Panic attacks prompted by pregnancy

[Anonymous]

During my second pregnancy I developed a major depression and frequent panic attacks. Now that I am pregnant again, I am terrified of going through that again. I am on Zoloft (fairly low dose) and both my OB and psychiatrist agree that it is safer for me (and therefore the baby) to stay on it for this pregnancy.

Anyone out there have panic attacks based on feeling trapped in their expanding pregnant body? I am claustrophobic in general and get panicky at the sensation of being trapped in my own swelling body. For those who have successfully navigated panic and serious anxiety while pregnant, what strategies worked best for you?

[Anonymous]

I'm not sure this is relevant for you, but I have a friend who experience panic attacks while pregnant. For her, it coincided with a specific window where a certain hormonal cocktail was present. She suffered the same thing while on the pill prior to getting pregnant. She would take an anti-anxiety (while on the pill) whenever she felt an attack or would be in a trigger situation. While pregnant, she just rode it out a few weeks until her hormones changed.

Good luck to you.

[Anonymous]

I've experienced panic attacks for the first time ever in my life while in my 2nd pregnancy. Ugh, they are horrific! Not correlated with claustrophobia, for me...mine have all been nocturnal, I wake up between midnight and 1 AM with chest pain, inability to breath, sweats, vomiting, diarrhea, panic, etc. They last about an hour. My doc prescribed Xanax, which I've now taken once, and it worked to stop an oncoming attack. She said she'd prescribe Zoloft if the panic disorder was accompanied by depression -- as may be the case for you -- and that's standard of care, but my attacks are totally episodic, so instead I am just to take the Xanax if I feel one come on.

I've also been doing guided meditation, exercise, cut out caffeine, sugar, all stimulants ... that really has seemed to help alot. I was considering starting Cognitive Behavioral Therapy, too, as it is supposed to be extremely efficacious, but haven't had any attacks of late (knock on wood) so haven't gone that route yet.

I totally agree with you, take the Zoloft if it helps...cortisol and other stress hormones racing through your body are more harmful (per research) to the fetus than the medication is thought/known to be.

GL, I know how horrible panic disorder is, I hope your get yours under control.

[Anonymous]

I don't have panic in particular but do have terrible anxiety which affects my ability to function - can't eat, sleep etc when in the midst of an attack. Mine has actually, contrary to the predictions of both my therapist and my OB, gotten BETTER during pregnancy. That said, I remain on Celexa (an SSRI similar to Zoloft, thought as the previous poster said to be much safer for the baby than overwhelming anxiety) in my third tri. I think the whole walk/yoga/eat less sugar stuff is ok, but if you have clinical anxiety like I do, it may just be meds you need. I've come to that conclusion after fighting it for years - my docs liken it to diabetes - it's an imbalance in my system, my whole family has issues with it, and it's healthier for me and the little one.

Remember when you feel panicked - it will pass. It will pass. It ALWAYS does. Another I use is - the world is the same whether or not I feel anxious. It's my reaction to it that changes things.

Good luck. YOU ARE NOT ALONE.

[Anonymous]

Yes, pregnancy has made me feel more claustorphobic and because it is harder to breathe in general, i am prone to anxiety. Hang in there. It's not easy.

[Anonymous]

CBTherapy, Prozac and acupuncture. Thats what helps me.

[Anonymous]

OP here--thank you for all the comfort and tips. Glad to know that I am not the only one.

For the poster who took Xanax while pregnant, at what stage in pregnancy did you do so? I am trying to avoid it for the first trimester.

In the past I have had success with CBT, so maybe it's time to try that again. Or perhaps acupuncture. Though it is hard to know how to fit in all the healthy things (all these appointments, sleep, exercise) while working and with older kids! Sometimes I feel like trying to manage anxiety/panic and general pregnancy health could swallow all my time, even without a full time job or family. Sigh. Thanks for listening.

[Anonymous]

Anonymous wrote:I've experienced panic attacks for the first time ever in my life while in my 2nd pregnancy. Ugh, they are horrific! Not correlated with claustrophobia, for me...mine have all been nocturnal, I wake up between midnight and 1 AM with chest pain, inability to breath, sweats, vomiting, diarrhea, panic, etc. They last about an hour. My doc prescribed Xanax, which I've now taken once, and it worked to stop an oncoming attack. She said she'd prescribe Zoloft if the panic disorder was accompanied by depression -- as may be the case for you -- and that's standard of care, but my attacks are totally episodic, so instead I am just to take the Xanax if I feel one come on.

I take Xanax as needed for panic when not pregnant (maybe 3x per year). Often just having it in my drawer or purse helps. How much Xanax is your dose? How far along are you in the pregnancy? I think just knowing it was an option might reassure me. I too often panic in bed at night.

