By Allyson Guilbert, LCSW

View original article published in Psych Central–

I’ve been a mental health therapist for over 10 years and in the social work profession for more than 20. I have been pregnant 8 times, with 4 living children. I consider myself to be pretty self-aware, intelligent, and inquisitive. And yet… I had some form of perinatal mood and anxiety disorders (PMADs) with each of my pregnancies. I just didn’t know it.

Oh, sure, I got sad and I got angry and with my older son, I couldn’t let myself fully bond to him until he was 9 months old, but I was fine, right? I even took medication, but that’s normal, right?

I was introduced to PMADs last year when a friend of a friend posted about it on social media. I was intrigued. This was a thing? As I learned more about it, I realized many things that I didn’t know before, both for me personally and professionally. Why had I never heard these things before? It was very eye opening and made so much of what I had experienced make more sense. So here are 10 things that I learned about PMADs.

1. It’s not just “the blues.” It is common for people to feel down or sad after birth. You just pushed a baby out after 9 months! This takes a toll on your body and mind. But sometimes it lingers and even gets worse. This is not as common.
2. It’s not just depression. Depression, anxiety, bipolar, OCD, and psychosis can all occur. That’s why the term PMADs, which stands for perinatal mood and anxiety disorders, is becoming the more accepted term for these collective disorders. I wasn’t sad, I was angry and ragey and irritable.
3. It’s not just postpartum. People can experience mood and anxiety problems anytime during the childbearing process. I experienced a lot of anxiety surrounding sleep while pregnant. I worried about not getting enough or waking throughout the night. This created a downward spiral. The more tired I was, the more anxious I felt about even getting in bed and closing my eyes at night.
4. It is more common than I thought. One in 5-7 women will experience some type of PMADs during and after pregnancy. It is the most common health problem experience with pregnancy.
5. It’s not just women. One in 10 men will also experience some type of PMADs. Watching a partner go through an often difficult experience, feeling left out, experiencing tremendous changes in routine and family life can take its toll on that partner.
6. Doctors and nurses don’t always take the time to explain what is going on. The birthing process may be an everyday occurrence to them, but to the laboring mom, she may not know what is going on. I took a birth class, watched videos, and read all the books I could get my hands on. And I still didn’t fully understand what was happening. I am encouraged that I am seeing more in the media about PMADs, which I hope will translate into more education in the offices and delivery rooms.
7. Birth trauma is a real thing. Not all births are the wonderful process that we see in the movies. I wish they could have explained more what was happening when they chose to use forceps on my first child. I wish I had known to ask more questions about the problems with the epidural. I knew about those things possibly happening but didn’t understand how it would affect me for weeks and months after they happened. Postpartum PTSD is most likely to occur when forceps are used during delivery. I wish I had known to look for that.
8. Even when psychotropic medication is offered, it may not be enough.There is a saying: Pills don’t substitute for skills. Often, pregnancy and childbirth magnify already underlying mental health concerns. Therapy is a great tool to help parents understand and manage what is happening to them and their partners. More and more therapists are gaining experience and education in helping this unique population. Medication was offered to me at my 6 week follow up, but therapy was never mentioned. It wasn’t for many years that I finally reached out to a therapist, which was very helpful.
9. Parents don’t have to suffer alone. Cultures where birth and motherhood are supported by others in the community have lower rates of PMADs. There are not enough services available to parents with PMADs, but we are trying.
10. Not everyone will understand. Many women are told that it is “just” hormones, or in their heads, or something that will go away eventually. But sometimes it isn’t. It is real. Sometimes it doesn’t go away on its own. Often they need someone to listen to them. And always they need to know that there is help available. The success of the parents and the baby depend on.

If you or someone you love is experiencing some form of PMADs, please reach out. Talk to a doctor or a therapist in your area. One resource is Postpartum Support International, who sponsors a warm line to connect you with someone who can help. Please don’t suffer in silence.