Understanding Perinatal Mood and Anxiety Disorder (PMAD), With Pregnancy Support For Infant Risk

Perinatal Mood and Anxiety Disorder

Having a baby is an extremely large step in both a woman’s and a man’s life. As such, there are a number of factors to consider when planning and having a child. Furthermore, having a baby can pose many additional challenges to your daily life that exclude the obvious changes that will take place. Perinatal/ Postpartum Mood and Anxiety Disorder (PMAD) could potentially be one of these challenges. Through this article, CareClinic seeks to enlighten you on what symptoms PMAD can cause, the factors and predictors of the effect of PMAD and what potential treatment options are available. Finally, this article will also include instructions on how to use the CareClinic app to minimize the effects of Perinatal Mood and Anxiety Disorder through its easy-to-health management modules!

Firstly, let’s take a deep dive into what Perinatal/ Postpartum Mood and Anxiety Disorder is.

What is Perinatal Mood and Anxiety Disorder (PMAD)?

Perinatal Mood and Anxiety Disorder is related to mood and anxiety symptoms that occur during pregnancy or up to one year postpartum (post-birth). While many women experience some mild mood changes during or after the birth of a child, 15 to 20% of women experience more significant symptoms of depression or anxiety. PMAD and its effect do not discriminate. Women of every culture, age, income level and race can develop perinatal mood and anxiety disorder. With this in mind, it is clear that the symptoms that can be developed are far-reaching and can have a great impact in a multitude of ways.

The section of the article defines the most common forms of PMAD by grouping the symptoms and disorders into two classes: Disorders that relate to Pregnancy and Disorders that relate to Postpartum time periods. After each PMAD, its symptoms and treatment options are identified, the article will highlight the different functions of the CareClinic app that you can use to ensure that managing your symptoms is made easy. Furthermore, depending on the type of treatment needed, CareClinic’s module can even help facilitate treatment.

Disorders Related to Pregnancy Anxiety

The following list of disorders, conditions and symptoms are most commonly related to the perinatal time period.

Pregnancy Support for Perinatal Depression

PMAD Symptoms

Pregnancy Support

Perinatal Depression is considered one of the most common problems women face during pregnancy. Similar to Depression, Perinatal Depression can be described as feeling sad, empty, and/or overall “down”. This stated the advent of these symptoms begins with becoming pregnant. Regarded as a medical condition, many of the symptoms that Perinatal Depression can cause simply go away naturally for many women. However, this is not the case for some who suffer. If left untreated, particularly during the 1-year postpartum time period, this form of depression can indirectly affect your baby’s development. Mother-child bonding is important for a baby’s development. Becoming close to your baby, both physically and emotionally, plays a large role in this bonding. Depression during pregnancy or after birth can make it difficult to achieve this.

  • Extremely sad or angry without warning
  • Foggy or have trouble completing tasks
  • “Robotic” or going through the motions lifelessly
  • Guilty and like they are failing at motherhood
  • Little interest in things they used to enjoy
  • Scary, upsetting thoughts that don’t go away
  • Restless sleep
PMAD Treatments

The nature of Perinatal and Postpartum Depression makes treatment non-linear in nature. In other words, there is no best treatment method that will cure what you are experiencing. This stated, in consultation with your medical provider, the following are options that could be considered:

  • Counselling
  • Creating a support framework (particularly with other mothers)
  • Medication (Antidepressants)
How Can CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Diary Entry
  • Medication Tracker
  • Symptoms Tracker
  • Therapy Tracker
  • Daily “Factors” Tracker
  • Sleep Tracker
  • Creation of Care Teams

Perinatal Obsessive-Compulsive Disorder (OCD)

Perinatal OCD is one of the most misdiagnosed and misunderstood Perinatal Mood and Anxiety Disorder. With approximately 11% of mothers experiencing repetitive, unwanted thoughts, obsessions and compulsions, the effects that Perinatal OCD can have cannot be understated. Unsurprisingly, mothers can find these symptoms and those highlighted below extremely scary, with compulsions bringing on a sense of horror and/or anxiety if not acted upon.  This stated, close to all compulsions can simply be ignored and will fade over time.

OCD Symptoms

Medication Management

  • Thoughts or images that keep coming to your mind. These are called obsessions.
  • Anxiety – usually caused by obsessional thoughts.
  • Thoughts or actions that are repeated to try to reduce your anxiety. These are called compulsions.
  • Restless Sleep
OCD Treatments

The following are the most effective treatments of Perinatal Obsessive-Compulsive Disorder. They can also be used in conjunction with each other. Be sure to consult with your healthcare provider to ensure you take to implement the best routes of treatment.

