Perinatal Mood and Anxiety Disorders (PMAD’s) are the most common complication of childbirth. But, in my opinion, the most unspoken complication. We hear more about the health and well being of the baby, with less focus on the experience of mothers and parents. Our culture is riddled with images of happy, joyous parents looking well rested, refreshed, and completely put together. When, in actuality, parenting has a very different face for the 1 in 7 mothers experiencing a PMAD. Difficulty during the postpartum period doesn’t always mean that you are experiencing a mood disorder; the transition to parenting is a difficult one. The need to voice your difficulty is a necessary one for all mothers. Silence only exacerbates your pain and strengthens the fantasy image of the perfect mother or father portrayed by our culture.


Why do women experience a PMAD?

This is a big question and the answer is unique to each woman. Here are only a few potential reasons why:

  • A history of anxiety, depression, OCD, bipolar, trauma or a family history of these and/or a history of PMAD’s.
  • Hormone shift: 24 hours of delivering a baby, estrogen and progesterone levels drop to 200 times below pre-pregnancy levels. Estrogen works directly with Serotonin in the brain and so this sudden drop in levels of estrogen can leave the brain more vulnerable to stress. A woman’s sensitivity to this shift and the hormonal fluctuations throughout the postpartum period are a risk factor.
  • The level of support and stress experienced postpartum.
  • Birth Trauma: Birth trauma is in the eye of the beholder. So, even if everyone around you feels like your birth was successful because you have a healthy baby, but you feel traumatized by your birth, reaching out for help is vital!


How do I know if I am experiencing a PMAD?

We hear the most about Postpartum Depression. While depression is common, some women never feel depressed at all. In fact, most women I see are incredibly anxious or irritable.   The following is a list of potential symptoms:

  • Anxiety and/or overwhelm
  • Sadness
  • Mood swings
  • Difficulty concentrating
  • Difficulty making decisions
  • Irritation or anger
  • Lack of interest in things you used to enjoy
  • Difficulty making decisions
  • Sleep and appetite changes
  • Panic attacks
  • Excessive worry about your baby
  • Disturbing thoughts about harming your baby
  • Racing thoughts
  • Excess energy with little sleep
  • Headaches and stomach problems
  • Guilt
  • Delusions and hallucinations

When women experience these symptoms, guilt and shame are often concurrently experienced. Having these symptoms does not mean you aren’t a good mom and it certainly doesn’t mean you don’t love your baby or don’t want to care for him or her. The symptoms can interfere with enjoying your baby or how well you bond with your baby.


You can feel better!!

The good news is that with support, you can get better. Counseling, Brainspotting, acupuncture, medication, naturopathy, homeopathy, and yoga are all ways you can support yourself in feeling better. PMAD’s do not typically go away on their own. We know that untreated PMAD’s are more detrimental to the overall well-being of parents, babies, and children.   The sooner you get help, the sooner you can feel better.



Postpartum Support International

The Postpartum Stress Center

Mass General Center for Women’s Mental Health