Perinatal Mood and Anxiety Disorders (PMADs)
"I never thought that I would be the one in five women that develop a mental health condition."
Perinatal mental health is a broad term that refers to the mental health concerns of pregnant and postpartum women.
Pregnancy and postpartum bring about significant physical, hormonal, and emotional changes. If a woman experiences persistent emotional symptoms that impact her functioning, she may have a perinatal mood and anxiety disorder (PMAD). A PMAD is a mental health condition that affects women who are pregnant or up to one year postpartum.
The different types of PMADs are:
Read on to learn more about the different types of perinatal mood and anxiety disorders.
Between 50% and 85% of postpartum women experience the ‘baby blues' within the first few weeks of giving birth. During this time a woman may feel sad, anxious, irritable, and tearful. This experience can be confusing for both her and her partner since we tend to associate new motherhood with joy and excitement, not tears and anxiety.
The baby blues are completely normal and typically subside within the first month. They are not considered a perinatal mental health disorder. In some cases, though, symptoms may continue beyond this time frame or briefly go away and then return later on. If a woman’s symptoms are moderate to severe, impact her functioning, or persist beyond one month, then she may be experiencing a PMAD.
Perinatal depression is also referred to as peripartum, prenatal, or postpartum depression, depending on when it develops. Depression during pregnancy affects around 10% of mothers and postpartum depression affects approximately 12 percent. It’s important to note that actual numbers may be higher, since women may not report depression for a number of reasons, including a fear of being judged.
Symptoms of perinatal or peripartum depression include:
Some of the symptoms above may occur in mild form during the baby blues. To qualify for a diagnosis of perinatal depression, symptoms must occur most days for at least two weeks.
Anxiety can present at any point during pregnancy or the postpartum period. By definition, anxiety involves a sense of worry that feels beyond a person’s control. Sometimes a mother may be aware of why she’s feeling anxious. Other times she may feel uncomfortable or distressed but have trouble pinpointing why.
Anxiety is the most common mental health concern experienced by pregnant and postpartum women. Rates of anxiety are approximately 35% among pregnant women and 20% among postpartum mothers.
Women with postpartum anxiety often experience postpartum depression too.
Anxiety symptoms can include:
Some women with anxiety may also experience panic attacks. These are sudden episodes of severe anxiety. Other symptoms of panic attacks include:
Perinatal obsessive-compulsive disorder (OCD) affects around 1 to 2% of new mothers. It is a type of anxiety disorder that involves obsessions and compulsions.
Obsessions are persistent thoughts or images that are distressing. Compulsions are repetitive behaviors that are performed to help cope with obsessions.
Women who are pregnant or postpartum are at an increased risk of developing OCD. A woman with existing OCD may experience a worsening of her symptoms during this time.
Other risk factors include:
Symptoms of perinatal OCD include:
Many women with perinatal OCD who have obsessions about hurting their babies worry that they will act on these thoughts. Experts say that people with OCD are at very low risk of acting on their obsessions. The fact that you are disturbed by these thoughts are what distinguishes perinatal OCD from postpartum psychosis (more on that below).
Post-traumatic stress disorder (PTSD) can develop after a traumatic birth experience. A traumatic birth is one where a mother or baby’s life is threatened. It can also be a birth where a mother feels powerless or unsupported. Trauma is said to be ‘in the eye of the beholder.’ So an experience that is traumatic to one person may not be to another. Examples of traumatic birth experiences include:
Symptoms of PTSD include:
Perinatal psychosis, also referred to as postpartum psychosis, is a serious mental health condition where a woman experiences a break from reality. She may hear or see things that are not there, function on little to no sleep, and have unusual beliefs that may feel real to her. It is a rare condition that affects approximately 1 out of every 1,000 postpartum women. Symptoms of postpartum psychosis include:
Women with a history of bipolar disorder are at greatest risk of developing postpartum psychosis. Other risk factors include a family history of bipolar disorder or having a previous psychotic episode. Postpartum psychosis is a serious condition that requires emergency intervention. There is a greater risk of suicide and infanticide in women experiencing a postpartum psychotic episode. If you suspect that a person is experiencing this condition, you should seek help right away. Take action by contacting their healthcare provider, calling 911, or taking them to the nearest emergency room.
For more information and support, see the following resources:
Admitting that you’re struggling with a PMAD can be difficult. You are not alone and reaching out is a brave and positive step towards feeling better.
At Phoenix Health, we support parents throughout their family-building journey. If you’re experiencing a PMAD, we are here to help. Schedule an appointment with a maternal mental health specialist and start feeling better today.
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