Panic Attacks During Pregnancy

By OBGYN Dr. Kenosha Gleaton

A panic attack is an intense and sudden episode that triggers feelings of fear and related physical sensations. [1] Some people may never experience panic attacks, while others may experience them regularly. Panic disorder is an anxiety disorder that involves experiencing multiple panic attacks. [1] It is important to note that if you or someone you know has experienced one or more panic attacks, they may not necessarily have panic disorder. While about 11% of the United States population will experience a panic attack every year, only about 2 to 3% of people in the U.S. actually have panic disorder. [1] 

Panic attacks can be very frightening, especially if you’re experiencing one during pregnancy. It’s important to reach out to a healthcare provider if you’re experiencing any concerning symptoms to ensure you receive appropriate treatment. 

What Causes Panic Attacks?

Typically panic attacks will occur without a specific reason or trigger, so there isn’t always a clear cause. [1] There is thought to be a slight genetic link to panic disorder, but researchers are still learning more about panic disorder, panic attacks, and what causes them. Many researchers believe that panic attacks are “false alarms” where the body goes into survival mode too often, too strongly or a combination of the two. [1-2] Some also think that dysfunction of a certain part of the brain or chemical imbalances could be at the root of panic attacks. 

It’s important to note that there is a difference between panic attacks and anxiety attacks. While panic attacks don’t have a specific trigger, anxiety attacks often do. Anxiety attacks are also more likely to build up gradually rather than suddenly and unexpectedly. [1] Read my guide on pregnancy OCD.  

What Causes Anxiety During Pregnancy?

There are many reasons someone may be experiencing anxiety during pregnancy, from an underlying anxiety disorder to general worries about parenting, giving birth, health outcomes, finances, etc. [1-3] If you are having trouble managing your anxiety or are concerned about your mental health, you should always reach out to a healthcare provider for support. 

Anxiety can start at any point in your life, including pregnancy. In fact, some pregnant people may even be at a higher risk of having an anxiety disorder or experiencing panic attacks. [4] Some risk factors include [1,4]:

• History of pregnancy loss
• Family history of anxiety disorders
• Previous anxiety disorder
• Childhood trauma
• Having a child with health challenges
• Having personal health challenges

It’s important to note that feeling anxious or having anxiety is not the same thing as having a panic attack, however these can all be connected.  

Symptoms of a Panic Attack

Panic attacks often begin very quickly and without warning. There are many variations to panic attacks, but symptoms usually peak within a few minutes and include the following [3]:

• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Sense of impending danger
• Hot flashes 
• Chills
• Nausea
• Shortness of breath 
• Cramping
• Headache
• Chest pain
• Feeling faint or dizzy
• Numbness or tingling 
• Feeling detached 

Panic attacks can occur at any time, whether you’re sleeping, at work, relaxing at home, or driving. Some people may have panic attacks very occasionally while others may experience them frequently. 

If you are experiencing intense feelings of fear coupled with some physical sensations that seem to happen rapidly and without a clear cause, you may be experiencing a panic attack. If you have general uneasiness or worry that seems to build gradually or is caused by something specific, you may be experiencing anxiety. It’s important to speak to a healthcare provider to better understand your symptoms. 

The Effects of Having a Panic Attack During Pregnancy

You may be concerned about the effects of a panic attack or anxiety on your pregnancy. Research suggests that anxiety does have the ability to impact both maternal and fetal health. Data shows that anxiety can increase the risk of preterm birth and low birth weight. [5] Other data also suggest that severe anxiety can have an impact on infant height, weight, and head circumference. [6] Additionally, chronic or extreme anxiety may lead to changes in blood flow to the baby, potentially impacting how nutrients are transferred from mom to baby. Maternal health is also impacted, with research showing that anxious mothers are more likely to feel overwhelmed and fatigued, therefore impacting dietary habits, sleep, and consistency of prenatal care. [6] 

You may be thinking “great- how is hearing all of this supposed to help with my anxiety?”. I know that it can be very scary to hear about what can go wrong, but keep in mind that there are many ways to manage and treat anxiety or panic attacks, and most of this data is based on chronic, extreme cases of anxiety. I encourage you to take a deep breath, drink some water, and plan to meet with your healthcare provider soon if your anxiety or panic attacks are troubling you. 

How to Deal with Pregnancy Anxiety

Fortunately, there are things you can do to manage and treat panic attacks and anxiety during pregnancy. From self-care to medications, let’s take a look at some of your options. 

