What Is Perinatal Mood and Anxiety Disorder (PMAD)? 

Perinatal Mood and Anxiety Disorder (PMAD) is an umbrella term healthcare providers use to describe mood shifts that can impact women during pregnancy and after childbirth. It’s also known as “post-partum depression.” 

A significant screening study involving 10,000 women revealed that, at 4-6 weeks postpartum, 1 in 7 women experience symptoms of anxiety or depression. Over the first year postpartum, 1 in 5 women are affected.  

While some women do experience temporary sadness, known as the "baby blues," persistent feelings of sadness that last longer than 10 days, or the presence of previous depressive or anxiety issues, are more likely signs of PMAD. 

Symptoms Include: 

• Depressed mood, anger, and irritability 
• Sleep and appetite changes 
• Lack of interest in the baby 
• Feelings of guilt, hopelessness 
• Frequent crying 
• Anxiety or excessive worry 
• Intrusive thoughts about the baby’s safety 

• If you experience suicidal ideation, seek help immediately. 

   

Therapy for PMAD 

Therapy is a crucial part of overcoming post-partum depression. Your therapist can help you to change patterns of thought that are feeding your depression. He or she can help you to process your feelings during this transitional time. If necessary, your therapist can refer you to a psychiatrist at Pesach Tikvah for medication. Your therapist and psychiatrist will work as a team.  

Cognitive Behavioral Therapy is very effective for treating post-partum depression. It focuses on recognizing unhealthy thoughts and refocusing on positive thoughts. Psychodynamic therapy is also effective for treating post-partum depression. Pesach Tikvah offers other effective modes of therapy as well, like ACT, IFS, and attachment-based therapy. You and your therapist will create a treatment plan that works for your particular situation. 

Medication for PMAD 

Anti-depressants can be a very effective part of your treatment plan when they are used in conjunction with therapy and self-care.  

Modern anti-depressants are effective and have minimal side effects. It can take time (meaning weeks) to build up to a therapeutic dose, so patience is key to starting an anti-depressant. If you are having problems with your anti-depressant, communicate with your psychiatrist. Often a small change in dose is all that is needed.  

Many anti-depressants are safe to use while breastfeeding. Your psychiatrist or OB/GYN will be able to advise you. Do not avoid using anti-depressants because you have heard that they are unsafe while breastfeeding. Your psychiatrist can prescribe you one that is safe while breastfeeding.  

Self-Care During Post-Partum Depression 

Self-care when you have post-partum depression is key to overcoming it and keeping it at bay. It makes therapy and medication work better and is absolutely essential for recovery. While it can be difficult to find time to care for yourself when you have a new baby, the following tips have been implemented by many busy mothers. You got this! 

Sleep is medicine. 

Round the clock breastfeeding causes sleep deprivation, but it’s unavoidable.  

• Sleep as much as possible while the baby is sleeping.  
• Consider pumping so that your spouse can do one or more of the night-time feedings.  
• Prioritize sleep over other activities. 

Exercise gently. 

• Exercise helps to relieve depression and anxiety but do it gently because your body is recovering from birth. 
• An easy way to get outside and exercise on a daily basis is to take the baby for a walk in the stroller or baby carrier. 
• Short mat-based workouts that you can do at home give your mood a boost. 

Eat for health. 

• Eating sufficient protein, whole grains, vegetables, and fruits is good for your mood. It can be hard to prepare meals while you have post-partum depression. Eating easy-to-prepare foods like whole fruits and vegetables (no need to slice) and whole grain sandwiches will do the job. 
• Many people with post-partum depression notice that eating a lot of sugar and junk food negatively affects their mood. 

Interact with other people. 

• Isolation contributes to post-partum depression. A post-partum support group is a good way to get some much-needed support and social engagement.  

Take it easy. 

• You don’t need to be “the hostess with the mostest” while you have a new baby. Try to delegate or outsource responsibilities as much as possible.