One of the commonest questions I get asked is ‘Do you have any tips for managing anxiety in the first trimester?’. Pregnancy is naturally a worrying time for all parents, but if you have a history of fertility struggles, pregnancy loss or any other related forms of anxiety, it can sometimes feel almost too much to bear.
I am so grateful to clinical psychotherapist Anna Mathur, of www.annamathur.com who has joined me to write this post and shared her tips and wisdom.
Why do I feel anxious?
Anxiety is basically fear. It’s a response triggered by something, be it a worry, a thought, an experience or a situation in which we feel at threat somehow. In that moment, whether it’s imagined or real, our safety, or the things we look to in order to feel safe and grounded feel jeapordised.
Our thoughts rush ahead at 100mph, often searching for ways to feel safe again. This is a nervous system response called the ‘fight or flight response’. It’s a primal, physical reaction to danger, that gives us a spurt of adrenaline so that we might act quickly.
Think of Zebras grazing away at the water hole. They hear a lion in the distance. Their flight or fight response is triggered to enable them to act or flee. They are tense, vigilant and poised. They hear the lions pass, and they continue their grazing. Their rest state returns, and they eat at ease.
This is ideally how our anxiety response works. It works when we are threatened, and then abates when we are no longer at risk.
The challenge is that in our modern day life, we are no longer purely having a physical response to a physical trigger, like having our lives threatened by a bear outside of our cave.
Most of the things that trigger this flight or flight response are internal fear, or imagined situations that may or may not happen. It is down to the way we think about situations, and how we brace ourselves when we feel threatened by something.
Many of us spend time overthinking. Our minds hurtle off down the roads of many different possibilities and scenarios with the hope of protecting ourselves from the pain of them happening, as if pre-empting something gives us a sense of control. Our body is wired to believe that these situations are real, and so acts accordingly. We often feel waves of fear, grief, sadness, terror and loss, even though that thing hasn’t, or may never happen.
Recognising your triggers enables you to gain control over the runaway train that is anxiety. When you start noticing your thoughts pick up speed, or your heart racing and breath getting shallower, you can use certain techniques to help re-ground and calm yourself. You are grabbing the gears and breaks of that runaway train, using your strength to bring it to a safe halt.
This brings you back to your ‘rest and digest’ state, enabling you to think with more clarity and rationality.
Is it normal?
Anxiety is a life saving tool to keep you alive. So, yes, it is normal. But I think that so often, we just accept it as part of pregnancy or motherhood.
We believe that it’s part of the job description. Anna’s mission is to encourage women that there are ways to help anxiety.
Anxiety might be common, but living in a continued state of anxiety, being kept awake by horrible or stressful thoughts, living in a state of stress, does NOT need to be their normal.
We deserve more than to have our motherhood experiences robbed by anxiety.
Tips for managing your mindset
Sometimes knowledge really is power, and knowing what is happening in your mind and body when you feel anxious, can enable you to regain control of it, rather than feeling controlled by it.
Reframing your anxiety means to know it, to understand how it ticks, and to not be fearful of it.
It means to see it differently, as something less threatening, and to feel absolute hope that you can address it in a way that will find you living more authentically with less fear.
As humans we tend to have more fear around the things we know less about. They feel unpredictable and overwhelming.
Reframing anxiety is like seeing that the dog that was barking round the corner, and sounded so terrifying, was actually a small, fluffy Chihuahua.
Anxiety after previous loss or infertility
Loss and trauma fuel anxiety because it becomes harder to reassure yourself that the worst won’t happen, when it already feels like it has. Seek additional support through online networks, resources and communities.
It’s important to feel understood when your journey through pregnancy after a tough journey to get there. No emotion is out of bounds. Allow yourself to feel what you feel.
If you feel it would be helpful, seek therapeutic support to help you navigate the emotions that come with pregnancy after infertility or loss.
Let your sonographers and midwives know about any previous experience or current anxieties so that they can be mindful. They may be able to refer you for support, or simply hold your history in awareness as they relay information to you.
