Pregnancy has amplified my anxiety disorder, but I’m finding comfort in nesting

Irina Gonzalez

THE WASHINGTON POST – It’s three o’clock in the morning when I finally get out of bed, head to the kitchen for a glass of water and make my way to the nursery. I sit in the nursing chair we bought months ago, rub my 30-week pregnant belly on the eve of my baby shower and debate what I should tackle tonight. The changing table needs some organising, I think, and I begin my hours of nesting.

This isn’t an unusual scene for me anymore. Since I hit the second trimester of pregnancy, I’ve had terrible insomnia every other day or so – which has been made worse by my anxiety. Almost every night, the scene was the same: I would wake up, toss and turn for hours, and then drift off to sleep again just as the sun was rising. But somewhere around the 20th week of pregnancy, after discussing the insomnia and anxiety with my OB/GYN and my therapist (something all pregnant women should do if they have questions or issues), I found something that helped calm my nerves: nesting.

Before getting pregnant, I never thought about how my generalised anxiety disorder might be amplified by my growing belly. I already had anxiety, so wouldn’t this be more of the same? Apparently not.

According to the National Alliance on Mental Health, 19.1 per cent of Americans have an anxiety disorder. I am one of them. But another 8.5 to 10.5 per cent of pregnant women are hit with perinatal anxiety, according to a study published in the Journal of Women’s Health, and it turns out I was one of those lucky few. I struggled to recognize the difference between my GAD and my perinatal mood disorder.

“There are no diagnostically relevant differences,” says Krysta Dancy, a licensed marriage and family therapist and founder of the Birth & Trauma Support Center. “The symptoms are the same. The pregnancy and newborn just provide a new source of worry and the stress can intensify the symptoms.”

That was definitely the case for me. In addition to struggling with sleep, I worried constantly about the pregnancy, fearing something bad was going to happen. I couldn’t sit still and my thoughts were racing all the time. All of these are typical symptoms of perinatal and postpartum anxiety, according to Postpartum Support International.

But the problem was that it was impacting my day-to-day life. With my anxiety keeping me up at night and not allowing me to enjoy my pregnancy much, I started to nest – all the time.

It started slowly. During the first trimester, as a way to get excited after a miscarriage earlier in the year, I bought myself a couple of cute pregnancy shirts and dresses even though I wouldn’t show for another couple of months. Early in the second trimester, I started to research items for the nursery. Soon after, my husband and I bought the crib, dresser and changing table that I liked and started to move things out of our then-office. By the 17th week of the pregnancy, we were building furniture and I was nesting almost daily: buying baby clothes, getting decorations, reorganising the kitchen, writing and rewriting a massive to-do list.

What I didn’t realise until weeks later, though, is that my nesting – what the American Pregnancy Association defines as an “urge to clean and organise” that often occurs in the last couple of weeks of pregnancy – was actually helping my anxiety.

“All of us have anxiety or we would never accomplish anything,” says Dancy. “Anxiety is functional as long as it is functional. If you can channel your anxiety into preparation for the baby and that relieves the anxiety, then that’s functional and that’s a great trade.”

All of that building furniture, finalising the registry, washing and organising the baby clothes, painting photo frames and more brought anxiety relief and gave me something that I could control when I couldn’t control much else about my changing body or raging hormones.

“Nesting can have very positive effects as it is part of parenting and preparing for the arrival of the child,” says Katayune Kaeni, psychologist and host of the Mom & Mind Podcast. “People can curb their worries by preparing and having things ready for the baby or for themselves. Nesting is also a way to connect with the baby because it helps you think about the baby’s needs, your needs to support the baby, and [helps] foster the relationship between you.”

All of that late-night nesting did seem to help. Not only was the baby’s room getting done in record time but it also gave me something to do in the middle of the night when I just couldn’t shut off my brain long enough to get back to sleep. And those bursts of activity were also tiring me out quickly so I could get a couple of hours of sleep after the bout of insomnia. Nesting had become my best coping mechanism for perinatal anxiety.

But I also tried other methods of calming my anxiety. Dancy recommends physical activity (cleared by a doctor), fresh air, yoga and meditation (I loved the Expectful app), prenatal massage and establishing a strong support network.

“When a pregnant or postpartum woman feels overwhelmed, she is likely to isolate herself to regain a feeling of control,” Dancy says. “But that isolation can lead to more feelings of overwhelm. A supportive net that can help with practical concerns, give her a break and a listening ear, can make a huge difference.”

As my baby shower came and went, and I built my village by opening up to my husband and close friends about the anxiety, my sleep started to improve. I was also keenly aware, though, that the nesting occasionally made me feel like I was taking on too much.

“As with any type of anxiety, it is also possible for nesting to negatively impact or increase anxiety when it feels compulsive or feels that you can’t do all of the things you want to do,” says Kaeni.

As the weeks ticked by, I also started to see my therapist more frequently and talked to my OB/GYN about the possibility of medication if my anxiety continued or got worse after I gave birth.

“When the intensity, duration, and frequency of distress is overwhelming, it might be time to consider inviting the mother to have a conversation with a reproductive psychiatrist so that they can assess and make a decision about what next steps will be the right steps to address the anxiety,” says Christiane Manzella, a senior psychologist at Seleni Institute.

I’m in the last month of my pregnancy now, and I’m feeling grateful for my anxiety and my early nesting. If it weren’t for my intense anxiety, I may still be worrying about all of the things left on my pre-baby to-do list. But here I am, 36 weeks pregnant, and everything is ready; the clothes have been washed, the nursery has been decorated, the car seat has been safely installed and inspected, and the freezer is full of healthy meals for the postpartum period.

My anxiety is what propelled me to be proactive, and it has helped me feel about as ready as I’ll ever be. My sleep is better, too, though I can’t be sure if that’s because I’m more tired or because I’ve calmed down significantly. Either way, I’m feeling stronger and more prepared. Perhaps I can handle this motherhood thing – anxiety and all.