Understanding and Preparing for Perinatal Mood & Anxiety Disorders (PMADs)
By: Kim Konderla, MSW, LCSW
When one is planning their family or preparing to bring home a new baby, it is not typically front of mind that they may develop a mood or anxiety disorder during pregnancy and/or the postpartum period. We are decorating nurseries, finding pediatricians, making sure we have all of the necessary supplies, packing hospital bags, purchasing shoes that we do not have to tie, taking care of toddlers and hoping they’ll adjust to the new baby okay, and attending showers with loved ones, and…you get it.
None of us is going to voluntarily imagine that our pregnancy and postpartum experience would be anything other than sleepless, maybe emotional, but blissful. It is here that I will advocate for a healthy blend of hoping for the best and being prepared for some tough stuff beyond the typical pregnancy/postpartum experience. The odds that some of us will develop a perinatal mood or anxiety disorder (PMADs) are statistically significant, but they don’t have to be significantly frightening. We can be informed, prepared, and supported well ahead of time with just a little bit of learning and preparation.
Based on the current data, 1 out of 7 new mothers will develop a PMAD (and 1 out of 10 dads). It is theorized that this statistic should be much higher as it is based on reported data, and we know many women fall through the cracks, only discovering years later that their suffering was out of the norm. I could stand on a soapbox all day about the pressures of perfectionism in motherhood, but we’ll save that for another day.
For many of us, our understanding of PMADs is limited to Postpartum Depression (PPD). Some celebrities have come out to share their experience with PPD, we’ve maybe seen some ads on TV talking about it; but even so, how many of us could identify if we or someone we know was experiencing PPD? What’s the difference between baby blues, exhaustion, and depression? How much distress is expected and how much is worth talking to a professional about?
Being professionally trained as a licensed therapist with specific training in PMADs, I am able to identify such things, but I am left wondering why the information I have about PMADs is not universally taught. I am not one to gatekeep, so let’s consider this blog post a step in making this information more widely available and accessible. This information could help you, a loved one, or a stranger on the internet to avoid unnecessary suffering and get much needed (and deserved) help as soon as possible.
Let’s jump into the nitty gritty, shall we?
Define “perinatal:”
The term “perinatal” is used to address the period of time from conception through loss or birth, and the year post loss/delivery.
What are PMADs?
Perinatal Mood and Anxiety Disorders are mood and anxiety disorders that (you guessed it!) occur during/as a result of pregnancy, loss, traumatic birth, and/or the postpartum period. PMADs are typically the result of a combination of several factors including social, psychological, and biological stressors. None of us can control whether or not we will develop a PMAD, but there are some risk factors that we can take into consideration when coming up with a postpartum care plan.
Risk Factors:
● Personal history of anxiety and/or depression
● Personal history of psychosis
● History of diabetes/thyroid issues
● Past/current abuse (physical, sexual, psychological)
● Traumatic pregnancy and/or delivery
● Previous history of pregnancy and/or infant loss
● Pregnancy/birth of multiples
● Baby in the NICU
● Relational stress and/or single parenting
● Inadequate social support
Find a more thorough checklist here.
What are the different types of PMADs?
● Postpartum Depression
● Postpartum Anxiety
● Postpartum OCD
● Postpartum Post Traumatic Stress Disorder
● Postpartum Psychosis
● Postpartum Panic Disorder
● Postpartum Bipolar Disorders
What are the signs/symptoms?
● Feeling depressed, numb, and/or hopeless
● Lack of interest in your baby
● Trouble concentrating, brain feels really foggy
● Feeling anxious or panicky
● Extreme worries/fears
● Anger and irritability that are out of the norm for you
● Dizziness, heart palpitations
● Difficulty sleeping even when baby is sleeping
● Intrusive thoughts (fancy way to say: scary and unwanted thoughts)
● Urge to repeat certain behaviors
● Seeing/hearing things that others cannot see/hear
What’s the difference between baby blues and PPD?
“Baby Blues,” experienced by approximately 80% of new mothers, is a period of mood swings and weepiness lasting 2-3 weeks after birth. This is an expected adjustment period that resolves without medical intervention. Any of the above symptoms that outlast 3 weeks after birth are worth mentioning to your doctor.
When/how should I talk to my doctor?
Anytime! I’ll say it again- ANYTIME you have a concern is a good time to talk to a professional. Especially in the midst of sleepless nights, it can be helpful to have an outside perspective. Whether it’s because you’re 3 weeks post-delivery and you’re still experiencing what you thought was baby blues, or your baby is 3 months old and you’re still having difficulty feeling connected to them, the above lists and tools can help you identify what you’re experiencing, and you can use these to start a conversation with your doctor or a therapist.
What can we do ahead of time to ensure proper mental health support for ourselves and other new moms?
My number one suggestion for moms-to-be is to go ahead and consult with a couple of therapists before delivery. Finding a therapist that is a good fit takes a bit of planning and effort, neither of which you will be able to give while caring for an infant and possibly other children. Most therapists offer a free 15-20 minute consultation, so I highly recommend jumping on Psychology Today or the directory of perinatal mental health providers hosted by Postpartum Support International and putting together a list of 2-3 therapists to consult with.
It can also be helpful to have conversations with your people (the ones that you’ll be around the most during pregnancy and postpartum) about PMADs. Talk to them about the signs and symptoms so they can help take care of you in ways that it can sometimes be hard to care for yourself.
Additional Resources:
Kim Konderla, MSW, LCSW is a licensed clinical social worker working with folks in North Carolina as they work through family planning, perinatal and postpartum mental health concerns, and grief/loss. She is here to help you take a deeper dive into your emotional experiences so that you can better understand yourself, your patterns, and your relationships. Using the therapeutic space and relationship, she aims to help you learn to feel safe with your emotions and the emotions of others. She will help you learn to offer yourself compassion instead of criticism. Learn more on her website: www.groundedlivingpllc.com
Last medically reviewed on June 5, 2023