Coping with investigations and scans
Compassion
Firstly, have compassion for yourself. When we feel fearful, we need compassion and guidance. Ridicule or criticism coming from others or yourself isn’t helpful. Whether those around you understand how you feel or not, try and cultivate some compassion towards yourself because it’s not your fault that you feel heightened anxiety right now.
It might be that you or someone close to had a difficult or traumatic experience in previous investigations or scans.
Whatever your experience, whatever you are worried about regarding your scan or investigation, shaming and berating ourselves keeps us stuck.
Not everyone will relate to your experience (although many will), but it doesn’t mean that your anxiety is less valid or your feelings less valuable and worth addressing.
If you find yourself feeling frustrated, consider how you would reassure a friend, and try to use that supportive and understanding voice towards yourself.
Limit your exposure to reading experiences or forums
When we feel anxious, we are less able to rationalise what we read, and more likely to overemphasise the negative. Constantly reading other people’s experiences can fuel anxiety.
As you find yourself opening a search window, pause, and ask yourself what you’re going to gain. Knowledge isn’t power when we are overwhelming ourselves with it.
Searching for too much information, or searching in the wrong places can be disempowering, confusing, conflicting and frightening. Cut out the noise by choosing to stick to the facts provided by medical professionals.
Limit Discussion
When discussing your concerns with friends or family, some people’s opinion and approach will fuel your anxiety and some will calm it.
Limit how much you talk about it and when you do, choose to speak to those who are supportive and ground you.
Maintain Healthy Routine
Eating well, giving yourself the best chance to get good sleep and adequate rest, and exercising in whatever way you most enjoy is brilliant for both your mental health and your immune system.
Consider any habits that could benefit from a bit of a tweak because perhaps they add to feelings of anxiety and get support in addressing them if needs be. Again, this is a good thing to do for your future, let alone pregnancy.
Ground yourself in the present
Feelings of anxiety are triggered when we focus on negative, future unknowns and uncertainties. The difficult thing is that we aren’t creating stories about alien invasions, they tend to be fears based in potential realities, that have not, or may not happen.
The more we think about a fearful scenario, the more our body and nervous system will respond with physical symptoms of anxiety (such as increased heart rate, stress hormones, panic attacks).
We can interrupt this process by stopping the whirlwind of our thoughts in their tracks. There are many techniques that can help halt overthinking by shifting our focus from the unknowns of the future, to the realities of the present moment.
Some of Anna’s favourite techniques are:
- Count backwards from 100 in 3’s.
- Name 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell and 1 thing you can taste.
- Take a walk outside, breathe deeply and pay close attention to the things you see
- If you have any physical feelings of anxiety, do ten rounds of grounding breaths to calm your nervous system. Breathe in deeply for four, and steadily exhale for a count of 6-8 (dependent on what feels most comfortable)
- Utilising a guided meditation app such as ‘Headspace’ or ‘Calm’
Use these techniques as soon as you feel your mind begin to overthink or catastrophise. Practice them as you fall asleep. Use them when you don’t need them so that when you do, they feel familiar and instinctive.
When to seek specialist help
We believe that if you’re asking yourself the question ‘do I need help’, take a step to seek it.
You’re worthy of support regardless of how many checkboxes are ticked for medical diagnosis criteria!
Places to check include:
The Royal College of Psychiatrists recommend the following self-help books:
- Overcoming Anxiety by Helen Kennerley
- Overcoming Anxiety, Stress and Panic: A Five Areas Approach by Chris Williams
- Feel the Fear and Do It Anyway by Susan Jeffers
- Overcoming Panic and Agoraphobia by Derrick Silove and Vijaya Manicavasagar
- Panic Attacks: What They Are, Why They Happen and What You Can Do About Them by Christine Ingram
- An Introduction to Coping with Phobias by Brenda Hogan
Check out Anna’s self-help courses and her book ‘Mind Over Mother‘