Panic disorder is relatively common and the number of diagnosed sufferers is growing year after year. It is particularly common in women, with the number of female sufferers outnumbering male sufferers by approximately six to one. A proclivity to panic attacks is stressful for any sufferer, but can be especially difficult for women who are pregnant. Most are aware that the mother’s emotional state can affect the unborn child, and there may be additional concerns about whether they can safely continue with their usual medication. Regrettably, this is a health area which is under-researched and the advice which is available from psychotherapists and medical professionals can be inconsistent.
Not all women who suffer with panic disorder during pregnancy suffered from attacks prior to falling pregnant. In fact, many women who suffer from this mental health disorder experience their first attack whilst pregnant — this can be more likely if they already showed a genetic predisposition to conditions such as depression or anxiety. There are several reasons why pregnancy is linked with an increased incidence of panic disorder. Firstly, there is a very strong link between significant life chances and the disorder. As life changes go, pregnancy is a very big one. The second reason why pregnant women are at increased risk is hormonal changes, especially in the first trimester when HCG levels will rise very quickly.
If a woman has had one or more panic attacks before she fell pregnant, the above reasons also account for why she may start to see a resumption or worsening of the disorder. Increased tiredness and feeling unwell may also make women more susceptible to an attack, and women who were taking medication to control mental health problems may have had to reduce or cease their drugs because of risks to the fetus. Naturally, this leaves them prone to more incidences of panic.
The primary concern for most pregnant women who suffer from panic disorder is whether their baby’s development will be harmed. Unfortunately, it can be very difficult to come up with a definitive answer to this question because the research which has been done is lacking or conflicting. There is some evidence — which came from a Taiwanese study conducted in 2009 — that mothers who had suffered multiple panic attacks between the first and third trimester were more likely to go into labor before term or have babies with a low birth weight. But other studies do not support this, and the correlation which was found in the study was very small.
What is more certain, is that any sort of mental health disorder in the mother — such as anxiety, depression or stress — is linked to increased risk of the child developing similar problems in later life. Children of mothers with mental health issues are also at greater risk of conditions such as ADHD. However, it cannot be proven if the reason for this link is an impact on fetal development, a genetic predisposition which is passed on, or being raised in an environment where a parent is depressed or anxious. Therefore, it is not guaranteed that a child will suffer from their own mental health problems because the mother had panic attacks whilst pregnant.
However, it is still essential that the mother finds a way to control her panic disorder during pregnancy, if only for her own well being. The majority of medications which are used to treat panic attacks carry a risk to fetal development, although the risk is generally only very low to moderate. Most doctors prefer not to treat panic attacks with medication during pregnancy, unless absolutely necessary. This decision will be based on the patient’s medical history and which drug has the lowest risk. Women who normally use natural remedies, such as Bach’s flower remedy and St John’s Wort should speak to a medical professional before using them during pregnancy. Side effect and interference with prescription medications normally mean that they are not recommended for use whilst pregnant or breastfeeding.
Sometimes, a doctor may prescribe non-medicinal treatments such as cognitive behavior therapy (CBT). CBT has been proven to be very effective in the treatment of panic disorders, as it teaches good coping strategies. Some women also find that self help methods such as meditation or pregnancy yoga classes are very useful, as panic attacks tend to occur less frequently if the person is relaxed. The reason for this is believed to be the positive effect that the techniques have on breathing, as poor breathing habits and a tendency to hyperventilate are believed to trigger attacks in some sufferers.
Pregnancy can be an anxious time, especially if you are a panic attack sufferer. Your doctor can help you find ways to control the disorder, so that you can enjoy a healthy and normal pregnancy.