PMAD 101- What if I don't feel "blue" or "depressed?"

Perinatal mood and anxiety related symptoms are outside those of what you may have heard called "The baby blues."  The baby blues' symptoms, most often sadness/weepiness, general moodiness subside with no special support or intervention on their own, typically within the first 10-12 days after birth/delivery.

So where do we start? Perinatal means "surrounding birth." This includes all of pregnancy ("antenatal"), birth and after delivery ("postpartum").

Perinatal Mood and Anxiety Disorders (PMAD) is best described as a spectrum of symptoms. You may be familiar with the term Postpartum Depression.  If you pay attention to the news or media lately, there have been an influx of mentions towards Postpartum Depression ("PPD"). While it is wonderful more people are stepping forward to discuss realities in their adjustment to parenthood - at times the media doesn't do a great job of communicating the whole picture.

PMADs include:

-Depression/anxiety DURING pregnancy: an estimated 15-21% of pregnant women experience moderate to severe symptoms of depression or anxiety (Wisner KL, Sit DKY, McShea MC, et al. JAMA Psychiatry 2013).

-Postpartum Depression: symptoms may include: feelings of anger, fear or guilt, lack of interest in the baby, appetite and sleep problems, difficulty making decisions or concentrating, and possible thoughts of harming baby or self.

-Perinatal (pregnancy or postpartum) Panic Disorder: This form of anxiety includes feeling very nervous, shortness of breath, chest pain, heart palpitations; many worries or fears.

-Perinatal (pregnancy and postpartum) Obsessive-Compulsive Disorder: Symptoms include persistent thoughts or intrusive mental images often related to baby (obsessions).  Compulsions- doing things repetitively to REDUCE those fears and obsessions, or avoidance and a sense of horror and discomfort about the obsessions. **These mothers know the thoughts are bizarre and are very unlikely to ever act on them (Miller ES. J Reprod Med 2013).

-Postpartum Posttraumatic Stress Disorder: Symptoms typically include a traumatic childbirth experience with re-experiencing of the trauma (thoughts, dreams); avoidance of things associated with the event (places, details of the event, thoughts, feelings), and persistent irritability, difficulty sleeping, hypervigilance, exaggerated startle response.

-Perinatal Bipolar Disorder: Over 70% of women with bipolar disorder who stop medication when pregnant become ill during pregnancy. 22% of depressed postpartum women are suffering from a bipolar depression (Wisner KL, Sit DKY, McShea MC, et al. JAMA Psychiatry 2013).

-Postpartum Psychosis:  This MEDICAL EMERGENCY occurs in about 1-2 of every 1,000 deliveries.  The beginning of the symptoms typically takes place within the first 4 weeks post-delivery and usually come on quickly.  Symptoms include: delusions (strange beliefs) and/or hallucinations, feeling very irritated, hyperactive, decreased need for sleep, and significant mood changes with poor decision-making.  IMMEDIATE treatment is CRUCIAL.

What about men/partners?  About 10% or 1 in 10 men/partners experience mood or anxiety problems as well (Paulson & Bazemore, JAMA 2010).  We cannot leave out the partner's susceptibility to PMADs.


 You are not alone! PMADs are the #1 health complication related to pregnancy, birth and postpartum.

Seems like the best--WORST--kept secret about pregnancy, birth and after, right?! Countless people we serve say the same thing, "Why didn't I ever hear about this?"

Now What?

The good news- PMADs are treatable and with the RIGHT help and support, typically resolve rather quickly. 

REACH OUT FOR HELP. No one should "tough it out" by living daily with these symptoms. YOU DON'T HAVE TO. 

What will it take to make your emotional and psychological health a priority? Untreated mental health has long-lasting, negative effects on you, your child(ren) and others in your home.  (Maternal depression and child development. (2004). Paediatrics & Child Health, 9(8), 575–583.)

At Postpartum Wellness & Family Counseling, LLC we offer individual, couples and group therapy.  We also offer HIPAA-compliant telehealth (videoconferencing) sessions for those who cannot make it in to the office for various reasons and/or PREFER the convenience to engage in the therapeutic process wherever they are.

You are worth it! Learn more about relief of these symptoms.  Call us (352) 278-2538


Lauren DePaolaComment