Treatment of postnatal anxiety
There are a range of safe and effective approaches available for the treatment of postnatal anxiety. The type of treatment that is right for you will be determined by a range of factors including your personal history, and how severe your anxiety condition is at the time that you seek help.
If your anxiety is mild to moderate, this generally means you are experiencing a few symptoms and, whilst affecting your quality of life and ability to get things done, you are still likely to be able to function generally. If this is the case, emotional and practical support together with support counselling and/or psychological treatments can be very effective.
This can be provided individually or in groups, providing you with an opportunity to talk through how you are feeling and thinking with someone who can support and listen in a non-judgemental way. Support counselling can also help you to develop strategies to help deal with challenges that may be contributing to your feelings of anxiety generally, or in specific situations.
There are two types of psychological treatments that can be effective for treating mild to moderate anxiety:
- Cognitive behaviour therapy (CBT) – this is a structured treatment, which targets your way of thinking (cognition) and acting (behaviour), which in turn can impact on the way you feel – in this case by reducing your feelings of fear and anxiety.
It is common for people with anxiety to view things in a catastrophic way, leading them to believe that the worst will happen, or perceive things to be worse than they really are. The aim of the cognitive component of this therapy is to identify these thinking styles, and help you to rationalise your thinking and begin to look at things more objectively. Once these thinking patterns are recognised, you can begin to consciously and deliberately challenge and replace these thoughts to reduce anxiety and give you greater control over the symptoms.
As anxiety can also make you feel strong feelings of fear and anxiousness and/or panic, CBT can also teach you strategies to reduce the intensity of these physical feelings, and bring these physical symptoms under control through a range of strategies including deep breathing and muscle relaxation to reduce the feelings of tension. Anxiety also can cause people to avoid situations that cause them distress, so using the above cognitive and behavioural techniques, CBT can give you the tools to help you approach situations that you may have been avoiding.
- Interpersonal therapy (IPT) – often anxiety may be caused by tensions with others, personal losses, changes and/or conflicts in relationships. This type of talking therapy helps people to find new ways of approaching and dealing with these types of situations which may be leading to ongoing feelings of anxiety.
These psychological treatments can be conducted one-on-one with a professional, in groups, or online, and are generally delivered by a trained health professional with expertise in mental health. These therapies can also involve you and your infant together, with the treatment also focussing on your relationship and bonding with your baby, as you also learn to manage anxiety.
If your anxiety is moderate to severe, there are safe and effective medications that can be used to help bring the often overwhelming symptoms of anxiety under control.
Although commonly associated with the treatment of depression, antidepressant medications can be very helpful in the treatment of anxiety disorders. In particular there are two types of antidepressants that are recommended – selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These medications can be safely used to manage anxiety (as well as depression) symptoms, and can be safely used when breastfeeding.
If you are prescribed one of these medications, it can take up to three weeks to have an effect, and you may experience some side-effects. This is a good discussion to have with your health professional in relation to the medication being prescribed.
My doctor let me know ‘hang in there for 4-6 weeks – at least you know there will be an end.’
In cases where a woman’s anxiety symptoms are very severe and/or she is experiencing panic attacks, and faster relief is required, another class of medication called benzodiazapines may also be prescribed whilst the antidepressant takes effect. If required, these medications should only be used for a short period (up to three to four weeks) as they are addictive. Benzodiazapines also vary in the amount of time it takes for the body to eliminate them. Those that are eliminated more quickly (‘short-acting’ benzodiazapines) are the type that can be used, whilst ‘long acting’ benzodiazapines should be avoided. Again, if you are discussing medical treatment with your health professional, you can clarify the nature, type and action of the medication you are being prescribed as well as discuss common side effects.
Whilst the thought of taking medication may be concerning, it’s important to weigh up the pros and cons of medication for you. Taking medication can help give you the resources to get on top of anxiety. Sometimes medication is important to take to manage the symptoms, so that you can benefit from other psychological and/or supportive therapies.
Anxiety can get worse if not treated early, and when trying to manage the demands of a new baby, this may make it more difficult to get on top of anxiety without professional help.
The faster you get help for anxiety, the faster you can recover.