  • Cognitive Behavioral Therapy (CBT)
  • Medication (Antidepressants)
How Can CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Medication Tracker
  • Symptoms Tracker
  • Therapy Tracker
  • Sleep Tracker
  • Creation of Care Teams

Perinatal Postpartum Panic Disorder and Anxiety

Perinatal/ Postpartum Panic Disorder and Anxiety is essentially akin to normal anxiety. This form of anxiety occurs in up to 10% – 11% of new mothers and causes a multitude of symptoms (listed below). Perinatal/ Postpartum Panic Disorder and Anxiety can be debilitating, but with the proper attention and care, treatment and self-care techniques can be implemented effectively.

Perinatal Postpartum Panic Disorder and Anxiety Symptoms

Pregnancy Anxiety

  • Constant worry and nervousness
  • Racing thoughts
  • Inability to sit still
  • Disturbances of sleep or appetite
  • A feeling that something bad is going to happen
  • A feeling of losing control
  • Physical symptoms like dizziness, hot flashes, numbness, tingling and nausea
  • Restless Sleep
Perinatal Postpartum Panic Disorder and Anxiety Treatments
  • Counselling
  • Medication (SSRIs)
  • Creating a support framework (particularly with other mothers)
How Can CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Diary Entry
  • Medication Tracker
  • Symptoms Tracker
  • Therapy Tracker
  • Daily “Factors” Tracker
  • Sleep Tracker
  • Creation of Care Teams

Disorders Related to Postpartum

The following list of disorders, conditions and symptoms are most commonly related to the postpartum time period. While the disorder is similar in nature to its perinatal counterparts, key distinctions regarding time period, risk factors and available treatments can be identified.

Postpartum Depression

Changes in mental state and mood after birth is very common. Furthermore, 50% – 85% of women experience Postpartum Blues or “Baby Blues”. This often lasts for 1 – 3 weeks postpartum, after which symptoms like mood instability, depressed mood, weepiness, sadness, irritability, anxiety, lack of concentration and feelings of dependency usually resolve themselves.

It is important to distinguish the “Baby Blues” from Postpartum Depression, the latter of which has increased severity and duration of symptoms. Occurring in up to 10% of births, Postpartum Depression typically emerges over the first 2-3 months after childbirth and typically lasts over 2 weeks. As noted within the Perinatal Depression section of the article, if left untreated this form of depression can indirectly affect your baby’s development. Mother-child bonding is important for a baby’s development. Becoming close to your baby, both physically and emotionally, plays a large role in this bonding. Depression during pregnancy or after birth can make it difficult to achieve this.

Postpartum Depression Symptoms

Restless Sleep

  • Feeling sad, depressed, and/or crying a lot
  • Intense anxiety; rumination, obsessions (See Postpartum Anxiety Disorders below)
  • Loss of interest in usual activities
  • Feelings of guilt, worthlessness or incompetence
  • Fatigue, irritability, sleep disturbance
  • Change in appetite
  • Poor concentration
  • Feeling inadequate to cope with a new infant
  • Excessive worry about baby’s health
  • Restless Sleep
  • Suicidal thoughts
Postpartum Depression Treatments
  • Counselling
  • Creating a support framework (particularly with other mothers)
  • Medication (Antidepressants)
How Can CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Diary Entry
  • Medication Tracker
  • Symptoms Tracker
  • Therapy Tracker
  • Daily “Factors” Tracker
  • Sleep Tracker
  • Creation of Care Teams

Postpartum Post-Traumatic Stress Disorder (PPTSD)

Occurring in approximately 1% – 6% of women after childbirth, Postpartum Post-Traumatic Stress Disorder (PPTSD) is often caused by a traumatic birthing and is not unlike normal PTSD. The symptoms listed below may include flashbacks of the event in question with feelings of anxiety. This can then lead to the compulsion of avoiding things related to that event. These events can include a prolapsed umbilical cord, an unplanned C-section, the use of a vacuum extractor or forceps for delivery, the baby requiring further care in the NICU, and lack of support and reassurance during the delivery.  Postpartum Post-Traumatic Stress Disorder can even be caused by those who have experienced previous trauma, such as rape or sexual abuse.

Postpartum Post-Traumatic Stress Disorder Symptoms

Psychiatric Evaluations

  • Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
  • Flashbacks or nightmares
  • Avoidance of stimuli associated with the event, including thoughts, feelings, people, places and details of the event
  • Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
  • Anxiety and panic attacks
  • Feeling a sense of unreality and detachment
Postpartum Post-Traumatic Stress Disorder Treatments
  • Counselling
  • Creating a support framework
How Can the CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Diary Entry
  • Symptoms Tracker
  • Therapy Tracker
  • Daily “Factors” Tracker
  • Creation of Care Teams

Postpartum Psychosis

Postpartum Psychosis is a rare illness when compared to the rates of other issues and disorders listed within this article. It occurs in approximately 0.1 – 0.2% of births. Onset is usually sudden and most often occurs within the first 2 weeks postpartum. Individuals experiencing psychosis sometimes see and hear voices or images that others can’t, called hallucinations. False beliefs and distrust of those around them are also common. In addition, they may have thoughts of self-harm and even thoughts of harming the baby.

