What the #$%& are PMADs?

PMADs — perinatal mood and anxiety disorders — are the most common complication of pregnancy and childbirth.  PMADs are often a combination of anxiety and depression.  We once referred to PMADs ‘postpartum depression.’

 

What happened to 'postpartum depression'?

Postpartum depression (PPD) captures only one aspect of PMADs: depression or sadness AFTER having a baby.  We’ve learned that it’s not just depression…it’s also anxiety and it’s not just postpartum…it can also happen during pregnancy.

Hence the fancy name ‘perinatal mood and anxiety disorders.’

 

How common are PMADs? When do they occur?

PMADs affect up to 1 in 5 women during pregnancy or the first year after baby arrives.  Believe it or not, dad, partners, and even adoptive parents can also experience PMADs.

 

What causes PMADs?

PMADs are ‘the perfect storm’ caused by a complicated set of physical, emotional, and social changes. It’s never just one thing …it’s a bunch of things.  Learn more HERE.

 

What are the significant risk factors?

Risk increases significantly for women who have a personal or family history of PMADs, anxiety or depression.  Other risk factors are biological, such as changes in hormones and sleep, life stressors, such as lack of support from partner/ family, and psychological factors, such as difficulty with transitions.

 

What about hormones?

During pregnancy, estrogen and progesterone reach very high levels (estrogen is 100 times higher during the last few weeks of pregnancy than prior to pregnancy) and then plummet after baby is born.  At the same time, other hormones increase in preparation for breastfeeding.  Hormones change again when breastfeeding ends.  Some women are more sensitive to these changes than others.  If hormones were the only cause, then ALL mothers would experience PMADs, right?

 

What about thyroid and other physical changes?

Pregnancy can impact the thyroid gland, which may add to feelings of lethargy and sadness.  Changes in blood volume, blood pressure, immune system and metabolism can contribute to fatigue and mood swings. New moms who are feeling poorly should ask their doctor to check for thyroid changes and anemia.

 

What are the signs and symptoms of PMADs?

Some women show signs of depression: sadness, lack of energy, lethargy, feelings of hopelessness. Some are anxious or have scary thoughts, perhaps of harm to baby. Others are highly irritable, angry, or feel out of control.   Some women report physical changes, such as weight loss or inability to sleep. Some women have one symptom, some have all of the above.

 

With this wide range of symptoms, how can a new mom tell if she's anxious or depressed?

If a woman isn’t feeling like herself, or if the transition to motherhood seems to be harder than it should be, then she could be anxious or depressed.  Unfortunately, there isn’t a simple test, like a blood or saliva test.  But there are some screening tools, like the Edinburgh Postnatal Depression Scale, than can assess a woman’s risk for experiencing anxiety or depression either during pregnancy or after baby’s arrival.

 

How are PMADs diagnosed?

As with any mental illness, diagnosis is best made by a trained mental health professional who can conduct a thorough assessment and administer diagnostic or screening tools such as the Edinburgh Postnatal Depression Scale (EPDS).

 

How do people recover from PMADs?

Fortunately, PMADs respond well to treatment, which usually consists of a combination of

  • self-care (sleep, nutrition, exercise, time off)
  • social support (connecting with other PMAD survivors)
  • talk therapy (talking with a trained professional)
  • medication (when necessary)

PSVa refers to this as the Path to Wellness.

 

What's this about 'self-care'?

New mothers need to be mothered themselves.  Being a new mom can be physically and emotionally draining.  The days become nights as mom feeds, burps, changes, holds, carries, rocks her new baby.  Sometimes new mothers need to be reminded about the basics:

  1.  SLEEP.  Research shows that most humans need at least 5 hours of uninterrupted sleep to maintain basic functioning.  The lack of sleep can be devastating to some new mothers.
  2.  EAT.  New mothers should eat and drink every time baby eats.  Some moms create a basket with healthy snacks and bottled water so that they can renourish throughout the day.
  3.  EXERCISE.  A gentle walk around the neighborhood can do wonders to lift the spirits.  Never underestimate the combined power of change of scenery, fresh air, and Vitamin D!
  4.  TIME OFF.Every new mom deserves a few minutes to herself every day.  A newborn is a very demanding boss, requiring 24×7 love and care.

 

And if self-care doesn't work?

There are lots of other ways moms can get help:

  1.  Talking with other new moms.  PSVa runs support groups throughout Virginia, which give give women an opportunity to connect, share stories, and support each other.
  2.  Talking with a therapist.  PSVa maintains listings of mental health professionals who can help identify coping skills and ease the transition to motherhood.
  3.  Taking medication.  Some women can benefit from taking anti-depressant medication.  Fortunately, research shows that some medications are safe to take during pregnancy or while breastfeeding.

 

Where can I learn more?

PSVa maintains a resource-rich website with all kinds of information, including:

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