What are Perinatal Mood and Anxiety Disorders
Perinatal Mood and Anxiety Disorders (PMADs) is a term to describe several disorders that most commonly impact moms during that first year after having given birth. Between 15-20% of women experience significant depression and anxiety. These disorders are perinatal depression and postpartum, perinatal anxiety and postpartum anxiety, pregnancy or postpartum obsessive compulsive disorder, bipolar mood and psychosis.
The signs and symptoms of these disorders can vary depending on the person and situation, but one important note is that PMADs are seen across various cultures, racial groups, social and economic backgrounds. There are many contributing factors to being diagnosed with a PMAD and the worsening of the disorder. There are biological, psychological, social and environmental factors that influence how this may look.
Being aware of what these disorders are, how they can affect you, and the resources available within your community can be helpful when transitioning into parenthood. If you’re here for education or because you’ve recently been diagnosed, please be encouraged in knowing that there’s effective treatment options and skillfully trained providers that you can utilize today. Treatment that works for many experiencing these issues find psychotherapy and medication helpful.
Psychotherapy can be individual or involve your partner or support person. Psychotherapy can be conducted by so many professional backgrounds within this field. So, you may see a Dr., LCSW, ,LISW, LPC, LMFT, or LMHC provide this service. This form of treatment is usually conducted in-person or virtually and is sometimes called “talk therapy“. Talk therapy is the exchange that happens between a client and therapist where evidenced based practices are utilized. Part of the therapeutic experience, between the client and therapist, involves establishing a safe space for the client to share. That sharing includes building a treatment plan or “framework“ that identifies goals to help a client reach. So, for a perinatal or postnatal client coming into therapy, this could look like identifying what some of the concerns are and how they’d like for them to be different (i.e. change or overcome). The therapist will work with this client through exploration and processing. This can be such a relief for a pregnant mom or new mom who is feeling alone, unheard, or even confused. To hear another person, a trained professional, say “you’re not alone, what you’re feeling is normal and expected and here are ways that might be helpful” is something that we all can appreciate when we’re struggling.
Medication paired with psychotherapy is recommended when there’s no symptom relief or symptoms are worsening. It has to be incredibly difficult to want to tackle an issue but not be able to do so, even with your best effort. In those cases, medication would be encouraged. Some clinicians work closely with OBs, primary care, and psychiatrists and some refer out to these same providers so that clients are able to get help with managing these issues. Medication compliance is incredibly important when moms have a diagnosis and it not recommended to stop usage just because you’ve found symptom relief or you think it’s been long enough. It’s strongly encouraged to follow your doctors recommendations and notify them of any changes.
In some cases, a client may reach out to a therapist for services or already be in treatment but need a higher level of care. In this instance, the client will be referred to either inpatient hospitalization, partial hospitalization, or intensive outpatient. There are criteria for each and that therapist will make the appropriate recommendation. In most cases, a client is compliant and understands the significance of being referred for a higher level of care and is compliant with going and other times this isn’t so. Each state operates differently in how the situation is managed when someone isn’t voluntary. Something like a client who’s thoughts have shifted from thoughts about dropping baby to now a plan to harming baby with specific detail on how they would do it - certainly would need a higher level of care. I know you’re probably thinking well duh but in that moment, if you’re a client who’s having these intense thoughts and feelings, you aren’t able to think rationally that what’s going on is of danger and the best option is going to the hospital. It’s extremely important for me to say that your therapist is trained to assess and gather evidenced to where they can make an informed decision. I say this to highlight the relationship that’s build between therapist and client and the significance of being transparent. Just because you tell your therapist that you have thoughts about wanting to be with your daughter who you miscarried doesn’t mean that they’ll automatically assume you’re wanting to kill yourself. They will listen, provide empathy, and encourage you to share so you’re able to work through what’s going on and they’re able to assess where you’re at (i.e. yearning for the child you lost v wanting to harm yourself). It’s so validating to get the support you need and get on the path of recovery with someone who is willing to carry your emotional, mental, and physical pain with you.
It takes an incredibly strong person to recognize that they aren’t okay or that they’re struggling with this new life transition while still finding courage to reach out for help. There is help. Each of these PMADs are treatable and you can manage them. It may be a journey but these thoughts and feelings that are challenging are temporary - they won’t last forever. You have the ability to heal from devastating experiences and not suffer any longer.
If you’re interested in learning more about PMADs come back and visit for more information.
If you are experiencing a life threatening emergency such as thoughts or feelings of hurting someone else or yourself, call 911 or go to your local emergency room.
If you’re interested in individual or couples counseling, with me, for anything related to perinatal mood and anxiety disorders, motherhood, or women’s issues and located in Georgia or South Carolina, please schedule a consult so we can connect today.
For information on providers in your community that specialize in perinatal mental health, visit postpartum.net and click on get help at the top then client provider directory (find a provider).