What are PMADs?

PMADs stands for Perinatal Mood and Anxiety Disorders. PMADs is an umbrella term that encompasses Maternal Mental Health illnesses during pregnancy and up to one year postpartum. They are caused by changes in biology, hormones, psychology, and environment. All PMADs are treatable and with the right treatment plan you will get better. It may consist of a combination of talk therapy, self-care, social support and medication.

  • PPD is a mood disorder that affects ones ability to function. The symptoms can range from mild to severe.

    Symptoms include:

    Insomnia or sleeping too much while lacking the energy to function; Sadness and excessive crying, but unsure why; Lack of interest in things you used to enjoy and feeling disconnected to baby; Feelings of guilt, worthlessness, or hopelessness; Feeling overwhelmed and out of control; Feeling withdrawn and wishing to escape from everything; Intrusive, disturbing thoughts about harming oneself or baby; Poor concentration, irritability, anxiousness or anger; Loss of appetite or eating too much; Unexplained aches and pains, or illnesses.

  • Catastrophic thinking about the future, beyond normal worry.

    Symptoms include: Excessive worry; Irritability; Racing thoughts; Forgetfulness and difficulty focusing; Repeated checking; Washing; Avoidance; Reassurance seeking; Increased heart rate; Palpitations; Nausea; Aches; Shortness of breath; and loss of appetite.

  • Intrusive or unwanted thoughts that cause distress. Rituals or repetitive behaviors designed to reduce stress or to ward off disaster.

    Symptoms include: Intrusive unwanted distressing thoughts; Obsessions or fear of contamination or harming baby; Doubting; Rituals involving checking, or washing; Avoidance or reassurance seeking; Insomnia due to obsessions and compulsive urges.

  • Sudden and intense rush of fear that lasts for about 10 to 15 minutes, often coming out of nowhere. It can seem terrifying but is generally harmless.

    Symptoms include: Lightheadedness or dizziness; Racing heart; Numbness or tingling in the hands and feet; Chest pain or discomfort; Sweating; Trembling; Nausea; Chills or hot flashes; Feeling short of breath, Choking feeling and fear of dying.

  • After a traumatic event where a person feels intense terror, horror or helplessness, Re-experiencing the trauma is one of the main causes of PTSD.

    Symptoms include: Insomnia; Intrusive distressing thoughts or images; Nightmares; Flashbacks; Poor concentration; Despair; Irritability or anger.

  • Help is available regardless of diagnosis. Research show 50% of women with bi-polar disorder are initially diagnosed in the postpartum period. There are two phases of bi-polar mood disorder: Lows and highs. The low time is clinically called depression while the high is called mania or hypomania.

    Symptoms include: Episodes of severe depressed mood; Irritability; Euphoric mood; Rapid speech; Little need for sleep; Continuous high energy; Overconfidence; Racing thoughts; Poor concentration; Impulsiveness; Poor judgement; Paranoia; Grandiosity; Delusions and Hallucinations.

  • A serious perinatal health disorder that usually has an onset in the first two weeks and up to a year postpartum. Occurring in 1 to 2 out of every 1,000 births, an active case of PP is considered a mental health emergency and requires immediate medical and psychiatric attention, and hospitalization.

    Symptoms include: Delusions; Strange beliefs; Hallucinations; Seeing or hearing things that aren't there; Irritability; Hyperactivity; Severe depression or flat affect; Insomnia; Paranoia; Rapid mood swings; Difficulty communicating; Confusion or disorientation; Attempts to harm oneself or baby.

  • Risk factors for PMADs:

    Biological: Hormones; Fertility treatments; Loss such as miscarriage/stillbirth/termination/infant loss; Severe Premenstrual Syndrome; Difficult pregnancy/labor/delivery; Mental health history; Thyroid changes; Anemia and sleep deprivation.

    Psychological: Personality and behavior such as difficulty with transitions; Perfectionist tendencies; Self-esteem issues; Unrealistic or rigid expectations about Pregnancy/labor/delivery/motherhood or work; Relationships with own mother or spouse; Breastfeeding expectations, desires, ability and pressure from others; Lack of support; Weaning.

    Social/Environmental: Traumatic prenatal care/labor/delivery/postpartum care; History of childhood trauma or experiences; Domestic violence; Loss or illness of a loved one; Life changes; Isolation or lack of social support; Substance abuse.

    Other Factors: Colicky baby; Premature baby; NICU stay, Multiple; Baby health issues; Relationship issues; Financial stress.

  • Talk Therapy: Talking to a third party often short term with therapists that are trained in maternal mental health can help tremendously. Evidence based therapy types include: Cognitive Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT), Exposure and Response Prevention (ERP), Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR) and Brain spotting.

    Self-Care: It is important for parents to self-care in order to care for others. A combination of time for yourself to recharge and rejuvenate; Getting at least 4-5 hours of uninterrupted sleep; Eating well and staying hydrated; Gentle exercising.

    Medication: Consult with a doctor to see what medication might work for you. Antidepressants, anti-anxiety medications, and sleep medications can help treat PMADs.

    Social Support: Support groups offer nonjudgemental listening, support and encouragement from peers who are experiencing similar issues. Lead by trained professionals that care and offer guidance, tips, help remove stigma and isolation and help process emotions and feelings.