[Anonymous]

Try EMDR.

[Anonymous]

What is EMDR?

[Anonymous]

Eye Movement Desensitization and Reprocessing

[Anonymous]

Cognitive Behavioral Therapy, The Anxiety and Phobia Workbook, describing (either silently in my head or out loud if I can) the things around me using all my senses (for example, "that seat is yellow plastic and that sound is the train moving and those trees have snow on them) and repeating phrases to myself like "I'm here right now and I'm safe" and "Just ride the wave of adrenaline, it will pass") while breathing. Then I try to distract myself and think of more pleasant things.

[Anonymous]

13:34 Xanax taker here.

OP: In response to your follow up question, I've only taken Xanax in the 3rd trimester. I believe the research shows no evidence of developmental detriment from taking Xanax in the 2nd and 3rd tri's; with prolonged/daily use, there is a risk of fetal dependency/withdrawal, but even that is manageable and short-term. I'm taking it only episodically--and in fact only once, so far--which is not thought to cause any dependency or risk of withdrawal. I'm not sure if there is any research that reflects possible detriment if taken in the 1st tri, however most doctors, as I'm sure you know / have heard, are more conservative then given that most cellular development occurs in the 1st tri so it's the most "sensitive" trimester in terms of interractions and potential to effect fetal development. I would ask your doc. about that.

16:48: My dose is .5 mg, which I think is the lowest dose they prescribe. As noted above, I've only taken it in the 3rd tri -- my nocturnal panic attacks started in the 2nd tri -- and only once, but it definitely did the trick when I took it. The just-starting panic attack was totally gone within a few minutes, maybe even only 1-2 minutes. I was lying in bed doing deep breathing, etc., too, so not sure exactly, but it was an incredibly quick response to the meds; my understanding is that Xanax is the fastest acting benzodiazipine available; and also the fastest to leave your system, another benefit if you don't want it to build up in your system b/c you're pregnant. I definitely think having the prescription available, sitting on my nightstand, and knowing it's an option, has in and of itself helped stem the attacks. I'd had a series of attacks one wkd, saw the doc. that Tuesday, got the script that day, and didn't have another attack (once bottle was in hand) for 5 more weeks. It's a huge comfort, psychologically, to know it's available should an attack ensue.

[Anonymous]

Anonymous wrote:13:34 Xanax taker here.

OP: In response to your follow up question, I've only taken Xanax in the 3rd trimester. I believe the research shows no evidence of developmental detriment from taking Xanax in the 2nd and 3rd tri's; with prolonged/daily use, there is a risk of fetal dependency/withdrawal, but even that is manageable and short-term. I'm taking it only episodically--and in fact only once, so far--which is not thought to cause any dependency or risk of withdrawal. I'm not sure if there is any research that reflects possible detriment if taken in the 1st tri, however most doctors, as I'm sure you know / have heard, are more conservative then given that most cellular development occurs in the 1st tri so it's the most "sensitive" trimester in terms of interractions and potential to effect fetal development. I would ask your doc. about that.

16:48: My dose is .5 mg, which I think is the lowest dose they prescribe. As noted above, I've only taken it in the 3rd tri -- my nocturnal panic attacks started in the 2nd tri -- and only once, but it definitely did the trick when I took it. The just-starting panic attack was totally gone within a few minutes, maybe even only 1-2 minutes. I was lying in bed doing deep breathing, etc., too, so not sure exactly, but it was an incredibly quick response to the meds; my understanding is that Xanax is the fastest acting benzodiazipine available; and also the fastest to leave your system, another benefit if you don't want it to build up in your system b/c you're pregnant. I definitely think having the prescription available, sitting on my nightstand, and knowing it's an option, has in and of itself helped stem the attacks. I'd had a series of attacks one wkd, saw the doc. that Tuesday, got the script that day, and didn't have another attack (once bottle was in hand) for 5 more weeks. It's a huge comfort, psychologically, to know it's available should an attack ensue.

13:34 here again. One more thing -- 16:48 PP, you asked how far along I am, I'm 39 (!!) weeks. My panic attacks started mid-2nd tri (around 20 weeks) and continued into the 3rd, but again, I have now only had 1 (knock on wood) in the past 6 weeks, now that I have the Xanax in hand.

[Anonymous]

OP here, thank you so VERY much for all this detail about taking Xanax, immensely comforting. I am only 6 weeks along in this pregnancy and will try to avoid Xanax until second tri. I could always take a Bendaryl, that would make me drowsy.

Congratulations on your impending arrival!! I wish you an easy and healthy birth and newborn.