Understanding PMADs: A Guide for New Parents
By Jen Kost, MSW, LCSW, PMH-C
Bringing a baby into the world is often described as one of life’s most joyful experiences. But for many new parents, the reality is far more complex. Amidst the snuggles and first smiles, there can also be waves of anxiety, deep sadness, or an overwhelming sense of self-doubt. If this sounds familiar, you are not alone.
Perinatal Mood and Anxiety Disorders (PMADs) affect up to 1 in 5 birthing people and can significantly impact their well-being and that of their families. While these challenges can feel isolating, understanding PMADs, recognizing the signs, and seeking support can make a world of difference.
What Are PMADs?
PMADs encompass a range of emotional and psychological challenges that can arise during pregnancy and up to a year postpartum. They are not just about feeling “down” or overwhelmed; they can deeply impact daily life and the ability to bond with a baby. Some common types include:
Postpartum Depression (PPD): Persistent sadness, loss of interest in activities, difficulty bonding with the baby, and feelings of worthlessness.
Perinatal Anxiety (PPA): Excessive worry, racing thoughts, physical symptoms like dizziness or nausea, and difficulty sleeping.
Postpartum Obsessive-Compulsive Disorder (PPOCD): Intrusive thoughts, compulsive behaviors, and intense fears about harm coming to the baby.
Postpartum Post-Traumatic Stress Disorder (PPTSD): Often linked to a traumatic birth or pregnancy, this includes flashbacks, nightmares, and hypervigilance.
Postpartum Psychosis: A rare but serious condition that involves delusions, hallucinations, and disorganized thinking. This is a medical emergency that requires immediate intervention.
Who Is at Risk?
While PMADs can affect anyone, some factors increase vulnerability. Recognizing these risks can help with early intervention and support:
Mental Health History: Personal or family history of depression, anxiety, bipolar disorder, or sensitivity to hormonal changes.
Pregnancy & Birth-Related Factors: Fertility struggles, high-risk pregnancy, traumatic birth, NICU stay, or pregnancy loss.
Stress & Lack of Support: Relationship struggles, single parenthood, financial hardship, isolation, or lack of emotional/social support.
Physical & Medical Factors: Sleep deprivation, thyroid issues, breastfeeding challenges, or postpartum complications.
Personality & Trauma History: Perfectionism, high self-expectations, past trauma, or childhood adversity.
Signs to Look For
It’s important for new parents and their loved ones to recognize when extra support may be needed. Signs of PMADs may include:
Persistent sadness, hopelessness, or emotional numbness
Frequent crying spells
Intense anxiety or panic attacks
Difficulty bonding with the baby
Changes in eating and sleeping patterns
Intrusive or distressing thoughts
Social withdrawal and isolation
Expressing thoughts of self-harm or harming the baby (which requires urgent medical attention)
What You Can Do
If you or someone you love is struggling with PMADs, know that help is available. Here are some steps to take:
Acknowledge your feelings. It’s okay to not feel okay. You are not alone, and PMADs are common and treatable. Be gentle with yourself.
Prioritize self-care. Focus on small but meaningful actions—nutrition, hydration, gentle movement, and rest. Even taking a shower can be a game-changer.
Reach out for support. Talk to a trusted friend, family member, or professional about what you’re experiencing.
Try grounding techniques. Simple strategies like deep breathing, progressive muscle relaxation, or stepping outside for fresh air can help with anxiety.
Seek professional help. A therapist specializing in perinatal mental health can provide valuable guidance. In some cases, medication may also be beneficial.
Know that help is available. You don’t have to go through this alone. Support groups and professional resources are here for you.
Where to Find Support
If you or someone you know is struggling with PMADs, these resources can help:
North Shore Mom’s Line: 866.364.MOMS (866.364.6667)
National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262) – Free, confidential support 24/7
Postpartum Support International: 1-800-944-4773 – Support, resources, and information
988 Suicide & Crisis Lifeline: Dial 988 for free, 24/7 access to a trained counselor
Text HOME to 741741 to text with a crisis counselor
Nearest Emergency Department or Dial 911 if you are having a mental health crisis
Final Thoughts
If you are struggling, please know that you are not alone, and help is available. PMADs are real, but they are also highly treatable. Seeking support is a sign of strength, not weakness. If you notice someone close to you struggling, offer them compassion and encourage them to reach out for help.
Together, we can create a culture where mental health is prioritized, and every new parent receives the support they need and deserve.
