Coping With Anxiety During Pregnancy and Postpartum

We have all experienced anxiety, uncertainty, a feeling of being overwhelmed and not able to control our thoughts or emotions at one time or another. In the sleep deprived, sometimes stressful transition to new motherhood, these feelings may seem heightened. While postpartum depression has become more widely acknowledged, prenatal and postpartum anxiety get less discussion but are very common as well.

As a mental health therapist and mother of two, I’d like to offer a few tips for identifying and coping with postpartum anxiety. Try them out and incorporate the ones that work best for you into your daily routine. When we are highly anxious, our bodies go into fight or flight. You may experience a kind of tunnel vision, a tightness in your body or shortness of breath and difficulty concentrating (among other symptoms). Make sure to practice your coping skills in less anxious times, as this way you will be more readily able to access them and ease yourself out of the fight or flight zone.

Tips for identifying and coping with postpartum anxiety

  1. Be present.

    Take five deep breaths and focus on two things in the present moment. It often helps if they are sensory. For example, notice your feet rooted firmly on the ground and push through them to stand tall while taking a cleansing breath or two. Aromatherapy can be helpful in orienting to the present as well. You can keep something that has a comforting smell nearby for anxious times, like an essential oil.

  2. Have a soothing mantra. 

    Think of a phrase that you find calming or empowering. “I’m anxious right now but I am also strong enough to handle it” or “I can do hard things. I’ve done it before and I can do it again” or “I’m scared right now but I’m not alone. I have supports I can call.”

  3. Let someone in. 

    For many reasons, we often isolate ourselves and don’t talk about our new motherhood challenges. This journey is difficult enough though without trying to go it alone. Choose one or two people who you know can really be there with you in the hard times. People often don’t know the right thing to say so don’t be afraid to give them a little direction so that they can truly support you. “When I’m struggling, I need you to just listen” or “I’d like you to give me a pep talk.” What you need is unique to you and it’s valid. Most people are relieved to know what you need from them.

    If you find you don’t have the pregnancy or new mom supports you need, fill in your support roster by joining a prenatal yoga class or a new moms group.  In these settings, you’ll be surrounded by people who are navigating many of the same struggles you are. And you never know when you might make a new life long friend.

  4. Try a mindfulness meditation. 

    When we are anxious, our thoughts often feel out of control. They gain speed through the forest of “what ifs” and barrel right toward the worst-case scenario. Mindfulness can help us slow down our thoughts and train new neural pathways. In a sense, through mindfulness, we can change our brains and our reactions to negative thoughts. Below you’ll find one of my favorite mindfulness exercises. The following, called Leaves On a Stream, is the coping skill my clients seem to find most helpful:

“Leaves on a Stream” Exercise

(Harris, 2009 ACT)

  • Sit in a comfortable position and either close your eyes or rest them gently on a fixed spot in the room.
  • Visualize yourself sitting beside a gently flowing stream with leaves floating along the surface of the water.
  • For the next few minutes, take each thought that enters your mind and place it on a leaf… let it float by.  Do this with each thought – pleasurable, painful, or neutral.  Even if you have joyous or enthusiastic thoughts, place them on a leaf and let them float by.
  • If your thoughts momentarily stop, continue to watch the stream.  Sooner or later, your thoughts will start up again.
  • Allow the stream to flow at its own pace.  Don’t try to speed it up and rush your thoughts along.  You’re not trying to rush the leaves along or “get rid” of your thoughts.  You are allowing them to come and go at their own pace.
  • If your mind says “I’m bored,” or “I’m not doing this right” place those thoughts on leaves, too, and let them pass.
  • If a leaf gets stuck, allow it to hang around until it’s ready to float by.  If the thought comes up again, watch it float by another time.
  • If a difficult or painful feeling arises, simply acknowledge it.  Say to yourself, “I notice myself having a feeling of boredom/impatience/frustration.”  Place those thoughts on leaves and allow them float along.
  • From time to time, your thoughts may hook you and distract you from being fully present in this exercise. This is normal.  As soon as you realize that you have become sidetracked, gently bring your attention back to the visualization exercise.

Try this exercise for 2 minutes to start and then lengthen it to 5 or even 10 minutes per day. I hope you find this helpful and calming.

Taking care of your own mental health is one of the best things you can do for yourself and your family!

About Evelyn

Evelyn Gama is a mental health therapist specializing in fertility, prenatal and postpartum mental health. Evelyn works with new parents to develop plans for postpartum care.  She also specializes in working with families who’ve experienced a NICU stay or who have special needs or medically fragile children. Evelyn is also a mother of two based out of New York City.