Understanding and Defining PMADs Plus What to Know About Them

While some mothers are at a higher risk of developing perinatal mood and anxiety disorders (PMADs), many are caught off guard when one happens postpartum.

A few well-known risk factors can indicate whether or not a new mother might experience postpartum depression, anxiety, or other PMADs, but imagine what it would feel like to be caught off-guard, as many new mothers are.

Keep reading to learn more, including the definition of PMAD and how you can best prepare for one after birth.

mom experiencing postpartum anxiety

What is the definition of PMAD?

When talking about postpartum mothers, PMADs stands for Perinatal Mood and Anxiety Disorders and cover a range of diagnosable mental disorders up to one year after birth.

The below disorders are PMADs:

  • Anxiety
  • Depression
  • OCD
  • Rage
  • Psychosis

While every mother might not experience a PMAD, there are some specific risk factors for developing a perinatal mood and anxiety disorder to be aware of and educated about, especially if you have a history of mental disorders.

What PMADs can feel like in postpartum

Imagine that the postpartum period is a party. A party you’ve been looking forward to for as long as you can remember. You’ve prepared the best you can, picked the perfect outfit, and the day has come.

You arrive at the party, and things are going smoothly at first. Several people welcome you at the door and check on you frequently when you arrive. As the party continues, you look around and wonder where your friends went.

(Like the postpartum period) Everyone continues to go through the motions and smile through the discomfort.

You start to worry that you picked the wrong outfit and that people judge your every move. Unexpected guests begin to show up, and you’re looking around at other party-goers (new moms), wondering if you’re the only one feeling like something isn’t right.

You exchange anxious glances with other people, but everyone continues to go through the motions and smile through the discomfort. Something doesn’t feel right, but you continue to fake it because this is the party of the year, and no one else is admitting that this isn’t what they expected. 

mom looking disconnected from new baby

When postpartum isn’t like you planned

You’re a new mama navigating the postpartum period. A joy-filled chapter that you’ve been yearning for as long as you can remember. 

You have picked the perfect registry items and the ideal going-home outfit. You’ve researched everything, down to the wheels on the stroller and the best way to clean a bottle.

The day has come to take your bundle of joy home. You get home, and things are going smoothly. You have family and friends checking in on you frequently in those early days, and this “party” is exactly what you dreamed about happening.

Then your support starts to dwindle, and you’re feeling isolated. You’re feeling judged and worried about your decisions for yourself and your baby.

You’re sleep-deprived. Your hormones are going through monumental shifts. You’re getting to know this new being while navigating the relationship with your new physical and emotional identity.

You start to feel like you don’t know anyone at this party anymore. 

The unexpected guests are various manifestations of Perinatal Mood and Anxiety Disorders. As they begin showing up, they start making you feel uneasy.

You feel like you can’t entirely be yourself. You go through the motions and smile through the discomfort, but this “party” isn’t what you expected. 

Who invited rage and irritability, anyway? 

Anxiety was not on the guest list. 

Depression strolled in late. 

mom in green sweater with postpartum depression

One mom’s story with PMADs

Postpartum isn’t quite what you were expecting? You’re not alone!

By inviting the discussion of the ambivalence of motherhood, we can normalize the conversation that we could all use more support in a season that can feel so damn isolating. We can fight the supermom stigma that has set the bar unattainably high.

We can educate mamas and support systems to recognize various manifestations of postpartum struggles– from birth trauma to postpartum mental illness– and everything in between so that families can better navigate the fog and find the resources and support that exist to help you thrive in this season.

Motherhood is hard. And joyful. And wonderful. And hard

It (postpartum anxiety) took hold when I least expected it, and it stole a precious year away from me.

After an unexpected battle with debilitating postpartum anxiety, I realized that postpartum mental illness isn’t black and white.

It didn’t fit in the box I had put it in, so it took hold when I least expected it, and it stole a precious year away from me. I had the support system any mother would dream of, I worked in healthcare with new mothers, and I had dealt with anxiety for many years, so I thought I was untouchable regarding postpartum mental illness.

I discovered that I was naive and uneducated in the various ways PMADs can manifest. I was hesitant to admit that I struggled, even with everything I had ever dreamed about having. 

mom holding phone with postpartum rage

Five things I wish I knew about PMADs

1. Support makes you stronger

Recognizing the need and seeking support doesn’t make you weak; it’s a sign of great strength and insight.

2. PMADs affect everyone differently

Postpartum Mood and Anxiety disorders aren’t black and white. They can manifest in various ways unique to each person experiencing them. Just because you don’t check all the standard boxes for a traditional diagnosis doesn’t mean you aren’t experiencing PMADs.

3. Your support system needs to know

If your support system doesn’t know how to approach this sensitive subject when they recognize it, it’s time to plan. Planning proactively can help build a foundation for challenging conversations and have a plan in place when needed.

4. Baby blues are common

The “baby blues” happen to nearly all new moms. As you adjust to this new normal, you can expect about two weeks of transient ups and downs in your mood, tearfulness, exhaustion, and hormone shifts.

If symptoms are worsening or they aren’t lifting after about two weeks, it’s time to talk to someone about how you’re feeling. 

5. If something feels off, it probably is

The bottom line is that if something feels off, it probably is. Check in with your appetite and sleep (when you’re able to sleep). Advocate for yourself when something doesn’t correct.

Invest in your health and well-being right alongside your baby’s.

Read next: Five Steps to Advocate for Yourself After Birth

mom cuddling new baby on shoulder

Final thoughts on PMADs

Ultimately, know some experts and resources exist to serve you in this season. You don’t have to navigate PMADs on your own. And trust us, you are not alone.

It’s estimated that 75% of women with a Perinatal Mood and Anxiety Disorder never receive proper treatment.

Use my story as a case study, and don’t miss out on precious, fleeting moments. With support and resources, you can be and will be well. A healthy and happy parent is the best gift you can give your baby.

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Lauren Hays

Psychiatric Mental Health Nurse Practitioner

Mama of three precious little men and psychiatric mental health nurse practitioner who turned her pain into purpose by using personal and professional recognition of the void in mental health care for mamas into a career shift + the "why" behind The Matrescence. Each offering from The Matrescence comes from a desire to weed through the overwhelming opinions of today's digital world and curate an intimate and personalized experience for each mama who comes to this space with a promise that all guides + support will come directly from experts who exist to serve you.

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