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So, what is perinatal anxiety?

Firstly, perinatal simply means “around pregnancy”.

I’m sure we’re all familiar with what anxiety is, but just in case, and so that I can more easily explain some helpful techniques later, anxiety is an emotion that can have both a physical and cognitive component and, like all emotions, it can be helpful to visualise it as a wave, which builds, peaks, and then reduces.

Anxiety can also be both a state, e.g. in response to a situation, like delivering a presentation, or a trait; a more consistent aspect of your personality e.g. you’re a worrier.


The physical symptoms of anxiety tend to be:

  • shallow/ fast breathing

  • fast, pounding or irregular heartbeat

  • dry mouth

  • churning stomach

  • sweating

  • inability

  • restlessness

  • pins and needles

Sometimes you can experience the physical symptoms of anxiety disconnected from conscious worry.


Or, they can be felt in addition to anxious thoughts. Anxious thoughts can play over and over in the mind, escalate, and tend to be concerned with things that ‘might’ happen in the future.


How can we soothe it?

Firstly, fundamental to being able to self-regulate is making sure that you have eaten, slept, moved and seen someone recently. I appreciate some of these things are a challenge, particularly in early motherhood, but try, as much as you can, to make these your non-negotiables.


Secondly, it can help to also remember that our brain just wants to keep us safe, help us learn from our mistakes and prevent us from making them again in the future. It also wants to help us get our needs met, avoid pain and alert us to things that require our attention. In doing so however, it can often throw up thoughts that are unhelpful, which can result in us trying to avoid, escape, or suppress them, or, give in to them all together.


It is also really important to note that our threat system is naturally dialled up in the perinatal period in order to keep our little ones safe, making this even more powerful.

1.) Notice, Name & Thank

Notice

Holding the wave analogy of emotion in mind, my first tip, however plain, and obvious, is to notice. By this I mean bringing your attention to your anxious thoughts and internal physical state. Anxious thoughts can act like the wind, whipping up the waves. If we don’t notice our anxiety rising, we have less chance of being able to dissipate it, or respond to it productively whilst the wave is building.


Name

You can use the following ways to name your anxious thoughts, either inside your head, or out-loud:

  1. “I’m having the thought that…the baby isn’t breathing.”

  2. “My mind is telling me…those people think I’m a bad mother.”

  3. “Name the story…I’m telling myself the story that I can’t cope.”

  4. “Name the process…I’m worrying about the state of my marriage.”

Noticing and naming are important, as they help to create distance between ourselves and the thought and/ or feeling, reducing their ability to overtake us and influence our behaviour. Literally putting the extra words around the thought, allows us to ‘step back’ and distance ourselves from it, enabling us to see it as something temporary that will pass.


Thank

Remember, your anxiety is there to protect you. Think of it as an overprotective parent. It can be helpful to thank it and let it know that you’re actually safe: “Thanks mind, I know you’re trying to keep safe but me and the baby are fine, we’re safe”.


If, for whatever reason, that hasn’t worked, or maybe you’ve found yourself in a situation that has caused your anxiety to go from 0-100 very quickly, your best tool to get you down from the peak of the wave will be to use your breath.


“It is very hard to control the mind with the mind, especially when we are in heightened states of activation,stress or tired.” (Huberman, 2021).


2.) The physiological sigh

The physiological sigh involves breathing out slower than you breathe in, in order to activate the parasympathetic nervous system. To do this, do two quick inhales through the nose, followed by a long, slow, exhale through the mouth.


When we are stressed, carbon dioxide builds up in our system, as the small air sacks in our lungs called alveoli stop working, and this excess of carbon dioxide makes us feel agitated. The double inhale of the physiological sigh increases the alveoli’s capacity, and the long exhale expels the carbon dioxide, resulting in a calming effect.


Alternatively, you can use box breathing or the 5-4-3-2-1 grounding technique.


3.) Dial up your soothing system

In counterbalance to our threat system (and our drive system, but more on that another time) we have a soothing system. Our soothing system switches on when we are not busy achieving or avoiding threats. Because our brains have evolved to respond to nurture this is something we can strengthen with active engagement.


How you activate your soothing system depends on what makes you feel good - here are some of my favourites:

  • Deliberate Cold Exposure (DCE) - This was a life saver for me last winter. Studies that have found DCE can elevate dopamine up to 250-500% over baseline (Šrámek et al., 2000). Dopamine is known to elevate mood and make us feel energised and focused. If jumping in a cold shower feels too extreme, holding ice can be really effective.

  • Get Outside - Dr Samer Hattar (2021) suggests 5-30 minutes of viewing sunlight outside as soon as possible after waking. The length of time for an effective dose will vary depending on cloud cover; the more overcast it is the longer you might need. Not only does this boost mood, but it also regulates our sleep-wake cycle.

  • Connecting with Something or Someone that brings you joy Loneliness creates a molecule in our body called tachykinin which impairs our immune systems and makes us feel paranoid and fearful (Huberman, 2021). Feeling like we are connected and that have a sense of belonging suppresses tachykinin. Whilst connecting to other humans is good, it doesn’t have to be human connection that we seek; connecting with someone or something that brings us joy leads to the release of serotonin, which makes us feel content, bliss, trust, and comfort (Huberman, 2021). That might be a pet, knitting, walking in nature, or going to a class at The Barn KT9!

4.) Stop Scrolling

Reduce the amount of info you consume through scrolling. It can feel like we’re mindlessly scrolling in order to switch off but our already overloaded brains still have to process it all.


5.) Physically Slow Down.

Rushing around activates our fight or flight system.


It is important to remember that anxiety is an understandable response to a profound life change and its accompanying responsibility (Oakeley, 2023).


That said, don’t hesitate to talk to a professional, if your feelings are interfering with your ability to function, or feel any forms of pleasure.

Even if you are worried you don’t meet the criteria for a definition, seek support.


About Charlotte Sharpe Therapy

Charlotte Sharpe is a counsellor/psychotherapist based in Leatherhead, Surrey, providing collaborative, client-led therapy for working through life’s challenges, changes, losses, and relationships.

She runs a monthly group therapy session for mums called Offload the Motherload, giving you a chance to talk through anything and everything in a supportive environment.


Want to come to the next Offload the Motherload?

It’s on Tuesday 7th November at 11.45am at The Barn KT9.

The theme will be: Identity - who am I now?


Want to get support on a 1-1 level?

If you’re thinking that you need that extra level of support, you can book in your free intro call with Charlotte today.


Other support services

The Maternal Mental Health Alliance have a list of great support services linked here and you can search by area or postcode.





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