You're sitting on the couch, your hand resting on your growing belly when suddenly your heart starts racing. Air grows scarce, dizziness sets in, and a wave of fear floods over you - for no apparent reason. What's happening feels frightening, but you're not alone: Many pregnant women experience exactly this. The good news? There are ways to cope, and you can learn to master these moments.

Watercolor illustration of a pregnant woman in her late twenties sitting peacefully on a cream-colored sofa in a sunlit living room, her hand gently resting on her rounded belly, soft morning light streaming through sheer curtains creating gentle shadows, pastel tones of peach, lavender, and warm beige, delicate brushstrokes capturing a moment of quiet contemplation mixed with subtle tension in her expression, a cup of herbal tea on a side table, indoor plants in the background, serene yet emotionally complex atmosphere, intimate close-up perspective at eye level, shallow depth of field focusing on her face and belly, 85mm portrait lens feel, gentle and reassuring mood

Why Your Body is on a Rollercoaster: Hormones and Their Psychological Effects

During pregnancy, your body undergoes a hormonal revolution. Estrogen and progesterone skyrocket - and these changes affect not only your body but also your psyche.

Progesterone is particularly interesting: Although it is supposed to have a calming effect, it can paradoxically trigger restlessness and anxiety in sensitive women at first. Your nervous system needs to adjust to the new hormone levels - and in this transitional phase, panic attacks can emerge.

Other hormonal factors that play a role include:

  • Cortisol fluctuations: The stress hormone may be elevated during pregnancy, increasing your susceptibility to anxiety.
  • Thyroid hormones: Changes can intensify heart palpitations and inner restlessness.
  • Oxytocin preparations: Your body prepares for childbirth, which can increase emotional intensity.

Important to know: These hormonal changes are completely normal and part of your body's natural adjustment. They do not mean that something is wrong with you or your baby.

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Is This Still Normal? Pregnancy Anxiety vs. Panic Disorder

Maybe you're wondering: Is what I'm experiencing still within the range – or do I need help? This question is absolutely valid and important.

Recognizing Normal Pregnancy Anxiety

Temporary anxieties, mood swings, and emotional lability are part of pregnancy. Are you worried about the baby, the birth, or the future? That’s human and physiologically completely normal.

Typical signs of normal pregnancy anxiety include:

  • Occasional worries that come and go
  • Emotional moments that can be calmed through conversation or distraction
  • Nervousness before doctor appointments or labor
  • Mood swings that do not significantly interfere with your daily life

When It Could Be a Panic Disorder

A panic attack is more intense and sudden. It often occurs out of nowhere and brings with it physical symptoms that feel real and threatening.

Signs of a panic attack include:

  • Sudden heart racing or pounding
  • Shortness of breath or feeling of choking
  • Dizziness, trembling, sweating
  • Intense fear of losing control or dying
  • Duration: usually 10-30 minutes

If such attacks occur repeatedly and you start avoiding certain situations out of fear of the next attack, a treatable panic disorder may be present. This is not a weakness – but a mental health condition that can be effectively treated.

Watercolor infographic showing two side-by-side panels comparing normal pregnancy anxiety versus panic disorder, left panel depicts a South Asian pregnant woman in a peaceful garden setting with soft worried expression and thought bubbles showing gentle concerns, right panel shows an African woman experiencing panic with visual symbols of racing heart, shortness of breath, and overwhelming fear, both panels connected by a subtle dividing line, educational labels in English clearly distinguishing the two states, pastel color palette with gentle contrasts, medium wide composition, informative yet compassionate visual storytelling, 35mm reportage lens feel

What Really Helps You Now: Treatment and Support

The most important message first: A panic attack does not pose a direct risk to your unborn child. Your body has advanced protective mechanisms. Still, treatment is important so you can enjoy this special time in a relaxed manner.

Psychotherapy Without Medication

Psychotherapy is not only possible during pregnancy but particularly meaningful. The Bernhardt method, for example, works exclusively with mental techniques and is therefore particularly well-suited for pregnant women. It helps you break the fear of fear and develop new thought patterns.

Other proven approaches include:

  • Cognitive Behavioral Therapy (CBT): Helps you identify and change anxiety-inducing thoughts
  • Mindfulness-based therapy: Teaches you to stay in the moment instead of drifting into disaster scenarios
  • Pregnancy-supportive counseling: Provides a safe space for your fears and worries

Relaxation and Breathing Techniques

Specific breathing techniques can help acutely during a panic attack and have a preventive effect. The 4-7-8 breathing technique, for example, calms your nervous system: inhale for 4 seconds, hold for 7 seconds, exhale for 8 seconds.

Progressive muscle relaxation according to Jacobson is also safe and effective during pregnancy – it helps you consciously perceive and release physical tension.

When Are Medications an Option?

In severe cases, medication may be necessary. Your doctor will weigh with you which medications are acceptable during pregnancy. Some antidepressants are considered relatively safe – the decision should always be made individually.

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Your Daily Self-Care: Small Steps, Big Impact

Besides professional help, there is much you can do to reduce stress and strengthen your inner balance.

Regular breaks are not a luxury but a necessity. Deliberately plan moments when you are just for yourself - even if it’s only 10 minutes a day.

Practical self-care tips include:

  • Meditation and mindfulness: Apps like "Calm" or "Headspace" offer guided pregnancy meditations
  • Moderate exercise: Pregnancy yoga, walks in nature, or swimming soothe body and mind
  • Sleep hygiene: Regular bedtimes and a relaxing evening routine support your nervous system
  • Social support: Share experiences with other pregnant women - you'll find many share similar experiences
  • Diet: Avoid caffeine and sugar crashes; focus on balanced, nutrient-rich meals

A crisis plan for acute panic moments can provide you with security: write down which techniques help you (breathing, certain thoughts, calling a trusted person) and keep this list handy.

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You Are Not Alone: Experiences from Other Mothers

Sometimes it helps the most to hear that other women have gone through exactly this - and have made it.

Sarah from Zurich shares: "In my 22nd week of pregnancy, I had my first panic attack. I thought I was dying. But through therapy and breathing exercises, I learned to control the attacks. My baby gave me the strength to finally get healthy."

Isa from Bielefeld reports: "For years, I was afraid of vomiting (emetophobia). Initially, pregnancy was a horror for me. But it also helped me confront my fears – and I made it. Today I’m a proud mom and much stronger than before."

These stories show: Pregnancy can be a time of growth and healing despite – or precisely because of – the challenges. You have more strength within you than you might believe right now.

Your Next Step

If you experience panic attacks during pregnancy, don't hesitate to seek help. Talk to your midwife or gynecologist. There are specialized therapists and counseling centers for pregnant women with anxiety disorders.

You deserve to experience this special time in peace and joy. Panic attacks are treatable – and you don't have to go through this alone. With the right support, self-care, and perhaps professional help, you can learn to manage the hormonal roller coasters and focus on what matters: the anticipation of your baby.

Breathe deeply. You can do this. Step by step.