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Advice for moms struggling with anxiety



5 ways to slay anxiety


After Emily* gave birth to her first child, she suffered from anxiety. She'd had issues with anxiety in the past, and the birth of her baby intensified those feelings. When she became pregnant again, her midwife suggested she seek help to prevent a destabilizing breakdown.

Seven months into her pregnancy, Emily wound up in the office of Dr. Agathe C. Pierre-Louis, a licensed clinical psychologist at EMBRACE Therapy, which has offices in Goshen and Croton-on-Hudson. Dr. Pierre-Louis worked with her to identify what worked and what didn't in her last pregnancy and figure out coping mechanisms to better manage her anxiety the second time around.

"We did a lot of work around sleep, around unrealistic expectations she had of motherhood and around communication issues she had with her partner," Dr. Pierre-Louis says. "She recognized that she had been feeling very isolated."

Although she did not feel that way, Emily was far from alone. According to the American College of Obstetricians and Gynecologists, about six percent of pregnant women experience anxiety before giving birth, and ten percent experience it after. Dr. Pierre-Louis believes the numbers in reality are actually far higher, as many women do not report their anxiety and try to deal with it alone.

READ MORE: Managing stress while pregnant

Perfect moms don’t exist
Anxiety has been on the rise in recent years, sometimes co-occurring with post-partum depression. "There is so much pressure to be a perfect mom from society, so many opportunities to compare yourself to other moms on social media, that moms today never get a break," Dr. Pierre-Louis says. "Add that to the stress of having a baby, and it can be really overwhelming."

Women who had anxiety before getting pregnant or who have a family history of anxiety may be especially prone to developing anxiety while pregnant or after giving birth. But any new mom can be susceptible, thanks to the biological changes that occur during and after pregnancy. Recognizing the symptoms of anxiety is the first step to managing it.

"Certainly mothers should be aware if their anxiety is interfering with their ability to take proper care of their children," says Dr. Jennifer Buchwald, a psychologist at the Hudson Valley Center for Cognitive Therapy in Upper Nyack. "Usually, anxiety is not this severe and typical signs include excessive, uncontrollable worry, crying, irritability and physical feelings of nervousness, such as palpitations, shakiness and feeling light headed. Depression can accompany anxiety and so women should also be aware of depressive symptoms, which can include sad or down mood, loss of pleasure in things they usually enjoy and negative thoughts about themselves, the future and the world around them."

Problem solving to reduce anxiety
While women struggling with anxiety or depression certainly feel despair, there are many ways to work through those feelings. Dr. Buchwald says the first step is to accept that some degree of anxiety is to be expected in motherhood, and that low levels of anxiety can actually be useful.

"A good start is to ask yourself Is this a reasonable problem? Are there ways to problem-solve to make the situation better?" says Dr. Buchwald. "When the answer is yes, then the anxiety is actually helpful and women should focus on finding and implementing solutions."

When the answer is no, though, working through the anxiety can require a little more work. Mothers can start by labeling concerns that are unlikely to happen or that cannot be practically remedied as an "unproductive worry" and attempt to shelve the concern. But Dr. Buchwald acknowledges that it is not always easy to leave anxious thoughts behind.

"Unfortunately, it usually doesn't work to tell ourselves to stop thinking about something but women can learn ways to challenge their
anxious thinking by putting the problem in perspective, asking themselves what advice they would give a friend in the same situation and asking themselves the probability of the situation actually happening," she says.

READ MORE: Could stress be to blame for your baby-making struggles?

Seek support when overwhelmed
If that doesn't work, women can try relaxation techniques like mindfulness and deep breathing to ease physical tension and try to give themselves a better sense of control. The next step is seeking social support, making time for yourself or seeking professional therapy.

"Cognitive Behavior Therapy (CBT) in particular is the gold standard for anxiety reduction," Dr. Buchwald says. "CBT is an active, solution-focused type of therapy that helps people learn to identify and change their thoughts associated with worry and teaches coping skills to manage anxiety symptoms."

Mothers can also learn techniques for modeling ways of coping with fear or anxiety for their children. Dr. Buchwald says that children of anxious mothers may be more prone to developing anxiety themselves because of both genetics and  the behavior they see modeled, but that mothers who are aware of their anxiety can actively help children overcome it.

"Not only can she be more understanding when their children feel uncomfortable but they can also help them practice skills to build their confidence early in life," she says. "I had one patient with social phobia who encouraged her children at a young age to make eye contact, talk to new people, and speak on the phone so they would grow up feeling confident in situations that had made the mother uncomfortable."

READ MORE: Do you have postpartum depression?

Validate your fear and move forward
In Emily's case, she had a particular fear of her child falling while she walked down the steps. Dr. Pierre-Louis says the first thing she did was validate that fear - she acknowledged that it is reasonable for a mother to be concerned about her child falling and injuring himself. But then she and Emily talked about the steps Emily had taken and could take to prevent her child from falling, such as wearing a baby carrier and
holding onto the railing. Then, Emily visualized herself walking down the steps with her child while breathing deeply and focusing on the task at hand. Two weeks later, her anxiety had lessened considerably.

"Her feelings make sense," Dr. Pierre-Louis says. "She was able to protect this baby and carry the baby inside her for nine months, and now the child is out in the world and she doesn't have as much control."

Those validating techniques can work for partners or family members of mothers with anxiety.

"First and foremost, family members can listen to what parents are going through and offer reassurance that many people feel similarly," Dr. Buchwald says. Offering to help with daily task to give the mother a break, like babysitting or running an errand, can also bring welcome relief. If the problem does not seem to be getting better, Dr. Buchwald recommends encouraging the mother to seek help.

"Mothers don't need to suffer with anxiety," she says. "Anxiety is highly treatable and people can learn ways to feel better."

*Name has been changed.

The Hudson Valley Center for Cognitive Therapy can be visited online at hvcct.com. EMBRACE Therapy can be visited online at iEmbraceTherapy.com.


Elora Tocci is a freelance writer born and raised in Newburgh. She is a public affairs associate at Citizens' Committee for Children of New York.