Perinatal Mood and Anxiety Disorders


The mood disorders of depression and anxiety that occur during pregnancy and childbirth are called Perinatal Mood and Anxiety Disorders (PMAD's)


Perinatal Mood and Anxiety Disorders (PMAD's)

Other psychiatric disorders that may also present during pregnancy and childbirth period are:


PMAD's Defined

Baby Blues

• 50-85%* of women will experience symptoms of the baby blues (not a mental health issue)

• symptoms present within the first few days post childbirth; may last few hours/up to 2 weeks

• symptoms include:

crying,  confusion,  mood lability (mood swings),  anxiety and depressed mood

• generally, treatment is not necessary


Postpartum Anxiety and Depression (PPAD)

• 21.9%* of women will experience a clinical depression following the birth of a child

• 17%* will experience postpartum anxiety

• symptoms typically present after 2 weeks postpartum and within the first month. Symptoms of PPAD can present up to 3 years post childbirth.

• a woman experiencing PPAD may have any combination of these symptoms:

profound sadness

crying a lot

overwhelming anxiety (including OCD symptoms)

intrusive thoughts (thoughts of harm coming to the baby)

intense mood swings

irritability

isolation

difficulty concentrating

impaired judgement

sleep deprivation

appetite changes

a sense of inadequacy

difficulty bonding with baby

feelings of guilt and shame

not feeling “like myself",

PTSD symptoms

thoughts of harming the baby and suicidal thoughts

• professional treatment is needed and may include a combination of medication and psychotherapy


Postpartum Psychosis (PPP)

• a rare and serious illness that occurs in approximately 1 to 2 of every 1,000 US deliveries

• onset of symptoms is usually sudden, most often within the first 2 weeks postpartum

• symptoms can include any of the following:

rapid emotional dysregulation (mood swings)

depression

suicidal thoughts, including plan and intention

severe confusion

high mood (mania); loss touch with reality

excessively irritable

hyperactivity

decreased need for or inability to sleep

impaired judgment

difficulty communicating 

paranoia and suspiciousness

delusions or strange beliefs

hallucinations (seeing or hearing things that aren't there)

• other significant risk factors can include:

     1. personal or family history of Bipolar I or II Disorder or a previous psychotic episode

     2. history of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)

PPP is a psychiatric emergency. A woman experiencing any of the symptoms of PPP requires immediate medical attention. Call 911 or report to your local hospital's emergency room.

*Statistics cited from https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=2084


Risk Factors of PMAD's

 

The causes of mood disorders of childbirth are complex.

The natural hormonal shifts that occur during pregnancy and the postpartum period cause biological changes in the brain and can trigger changes in mood, thoughts, and behaviors.

 

If you identify with one or more of the following, you may be at risk for developing a PMAD:

• traumatic birth experience

• marital/relationship problems

• depression and/or anxiety during pregnancy

• lack of/poor social support (no village)

• stress or negative life events occurring during pregnancy or postpartum (moving, new job, new environment)

• history of loss or unresolved grief

• history of PMS (premenstrual syndrome) OR history of PMDD (premenstrual dysphoric syndrome). For more information on PMDD, the symptoms and the timing of the symptoms during the menstrual cycle, please click here.  PMDD can often be misdiagnosed as Bipolar Disorder.

• previous PMAD with other pregnancies

• family or personal history of depression, anxiety, or other mental health disorder

• family of origin conflict or trauma

• thyroid issues

It is important to note, however, that any woman can develop a PMAD.


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