10/09/2013 12:09 pm ET Updated Jan 23, 2014

To Medicate or Not Medicate

If you are like 23 percent of woman, you may be taking a selective serotonin reuptake inhibitor (SSRI) to manage your anxiety or depression. You may also be contemplating getting pregnant, and you're confused about tapering off or staying on your medication. You are not alone, but your decision is a personal one to be discussed with your OB-GYN and the physician who prescribes your psychotropic medication.

If you decide to take a break from medication while you're pregnant or discontinue taking it indefinitely, make sure you do so under the supervision of your doctor. Learn about discontinuing your medication, including what you should know about withdrawal effects and potential relapse.

But you can help successfully manage your anxiety using cognitive-behavioral therapy (CBT) tools.

1. Break the cycle of fearing fear. The first step in utilizing CBT is learning that you need not fear anxiety. The more we fear feeling anxious, the more we feel anxious. This pattern leads to a continuous cycle of fear of fear. It is possible to teach your brain that although anxiety is uncomfortable, it's not dangerous so it need not be feared.

2. Mindfully observe vs. react to anxiety. Mindfulness-based treatment for anxiety entails noting that which is uncomfortable, and then allowing anxious thoughts and sensations to pass, without clinging to them or attempting to eliminate them. By learning to mindfully observe all thoughts and sensations, whether they are labeled good or bad, you can more quickly move on from anxious moments, in contrast to getting stuck in them.

3. Slow breathing calms and soothes the body and mind. By practicing slow, diaphragmatic breathing, you can train your body to calm down, even if your mind is anxious. After engaging in slow breathing for several minutes, your mind will catch on to the body's signal that the coast is clear and there's nothing to fear. Then your body will shift from the fight-or-flight response to the relaxation response.

4. Obtain assistance. Don't go at this alone. Getting help to manage your anxiety is a sign of strength and an act of bravery. To admit that you are imperfect and have struggles is a key ingredient in moving past anxiety's demand for "perfection or bust."

5. Stay active. Anxiety loves time to snuggle up and get cozy. It has a harder time soaking up all of your attention when you are engaged in valued living. By choosing (or even forcing yourself) to participate in a meaningful activity, you are teaching anxiety that it can chill out and take a break from guard duty.

6. Practice self-compassion. Be kind to yourself. You are working hard to live life to its fullest. There are hard moments and beautiful moments. Try to hold them all lightly. Accept yourself for whom you are while striving to be the person you know you can be.

For assistance in moving past anxiety, contact a mental health professional trained in cognitive-behavioral therapy (CBT) or pharmacotherapies, or both. You can search for a therapist in your area on the ADAA website to help you with this challenging, but very important work. Consider taking a look at the self-help materials on the ADAA website, including "Facing Panic: Self-Help for People with Panic Attacks."

For more by Debra Kissen, click here.

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