Perinatal Mood and Anxiety Disorders (PMADS) is a clinical term that means depression and/or anxieties that women might experience during pregnancy or postpartum. These feelings often conflict with assumptions and fantasies of how a woman should feel. A pregnant woman and her husband can be at a loss as to how to understand what is happening and how to cope.
PMADS is triggered by dynamic and profound hormonal and physiological changes that begin with pregnancy and continue through labor, delivery and the first postpartum year. Every woman is unique in her capacity to tolerate and cope with hormonal changes. This is due to genetic and psychological makeup, learned expectations, life situation and availability of a good social support system.
The examples that follow focus on postpartum experience, but the feelings described may also be experienced during pregnancy.
At one end of the spectrum are the common form of mild anxiety and depressive mood. For example, a new mother, ecstatic that she has given birth to a beautiful, healthy baby, might worry that something is wrong when she feels moody, weepy, irritable or frightened. These feelings may alternate with emotions of joy and serenity. These experiences are known as the baby blues, and usually resolve within two to three weeks.
One in five new mothers experience more severe symptoms of anxiety and depression. These may manifest as persistent sadness, irritability, anger, or difficulty taking care of herself or her baby. Some new mothers report upsetting and unwanted thoughts or images that express fears that harm may come to herself or her baby. Some women even experience panic attacks.
At the opposite end of the spectrum, a small number of women suffer a postpartum psychosis. This is a medical emergency requiring immediate medical and psychiatric attention. Symptoms include agitation, inability to sleep, paranoid or delusional thinking, hallucinations and suicidal or homicidal thoughts and feelings.
It is crucial that women who suffer with any of these feelings or symptoms, and the people who are around them, recognize that these experiences are not signs of weakness, character flaws, or moral failings; nor are they self induced. They are reactions to hormonal and physiological changes.
Pregnant and new mothers, as women in general, can empower themselves to cope with the dysregulations triggered by hormonal changes.
First, know the importance of valuing yourself and honoring your needs and feelings. Second, learn and practice mind/body skills that help with regulating the impact of hormonal and life challenges and promote ongoing well-being. These skills help provide nurturing and soothing self-care. They include relaxation breathing, meditation, imagery, guided visualization, journaling, exercise, music, good nutrition, prayer and cognitive restructuring.
Of utmost importance is a Woman's emotional and social support system. It is both folk wisdom and scientific knowledge that a new mother needs to be mothered. Not enough can be said about the importance of having a loving connection with her husband. In addition, family and friends can provide nutritional meals and create opportunities for rest, sleep and respite from stress.
Pregnant and postpartum moms should not hesitate to ask for help when it is needed. Good resources include mental health professionals who specialize in PMADS and local maternal/child health consortiums and organizations. Good intervention brings relief, facilitates recovery and wellbeing, and helps new parents find the support they need to successfully negotiate the transitions from couplehood to parenthood and a happy and healthy family life.
Chana Simmonds, MSW, LCSW, specializes in PMADS, Couples and Sex Therapy and Parenting. She has a private psychotherapy practice in Teaneck, New Jersey.