How can I handle my anxiety during pregnancy?

It's common to worry during pregnancy. You may worry about everything from the outcome of your pregnancy and the health of your baby to how you will be as a parent.

It's common to worry during pregnancy. You may worry about everything from the outcome of your pregnancy and the health of your baby to how you will be as a parent. Pregnancy is such an exciting and scary time that it's totally normal to feel anxious. In fact, it would be unusual if you were not anxious.

But even though worry during pregnancy is universal, and many of the things pregnant women worry about never end up happening, there is still no guarantee that they won't. So trying to talk you out of these worries is not as useful as helping you gain a greater tolerance for the inherent uncertainties of pregnancy.

A combination of cognitive behavioral therapy (CBT) and a mindfulness approach can help you manage anxiety. Rather than focusing attention on future worries or ruminating about the past, learning coping skills can help you stay in the present moment and develop an acceptance of the thoughts and emotions that are a normal part of pregnancy.

Can you give me an example?

Say you are worried about getting the results from genetic testing. Rather than pushing the thought from your mind or trying to reassure yourself by endlessly calculating the odds of a bad outcome, try something different: Simply acknowledge your thoughts and emotions and accept them. Say, "Wow, that's a scary and terrible thought. It's hard to wait for these results and to sit with the uncertainty, but I'm worrying about something that hasn't happened."

Then refocus your attention to the present. Think, "What is happening right now?" You could pay attention to your breathing, noticing where in your body you can feel the sensations of your breath, allowing it to come and go without trying to control it. Or, if you are washing the dishes, for example, feel the warm water on your hands, smell the soap, hear the clinking of the silverware. Whatever you're doing at the time, bring your attention back to the moment you're actually experiencing – not what could happen in the future.

How do I handle conflicting advice and information?

A lot of people who experience worry or anxiety seek more and more information in an attempt to gain certainty and reassurance, but this strategy often backfires. There are so many conflicting and inaccurate sources of information that you're bound to come across something that confirms your worst fears. Instead, pick one or two reliable sources of information – perhaps your ob-gyn or a reputable website, such as the Mayo Clinic.

And stay away from privately maintained websites unless one has been recommended by a trusted source. Too often, these sites have misinformation or opinion-based discussion boards that include personal horror stories. Remember that reading something on the Internet is as reliable as saying "I heard it on the telephone."

How can I get my family and friends to help me feel less anxious?

Share your goal of staying positive and focused on the present with your family members and friends so everyone is on board and sensitive to your worries. Yelling or scolding never helps, nor does telling you to "stop worrying," but even well-meaning family members may not know what to do. Sometimes it helps if you come up with some support statements that you would find useful, and ask family members to say them to you during a moment of anxiety.

On the flip side, hearing empty reassurances that "everything will be fine" may sometimes help temporarily but ultimately worsen the worry cycle. Gentle reminders to practice mindfulness skills or suggesting a different activity, such as going for a walk or planning the nursery, can help. Share the self-help resources you find with your loved ones, so they can better understand the anxiety you are experiencing.

How do I know if I need professional help to manage my anxiety?

Anxiety becomes a problem when you are anxious or worried much of the day or when anxiety gets in the way of your normal responsibilities at work or home. If self-help coping skills are not working, it may be a sign that you could benefit from seeing a professional therapist during this difficult time.

The Anxiety and Depression Association of America, Association for Behavioral and Cognitive Therapies, and Academy of Cognitive Therapies have online search options to help you find qualified cognitive behavioral therapists.

How can these therapies help?

Cognitive behavioral therapy and acceptance-based behavior therapy (ABBT) are short-term, problem-focused therapies that emphasize developing new skills to manage anxiety and other emotional issues. These therapies can help you to change your relationship to your thoughts and weather your moods to prevent you from getting stuck in the negative cycle of worry.