Why People Misunderstand Perinatal Mood and Anxiety Disorders

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Signs of encourage on a chain link fence with green trees behind it.One out of five new mothers will experience a Perinatal Mood and Anxiety Disorder (PMADs). With so many women suffering, why are there still misunderstandings about what perinatal mood and anxiety disorders are? When families don’t know the signs and symptoms, moms or their partners (yes, partners can also experience PMADs) don’t get help.

Let’s start by defining Perinatal Mood and Anxiety Disorders.

PMADs can begin anytime during pregnancy through the first year postpartum. Often it peaks at 3 months after giving birth, but it may be later which is why they may not be detected. The general population may not know that PMADs can happen in pregnancy. I’ve seen many expectant mothers in my practice with severe anxiety who go on to have a rewarding first year with their baby because they were able to recognize that something didn’t feel right and got help as soon as possible.

Many people may be familiar with postpartum depression, but don’t realize that other disorders fall into the umbrella of PMADs.

Some symptoms cross over, so it’s not uncommon to have symptoms of more than one PMAD. Here’s a list of what is considered a perinatal mood and anxiety disorder.

  • Postpartum Depression.
  • Postpartum Anxiety
  • Postpartum Obsessive Compulsive Disorder
  • Postpartum Post Traumatic Stress Disorder
  • Postpartum Bipolar Disorder
  • Postpartum Psychosis (very rare; 1-2 in 1,000)
A common misunderstanding is that you can tell if someone has a PMAD by looking at them.

This is simply untrue and a reason why screening at OB and Pediatric baby wellness appointments is so important. A mom may look like she has it all together on the outside. She may be curating posts on social media that make it look blissful, when inside she may be feeling anxious, alone, guilty, or afraid to leave the house.

This brings me to my next point. PMADs are very individual to the person experiencing them.

The picture many people paint about what postpartum depression and anxiety look like is not necessarily what someone may be experiencing. For example, postpartum depression may show up as irritability, rage, and difficulty concentrating as opposed to crying throughout the day.

Postpartum Anxiety and Postpartum PTSD may not have the same signs and symptoms of depression.

People may assume the anxiety a mother is feeling is just part of the transition into motherhood, but postpartum anxiety can hold a mother back from trusting herself and integrating baby into her life. Postpartum anxiety may be placed in many areas such as the fear that baby is not getting enough to eat if mom is breastfeeding, anxiety about the baby’s health or development, or fear of driving while pregnant or with the baby. It can be debilitating and it can easily go unnoticed.

The media…oh the media.

The media paints a certain picture of women suffering with a PMAD. Often they are seen as “crazy” or a danger to their baby. The media often categorizes PMADs as postpartum depression, when in fact a lot of the media attention is geared toward women with postpartum psychosis because coverage usually occurs after a tragedy has happened. Postpartum psychosis is a medical emergency that requires immediate hospitalization. Because many people miss the signs of postpartum psychosis, if tragedy does happen, the media often blames the mother and not the illness.

What can you do to help pregnant or new moms?
  • Ask them how they are feeling, not just how the pregnancy is going or how the baby is doing.
  • Ask how they are adjusting.
  • Ask what they thought motherhood would be like and how it actually is.
  • Refrain from judgment.
  • Stop yourself before giving advice.
  • Encourage the help of a mental health therapist trained in working with mothers who are experiencing PMADs. The credential of Perinatal Mental Health Certified (PMH-C), is a designation that a person has advanced training and experience working with pregnant and postpartum families and has passed an exam that demonstrates competency in this specialty.
  • Be available to listen.

Perinatal Mood and Anxiety Disorders are more varied than postpartum depression alone, with the picture that a mother is crying all day and can’t get out of bed. While this picture can happen, it is more nuanced, more individual to the person. When we can better understand what the full range of symptoms might be and ask a mother how she is doing emotionally, we can help mothers feel more supported and less misunderstood.

Please note that this article is for educational purposes only and is not a substitute for medical advice from a doctor or mental health professional.

If you are a mother who needs support, please contact me for a free 15 minute consultation to see if we would be a good fit in working together.