Talking about perinatal mood and anxiety disorders

Having a baby can be one of the most magical times in a couple’s life, but it can also lead to some of the toughest times. While not always discussed, and often untreated, perinatal mood and anxiety disorders (PMAD) are very real and challenges close to one in five new parents.

Perinatal mood and anxiety disorders include depression, anxiety, mood shifts and — in serious cases — thoughts of self-harm or harm to your baby, including suicide or infanticide during pregnancy or after childbirth.

About 15% to 20% of all mothers experience some degree of perinatal mood and anxiety disorder. While PMAD can affect any new mom, you are at higher risk if you’ve had PMAD in the past or if you have a history of mental illness or depression.

Contrary to many people’s belief, an equal number of fathers may also develop PMAD. What’s more, you may be surprised to learn that it’s not uncommon for PMAD to begin during your pregnancy.

“Most women don’t realize that postpartum depression can start even before their child is born,” says Veronica James, a clinical social worker at Sharp Mary Birch Hospital for Women & Newborns and facilitator of the hospital’s Postpartum Support Group. “Women may wonder why they aren’t excited about a pregnancy that was very much planned and wanted, or why they are constantly feeling anxious when nothing appears to be wrong.”

Symptoms of PMAD during your pregnancy might include a lack of motivation, feelings of hopelessness, constant worry, frequent crying and obsessive thinking. Sadly, these contrast greatly with the feelings of giddy anticipation, joy and boundless love you may have expected to feel.

These symptoms may continue after you give birth, with the addition of negative thoughts toward your baby, and other symptoms that may be more subtle:

• Anger or snappiness that you and your loved ones may chalk up to fatigue

• Angst over breastfeeding

• Overly intense behaviors, such as not being able to separate from your new baby

• Fleeting thoughts of abandonment or thoughts of worthlessness

Moms experiencing PMAD often project their own feelings of inadequacy onto their baby. You may even believe your baby feels negatively about you.

“I’ve had moms tell me they think their baby hates them, or if they’re having trouble breastfeeding, it must be because their baby doesn’t like their milk,” says James. ”The one distinction between normal worry and clinical anxiety is whether or not the symptoms are impacting your daily life, ability to function and relationships,” says James.

If you are experiencing PMAD, many treatment options are available. As with regular depression and anxiety, the best form of treatment is usually a combination of medication and counseling. Talk with your health care provider about available treatment options.

If you suspect a loved one might be suffering from PMAD, you can play an important role by offering support and concern. James says using phrases such as, “I love you and I’m worried about you,” or “I want you to feel better, I think we should call your doctor,” are the best way to approach a loved one about getting help.

Support groups can also be helpful if you are experiencing PMAD. “The biggest takeaway for the participants in our postpartum support group is that they are not alone,” says James.