Perinatal anxiety - the hidden disorder

Feb 25 2009

You've probably heard of postpartum depression - a common problem after pregnancy, suffered by about one in seven new mothers.

But did you know there is a much more common form of distress that can also be harmful for pregnant women, parents and newborns?

Perinatal anxiety - unhealthy distress experienced during or soon after pregnancy - is the subject of a major new study being conducted by psychologists at the University of North Carolina at Chapel Hill and Florida State University.

"We call perinatal anxiety the hidden disorder," said Jonathan Abramowitz, Ph.D., co-principal investigator for the study, associate professor of psychology and director of the Anxiety Disorders Clinic in UNC's College of Arts and Sciences. Abramowitz is also a research associate professor in the UNC School of Medicine's psychiatry department.

"This is not new, but it's not been discussed or studied very much, even though it's a lot more common than postpartum depression," Abramowitz said.

Symptoms of perinatal anxiety may include general uncontrollable worries during pregnancy or the early stages of parenthood. First-time parents encounter many unknowns which can make them fearful, Abramowitz said. "They may think: is the baby going to be healthy? Is the baby normal? Am I going to be a good parent?"

"About 60 to 70 percent of new mothers and fathers have these kinds of thoughts," he said. "It's normal to think these things, dismiss them and move on. But when you can't control your thoughts, or they interfere with your sleep, your health or your ability to care for your baby, then you may need help."

In some cases, such anxiety results in panic attacks. In the most serious cases, parents may become obsessed with senseless, intrusive negative thoughts which they can't seem to control no matter how hard they try, Abramowitz said. "They may begin to worry about all kinds of things: What if the baby dies during sleep? What if I lose control and harm or molest the baby? What if I do something terrible to the baby? Worse, they may feel scared and confused about what these thoughts mean - fearful that they will act on these obsessional thoughts."

Abramowitz, an expert on anxiety disorders, has been studying perinatal anxiety since 2001. First he identified symptoms and explored how to predict if new parents were susceptible to the condition.

Now he and colleagues are trying to determine if first-time parents experiencing significant anxiety can be helped by cognitive behavior therapy (CBT). This form of psychological treatment is effective in treating other forms of anxiety, including panic attacks and obsessive compulsive disorder.

"Cognitive behavior therapy involves helping patients learn strategies to change maladaptive thinking and acting patterns that contribute to anxiety and obsessions," Abramowitz said.

All participants in the six-week study will receive helpful childbirth counseling as part of free weekly prenatal classes. Half of the participants will receive elements of CBT as well. Those who complete the study will also receive a modest fee at the end.

First-time pregnant women over the age of 18, and their partners, can learn more and complete a screening questionnaire online at www.babyprepstudy.com.

The Anxiety Disorder Clinic is part of UNC's psychology department. In addition to engaging in studies, the department's clinics provide low-cost therapy services to adults and children on a sliding-fee scale. They can be reached at (919) 962-6906.

http://www.unc.edu/