This is a severe condition. Research suggests that there is approximately a 5% suicide rate and a 4% infanticide rate associated with Postpartum Psychosis. While this may seem to blindside, what must be understood is that this condition leads to mental lapses from reality. This causes any actions and beliefs to be validated through the delusion they are having. While not all people that undergo Postpartum Psychosis have violent tendencies. It is important to be quickly assessed, treated, and carefully monitored by perinatal mental health professionals.

Symptoms

Individual Therapy

  • Delusions or strange beliefs
  • Hallucinations (seeing or hearing things that aren’t there)
  • Profound agitation
  • Hyperactivity
  • Decreased need for or inability to sleep
  • Paranoia and suspiciousness
  • Rapid mood swings
  • Difficulty communicating at times
  • Confusion and Memory loss
  • Manic Symptoms
Individual Therapy

The treatment of Postpartum Psychosis is not one size fits all and it is important to follow your perinatal mental health professional’s direction when treating this issue. Below is a list of potential treatments that they may consider:

  • Medication (Antipsychotics)
  • Medication (Mood Stabilizers)
  • Electroconvulsive Shock Therapy
How Can CareClinic Help?

CareClinic has multiple modules that aid in enabling you to manage any health care intervention. Below you will find a list of features that you could find beneficial for the treatment of the PMAD identified above. Furthermore, at the bottom of the article, there will be a list of instructions to aid you in using CareClinic’s modules.

  • Medication Tracker
  • Therapy Tracker
  • Creation of Care Teams

Pregnancy Anxiety Support

Studies have shown that up to 10 percent of fathers experience paternal depression or anxiety as well. PMAD in women has been linked to traumatic birth experiences, hormonal changes, thyroid problems, vitamin D deficiencies, previous history of mental illness and many other factors.

Then how can men be affected? While men may not experience the full gambit of biological and hormonal changes impacting women, they are experiencing a change in their role within their

PMAD

relationships and an overall major life change. The pressure to be a good father, the desire to succeed at being a strong paternal figure and the dramatic life change are all factors that can bring on paternal depression. In other words, PMAD can affect men as well.

In addition, fathers are also experiencing the lack of sleep, the frustration of trying to soothe a baby and the fear of making a mistake. Other factors of the male experience can also contribute to the effects of Paternal PMAD. This can include the change of family dynamics, feelings of exclusion from the parenting role, additional financial stressors and family responsibilities, unmet expectations for resumption of sexual intimacy and reduced likelihood of a man talking about feelings due to socialized ideas about masculinity.

Finally, if the man’s partner is experiencing any symptoms from a PMAD, he has an increased risk of developing one too. Much is still to be learned about paternal depression stemming from PMAD. This stated, not unlike regular depression, it is important to get help and/or treatment. Studies have shown untreated paternal depression can cause marital stress that leads to increased conflict in the home resulting in decreased bonding with the newly born child.

Predictors & Risk Factors for PMAD

Depression​ and anxiety during pregnancy or postpartum can happen to new mothers. This stated several factors give some women increased potential to develop a PMAD than others. These risk factors include:

  • Personal history of depression or anxiety
  • Family history of depression or anxiety
  • A difficult pregnancy or birthing experience
  • Giving birth to twins or more
  • Problems in your relationship with your partner
  • Financial stressors
  • Receiving little or no support to help you care for your baby
  • Unplanned pregnancy

Depression and anxiety during pregnancy or after birth don’t happen because of something you do or don’t do—they are medical conditions. Although we don’t fully understand the causes of these conditions, researchers think depression and anxiety during this time may result from a mix of physical, emotional, and environmental factors.

Managing Perinatal Mood and Pregnancy Anxiety Disorder Symptoms with CareClinic

Hopefully, after reading this article you have a deeper understanding of Perinatal Mood and Anxiety Disorder (PMAD) and the effects it can have on new mothers, fathers and their newly born children. Symptoms of PMAD vary widely from person to person, making it important to monitor your and your loved ones’ pregnancy symptoms. To ensure that you can manage and mitigate the effects of PMAD, CareClinic offers multiple modules and features to use in conjunction with your medical provider’s consultation. Below you can find tutorials, links to other CareClinic articles and examples that may be beneficial:

Diary Entry Links

Medication Tracker Links: Importance of Medication RemindersMedication Alerts and Medication Adherence

Symptoms, Diary and Factors Tracker Links: Fibromyalgia Trigger Points For Diary, Mood & Symptoms Trackers

Therapy Tracker Links: Mental Health Journal for Anger Management Therapy

Sleep Tracker Links: Sleep Apnea Stress: How Does Stress Affect Sleep?

Creation of Care Teams Links: CareTeams

Download CareClinic Pill & Symptom Tracker App
Shan Parhar