mental health

I Got Pregnant, And Then The Panic Attacks Started

My panic disorder was well-controlled for most of my adult life. I wasn’t prepared for what pregnancy would do.

Sad middle age woman
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Since I was a child, I’ve dealt with panic attacks. I wouldn’t consider myself a big worrier otherwise. The panic attacks strike out of the blue, typically when I’m at my most relaxed. Laying in bed watching Netflix or lounging by the pool, I’ll suddenly start to feel the inklings of the physical symptoms that lead to a full-blown attack. Among other things, my heart starts beating like crazy, I get dizzy and lightheaded, and I feel as though I can’t breathe.

My condition has been under control most of my adult life, and panic attacks have been generally rare over the past decade — maybe once or twice a year. I could typically get through them with a combination of breathing techniques and Xanax. OK, fine, it was 99% the Xanax. But, as many people with panic attacks will tell you, it’s often simply the knowledge that you have the medicine handy if needed. Knowing that it’s there is often all it takes to help you stay calm. As a medication-hesitant person, this was huge for me.

But when those same physical sensations — elevated heart rate, shortness of breath, dizziness when standing — took up daily residence in my body during the first trimester of my pregnancy, it became a different story.

As it turns out, pregnancy has been correlated with both new-onset panic disorder and worsening of the disease in previously diagnosed people. Despite being armed with the knowledge that those symptoms are a perfectly normal part of pregnancy, I couldn’t quite communicate that to my amygdala and nervous system in the same way that I understood it with the more logical parts of my brain. To the faulty systems deep in my brain, those symptoms still set off my body’s “time to panic!” alarms.

It played out something like this: I would be sitting on the couch minding my own pregnant lady business when I would become suddenly aware of how fast my heart was beating. I’d try to breathe and tell myself it was perfectly normal, but I ultimately couldn’t prevent the panic attack from coming. Partly because once a panic attack grabs hold of you, you lose the ability to think rationally.

So I would spiral. I’d start hyperventilating, and the muscles in my body would clench up. Worst of all, I’d experience horrible senses of disassociation and derealization. When panic attacks happened prior to pregnancy, I would think I was dying or losing my mind. When having panic attacks while pregnant, all I could think was that I was going to kill my baby. Which, unfortunately, had the opposite effect from calming me down. I can’t even keep myself calm for my baby’s sake, I would think. I’m such a horrible mother. I’m going to cause myself to miscarry, and I’m never going to forgive myself.

All it took was the first panic attack — and the sudden realization that I could no longer rely on Xanax — to set off a self-fulling prophecy spiral. The panic attacks started happening multiple times per week.

Of course, it wasn’t just the physiological symptoms. While those were the most direct catalyst, any person who has been pregnant will tell you that the first trimester is riddled with anxiety. I was constantly aware of the risk of miscarriage each consecutive week. The tiniest twinge in my abdomen, in my mind, meant I was losing the pregnancy. And even if everything with the baby turned out to be perfectly fine, then — holy shit — we were still having. a. baby.

I felt like hell physically, too. Nausea had me running to the bathroom every hour, and migraines left me confined to my bed with icepacks on my forehead. I couldn’t stomach nutritious food. I was surviving off Eggo waffles, so I was clearly a crappy mom already, or so went my internal monologue. My emotions were all over the place. I took everything personally. Irrational fears about my partner dying or otherwise leaving me became a constant background worry. Our once very stable, happy relationship became fraught with tension.

Finally, one Saturday morning when I had a particularly bad panic attack, my partner put me in the car and we drove to my OB. After discussing what had been going on, we made the decision to try Prozac, a medication that’s been repeatedly proven safe during pregnancy and effective for panic attack sufferers. I was terrified of taking any medication, but I also knew I needed to do something.

I spent about six weeks taking the drugs, which helped, even if it wasn’t a miracle cure. At that point, I was well into my second trimester and feeling physically and emotionally like a new person. Hitting the “safety” of the 12-week mark and losing the debilitating physical symptoms felt like I finally had control over my mind and body again. Everyone talks about the “honeymoon period” of the second trimester, and that was certainly how it felt for me. The panic attacks became more infrequent and less intense. The general worrying also diminished week by week. By 18 weeks pregnant, I trusted my gut that I was OK to stop taking the Prozac, and I haven’t had a panic attack in over three months now.

I’m currently 31 weeks pregnant, so we’ll see what postpartum holds. At the very least, I feel more prepared. I didn’t think of my panic attacks as something that needed to be discussed with my OB when I got pregnant, but I wish I had. I wish I had known that the hormones, worries, and physical symptoms of pregnancy can act as a pressure cooker for panic attack sufferers. I’m so thankful that I could ultimately trust my partner, my doctor, and myself in doing what was best for the health of this babe. Being better informed, knowing I have people I can rely on, and knowing my options for treatment have given me back the safety net that Xanax once provided.

Danie is a freelance travel and parenting writer with dual degrees in journalism and child psychology from NYU. She's been on the road since 2015 from Albania to Zambia (and 85+ other countries in between). You can find her portfolio at owentheglobe.com or her photos on Instagram @danieelizabeth.