The Most Common Problem in Pregnancy is Not What You Think

25% of pregnant women suffered from mental health problems

Posted Jan 22, 2018

“The minute I said the words to someone, help was there for me. When the doctor told me what I was feeling…it was so liberating. I felt such a sense of relief that I wasn’t going mad.”

Recently, the BBC reported on a UK-based study that found 25% of pregnant women suffered from mental health problems, including anxiety, depression, eating disorders, and bipolar disorder.

Our research shows that anxiety is the most common of all of these. In fact, we’ve found that 22% of pregnant women struggle with anxiety.

One psychologist I spoke with recently said that when she became a clinical psychologist, she thought she’d see mainly postpartum depression. Instead, she sees mostly prenatal anxiety.

Shutterstock, used with permission
Source: Shutterstock, used with permission

Prenatal anxiety is one of the least understood – and most missed – diagnoses in pregnancy.

Here are some facts:

  • Prenatal anxiety can precede depression, but commonly occurs alone as well
  • In up to 60% of women, prenatal anxiety is comorbid with depression. In other words, you can be experiencing symptoms of both anxiety (irritability, feeling agitated or worked up, not able to relax) and depression (sadness, anger)
  • Our research shows that high prenatal anxiety is always paired with high stress. Yes – they are different, and they seem to feed into each other.
  • Not understanding that there is such a thing as “prenatal anxiety” keeps 75% of pregnant women from mentioning their concerns to their doctors, midwives and nurses. Yes – they are different, and they seem to feed into each other.
  • The symptoms of prenatal anxiety tend to include irritability, constant and unrelenting worry, over-reaction, feeling a lack of control, and feeling overwhelmed.You can assess yourself using the tools below.
  • Studies show that women with prenatal depression are over 3 times more likely to experience postpartum depression, and those with prenatal depression and anxiety are almost 10 times more likely. In other words – don’t wait to take action.

Anxiety “screening tools” are sets of questions that are designed to detect anxiety. Two screening tools that are quite accurate for identifying anxiety are the 2-question Generalized Anxiety Disorder (GAD-2) and the anxiety questions of the Depression, Anxiety, Stress Scale (DASS-21). 

The GAD-2 questions are:

  1. Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious, or on edge? (score 0=not at all; 1=several days; 2=more than half the days; 3=nearly every day)
  2. Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying? (score 0=not at all; 1=several days; 2=more than half the days; 3=nearly every day)

Add up your scores for question 1 and 2. A total score of 3 or more indicates the presence of anxiety symptoms. If you do score 3 or more, talk to your doctor. There are many effective ways to reduce anxiety – with and without medication.

There are 7 anxiety questions of the DASS-21. 
Answer each question with one of the following 4 responses: 

0=did not apply to me at all
1=applied to me to some degree or some of the time
2=applied to me to a considerable degree or a good part of time
3=applied to me very much or most of the time.

Over the past week…

  1. I was aware of dryness of my mouth.
  2. I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion).
  3. I experienced trembling (e.g., in the hands).
  4. I was worried about situations in which I might panic and make a fool of myself.
  5. I felt I was close to panic.
  6. I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat).
  7. I felt scared without any good reason.

Add up the score of each question and multiply the total score by 2. For example, if you added up each question and the total was 6, multiply by 2 for a total of 12. A total score of 0-7 indicates no anxiety; 8-9 indicates mild anxiety; 10-14 indicates moderate anxiety; 15-19 indicates severe anxiety; and 20+ indicates extremely severe anxiety. At a score of 12, you would have moderate anxiety.

What do women think about screening? Many express relief – and a feeling of being validated. You may have suspected that something is different, but you don’t know how to get answers. In the end, you may feel that it gives you a place to move forward from. A fresh start.

Bottom line: Anxiety is one of the most common complications in pregnancy. Screening yourself for anxiety is a good place to begin because it can put a name to what you are feeling, and may validate your experience.

References

EveryonesBusiness.org

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819543/

https://www.ncbi.nlm.nih.gov/pubmed/26281038

https://www.ncbi.nlm.nih.gov/pubmed/18067974

http://cope.org.au/about/review-of-new-perinatal-mental-health-guidelines/

https://www.ncbi.nlm.nih.gov/pubmed/26719105

Lovibond, S.H., & Lovibond, P.F. . (1995). Manual for the Depression, Anxiety and Stress Scales (2nd ed.). Sydney: Psychology Foundation.

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