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Panic Disorder and Pregnancy

How one women dealt with panic attacks during pregnancy...

-  One Woman's Experience . . . and Joy  

by Beth Watson

Like most women, when I found out I was pregnant, my thoughts were filled with questions: Will the baby be healthy? What sex will the baby be? What kind of mother will I be?

Having panic disorder raised some different concerns for me, as well. I worried about my medication; would I be able to continue to take it, and what about side effects to the baby? I worried about the delivery; how would I ever manage the normal anxiety associated with labor and delivery compounded with my heightened level of anxiety because of the panic? And the question, "what kind of mother would I be," included questions about whether or not I could handle the daily care that a child requires. Could I take the baby to the doctor even though I was having a bad day? What if there was an emergency; could I handle it or would I panic?

When the nurse told me that the pregnancy test was positive, I was shocked, overjoyed, and scared to death--all at the same time.

The first trimester of my pregnancy was very easy for me. I went to my ob/gyn and together we researched the medication I was on (an antidepressant and a tranquilizer). After doing some reading, we both felt it would be safe to stay on the medication during the pregnancy. I then began reading every baby and parent book I could get my hands on. I was still very nervous about the delivery, so I decided that having a Cesarean section was the answer. I convinced myself that if I had a C-section, I would be able to set the date of the delivery, and I wouldn't feel much pain because of the epidural. I would be in total control! Now all I had to do was convince the doctor, but I had plenty of time for that. (Hormones do wild things to your perception of reality!)

I moved to another state during the second trimester, which meant changing doctors. When my new doctor learned of the medication I was taking, he became very concerned and started talking about possible birth defects and how my baby would have to be put on drugs after delivery to deal with the withdrawal. He then rushed me to a hospital to begin getting me off medication.

Needless to say, this was all pretty frightening. They proceeded very cautiously because I was pregnant, but within four weeks, I as off all my medication. The withdrawal from the medication wasn't fun, but I still don't know how much of that was withdrawal, how much was pregnancy, and how much was panic.

Now here I was in a new city, with no friends or family, pregnant, with no medication. If I could have crawled under the covers and stayed there, I would have, but luckily life doesn't work that way. And, to my surprise, I was able to handle many new and possibly difficult situations with ease. I've heard that the hormones your body produces while you are pregnant can block panic, and that may account for some of it. I also discovered that people are extra friendly and forgiving to a pregnant woman, which gave me a great deal of security. I knew that if I was in a line and began to feel panic, I could simply ask someone to hold my place while I went to the bathroom or ask if I could go ahead of them because I wasn't feeling well.

By my seventh month, I was feeling great. I was experiencing no anxiety, other than the "normal" new-mother concerns. The doctor had ordered two ultrasounds because I had been on the medication, and our little boy looked just fine. And although I realized at this point that I couldn't just decide to have a C-section, I was relaxing more and more about the idea of going through labor. After all, the doctors will let you labor for only twenty-four hours, and I could handle anything for twenty-four hours.

I began using the same tools I use to deal with anxiety to prepare for the upcoming event. I used a lot of visualization and rational self-talk, along with relaxation techniques which I planned to use during labor.

My husband and I took a Lamaze course which I highly recommend for all new parents. The fear of the unknown is hard for me, and this course answered a lot of my questions, dispelled a lot of myths, and gave me tools to practice so that I felt more in control of the situation.

Being the typical "high anxiety personality," I had my Lamaze bag packed six weeks before my due date. My husband and I practiced our breathing techniques regularly, and we even made up a computerized chart to use during the contractions. (The nurses loved it!) At this point, I was pretty confident about my ability to handle labor, but I was still trying to figure out how to get out of going through the delivery.

By my ninth month, I was more than ready to have this baby. I had gone over my list of final questions with my doctor. I must say I was a little disappointed with some of the responses I got. I had been told that there was a mild tranquilizer that could be given early in labor if the mother was very anxious. As my doctor knew of my panic disorder, I asked that this be made available to me if I needed it; I was told, "Don't worry, honey, everyone's a little nervous before they have a baby." I explained my circumstances again, thinking: the doctor sees a lot of patients, maybe he forgot. He then told me I could go back on my medication if I thought it was necessary. It was lucky for him that I was too big to move quickly, or I might have strangled him. After all we had gone through five months earlier--and now he had changed his mind. I know doctors differ on whether the antidepressants and tranquilizers are safe for pregnant women, but I assumed my doctor only had one opinion.

Finally, the big day arrived. My contractions started after breakfast, on my due date, five minutes apart. We called the doctor and he told us to go on to the hospital. We then called the hospital and asked if there was a nurse on duty familiar with panic disorder. They checked on it, and she was waiting for us when we arrived. I was calmer than I had thought I would be. In fact, my husband still teases me that I had to get that last load of laundry done before we left for the hospital.

After twelve hours of labor, I had an epidural. I didn't like the idea of being confined to bed (I was more comfortable walking than lying down), but once the epidural kicked in, I didn't mind. When I reached 10 centimeters dilation, the nurse told me I could push when I felt the urge. She came back a half hour later and seemed surprised to find me still lying there watching TV. (Believe it or not, I was still trying to figure out how to get out of delivering this baby!)

After a little coaching from the nurse, I began to push. In less than fifteen minutes, my son was born. Labor and delivery were not as bad as I had thought they were going to be. I had heard so many horror stories. But I found that if I relaxed and went with the contractions, time just seemed to slip by; before I knew it, T.J. was in my arms and I was officially a Mom.

We brought him home two days later. I had spent so much time preparing for the birth, but no one had prepared me for the first few weeks at home. Between the hormones, the lack of sleep, and the new person who literally depended on me for his life . . . I was overwhelmed and had a lot of anxiety. My mom stayed with me for the first week, and when she left I thought I was going to fall apart. To no one's surprise but mine, I didn't.

Today T.J. is a healthy, happy nine-month-old. I'm lucky enough to be able to stay home with him. Nothing in my life is the same as it was since the day the nurse told me I was pregnant. I've pushed myself at times because my son needed me, when in the past I might have let things slide. I'm stronger and happier (and more tired) than I was then. And I'm even thinking about baby number two.

I worry about what kind of example I will set for T.J. Will panic disorder affect his life, either through me or because he develops it? These are questions I can't answer now, but my husband and I joke that we aren't just saving for his college education, we're saving for his therapy. I know that along with some of the "high anxiety personality" traits that he may pick up from me, I will also teach him how to deal with stress and anger and give him the tools to manage the anxiety if it becomes part of his life.

Having a baby has also helped me to reach a long-term goal that I had set years ago when panic first came into my life. I wanted to learn how to have fun again. Now, when my son giggles, or shows wonderment at a new toy, I feel a joy and playfulness I haven't known in years. Oh, to see life through the eyes of a child!

Reprinted by permission, ABIL Newsletter, December 1993. ABIL Inc. (Agoraphobics Building Independent Lives) is located at 1418 Lorraine Avenue, Richmond, Virginia 23227.