IDENTIFYING PERINATAL MOOD AND ANXIETY DISORDERS (PMAD’S)

Have you ever wondered what exactly is a perinatal mood disorder? Maybe you have heard of postpartum depression but are wondering about anxiety symptoms. You might be feeling ashamed to talk about your experience or are uncertain of where to get support. This post is intended to provide some important information about the primary perinatal mood and anxiety disorders as well as treatment resources to support you if you are suffering. Rest assured, there are places to turn for care and recovery.

It is reported that during the postpartum period, roughly 85% of women experience some sort of mood disturbance. That means that you will very likely have moments in which you don't feel quite like yourself. That's to be expected and for most women, these mood shifts resolve on their own in time.

For some birthing people, however; mood disturbances turn into mood disorders that need treatment for recovery. Postpartum mood and anxiety disorders are classified under the following categories:

• Baby Blues

• Postpartum Depression

• Postpartum Anxiety

• Postpartum Psychosis 

I want to be clear, having the baby blues, or even a case of postpartum depression does not mean that you are disordered or that there is something wrong with you. It simply means that your body and brain are experiencing more significant impacts from the enormous experience of having a baby. 

Let’s take a look at some key components for the range of PMAD’s so that you know what to look for and when to ask for help if you are suffering.  

BABY BLUES

The baby blues are feelings of sadness and overwhelm that affect 4 out of 5 new birth parents. Baby blues can affect anyone, no matter your race, culture, age, or socioeconomic status. Here are some common statistics on who the baby blues impact:

• 80% of birthing people experience the baby blues

• Onset is generally 2-3 days post-birth

• Baby blues technically last about 2 weeks, although it's not uncommon for people to experience symptoms for 4-6 weeks. 

• Baby blues are largely caused by a significant decrease in the hormones estrogen and progesterone. 

• Baby blues occur for about 10% of non-birthing parents and can occur any time in the first year of your child's life. 

If you experience mood disturbances that are more significant than general sadness or irritability and last longer than 6 weeks, you may want to talk to your healthcare providers about the possibility of postpartum depression or anxiety. 

POSTPARTUM DEPRESSION

Postpartum depression shares many symptoms with baby blues but lasts beyond 2 months and has an underpinning of depression, whereas baby blues still allows you to access feelings of joy in between sadness. The following symptoms often indicate the need for postpartum depression screening:

• Insomnia

• Intense irritability or rage

• Difficulty bonding with baby

• Lack of appetite

• Frequent crying spells

• Feelings of intense guilt or inadequacy

Postpartum Depression typically lasts 3-6 months and 80% of those who suffer achieve a full recovery. Up to 15% of birthing people experience postpartum depression within the first year after giving birth. There are many factors that impact an individual’s experience of postpartum depression. Seeking medical and mental health care early, significantly increases your rate of recovery. If you are experiencing any of the listed symptoms for longer than 2 months or with great severity, please reach out to a healthcare professional immediate. 

POSTPARTUM ANXIETY + OCD

Excessive worry or fear are the trademarks of postpartum anxiety. Similar to postpartum depression, postpartum anxiety extends beyond the firsts two months after delivering your baby. Anxiety and stress are natural as you become a new parent. If you experience exaggerated fear, dread, uncontrollable racing thoughts, panic attacks or insomnia, it is likely that you are experiencing postpartum anxiety and may need additional support. 

If you have more severe anxiety that is accompanied with intrusive or scary thoughts about your baby, you should speak with your doctor about postpartum OCD. Postpartum OCD causes many birthing parents repeated unwanted thoughts about unintentionally hurting their baby. An example being the constant thought of accidentally dropping your baby when you are walking down stairs. 

Roughly 10% of birthing people experience postpartum anxiety and about 4% experience postpartum OCD. As previously mentioned, check with your healthcare providers if you are concerned that your symptoms align with any of these mood disorders. It's always better to get support rather than suffer alone. 

POSTPARTUM PSYCHOSIS

Postpartum psychosis is incredibly rare, impacting about 0.01% of birth mothers. The large majority of birthing parents who experience a postpartum mood disorder fall in the categories of anxiety or depression. However, postpartum psychosis is very scary and very serious, so it's good to be aware of the signs of this particular mood disorder. 

• Postpartum psychosis generally occurs in the first 2 weeks after delivery. 

• Early signs are extreme restlessness and irritability. 

• Insomnia is also a marker of postpartum psychosis. This type of insomnia is often associated with lack of tiredness and a manic state of functioning. It is different from the insomnia associated with postpartum anxiety, where you can't sleep but DO feel fatigued or exhausted. 

• Rapid mood swings from depressed to elated, erratic, disorganized, or confused states are often present. 

• Auditory hallucinations instructing the mother to harm herself or her baby can be present as well. 

If you feel like your baby would be better off without you, call 911 or your local crisis care line and get connected with a psychiatrist immediately. If there is a perinatal bonding program at your local hospital, that is the best place to find trained providers who can get you the help you deserve to get through this incredibly painful time. 

TREATMENT OPTIONS

Whether you are experiencing mild symptoms associated with the baby blues or more severe challenges, there is help available to get you through this challenging transition in your life. 

Medical Care

• Check in regularly with your primary care physician or your OBGYN

• Discuss the possibility of using medication to mitigate symptoms

• Advocate for an appointment sooner than 6 weeks postpartum if you are concerned about your health

Mental Health Care

• Consider working with a Perinatal Mental Health Therapist. Look for someone with a PMH-C credential. 

• If you struggle with leaving the house, consider online therapy or an in-home therapy intensive if there is one available in your city. 

• Join local or online support groups for postpartum mood disorders or postnatal support and community. 

Perinatal Bonding Center Day Programs

If you are struggling to bond with your baby or are suffering more significant postpartum depression or anxiety symptoms, check to see if there is a perinatal bonding program at a hospital near you. These programs are more comprehensive, providing valuable education, concentrated therapeutic support, and medication management. 

This post has provided you a general idea of what the different perinatal mood and anxiety disorders look like broadly and what symptoms you may experience if you have one. Most importantly, I want you to know that it is normal to experience challenges after birth and it is never inappropriate to seek help. It may actually be the best thing you can do for yourself and your baby. Please reach out if you are struggling and ready to get support. I’m happy to be of assistance or to get you connected with someone who can help.

-Rachael