Medicines for Perinatal anxiety

What it is

Perinatal anxiety is anxiety that occurs during pregnancy or in the year after having a baby (the perinatal period). While some worry is a normal part of pregnancy and new parenthood, perinatal anxiety is when the anxiety becomes excessive, persistent, hard to control, and distressing or impairing — affecting the person's wellbeing and daily life. It is common, and can take various forms: generalised worry (for example excessive, hard-to-control worries about the baby's health, the birth, or one's ability to cope), panic attacks, health anxiety, specific fears, and, in some, distressing intrusive thoughts (which can be particularly frightening for new parents but are common and do not mean a person will act on them). Physical symptoms of anxiety (such as a racing heart, restlessness, difficulty sleeping beyond the baby's demands, and tension) are often present. Perinatal anxiety frequently occurs alongside, or is confused with, postnatal depression, and because much attention focuses on depression, anxiety can be overlooked — yet it is just as important to recognise and treat. It can affect the parent's wellbeing, the pregnancy, and the developing relationship with the baby. Importantly, perinatal anxiety is common, treatable, and nothing to be ashamed of, and seeking help benefits both parent and baby.

How it is treated

Perinatal anxiety is treated with a supportive approach tailored to the person and the perinatal context, and effective help is available. Recognising it is the first step, so it is important that anxiety (not just depression) is asked about and taken seriously during pregnancy and after birth. Management may include: self-help and lifestyle measures (such as anxiety-management techniques, rest where possible, support networks, and psychoeducation, which help milder anxiety); psychological therapy, particularly cognitive behavioural therapy, which is effective for anxiety and is often a first-line treatment in the perinatal period; and, where anxiety is more severe or not responding, medication, which can be used in pregnancy and while breastfeeding with careful consideration of the balance of benefits and risks, guided by a doctor with perinatal expertise. Support for intrusive thoughts includes reassurance that they are common and do not reflect the person's character or intentions. Specialist perinatal mental-health services support more significant cases. Involving and supporting partners and family, and practical support with the baby, help. Crucially, any thoughts of harming oneself, or being unable to cope, need prompt help. The reassuring message is that perinatal anxiety is common and treatable, that it is important to recognise it alongside depression, and that seeking help — with therapy, support, and, where needed, medication — benefits both parent and baby.