What are Perinatal Mood and Anxiety Disorders (PMADs)?
Perinatal Mood or Anxiety Disorders (PMADs), also known as perinatal mental health disorders, refer to a group of psychiatric conditions that can occur during pregnancy or within the first year after childbirth. Not to be confused with the baby blues, PMADs encompass a range of more serious mental health issues that can show up in pregnancy or in the first year after childbirth. These challenges effect around 10-20% of women and can also show up in fathers or or non-birthing partners.
What’s Included Under the PMAD Umbrella?
Perinatal Depression: Roughly 21% of women deal with major or minor depression after giving birth, with rates as high as 60% for low-income women and teens. Symptoms vary and might include anger, fear, guilt, disinterest in the baby, disrupted appetite and sleep, loss of interest or pleasure, concentration difficulties, and thoughts of harming the baby or oneself. Symptoms may also include low energy, fatigue, feelings of worthlessness or guilt, and thoughts of self-harm or harming the baby.
Perinatal Anxiety Disorders: These disorders encompass generalized anxiety disorder (GAD), panic disorder, specific phobias, and social anxiety disorder that develop during pregnancy or the postpartum period. While some level of worry is common for new parents, postpartum anxiety involves excessive and uncontrollable anxiety, restlessness, irritability, difficulty sleeping, racing thoughts, and physical symptoms such as increased heart rate or shortness of breath that can interfere with daily life and well-being. It can look like constant worry about the baby's health and well-being, fear of being unable to care for the baby, or general feelings of unease.
Perinatal OCD: Around 11% of new mothers experience OCD or OCD-like symptoms during preganncy or the postpartum period. Symptoms include persistent obsessive thoughts (often about harm coming to the baby or family), compulsive actions to alleviate anxiety, avoidance, and singificant distress or relationship conlficts related to these obsessions.
Post-Traumatic Stress Disorder (PTSD): Roughly 9% of women may develop PTSD after experiencing a traumatic childbirth or other distressing events during pregnancy or the postpartum period. Symptoms may include flashbacks or reliving the traumatic experience, nightmares, heightened arousal, hypervigilance, avoidance of triggers/reminders, and emotional numbing.
Perinatal Bipolar Disorder: This is a specific form of bipolar disorder that emerges after childbirth. It involves extreme shifts in mood, ranging from intense highs (mania) to lows (depression). These episodes can impact mood, energy, and behavior. While symptoms may overlap with postpartum emotions, they're more severe and will remain persistent after the two week “baby blues” window following childbirth. Many women are diagnosed for the first time with bipolar depression or mania during pregnancy or postpartum. Treatment includes medication, therapy, and support. Sometimes, a person with severe episodes of mania or depression will have psychotic symptoms too, such as hallucinations or delusions.
Postpartum Psychosis: Although rare, postpartum psychosis is a severe and potentially life-threatening condition. It involves the onset of hallucinations, delusions, disorganized behavior, and significant mood disturbances. Women experiencing postpartum psychosis require immediate medical attention.
How do PMADs differ from the baby blues?
Onset and Duration: Baby Blues are common and typically begin within a few days after childbirth. They usually resolve on their own within a couple of weeks.
Symptoms: Mild mood swings, tearfulness, irritability, and feelings of vulnerability are common.
Impact: Baby Blues are temporary and don't disrupt daily functioning or require medical intervention.
Prevalence: Experienced by many new mothers, estimated to affect up to 80%.
Need for Treatment: Generally, no treatment is needed beyond emotional support and rest.
Perinatal Mood and Anxiety Disorders (PMADs):
Onset and Duration: PMADs include a range of more serious disorders such as postpartum depression, anxiety, OCD, bipolar disorder, and more. They can onset anytime during pregnancy or within the first year postpartum and may persist without treatment.
Symptoms: Symptoms are severe, persistent, and can significantly impact daily life. They may include extreme sadness, panic attacks, obsessive thoughts, mood swings, and more.
Impact: PMADs interfere with functioning, bonding with the baby, relationships, and overall quality of life.
Prevalence: While still common, they affect a smaller percentage compared to the Baby Blues.
Need for Treatment: PMADs require medical attention. Treatment may involve therapy, medication, and support.
Perinatal mood and anxiety disorders can significantly impact the well-being of both the mother and her family. It is crucial to seek help from healthcare professionals if experiencing symptoms of PMADs, as effective treatments and support are available to aid in recovery.