parents or your partner’s parents can change as they take on the role of grandparents and you become a mother to their grandchild. They may seek to impose their ideas about parenting on you.

Becoming a mother can bring up feelings about how your parents behaved towards you. If they were negative or controlling, you can have anxieties from the past that resurface now.

These changing or resurfacing family relationships can cause anxiety about the past, about others’ expectations of you and your needs.

Questions to ask yourself

Are there family problems that cause me to be anxious?

Have there been changes to our family that I am anxious about?

How has my relationship changed with my:

  • partner?
  • parents?
  • partner’s parents?

How anxious am I about the expectations of my:

  • partner?
  • family?

Have past anxieties about my family history resurfaced now?

What happens

When you are pregnant or have just had a baby, your relationship with your friends can change depending on what stage they are at in their life – are they also pregnant or nowhere near having children? Some friends will understand what you are going through and be a support, and some just won’t. Losing friends can cause great anxiety.

Questions to ask yourself

Do I feel accepted by my friends?

How much do my friends understand me and my life right now?

Are my friends at the same or a different stage in their lives to me?

How anxious am I my friends will forget about me and move on with their lives?

What happens

Having practical and emotional support when you are pregnant or a new mother is one of the most important things that can protect your mental health. Being separated from the people who support you because they live away from you or because they are not able to support you emotionally can cause great distress.

Questions to ask yourself

Do I have friends, family or people I trust who can be there for me?

Who accepts or does not accept me?

How supported do I feel?

Do I get the practical support I need?

Do I get the emotional support I need?

What happens

You might be worried about the changes happening in your life and whether you will have a healthy baby or what kind of mother you will be. Whether or not your pregnancy was planned, the idea of how a baby might change your relationships, your role, your body and your way of life can be unexpected and sometimes scary.

Other serious life events can add to the stress you feel, for instance if someone close to you has a serious illness or dies. You can start to feel vulnerable and anxious that bad things could happen and this can be a very strong feeling when you have another person to care for and protect because the threats seem much more real.

Questions to ask yourself

How do I feel about change?

Have I experienced any stressful or difficult events recently? If so, what are they?

How vulnerable and anxious do I feel that something bad could happen to me, my baby, or someone I love?

What happens

A new addition to the family means extra costs. You may worry about the expenses you have both large and small and the questions they bring like: do you need to buy a home, buy/move to a bigger home, buy baby furniture or clothes or equipment or toys? Have you enough saved up? Will you live on one income or will you go back to work? So many questions gives you so much to be anxious about.

Questions to ask yourself

How will I/we manage the extra costs of a baby?

Are there major financial decisions I/we need to make?

Are our expenses likely to be large or small?

Do we need one income or two incomes?

Community causes →
What happens

The community in which you live is important to your mental health. Finding yourself at home expecting a baby or with a new baby means you may see your community differently – where are the parks, the pram friendly cafes, the health centre or the medical centre? The health services in your community can be especially important at this time as local and easy access to maternal and child health care can help allay fear and anxiety.

Questions to ask yourself

How do I feel about the community where I live?

How safe do I feel in my community?

How connected do I feel and do I feel that I belong in my community?

What services are available to me or my baby in my community?

What happens

When you are pregnant or have just had a baby, you may be anxious about :

  • How safe and secure your job is.
  • Whether people will feel you are not pulling your weight as you juggle coping with pregnancy and a new baby.
  • Whether you will be overlooked if you take parental leave.
  • How demanding it is of your time and energy to do your job.
Questions to ask yourself

How anxious am I about my work?

How secure do I feel in my job?

Do I feel exhausted by my job?

How supported do I feel by my boss and work place?

Will my job be there for me when I decide to return to work?

Do I want to

  • keep working at my job?
  • change jobs/careers?
  • focus on being a mother?
Physical causes →
What happens

There is debate about whether anxiety is inherited. If you have a family member who has experienced an anxiety disorder this doesn't mean you will automatically get anxiety, but certain genes along with things that happen in your life may mix together to increase your vulnerability to anxiety.

Questions to ask yourself

Do I have a family member who has an anxiety disorder?

In addition to other causes of anxiety, does a family history add to my risk of anxiety?

What happens

Pregnancy, treatments like IVF, birth and breastfeeding all mean hormone changes. If your hormones are constantly changing and they take a while to settle, they can contribute to mood swings and anxious thoughts and feelings

Questions to ask yourself

How much is my anxiety related to hormonal changes I have experienced?

What happens

Having an illness, feeling ill with your pregnancy or becoming ill after birth can cause you to lose confidence in your body. You can become anxious about your health, your body and the future for youself and the health of your baby. Some illnesses such as polycystic ovary syndrome, arthritis and diabetes, can cause higher anxiety levels.

Questions to ask yourself

Do I have an illness, which causes me to be more anxious?

Does the illness I have put me at increased risk of having high levels of anxiety?

What happens

If you have been pregnant before and something happened such as a health scare or you had a miscarriage, you are more likely to have anxiety when you are pregnant again.

Questions to ask yourself

How anxious have previous problems in a pregnancy made me?

What happens

Complications with a birth, such as an emergency caesarean or your baby being born prematurely, can increase the time it takes you to physically and emotionally recover and this can add to your anxiety. And if your newborn baby has a medical problem that needs treatment, your level of emotional vulnerability is very high which can create significant anxiety.

Questions to ask yourself

Have any complications during childbirth for me and/or my baby caused me to feel anxious?

Has the length of time it has taken me to recover from childbirth added to my feelings of anxiety?

What happens

Apart from other health risks, taking alcohol or drugs when you are pregnant or have a newborn put you at greater risk of developing anxiety. Drinking or taking drugs to try to numb feelings of anxiety only makes the disorder worse.

Questions to ask yourself

How anxious am I that I drank and/or took drugs before I knew I was pregnant?

How much am I drinking?

Could drugs be making me more sensitive to anxiety?

Am I using alcohol and drugs to lessen my feelings of anxiety?

What happens

In the last few weeks of pregnancy it can be difficult to get comfortable in order to get quality sleep. Then a newborn baby’s sleeping and feeding schedule does not allow for a good night’s sleep. The lack of sleep can affect your ability to think clearly making it easier to be anxious. You can find it hard to imagine a future where you will ever get enough sleep again to be able to cope with your new life.

Questions to ask yourself

How much sleep do I get per night?

Do I get enough sleep so that I feel refreshed?

Is it

  • being pregnant,
  • having just had a baby or
  • my anxiety disorder 

that is causing me to have poor sleep?

What happens

Morning sickness and the fatigue of being pregnant make it difficult to eat a balanced diet and get some physical activity happening. If you have just had a baby it is hard to find the time to eat healthy food regularly. A poor diet and lack of exercise are known to affect your mood and make you more anxious.

Questions to ask yourself

Am I struggling to eat a range of healthy foods?

Do I have the time or energy to eat a healthy diet?

How much exercise am I getting?

What happens

Difficulties with breastfeeding or breast pain and infection can make you anxious about yourself and your baby.

Questions to ask yourself

Am I having difficulties with breastfeeding?

How anxious am I about breastfeeding?

Created on 18/08/2013 | Updated on 22/11/2013
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About Jean Hailes

Jean Hailes is Australia’s leading and most trusted women’s health organisation. We believe in physical and emotional health and wellbeing in all its dimensions for all women in Australia throughout their lives.

We offer a range of free resources and easy to understand information on women’s health and wellbeing. Appointments at our specialist women’s health clinics can be made in person (East Melbourne and Clayton, VIC) or across Australia via our Telehealth consultation service. www.jeanhailes.org.au

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