Susan is a 36-year-old mother in her third trimester of pregnancy. She also has a five-year-old son, Jacob.
Though she expected to return to work after having her first baby, Jacob had many early challenges with feeding and sleeping, and a lot of separation anxiety. As a result, Susan was uncomfortable leaving him with anyone, and spent almost all of her time with her son. After her maternity leave finished she decided to resign and has not returned to work. The first two years of Jacob’s life were very difficult for Susan and her partner, and she experienced postpartum depression.
Now that Jacob just started Kindergarten, Susan thought that she would enjoy her alone time, and finally get organized for the new baby. But instead she found that whenever she had time to herself she would experience a general feeling of dread. Her stomach clenched, her heart pounded, and her throat tightened at the thought of having a newborn and the possibility of becoming depressed again.
Susan experienced her first panic attack a few years ago when she was at the playground with Jacob. Out of the blue, Susan felt hot, shaky, and dizzy. She felt like her heart was racing and she was having difficulty breathing. She thought she was going to pass out, or even die. Susan was terrified and it seemed to go on forever, but slowly the symptoms began to decrease and she was able to get Jacob home. The rest of the day she was still shaky and wondered if she should go to the emergency room. Her partner helped calm her down, and they decided that it was probably a panic attack. The next day, her family physician confirmed it was likely a panic attack.
Since that day, Susan finds herself worrying about having another panic attack. She avoids activities that remind her of the physical sensations she experienced during the attack. Susan has become very sensitive to her breathing and heart rate, and is on alert to any sudden increases in her pulse. As she gets further along in her pregnancy, she is finding it difficult to deal with the changes in her body. She is very sensitive to her body sensations and worries about triggering more panics. For example, her lungs feel constricted by her growing fetus, and it is becoming increasingly difficult to take deep breaths and remain calm. Even going up the stairs is frightening to her and she takes them extra slow.
Susan also avoids the playground where she had the panic attack. This has been really confusing and frustrating to her son Jacob. She has a persistent fear of having a panic attack alone in a public place. As a result, Susan stopped going to the supermarket alone, and recently has tried to stop leaving the house completely. Currently, Susan’s only outing is to pick up Jacob after school each day.