1. Anxiety and Mothers A Mothers’ Mental Health Toolkit Project Learning Video with Dr. Joanne MacDonald Reproductive Mental Health Service IWK Health Centre Halifax, NS

2. Anxiety and Mothers Don’t most mothers worry? When is worry a problem?

3. Having concern and thinking ahead are typical for dedicated mothers. Being ruled by your worry is not a necessary part of motherhood. Constant worry and always thinking ahead about things that might go wrong can be a sign of an anxiety problem called - Generalized Anxiety Disorder (GAD) GAD is marked by difficulty stopping worrying thoughts, physical discomfort and tension, interferences with positive experiences. Anxiety and Mothers

4. Fast Fact: Anxiety is our natural mind and body response to fear or the risk of being harmed in some way. Sometimes this is described as the “flight or fight” reaction. An anxiety problem comes when the fear is much bigger than the likely or real here-and-now risk or threat. Anxiety and Mothers

5. How does anxiety feel in the body? muscle tension shortness of breath tightness in chest nausea, ‘stomach upset’ dizziness fatigue pain such as headache, abdominal discomfort Anxiety and Mothers

6. How does anxiety present in the mind? constant, full worrying thoughts preoccupation with negative future events planning for possible future harm/difficulty racing pace on negative thoughts slowed pace for other needs to concentrate, decide, plan Anxiety and Mothers

7. How does anxiety affect behavior ? More time spent on worry, strategies against possible future harm May avoid positive situations influenced by possible problem or signs of worry Turn to negative strategies to lessen anxiety Communicate unnecessary anxiety to others in her life Anxiety and Mothers

8. What if there are real problems and worries in pregnancy or with a woman’s child? Anxiety and Mothers

9. Worry and concern are natural in difficulty. Anxious thoughts and responses become a problem when they interfere with calm, function, decision-making and energy to react as needed and make decisions. Mothers need to be ready to respond. Anxiety and Mothers

10. Mothers and Anxiety

11. - Sudden experience of fear and intense body responses, sometimes without any warning, is how Panic Disorder presents. - It can feel like a health crisis in the body; anxiety can trigger powerful responses. Mothers and Anxiety

12. Earlier life real experiences of fear, prime our anxiety response. Some mothers have very sensitive fear responses. Post-traumatic Stress responses come from sudden spontaneous re-triggering of a previous real experience. PTSD (Post-traumatic Stress Disorder) is when this response happens frequently Mothers and Anxiety

13. PTSD symptoms include body anxiety, sudden visual or sensory flashbacks to traumatic event, sudden startle, unusual numbing as a protective response, headache, sense of constant readiness as though in a crisis of danger. In PSTD, the danger in the past was specific and real; but that danger isn’t here now. Mothers and Anxiety

14. Obsessive-Compulsive Disorder (OCD) is a particular anxiety problem, where the behavior of checking, counting, or organizing was a response to anxiety, but now has become a dominating need even when danger isn’t present. When a woman can’t repeat these behaviors, anxiety increases as though danger were coming. OCD can be very time-consuming, create fatigue and interfere with time for positive thoughts and activities. The strategy begins to control the woman, not control anxiety. Anxiety and Mothers

15. Obsessions are frequent repetitive thoughts Compulsions are repeated activities Examples: checking safety, cleaning, counting, washing hands, ordering Anxiety and Mothers

16. What can be done? General stress reduction, self-care and mindfulness techniques help reduce body tension and anxiety. Cognitive-Behavioral Therapy (CBT) helps reduce anxious thinking and behaviors. Self-management with CBT and/or assistance of a therapist trained in CBT can help. Anxiety and Mothers

17. What can be done? Sometimes medication helps to turn down the volume and frequency of anxious symptoms. Exercise, nutrition and focus on positive thoughts and activities will compete with anxiety for a mother’s time and attention. Anxiety and Mothers

18. Key Resource: http://perinatal.anxietybc.com Self-help for anxiety for moms. How to love and care without worry and tension. Anxiety and Mothers

19. The goal of reducing anxiety is to increase readiness and resilience within mothers. Anxiety and Mothers

20. Ready, calm and positive moms raise strategic confident children. Anxiety and Mothers

21. Take Home Point: Mothers need tools in difficult times. Less anxiety leaves more room for good planning, flexibility in uncertain situations, energy for readiness in crisis, and a toolkit of strategies to try. Anxiety and Mothers

22. A learning module in a series developed from the Mothers’ Mental Health Toolkit Project To promote knowledge and advocacy in mothers’ mental health through front line support & service providers A project of the Reproductive Mental Health Service, IWK Health Centre & Dalhousie University, Halifax NS Anxiety and Mothers

23. Thank You!