What are PMAD’s:
Peripartum Mood and Anxiety Disorders

 

The journey of becoming a parent can evoke powerful emotions, changes in relationships, and questions about oneself.  It is an all-encompassing experience that is filled with incredible joys, but also baffling contradictions and challenges. For many parents, the mixture of sleep-deprivation, financial stress, work changes, role & relationship changes, and the demands of a baby can introduce or exacerbate anxiety and/or depression. Memories and experiences from childhood can also return with new relevance, and power — and may require updated understanding for this new chapter of life.

 

PMAD’s are the most common complication of childbirth, affecting 20-25% of women — not a surprise being that following delivery is the most psychologically vulnerable time in a woman’s entire life. The postpartum time is a “perfect storm” of events, with physical pain, hormonal shifts, feeding challenges, exhaustion and round-the-clock care of a newborn - your life as you know it is turned on its axis. Not to mention that there can be other children who have needs, financial / work stresses, relationships that start feeling strained, a baby who is hard to decipher and soothe, and possible health complications / NICU stay, or multiple babies, a profound loss or a scary medical situation.

 

For women who have a history of depression, the risk is higher for developing a postpartum depression.  It can feel very isolating, and shameful - people often hear from well-meaning friends and family; “Isn't this the most wonderful time in life?”, or, “How can you feel depressed when you look at this baby?”  These opinions can make a suffering mother feel even worse. It’s important to know that postpartum depression is common, 100% treatable, and the sooner you get help, the sooner you will feel like yourself again. 

 

“Baby Blues” can last for three weeks postpartum, and this time can be marked by mood instability.

 

Postpartum Depression is an anxious depression that cycles around from “good days” and “bad days” — the more “bad days” you are having in a week, likely the more severe the state you’re in.  Here is an online evaluation tool that may be helpful to help you understand the severity of how you feel: https://psychology-tools.com/epds 

 

Some common symptoms of postpartum depression & anxiety are:

  • tearfulness/weepiness

  • feelings of hopelessness, worthlessness and guilt

  • irritability and restlessness

  • anxiety or feelings of panic  

  • insomnia or difficulty sleeping

  • loss of appetite  

  • feeling overwhelmed / fear of being alone with the baby

  • obsessive or repetitive thoughts or worries ("scary thoughts")

  • anger / loss of patience

If some of this list sounds like what you are experiencing — please let someone know because prolonged depression and stress is not healthy for mom or for baby.

 

Sometimes the anxious symptoms are much more pronounced and can begin to be a peripartum Obsessive Compulsive Disorder.

Symptoms of perinatal Obsessive-Compulsive symptoms can include:

  • Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and not something the woman has ever experienced before.

  • Compulsions, where the mom may do certain things over and over again to reduce her fears and obsessions. This may include things like needing to clean constantly, check things many times, count or reorder things.

  • A sense of horror about the obsessions

  • Fear of being left alone with the infant

  • Hypervigilance in protecting the infant

  • Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them.

 

Postpartum Psychosis is a very rare condition, occurring in 1-2% of births, and onset is usually sudden and within the first two weeks postpartum.  It is an emergent situation that requires immediate emergency medical treatment. Call 911, or go to the nearest crisis center.

 

Symptoms of postpartum psychosis can include:

  • Delusions or strange beliefs

  • Hallucinations (seeing or hearing things that aren’t there)

  • Feeling very irritated

  • Hyperactivity

  • Decreased need for or inability to sleep

  • Paranoia and suspiciousness

  • Rapid mood swings

  • Difficulty communicating at times

photo by Nick Kelsh