Perinatal Mood and Anxiety Disorders (PMAD)

By Wendy Eson, IBCLC, CEIM

Becoming a new parent, whether it’s first baby or fourth, is an incredible life adjustment that brings about all sorts of feelings. While it is a time for joy and celebration, many new parents, particularly mothers, feel sad, anxious and overwhelmed.

For some, these feelings are temporary, known as the “baby blues,” but for others these unwelcome feelings persist long beyond the first few weeks of parenthood. A good number of new parents, about 50-80% percent, will experience the baby blues. (*Note, we reference parents in this article, as PMAD can affect both parents, though it’s often most pronounced in mothers.)

These blues are clinically defined as periods of mood swings, bouts of crying and sadness that usually occur within the first 2-3 weeks postpartum. Fluctuating hormones following delivery play a key role in contributing to these feelings, however adoptive parents may exhibit similar feelings. Having a good support system at home and practicing self-care is important. Making sure parents sleep when sleep is available to them, eating well and staying hydrated is important.

For some though, these feelings persist well beyond the first few weeks. Research shows that 1 in 7 women will experience PMAD, which can persist for months or years. Symptoms associated with PMAD can include feelings of hopelessness, lack of interest in activities that normally bring joy, lack of interest in baby, loss of control, obsessive, intrusive thoughts, anxious feelings and in extreme cases, psychosis.

We need to recognize that PMAD is a real issue. Just as pregnant women are screened for medical issues such as gestational diabetes, all pregnant women should be screened for mood and anxiety disorders. Women with prior or current history of anxiety/depression are at greater risk and should be monitored carefully. High risk pregnancies, traumatic births or a baby who requires special care following delivery all increase the risk of PMAD. Many pediatric providers, such as those at Kids Plus, screen for postpartum mood disorders at pediatric well visits. They recognize that mom’s mood is important to the well-being of the whole family. Also, parents of new babies visit the pediatric office much more than their own providers, so it can be a good way to the conversation started.

Fortunately, there are many excellent resources available for those affected with PMAD. Discussing with your PCP or OB is a good start. If medication is needed and you are breastfeeding, there are many medications that are compatible, in addition to alternative therapies. Recognizing and asking for help is not easy, but taking that first step can help set parents on the path to wellness.