Therapy for Anxiety and Panic Attacks

Therapy is one of the most highly recommended treatment methods for those experiencing anxiety or panic attacks during pregnancy. [4] Therapy can provide very useful tools to help you cope with your anxiety and potentially lessen the severity or length of panic attacks. The most common type of therapy treatment for anxiety is psychotherapy (talk therapy). During sessions, your therapist can help you identify any unhealthy thought patterns, develop ways to change these patterns, and hopefully help to improve your symptoms. [4] Therapy can be done in a group setting or individual sessions, depending on your preference. Learn how to manage depression and anxiety during pregnancy → 

Medication for Panic Attacks During Pregnancy

Antidepressants and anti-anxiety medications are often used to treat anxiety and panic attacks. These medications work by balancing various chemicals and slowing down activity in the brain and nervous system. [1] Medication can be very helpful for treating anxiety, however, there are risks associated with using certain prescription medications while pregnant. [1] You should speak to a healthcare provider about any medications you have taken in the past or are currently taking, and whether or not the benefits outweigh the risks regarding your pregnancy. [4] 

Other Ways to Manage Panic Attacks During Pregnancy

There are plenty of other options available for you to explore when looking to manage or treat panic attacks and anxiety. It’s important to focus on activities that keep you calm and relaxed and to prioritize healthy habits and nutrition during pregnancy. Some options include [1,2,4]:

• Regular physical activity: Studies show a clear link between physical activity and mental health during pregnancy. [7] Staying active may be helpful for reducing anxiety and panic attacks. Be sure to check with your provider before trying any new exercises, and avoid overexerting yourself. Going for a walk, gardening, swimming, and yoga are all great options for exercise during pregnancy. 
• Avoid caffeine: Caffeine can increase your heart rate, potentially contributing to anxiety or panic attacks. While some caffeine is safe during pregnancy, you may want to cut it out altogether or stick to very low amounts of caffeine if you’re struggling with anxiety. Natalist Hydration & Energy Drink Mix is a great alternative that is caffeine-free, pregnancy safe, hydrating, and supports energy levels with vitamin B12. 
• Manage your stress: Limiting the stress in your life can also be extremely helpful. Try delegating more household labor to your partner, kids, or other family members, improve your work-life balance, and prioritize self-care. You may also benefit from healthy coping strategies such as reading, exercising, taking a bath, or meditating. Studies show that mindfulness can reduce worries about labor and may even decrease the risk of postpartum depression. [8] 
• Eat a healthy diet: Good nutrition is not only extremely important for pregnancy and fetal development, but studies show that eating a balanced diet can have a positive impact on mental health. [9] Be sure to drink plenty of water, eat nutritious meals, and take a prenatal vitamin to support a healthy pregnancy. Some research even suggests that supplements like inositol can improve anxiety, however more data is needed. 

How to Stop a Panic Attack

Some of the worst parts of having panic attacks for many people are the fear of a panic attack coming on or feeling as though a panic attack will never end. It’s important to remind yourself that it will pass and that your symptoms and feelings are just temporary. There is no way to stop a panic attack from occurring once it has begun, but you can try to manage your symptoms and potentially worsen the severity of a panic attack using these methods [1]:

• Relax your muscles: It’s common to tense your muscles when having anxiety. Try to relax your muscles one group at a time to stay present and reduce tension. 
• Focus on your breathing: Some people will hyperventilate when having a panic attack, which can worsen fear, heart rate, and other symptoms. Practice deep breathing by inhaling slowly through the nose, holding your breath for a few seconds, and exhaling slowly through the mouth. This can reduce symptoms of panic and anxiety. 
• Be present: It’s normal to feel detached from your body when experiencing a panic attack. Try to ground yourself by focusing on and interacting with what is around you, whether that includes smelling a candle, focusing your eyes on a particular object, touching something, etc.

Pregnancy Support With Natalist

With pregnancy comes a lot of questions, symptoms, concerns, and emotions that can feel like uncharted territory. As doctors and moms, we’ve been in your shoes and know how important it is to have resources and products that you can trust. Natalist is proud to offer evidence-based products that are made with fertility, pregnancy, and postpartum parents in mind. If you are someone you know is struggling with mental health during or after pregnancy, make sure you reach out to a healthcare provider. Know that you are not alone and we’re rooting for you! Shop pregnancy products or keep reading about mental health on the Natalist blog. 

References:

1. Panic attacks and panic disorder. Cleveland Clinic. February 2023. https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder 
2. Panic Disorder: When Fear Overwhelms. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Institutes of Health. NIH Publication No. 22-MH-8077. Revised 2022. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms#part_6105
3. Panic attacks and panic disorder. Mayo Clinic. May 2018. https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021 
4. Anxiety and Pregnancy. ACOG. FAQ 527. November 2021. https://www.acog.org/womens-health/faqs/anxiety-and-pregnancy
5. Grigoriadis S, Graves L, Peer M, et al. Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis. J Clin Psychiatry. 2018;79(5):17r12011. Published 2018 Sep 4. doi:10.4088/JCP.17r12011
6. Shahhosseini Z, Pourasghar M, Khalilian A, Salehi F. A Review of the Effects of Anxiety During Pregnancy on Children's Health. Mater Sociomed. 2015;27(3):200-202. doi:10.5455/msm.2015.27.200-202
7. Haßdenteufel K, Feißt M, Brusniak K, et al. Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool. Arch Gynecol Obstet. 2020;302(1):53-64. doi:10.1007/s00404-020-05570-x
8. Duncan, L.G., Cohn, M.A., Chao, M.T. et al. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth 17, 140 (2017). https://doi.org/10.1186/s12884-017-1319-3
9. Granero R. Role of Nutrition and Diet on Healthy Mental State. Nutrients. 2022;14(4):750. Published 2022 Feb 10. doi:10.3390/nu14040750