The term “Perinatal Mood & Anxiety Disorders” (PMADs) refers to a spectrum of mental health disorders that begin during pregnancy and/or the first year postpartum. PMADs are serious and debilitating illnesses that require intervention and properly informed treatment.
With proper help and support, they are all temporary and treatable.

PMADs include: 
Perinatal Depression
Perinatal Anxiety and Panic disorder
Perinatal Obsessive-Compulsive disorder (OCD)
Bipolar disorder
Postpartum Post-traumatic Stress disorder
Postpartum Psychosis**

Click here to go to the website of Postpartum Support International, for a detailed breakdown of each disorder.

‘Postpartum Depression’ — one of the disorders on the spectrum — has been identified as the most common complication related to childbearing, and tends to get the most attention from medical providers and in the media. While sometimes ‘Postpartum Depression’ is used as an umbrella term to refer to a range of symptoms, I purposely use the broader term PMADs in order to include the broader range of symptoms and illnesses. Remember, women typically experience a range of symptoms that do not fit ‘neatly’ into one category; and while it can be helpful to distinguish anxiety from depression for the purposes of treatment, each woman’s situation is unique, and symptom overlap is common.

Symptoms include, but are not limited to: 

Changes in appetite
Lack of energy; Feeling exhausted
Inability to sleep (even when given the opportunity)
Sadness, tearfulness, depressed mood
Anxiety, constant worry, or panic attacks
Intrusive ‘scary thoughts’ about harm coming to baby or self
Fear of being alone with the baby
Irritability, agitation, or crankiness
Anger or rage
Feeling overwhelmed
Feeling hopeless, or like things will never get better
Feeling ‘out of control’ or like she’s ‘going crazy’
Self-criticism, and self-doubt about her ability to parent
Hyperactivity, or decreased need for sleep
Difficulty concentrating; forgetfulness
Difficulty making decisions
Lack of pleasure or enjoyment
Guilt and shame, sometimes b/c she is not ‘enjoying every minute’ with her new baby
Thoughts of harming baby, harming self, or suicide

While mental health distress can affect any mother, there are certain factors that place a woman at higher risk of developing symptoms.
Some of these Risk Factors include:
A personal history of depression, anxiety, Bipolar disorder, OCD, PTSD, or psychosis
A family history of depression, anxiety, Bipolar disorder, or psychosis — whether diagnosed or not
A history of noticeable mood fluctuation related to monthly cycle
Previous difficulty adjusting to life changes
Miscarriage, fetal loss, or fertility treatments
Unplanned, and/or unwanted pregnancy
Perfectionist tendencies (‘Type A’)
Relationship difficulties/ unsupportive partner
Domestic violence (unfortunately this is quite common during/ after pregnancy)
Sleep deprivation
‘High-need’/ colicky baby
Financial difficulties/ stressors
Lack of support
->Depression/anxiety during pregnancy is a strong indicator that a woman will experience symptoms postpartum as well.

**A few words about Postpartum Psychosis — Postpartum Psychosis is relatively rare, but occurs in 1-2 out of every 1,000 births; it is also temporary and treatable. Postpartum Psychosis typically has a sudden/ rapid onset, and symptoms can include delusions (strange beliefs), hallucinations, paranoia, and more; click here for Postpartum Support International’s detailed description of signs and symptoms. Unfortunately, misinformation and stigma cast a particularly long shadow on this form of perinatal mental illness, leading to misdiagnosis, confusion, fear, and isolation. Postpartum Psychosis is always an emergency, and it is vital that women who may be suffering from this illness receive immediate medical care. If you think you or someone you love may be experiencing psychosis, call a doctor or crisis hotline right away, or go to your nearest emergency room.

Maryland Crisis Hotline: 1-800-422-0009