A healthcare provider may offer an assessment and diagnosis and if they do, should then follow up with a treatment plan, discussed with and agreed by the woman.  The treatment plan may include education, psychotherapy and medications and women should not hesitate to discuss treatment options and preferences with the healthcare provider.

There are several approaches to anxiety that have been shown to help and most women can decrease their symptoms with appropriate care.  They can then begin to enjoy pregnancy and the months following the birth.  Women may find some or all of the following helpful.

Supported self-help

Supported self-help includes regular appointments with a healthcare provider who provides support and structure when using resources such as self help guides.

Cognitive Behaviour Therapy (CBT)

CBT is based on the evidence-based view that the way we think and behave affects the way we feel. Depressed women may experience negative thoughts that they find difficult to stop. In CBT, the therapist helps the woman set realistic goals to change the way she behaves, identify her distorted thinking patterns and develop more realistic thoughts.

Medications

Medications are not always needed but where they are, they treat the symptoms of anxiety, decreasing them to a level where a woman can then take advantage of non-pharmacological treatments to make lasting changes in thinking and behaviour.  Two main types of medications are used to treat anxiety

• antidepressants (used to treat anxiety as well as depression)
• benzodiazepines (often used to provide short term relief whilst waiting for antidepressants to take effect)

If previously treated for anxiety or depression, stopping treatment during pregnancy or after the birth may lead to a relapse of the illness.  If medications are necessary, care is taken to prescribe the lowest effective dose of those medications that are safest during pregnancy or when breastfeeding but women may want to ask about:

• why they are being prescribed medications
• possible side effects
• effect of the medications on their pregnancy
• effect of the medications during breastfeeding
• how long they should remain on the medications

It is important to discuss all treatment options with your health care provider before making any changes, including whether medication should be stopped or not, to ensure that risk of relapse is reduced.

There is more information on Anxiety and skills that women can develop to make changes in their thinking and behaviours in Coping With Anxiety During Pregnancy and Following the Birth in the Resources Section.