Pregnancy comes with a lot of complex emotions. You're not alone. (Photo credit: Simona Balint)
Extreme emotions are completely normal in pregnancy, so don’t fret that there’s something “wrong with you” if you’re feeling anxious or depressed. You’d be weird if you weren’t kind of freaked out about this whole baby thing! It can be very overwhelming at times, and when the thoughts start snowballing it is very hard to break out of that down feeling. (As evidenced by my hyperemesis rant from a few days ago.)
We all have our down days, but if your down or anxious feeling is persistent and is interfering with your life, it’s time to do something about it. Although some folks are comfortable taking medication during pregnancy, I am not one of them! (I’m not really comfortable taking it when I’m not pregnant, but that’s another post for another day.) Fortunately, there are a ton of non-medication options that don’t require you to check yourself into a psychiatric hospital. And all of those options are completely safe to use in conjunction with meds if that’s the route that you and your provider deem best for you.
Here’s what’s worked for me:
Weekly depression and anxiety support group. Find one in your area at www.DBSAlliance.org. Even though I haven’t been able to attend in months, I still benefit from connections with other group members who check on me and offer individual support. I also find that I can draw from the support and encouragement I have received from my group in the past.
Weekly one-on-one cognitive-behavioral therapy (CBT) with a licensed clinical social worker (LCSW) or licensed psychologist. Ask your support group for recommendations or call your insurance company to ask them who they recommend in your area. Be sure it’s cognitive-behavioral therapy, which teaches you how to manage and change distressing thoughts before they make you depressed or anxious. The skills my therapist and I worked on when I was able to attend sessions regularly still help me daily even though I haven’t been able to see my therapist since I fell ill.
Reading and working hard on the book Feeling Good: The New Mood Therapy. It uses principles of CBT to teach you real-life skills to manage the thoughts that upset you and keep you stuck. It’s been especially helpful for me as I’ve been too sick to get to therapy or my support group with any regularity. Order Feeling Good new or used from Amazon.com.
Taking a free WRAP (Wellness Recovery Action Planning) class. WRAP is a tool developed by people with depression, anxiety, bipolar, schizophrenia, etc, to manage their “symptoms” and stay well with or without medication. You can get more info and help finding a class at www.mentalhealthrecovery.com. It’s usually 8 weeks and it teaches you how to make a completely customized gameplan just for you, and how to change it as your life circumstances change. I wouldn’t be getting through this pregnancy without my WRAP.
Healthy tip: Although a class is the best way to learn WRAP, if you can’t find one in your area or you can’t attend due to a schedule conflict, health complication, or other reason, all is not lost. You can order the WRAP workbook from Amazon.com and get started on your own.
Getting as much fresh air and sunshine as possible, even if it means just sitting next to an open window (which mostly for me it does because I’ve been so sick). Ideally, you’ll spend at least 15 minutes outside in the sun every day, which helps to regulate your body clock for better sleep and also improves your mood.
Exercising as much as possible, whether that’s an hour at the gym every day or just walking to the mailbox — whatever you can do to get moving within your personal limitations. For me, it’s stretching once a day and walking to the mailbox every day. I also try to water my plants on the front porch twice a week. It ain’t much, but at least it’s something.
Healthy tip: Whether you’re able to exercise or not, make a point of getting up and walking around for 2-5 minutes every hour or so. This will keep your blood circulating (helpful for avoiding blood clots) and energize you. It also keeps your metabolism going at a steady rate. Set a timer on your phone or computer to remind you to move every hour on the hour.
Getting enough sleep. When sleep comes in 90-minute bursts at best, this is really challenging — especially as your belly grows. I find that taking naps during the day is essential to maintaining a decent mood. When I’m tired, I am positively despondent and it’s harder to deal — both emotionally and physically — with my illness and the normal demands of pregnancy. Here’s a video with some tips on sleeping comfortably while pregnant.
Taking my prenatals. I switched to gummy prenatals months ago so I can take them even with my hyperemesis. Especially because my diet sucks, the vitamins are essential to staying in balance nutritionally.
Staying hydrated. I struggle to consume fluids without throwing up, but I still work at it every day. I feel lethargic and fuzzy when I’m dehydrated, so IV fluids and TPN have been real lifesavers for me. Those who can take fluids by mouth should drink plenty of water (put lemon or cucumber in it to make it more palatable) and 100% real fruit juices to stay hydrated.
Healthy tip: Cut your fruit juice with water or seltzer to maintain the flavor without taking in too much sugar or too many calories. Using seltzer can also make liquids more tolerable if you have nausea that makes it hard to drink.
Eating enough and healthy foods. Again something I struggle with, but I do the best I can and I see a real difference on “good food days.” If you’re able to eat a mostly normal diet (standard pregnancy food aversions notwithstanding), you should be fine. Aim for lots of fresh fruit and veggies, whole grains (whole wheat bread and pasta instead of white, for instance), and lean proteins.
Healthy Tip: Try to drink a glass of low-fat (not no-fat because babies need fat for brain development) milk with every meal. I prefer 2%, but you can do 1% or whole according to your preference.
Some of these tips may seem like general health tips, but they are essential to maintaining a good mood and good psychological health. Your actions have a huge impact on your attitude, so developing healthy habits and routines go a long, long way to helping you manage distressing emotions or thoughts. There’s solid medical evidence that backs up good nutrition and healthy habits as key to maintaining mental health and reducing the impact of depression and anxiety.
If you’re not sure where to start, the best tool I can recommend that combines all of these pieces is the FlyLady system, which I’ve mentioned here before. FlyLady teaches you how to develop healthy lifestyle routines through a series of small changes she calls “babysteps.” Her system is completely free and uses e-mail and downloadable tools to give you all of the information you need. She also has YouTube videos and a BlogTalkRadio show.
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