Natural Ways to Deal with Anxiety During Pregnancy

Reader’s Question

I have been taking Xanax for the past 5 years on an “as needed” basis only, whenever I get nervous, or I’m about to have a panic attack, or I feel nauseous because of the above. I take around 10-20 pills over the course of 12 months, that is approximately 0.5 mg of Xanax per month. Is this considered too much? I don’t take any other medication whatsoever.

Also, my husband and I are considering having our first baby (we’re both 31 years old), and I’m terrified that my anxiety will hit the roof during my pregnancy. How am I going to cope without any Xanax for 9 whole months? I’ve tried other techniques (breathing, exercising, yoga, drinking a glass of wine, even Valeriana pills); I’ve been to two different psychiatrists, who both diagnosed me with generalized anxiety; and I also saw a psychologist for over a year, but nothing seems to work except for Xanax. In fact, even though I’m using Xanax sporadically, I’ve been noticing that lately I need 0.5 mg to calm down, since 0.25 mg doesn’t do the trick anymore. Is it possible that this much Xanax could lead to dependence?

Psychologist’s Reply

As I am not a medical doctor, I cannot render an opinion about medication. Thus, I really cannot tell you whether you are taking too much, or if the amount you are taking could lead to dependence. If you are concerned about anything regarding your medication, you should consult with your physician or pharmacist, as they are the experts on medication. However, I can speak to some of your concerns about anxiety.

Some of the techniques you mentioned trying — specifically the exercise and yoga — are good ones, but they generally are used more to keep anxiety in check, and may not work well in reducing panic attacks or immediate anxiety concerns. While I don’t know what you worked on with your psychologist, I wonder if they used Cognitive-Behavioral Therapy (CBT), which has the most empirical support of psychosocial interventions for anxiety disorders. CBT has a multi-pronged approach, in which counselors help you retrain your way of thinking (cognitions), assist in increasing your ability to tolerate negative affect (emotions), and provide you with a repertoire of coping and emotion regulation skills (behavior). Many research studies have found that CBT works better in the long-term than medication, probably because it actually teaches people new skills.

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Another treatment for reducing anxiety is Acceptance and Commitment Therapy (ACT). It is a newer type of therapy, and is based on the idea that we should not label our struggles as disordered or abnormal. Instead, ACT practitioners seek to help people accept the circumstances of their lives without judgment, and teach people such non-clinical techniques as mindfulness, cognitive defusion, and relationship development. Since it is much newer than CBT, it doesn’t have as much research behind it, but it has been getting some good results. The main point here is that there are other things you can try besides Xanax. If you decide to try counseling again, make certain that your therapist is one who is trained specifically in anxiety reduction.

Yet another method to try, and one especially well-suited for new parents, is social support. There has been much research to support the idea that when people know what to expect they have better outcomes, and nowhere is this more true than in parenting. Consequently, now is the perfect time for you to reconnect with old friends or seek out women who are currently or have already gone through the pregnancy, birth and parenting process. See if there are support groups for pregnant women and/or new mothers. Your husband may want to seek out new fathers as well. Talk with your new friends about what you can expect, your concerns and how to decide what you need to worry about and what you don’t.

You are correct that pregnancy can be a very anxiety-producing time but it doesn’t have to be. Hopefully you will keep trying anxiety reduction techniques until you find some that work for you, and your pregnancy will be what it should be: a time of incredible discovery.