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What No One Tells You About Maternal Mental Health

by | May 6, 2020 | Maternal Mental Health

If you ask 10 postpartum women how they are doing, 7 out of 10 of them will hide their symptoms.  That means 70% of new moms are suffering in silence, afraid of the social stigma that comes with mental health complications during pregnancy or the postpartum period. Perinatal Mood and Anxiety Disorders (PMADs) frequently go unnoticed and untreated, often with tragic and long-term consequences to the whole family (1 in 10 dads get depression in the postpartum period).  World Maternal Mental Health Day (May 6) seeks to raise awareness and educate, which leads to more moms getting help, and overall healthier families.

Wait–what is a PMAD?

The scope of emotional issues that women experience during pregnancy and after giving birth is much broader than just depression; women can also experience anxiety, intrusive thoughts, OCD symptoms, and more.  As awareness about postpartum depression rises, the medical and mental health community is beginning to use the term “Perinatal Mood And Anxiety Disorder” (PMAD) to address the full spectrum of mood changes that may occur during or after pregnancy, rather than simply applying the term “Postpartum Depression” (PPD) as a catch-all.

There is a great lack of understanding regarding the different types of perinatal mood and anxiety disorders as well as their symptoms. For more information on PMADs, check out Postpartum Support International’s fact sheet.  Failure to identify, define and share information about these different disorders perpetuates the stigma around maternal mental health while also amplifying isolation for those who suffer.  The specific wording of what a woman is experiencing matters.

What you Need to Know

PMADs are the #1 complication associated with childbirth (they are more common even than gestational diabetes and other conditions that  every pregnancy is tested and screened for.  While screening for postpartum depression is increasing, there still isn’t adequate testing for the spectrum of PMADs in both the prenatal and postpartum period.

PMADs are TREATABLE. Treatment may include therapy, support groups, and medication. Complementary measures including yoga, mindfulness, and meditation are also beneficial. It is also recommended that you see your primary care doctor for a physical as there could be something physiological going on that is contributing to symptoms.

Pregnancy matters too.  It’s not just the postpartum period where we worry about mental health concerns.  Keeping women healthy during pregnancy is one of the strongest protective factors to postpartum depression.

Don’t immediately discount medications.  At the end of the day, nothing is more important than keeping women well during pregnancy–whether it be with medicine or therapy.  Many women are concerned about taking an antidepressant during pregnancy.  You should know that doctors know more about SSRI use in pregnancy than they do about any other medicine that women take during pregnancy (with the exception of prenatal vitamins).  While medication isn’t a cure-all, it can increase your emotional bandwidth enough for you to the do the healing work in therapy.  If you’re worried about your mental health before, during, or after pregnancy, reach out to your doctor for help.

How to Know if you have a PMAD

The presence of worry or sadness alone does not constitute a PMAD.  85% of women experience emotional reactivity in the postpartum period, otherwise known as the baby blues.  A PMAD can be thought  of the baby blues on steroids.  PMADs are often more intense, longer in duration, and not as responsive to first lines of defense.  In general, we look at:

  • The intensity – on a scale of 0 to 10, how intense is your worry/sadness/hopelessness/etc.?
  • The frequency – how often is it there?  Do these thoughts take up most of your day or do they come and go?
  • The prevalence – Can you be distracted from the feelings? Or are they all-encompassing?
  • Their responsiveness – Do the feelings improve or respond to help from friends or family?  Or do they persist despite help being offered?
  • The impact – How much are these feelings getting in the way?  Are they getting in the way of you enjoying moments with your baby, interfering with your sleep, etc. 

Ultimately, moms aren’t expected to be the experts, so if you’re worried about how you’re feeling, contact a professional.   

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