Postpartum Anxiety Disorders - Strategies for Managing Anxiety

Written by Linda Sebastian

Sandy, a twenty-two-year-old new mother, illustrates the emotional devastation that can result from agoraphobia and panic attacks:

I was driving to the grocery store with the baby for the first time. Six blocks from home, my heart started pounding. I was sweating. I thought I was going to faint. I went back home. I didn't tell anyone because I didn't want to worry them. Somehow I felt ashamed because I thought I should be able to do something as simple as go to the store.

I thought maybe I was still tired from the delivery or was anemic. But it kept happening when I drove, so I made up excuses not to drive. I refused to go out of the house for four months.

Finally my husband got impatient with me and made me go out. We got a sitter and went out. I had such a horrible time because I was so scared and wouldn't let go of his hand.

He made me go to see a counselor, and I found out I was having panic attacks. I never knew other people had the same thing. I was able to control my anxiety by breathing. I didn't need medication. I worry that I will have it again if I have another baby.

Sandy's story is tragic. Not only did she have a frightening experience, but she thought she was the only one affected with the problem. Her story also illustrates how people with anxiety may try to hide what is happening to them because they feel a sense of shame. Anxiety becomes a prison that keeps getting smaller and smaller.

If you or someone you know suffers from any of the anxiety disorders described in this chapter, seek help immediately. Like depression, anxiety is very responsive to treatment. Many people have these problems, so you are not alone.

Strategies for Managing Anxiety

In addition to medication and therapy, there are some strategies you can use to help lessen and eventually prevent anxiety episodes. The most common technique is relaxation breathing. Most of us breathe with only part of our lung capacity. We usually do not use our abdominal muscles. By deep breathing and using your abdominal muscles, you can tell your body and mind, "All is well, and you can relax."

Follow the instructions below to learn this breathing relaxation technique:

Relaxation Breathing Instruction

• Sit or lie comfortably. Close your eyes or gaze at a fixed spot in the room.
• Begin to focus on your breathing putting all other thoughts out of your mind. The only thing you have to do now is to practice relaxation breathing.
• Begin to pace your breathing by counting: "in-2-3-4, out-2-3-4." You can also pace your breathing with positive sayings like (breathing in) "I-am-more-relaxed-and-calm, I-am-more-relaxed-and-calm" (breathing out).
• Gradually take deeper and deeper breaths, consciously raising your abdomen when you breathe in and lowering your abdomen when you breathe out.
• Continue comfortably breathing for at least ten minutes.

Like any skill, this will take some practice. Do this for at least five minutes two or three times daily. Gradually, you will develop an automatic response to beginning this kind of breathing. You can use this breathing to help diminish your anxiety or even to prevent anxiety in situations that might create tenseness for you. This kind of behavior training is commonly used to help people lessen their reliance on medication.

A similar technique often used in conjunction with relaxation breathing is muscle relaxation. This is usually a guided relaxation exercise; it can be on tape or read to you by someone. You can tape record the steps yourself, but you may find it more helpful to have someone read the steps to you slowly, allowing you to concentrate on the breathing and relaxation:

Progressive Relaxation Routine

• Sit or lie comfortably. Close your eyes or gaze at a spot in the room. Gradually focus your mind on your breathing.
• Begin to take deeper breaths, raising your abdomen as you breathe in and lower your abdomen as your breathe out.
• Feel your body relax and become warmer and heavier as you continue the deep breathing.
• Curl your toes under on both feet and hold for a count of 1-2-3-4. Relax your toes and take two deep breaths.
• Curl your toes under again for a count of 1-2-3-4-5-6. Relax and breathe deeply, being sure your abdomen rises as you breathe in and falls as you breathe out.
• Now tighten your calf muscles for a count of 1-2-3-4.
• Relax and take two deep breaths.
• Tighten your calf muscles again for a count of 1-2-3-4-5-6.
• Let go and breathe deeply, making sure your abdomen rises as you breathe in and falls as you breathe out. Continue this tightening-release-tightening longer-release pattern with your thigh muscles squeezed together, then your buttock muscles, then your abdomen.
• Then continue pattern by clenching your hands into fists, then bending your forearms to the biceps, then shrugging your shoulders.
• Finish with the facial muscles by squinting your eyes, then opening your mouth as far as possible.
• Be sure to deep breathe after tensing each muscle group and count in a gentle rhythmic manner, tensing with the second tensing longer than the first.
• Notice how much more relaxed you feel. You feel calm, relaxed, and peaceful. Tell yourself you have just given your body and mind a treat. It feels good.
• Open your eyes when ready.

  

You can tape someone reading this for you, or you can tape it yourself, being sure to pace the reading so that you don't rush through it. As with relaxation breathing, consistent practice on a daily basis will develop your capacity to relax in stressful situations.

"Copyright © 1998 by Linda Sebastian. From Overcoming Postpartum Depression and Anxiety, by arrangement with Addicus Books."

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