What is a Perinatal Mood & Anxiety Disorder?
and why it wasn’t in my therapist vocabulary when I was pregnant in 2014
I am about to embark in a counseling private practice specializing in something I couldn’t even name less than a decade ago.
When I became pregnant with my first child in 2014, I was working as a music therapist in an inpatient mental health facility in northern Virginia. I had started my music therapy career in another inpatient hospital in Germany back in 2010, and I had seen some things in my tenure (to say the least). And yet when I started to feel symptoms of anxiety and depression during my pregnancy, I was in uncharted waters.
Googling got me nowhere. I thought that it must be rare to feel this way while pregnant. I found plenty of information on “postpartum depression.” But no, that wasn’t me. I had not had my baby yet, and while my mood was affected, I also was experiencing anxiety. Postpartum depression seemed like another world.
Being the mental health professional I was, I knew I needed some kind of support. Working for a mental health facility you would think we’d have excellent benefits for our own therapy, but we were provided with an insurance hardly anyone took. I found a list with a handful of therapists and just went with one of the women.
Instead of hearing “this is normal, many women experience anxiety and mood issues before birth,” this therapist did not normalize my experience. She was not a mother herself, and couldn’t pull from her own experiences, or the research and literature around her. To be fair, there wasn’t research and literature about what I was experiencing. This is because what we now know as “perinatal mood and anxiety disorders” or “PMADs” was not even a term in common use until after my first pregnancy.
What’s this? How could a mental health concern specifically affecting women be left unstudied and ignored by the medical and academic community, you ask? I will not use this blog post today to break that down. But I would like to bring you back into 2023 and the way we talk about perinatal mental health now.
Breaking Down “PMAD”
Perinatal is a term that includes the period before, surrounding, and up to one year after birth. My definition includes circumstances relating to these periods as well: trying to conceive, experiencing infertility, pregnancy loss, and transitioning out of the first year of parenthood into toddlerhood (few of us aren’t still reeling from that first year!).
Mood and anxiety disorders may seem self-defining, but under this umbrella there are a variety of mental health conditions which can be triggered or exacerbated in the perinatal period. While these include depression and anxiety, perinatal obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder, and psychosis may also arise in the perinatal period. To learn more about these different subcategories, please visit Postpartum Support International.
Working with any therapist who knows about depression and anxiety (or OCD, PTSD, or bipolar disorder**) may bring you some needed help during the perinatal period. However, working with a therapist who specializes in PMADs may be able to help you with a deeper understanding of how these mental health conditions show up specifically in the perinatal period.
Learn More
Unlike 2014-me, you will be able to find more information on PMADs wherever you look on the internet! However, Postpartum Support International is an excellent first place to start. Although “postpartum” is in their name for recognition and visibility, they have wonderful resources (and virtual support groups!) for a variety of niches in perinatal mental health.
If you are in North Carolina and looking for a therapist specializing in PMADs, please reach out to see if I can help you in your perinatal journey.
**I am not including postpartum psychosis in this list, because this condition indicates needing a higher level of care, at least to begin with and stabilize. Please see my FAQ page for a question about higher levels of care in the Triangle Area.
