Anxiety and panic attacks in pregnancy: causes and management

A panic attack is a very frightening experience for those who experience it: it is an episode of acute anxiety that generates a strong experience of anguish, apparently for no real reason. It can be defined as a specific period of time characterized by intense apprehension, dread and fear accompanied by the feeling of impending doom.

A panic attack described by the sudden onset, within a maximum of 10 minutes, of at least 4 of these symptoms:

  • palpitations, palpitations, tachycardia;
  • sweating;
  • tremors;
  • dyspnoea, choking sensation;
  • feeling of suffocation;
  • chest pain or discomfort;
  • nausea or abdominal discomfort;
  • feelings of dizziness, unsteadiness, light-headedness or fainting;
  • derealization (feeling of unreality) or depersonalization (being detached from oneself);
  • fear of losing control or going crazy;
  • fear of dying;
  • paresthesias (numbness or tingling sensations);
  • chills or hot flashes.

The physical symptoms are only so severe that many people go to the emergency room believing they have a serious physical problem, such as a heart attack.

Panic attack in pregnancy

With these premises, it is easy to understand how a panic attack during pregnancy can have an even greater impact. The pregnant woman is already in an intense period of emotions, positive and negative, which alternate in rapid succession and sometimes for no specific reason. You experience many worries, not least those related to your own health and that of the unborn child. She wonders about the future and what awaits them, especially from an economic and working point of view.

The pregnant woman’s body changes from week to week , placing her in front of new sensations, which can be interpreted as alarm signals and therefore generate anxiety. Having the experience of a panic attack is not a danger in itself but if the episodes repeat themselves over time and are not addressed, two types of problems can arise:

  1. an increase in the levels of psychophysical stress, with possible repercussions on the child’s health;
  2. an increase in worries about the future , with the risk of not being able to regulate them after the birth.

Main causes of panic attacks in pregnancy

In general, panic attacks do not have a single cause that is the same for everyone, nor is it yet clear why some people are more prone than others. As far as pregnancy is concerned, a predisposition can be hypothesized due to a set of genetic, environmental and personal factors prompted by triggering factors such as:

Hormonal fluctuations

Hormones affect the regulation of emotions, as well as play an important role in physical sensations A series of intense hormonal fluctuations could therefore increase the likelihood of experiencing a panic attack.

Previous panic attacks

Those who have already had panic attacks are more prone to having panic attacks during pregnancy: past experience leads to experiencing worries with greater intensity and feeling more anxiety in stressful circumstances.

Excessive health concern

Knowing how to listen to your body is a positive resource that risks being counterproductive when it becomes an excessive concern. People who spend a lot of time focusing on physical symptoms are more prone to anxiety and panic.

How to manage anxiety and panic attacks in pregnancy

Panic attacks generate a vicious circle: acute anxiety triggers a series of bodily alarm reactions, this alarm is read as a strong danger and anxiety increases even more. Hence the fear of being about to die at any moment.
During pregnancy, panic attack symptoms can lead to fear of a state of danger for oneself and the child and it is difficult to be convinced, even in the face of a medical check, that physically everything is under control. There will always be questions like “what if…?” : what if we were in danger? What if something is happening to the baby? What if I’m overlooking a warning sign? What if the doctor is wrong?

All these “what if…?” they only add to your anxiety even further — which is why it’s important to deal with them. Some useful tips to manage it can be:

Get checked regularly

Knowing that the pregnancy is going well and that the unborn baby is healthy can ease the anxiety. Carrying out regular visits and analyzes is a way to reassure yourself and feel more serene. In this sense, it is important that there is a good relationship with the carers, where you feel welcomed and free to bring doubts and perplexities.

Learn to recognize panic attacks

Knowing what most stimulates your anxieties and understanding what the first symptoms are is of great help in the prevention and management of panic attacks. For example, for many people hyperventilation is one of the first signs: recognizing it and learning to manage it can have a calming function.

Relaxation exercises

There are different types of relaxation exercises that can be useful in containing anxiety: deep breathing, progressive muscle relaxation, visualization, yoga techniques,… Courses of this type are now available in various cities: the important thing is to make sure that are conducted by professionals and that there are no medical contraindications.

(Re)discover the positives

Pregnancy brings with it many worries but also – and above all – moments of joy, happiness and fun. Rediscovering these aspects allows you to divert thought from negativity and anxiety. It doesn’t mean ceasing to be responsible for one’s own health and that of the child, on the contrary. It means taking care of both, even indulging in moments of positivity, ranging from decorating the bedroom for the baby to treating yourself to a beauty treatment, from buying clothes to dinner with your closest friends.

Ask for help

There is nothing wrong with experiencing a little anxiety in the face of such a big unknown as pregnancy, nor should panic attacks be seen as a shame or a guilt. Many women are afraid that admitting they have this problem automatically means being bad mothers or, worse still, “crazy”. On the contrary, asking for help is an act of responsibility and love towards yourself and the baby on the way.
If anxiety starts to be frequent and you can’t manage it with the previous suggestions, it’s good to go to the psychologist. Together we will work both on the causes of anxiety and panic and on the management of symptoms, for example through some of the techniques listed above.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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