J.B.
I had postpartum anxiety that escalated to the point that I really thought I was either going crazy or dying. My body was constantly wracked with pain, dizziness, painful limbs, difficulty breathing, etc. It was generalized anxiety (no specific triggers or fears). I can give you the textbook answers - some worked for me, some I didn't pursue far enough or I did several things at once so the results were hard to evaluate. Sorry it's so long - I know the pain of the struggle and the importance of tools to heal!
Exercise - walking is great, esp. during an attack. Swimming is really great when pregnant - check into parks and recs for a prenatal swim class, or join a regular one and just take it easy. It'll give your whole body good support as you exercise and have fun with other women.
Learn to breathe - as you are anxious, your muscles are tight and they don't get the O2 they should. You also start breathing more shallow, and it just keeps getting worse. Recommended for relaxation is breathe in on 4 counts through your nose, hold it for 7, and exhale for 8 counts through your mouth, listening to the air hiss out your lips, completely emptying your lungs. When I'm very anxious, I get breathless doing this, so I just focus on regular, rhythmatic breathing (inhale 4, exhale 4). Breathing works wonders, esp. during an attack. I did it in the car, at work, while I was with my family, in bed.
Meditation and yoga. I found a great yoga video at the library that I can't find again. The last 10 minutes was a relaxation thing that involved gentle stretching (like you'd do after aerobics) and progressive muscle relaxation. The Yoga itself didn't help me, but I'm so out of shape for that kind of thing that I didn't find trying to make the poses relaxing at all. I tried to meditate on a sentence or thought (I picked a soothing bible verse). It worked OK. However, focusing on my rhythmatic breathing helped A LOT, esp. at night when I was trying to fall asleep. Just listen to yourself breathe in and out, feel your chest and stomach rise and fall (use your whole abdomen to breathe). For relaxation, progressively send each muscle to sleep - focus on totally relaxing it. Some people tighten up their muscles really tight and hold it for 5 seconds, and then relax it. Start at your toes and work on each muscle one at a time, up to your head. Squish your face really tightly, too, to relax it.
Change your anxious thinking. Usually it's not logical thinking. You need to challenge your thoughts and see how distorted they are. There are 10 common distortions that we make in our thinking. Counter your anxious self talk. There's a great workbook by Matthew McKay (available at Fort Collins, CO library) on congitive therapy that talks about these. I see he also has several things available for relaxation. His book was so simple and easy, even for a busy mom. You read a little introduction and then go right to the chapters that help your symptoms. Not a lot of text, just a lot of action - things to help.
Therapist - I have been through depression once and then this anxiety, and I've found just the simple act of going to a therapist to talk has really helped. I'm not sure the conversations helped a lot themselves, but maybe just the fact that I was being proactive and seeking help, I was verbalizing what was on my mind, and there was light at the end of the tunnel helped me.
Definitely take time for yourself - see it as a medicine, not a luxury. Whatever soothes you - a message to help push O2 into your muscles, tea, warm bath, read a good book, etc.
Some other tools - imagery. I had a hard time with this one, but picture a scene in your mind - a place that you find beautiful and relaxing. See it, smell it, hear it, touch it, etc. Get all of your senses involved. And then take a little time out of the day (5 minutes - while you're going potty) to go there. They say it takes practice to do this. I wasn't patient enough.
6 second mini-relaxation. This one is great. Become aware of what's annoying you. Repeat the phrase "alert mind, calm body" to yourself. Smile inwardly with your eyes and mouth. This stops facial muscles from making a fearful or angry expression. It doesn't have to be something that others can see. Inhale slowly to a count of three, imagining that your breath is coming through the bottom of your feet. Exhale slowly. Feel your breath move back down through your legs and out the bottoms of your feet. Let your jaw, tongue, and shoulder muscles go limp.
I have a great book called The Healthy Mind Healthy Body Handbook by Time Life Medical that takes you through many relaxation techniques. IF you can't find it, drop me an email.
Acupuncture is supposed to be very effective on anxiety. I'm not sure it helped me much, but I know your results can vary a lot with practitioners.
As for pills, Doc says you want 3-9g (3,000 mg) of Omegas from your fish oil pills (that can be a lot of pills, so get a potent one). DHA is the Omega that has calming effect. You can get diarrhea, fishy burps, and more easily bruised, so you might want to talk to your OB. I use the one others have recommended, at a lower dose than my doc recommended, no side effects. Also take a multi-B vitamin, as that gets burned up when you're stressed, and a little extra won't hurt you. Someone talked about the vitamin A in fish oil. While pregnant, you DON"T want to take too much Vitamin A, so check on that. Some people take 5-HTP, which is available from health food stores, but I don't know it's safety in pregnancy. It's a precursor to seratonin. It will take several weeks to be fully effective, but you should see a response after 1-2 wks.
Also, if you feel you need to go with meds, I FINALLY found, after many doctors, someone who recommended buspirone (I was trying to get pregnant at the time). It's a seratonin, but works differently from things like Zoloft and paxil (the SSRI's). It's a class B drug, which is likely to be safe during pregnancy. I think SSRI's are class C, which should only be taken during pregnancy if you really must. Paxil has been shown to cause problems with the fetus. Apparently buspirone doesn't have as many success stories, but it worked better than the SSRI's for me, and it's cheap. I'm off all drugs now and using the other techniques, but I did need the drugs to get me started (I was anxious about my anxiety symptoms).
Let us know how you do!
