Maternal Mental Health: PMADs - Kamm McKenzie OBGYN

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Maternal Mental Health: PMADs

Many parents have heard the term Postpartum Depression, but PERINATAL encompasses both the pregnancy and postpartum periods, extending to 1 year AFTER delivery. While mild mood changes can be common during the perinatal period, up to 1 IN 5 women (20%) experience more significant perinatal mood and anxiety disorders – also known as PMADs. PMADs can affect anyone and do not discriminate based on ethnicity, age or socioeconomic status. Here, we’ll discuss the implications of PMADs during pregnancy, symptoms to look out for, and what you can do to reduce your pregnancy-related risks and to feel better.

Mood changes during pregnancy are common for several reasons. Life is about to change a whole lot, and that can feel both exciting and scary at the same time! Many women will even experience a feeling of ambivalence about pregnancy during the first trimester, even when the pregnancy is a planned and desired one. Additionally, hormonal changes throughout pregnancy can predispose women to a variety of mood symptoms, perhaps most commonly described as feeling more “emotional” or sentimental. All of this is well within the range of normal during pregnancy. 

More disruptive feelings of anxiety or depression, however, are not “normal,” and should be identified and addressed. Women with a history of underlying depression or anxiety, or anxiety/depression during a prior pregnancy are at increased risk for PMADs during pregnancy. Other risk factors for PMADs during pregnancy include a family history of mental health disorders, financial stress, marital stress, thyroid disorder, women with a multiples pregnancy (ie- twins or triplets), women who have undergone infertility treatment to achieve pregnancy, and women with any form of diabetes.

Some symptoms that can indicate a more significant problem include:

  • feeling more irritable or angry with people around you
  • feeling panicky, or panic attacks
  • crying or feeling sad for no reason
  • difficulty with eating
  • trouble sleeping 
  • distressing thoughts that you can’t get rid of
  • feeling “out of control” 
  • thoughts of harming yourself or others

Without treatment, PMADs can have negative implications to pregnancy including low birth weight or growth restriction for the baby, and premature delivery. These issues increase the risk for NICU admission for the baby after delivery, which can further exacerbate PMADs for new parents. There are also some known maternal risks of untreated PMADs including increased risk for hospital admission during pregnancy, pre-eclampsia, and poor nutrition. An increased risk for suicidality is the most substantial and concerning risk for pregnant women with untreated PMADs.

The GOOD news is there is no reason for pregnant women to suffer with PMADs given the multitude of safe and effective treatment options available. This can include medication, counseling, or a combination of the two and often looks different for each woman. If you are worried about any of your mood symptoms during pregnancy, do not hesitate to seek help from your OBGYN care provider. Reducing risks and promoting positive pregnancy outcomes is our number one goal as your healthcare team at Kamm McKenzie OBGYN.

Stay tuned for a future blog post about POSTPARTUM anxiety and depression.

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