“What are Perinatal Mood and Anxiety Disorders (PMADs)?”

From the time of conception through the first year of the infant’s life; the birthing person is at an increased risk of developing a perinatal mood and anxiety disorder (PMADs). These disorders’ impact are not just limited to the functionality of the mother, but also how they operate with their child and family. 

The symptoms of these disorders range from: persistent sadness, anxiety, feeling overwhelmed, having panic attacks, crying episodes, chronic fatigue, severe depression, avoidant behaviors, self-doubt, hopelessness, changes in sleep and appetite, feelings of guilt, irritability, anger, loneliness, concentration problems, to doubting one’s role and identity as a mother. 

Symptoms may increase during pregnancy and the postpartum period. Moreover, these symptoms may significantly impact the attachment relationship and neurodevelopment of the baby. These impacts are exacerbated by the increase of more significant clinical disorders and in rare cases, postpartum psychosis. 

Postpartum Depression

Depression during and after pregnancy are more common than people realize. Depression during pregnancy is also called antepartum or prenatal depression, and depression after pregnancy is called postpartum depression.

Approximately 15% of women experience significant depression following childbirth. Ten percent of women experience depression in pregnancy. In fact, perinatal depression is the most common complication of childbirth. If you are experiencing such symptoms; you are not alone and with support, you will feel better. 

Risk Factors:

• A personal or family history of depression, anxiety, or postpartum depression
• Premenstrual dysphoric disorder (PMDD)
• Inadequate support in caring for the baby
• Financial stress
• Marital stress
• Complications in pregnancy, birth or breastfeeding
• A major recent life event: loss, house move, job loss
• Mothers of multiples
• Mothers whose infants are in Neonatal Intensive Care (NICU)
• Mothers who’ve achieved pregnancy through fertility treatments
• Women with a thyroid imbalance
• Women with any form of diabetes (type 1, type 2 or gestational)

Postpartum Anxiety

Postpartum anxiety symptoms manifest themselves mainly in the form of worry. “You constantly feel worried and on edge.” Approximately 6% of pregnant women and 10% of postpartum women experience anxiety. Oftentimes, we may experience anxiety in conjunction with depression.    

Risk Factors:

• A personal or family history of anxiety
• Previous experience with depression
• Certain symptoms of PMS (such as feeling weepy or agitated)
• Eating disorders
• Obsessive-compulsive disorder (OCD)

Post-Traumatic Stress Disorder (PTSD)

Many individuals experience difficult deliveries and trauma during childbirth. Approximately 9% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth. This could be due to one of the following reasons: 

• Prolapsed cord
• Unplanned C-section
• Use of vacuum extractor or forceps to deliver the baby
• Baby going to NICU
• Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery
• Women who have experienced a previous trauma, such as rape or sexual abuse, are also at a higher risk for experiencing postpartum PTSD.
• Women who have experienced a severe physical complication or injury related to pregnancy or childbirth, such as severe postpartum hemorrhage, unexpected hysterectomy, severe preeclampsia/eclampsia, perineal trauma (3rd or 4th degree tear), or cardiac disease.

 The encouraging news is perinatal mood and anxiety disorders (PMADs) are temporary and treatable. If you feel that you may be struggling with a PMAD or have not feeling like yourself, please reach out for support. Here at Flourish, our intention is to provide the very best perinatal mental health care for our clients. We believe it is not in spite of, but because of our struggles that we all have the capacity to flourish. 

Warmly,

Hadeel Elder, MA, LPC, NCC

Flourish Staff Therapist

Background:

Hadeel is a Licensed Professional Counselor (LPC) with experience working with children, adolescents and adults. She has had the privilege of working with women of various backgrounds in both the Detroit and Chicago area, utilizing multicultural counseling approaches with women of various cultural backgrounds.

“I am invested in an approach emphasizing a more integrative, dynamic, and holistic approach to mental health. I am particularly concerned with the impact of loss and trauma and improving intervention to support trauma recovery for better emotional, physical and relationship health.”