Perinatal Mood and Anxiety Disorders (PMAD)

PMAD, or Perinatal Mood and Anxiety Disorders, describes a wide range of emotional and physiological reactions to childbirth. At least 10-20% of mothers suffer from this disorder. PMAD is more serious than the “baby blues”, which come earlier, are milder, and pass quickly.

Why Does It Happen?

The exact causes of PMAD are still unknown. We do know that the pregnancy and postpartum periods are times of enormous biochemical upheaval, as well as times of social and psychological adjustments, all of which create the conditions for PMAD.

Current research indicates that this disorder is related to the brain’s neurotransmitters, which are directly responsible for how we feel and are affected by heredity, hormonal changes and the environment.

While we wait for answers on the causes, it is important to realize that PMAD is a physical disorder, probably hormonally based, and that it is not self-induced. A woman cannot “pull herself out of it” any more than she could if she had the flu, diabetes or heart disease.

A woman suffering from PMAD may experience one or a combination of symptoms, each ranging from mild to severe. Examples are:

  • Exhaustion, insomnia
  • Anxiety, tension, panic
  • Irritability
  • Hopelessness, tearfulness
  • Poor concentration, memory loss
  • Rapid mood swings
  • Obsessions, frightening recurring thoughts
  • Lack of enthusiasm
  • Self doubt, low self-esteem
  • Eating disturbances
  • Feeling distance/removed from or lack of love for baby and/or partner
  • Thoughts of harming self and/or baby

Good days can alternate with bad days. All of these symptoms can be equally distressing for the mother, and often leave her feeling like she’s “going crazy.”

Treatment for PMAD varies depending on the type and severity of symptoms. All of the symptoms, from mild to severe, are temporary and treatable with support and skilled professional help.

Steps to Wellness

If these symptoms sound familiar, here are 8 things you can do to start feeling better:

  • Sleep when you can – especially when your baby is asleep
  • Eat a balanced diet, with plenty of protein
  • Take some time for yourself, including getting some exercise
  • Share your feelings with non-judgmental people
  • Reach out for support
  • Get referrals to professionals
  • Educate yourself on PMAD
  • Medication, if indicated

10 Coping Strategies

For the longer term, here are some tangible items to consider:

  • Joining a PMAD support group
  • Set goals for the day – no matter how big or small
  • Nurture the relationship with your partner, including time away from the baby
  • Ask for help
  • Accept help
  • Find resources for support and help
  • Investigate insurance options
  • Look at your current work situation (should I go back to work?)
  • Manage financial problems
  • Discover free and low-cost activities