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Cognitive Behavioral Therapy Reduces Anxiety During Pregnancy

Recent findings from a team of Canadian researchers indicate that a form of change-oriented psychotherapy called cognitive behavioral therapy can help ease the impact of anxiety in pregnant women.

Many people know that women have increased risks for developing symptoms of depression during pregnancy. However, women also have a roughly equal chance of developing the symptoms of an anxiety disorder. In a study published in February 2015 in the Archives of Women’s Mental Health, researchers from two Canadian institutions assessed the effectiveness of cognitive behavioral therapy as a treatment for pregnancy-related anxiety. These researchers concluded that the therapy can substantially reduce the effects of anxiety disorders in pregnant women, as well as the effects of depression.

Anxiety Disorders and Pregnancy

Anxiety disorders are a group of mental health conditions officially recognized and defined in the U.S. by an organization called the American Psychiatric Association. These conditions are categorized together because they all center on dysfunctional levels of dread, fear, worry or some other anxiety-based reaction to general or specific circumstances. Examples of anxiety disorders include panic disorder, generalized anxiety disorder, social anxiety disorder, specific phobia, separation anxiety disorder and agoraphobia. Two other conditions—post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD)—were once classified as anxiety disorders, although they now have their own individual diagnostic categories.

Pregnant women develop symptoms of generalized anxiety disorder and panic disorder roughly as often as they develop symptoms of major depression or other forms of depressive illness. In addition, pregnant women develop symptoms of obsessive-compulsive disorder about as often as they develop depression-related symptoms. Specific manifestations of anxiety disorders or OCD during pregnancy may include heightened levels of general worrying, recurring thoughts of damaging or fatal outcomes for a developing child, an inability to gain adequate rest from sleep, the excessively deep and/or rapid breathing pattern known as hyperventilation and the onset of temporarily debilitating episodes known as panic attacks. Whenever possible, doctors try to avoid medication-based anxiety treatment for pregnant women, since this form of treatment can lead to health risks for a developing child if not strictly limited.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is designed to do several things. First, a practitioner of this form of therapy helps his or her clients/patients understand why and how their emotions, thoughts and actions contribute to dysfunctional or damaging reactions to stressful situations. Next, a CBT practitioner will help his or her clients/patients learn to recognize specific examples of damaging emotions, thoughts and actions. Finally, a CBT practitioner helps his or her clients/patients develop new emotions, thoughts and actions that don’t support dysfunctional or damaging stress reactions. Cognitive behavioral therapy is well-supported by a large body of evidence-based research and has proven useful for the treatment of a range of serious mental health issues.

Usefulness for Pregnant Women

In the study published in the Archives of Women’s Mental Health, researchers from Canada’s McMaster University and St. Joseph’s Healthcare used a small-scale pilot project to help determine the usefulness of cognitive behavioral therapy as a treatment for pregnancy-related anxiety and anxiety disorders. The researchers undertook this project because, while CBT is a known effective treatment for anxiety in general, the research community knows very little about the impact of the therapy in the context of pregnancy. Some of the 10 women enrolled in the project were pregnant, while others had given birth within the previous year. All of the women had some form of diagnosable anxiety disorder. The researchers enrolled all of the participants in a six-week course of CBT conducted in a group format rather than in a one-on-one setting.

At the end of the course of group cognitive behavioral therapy, the researchers concluded that the participating women had experienced a substantial decline in their anxiety disorder symptoms. In addition, they concluded that the women experienced a similar decline in their exposure to depression symptoms. Crucially, the participants generally found their CBT treatment agreeable and self-reported a belief in the effectiveness of the approach.

The study’s authors believe that their findings point toward the usefulness of cognitive behavioral therapy as an anxiety treatment in the context of pregnancy and the postpartum period. However, they note the small scale of their work and call for future researchers to conduct larger studies capable of confirming or disproving their results.

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