Perinatal Mood and Anxiety Disorders

I am a mother, a birth doula, and a woman who has suffered through a severe perinatal mood and anxiety disorder, known as PMAD’s. I am also not alone. Recent studies tell us that 1 in 7 mothers, and 10% of partners will experience postpartum depression that requires treatment. However, up to 80% of birthing mother’s will experience feelings of isolation, anxiety, depression, guilt, remorse; all of which will go untreated, either by holistic measures, therapy, or medication. It’s important to also acknowledge that these statistics from the National Institute of Health (NIH) only account for live births. This leaves out mother’s and partners who have experienced PMAD’s from miscarriage, abortion, surrogacy and adoption; all experiences that are extremely valid, and relevant.

But, statistics aside, we aren’t just numbers. We are people that have gone to great lengths to birth a new generation, and we deserve the utmost care surrounding our mental health in postpartum. Most of us will have what is known as the “the baby blues.” And statistically most mother’s will start to feel better within the first 6 weeks as they adjust to breastfeeding/bottle feeding, sleepless nights, and the never ending cycle of constant change that a newborn brings.


This is not to say that everything feels “normal,” but that the clouds begin to part, there is less crying throughout the day, and you start to feel a sense of “I can do this.” But, for some of us, as the first couple of weeks go by, the skies begin to get gloomier, not lighter. And by 4-6 weeks, there is a low hanging feeling of doom, fear, and a constant state of worry that just won’t seem to leave. For a small majority these feelings can manifest into OCD, intrusive thoughts, suicidal ideation, and the most severe, postpartum psychosis.

At your six week postnatal appointment most OBGYN’s should be providing patients with something called the Edinburgh Postnatal Depression Scale, or the EPDS. While this assessment can help to detect how someone is feeling, it’s only as reliable as the person allows it to be. A new mother must feel safe enough, and comfortable enough with her provider to really tell the truth. And what if the provider was part of a traumatic birth? How can someone truly be assessed by a provider if they do not feel safe to open up. By and large, this is a critical, and crucial topic in our healthcare system. Taking a lens to statistics we can also see that WOC/POC, those below the poverty line, teens, and those with limited support, all have an increased chance of not only experiencing PMAD’s, but for it to go overlooked, due to racial disparities in our healthcare system.

So, what can we, as birthing people, and as the friends, and family of birthing people do to support our communities? The first thing you can do is educate yourself. Know what to look for. Postpartum Support International is a great place to start. Use your instincts. Is your friend, or partner having a hard time getting out of bed? Do they have a hard time making eye contact either with you, or the baby? Do they “seem” depressed? More than usual? Using your intuition, and valuable resources, you can make a difference in someone’s life. Or even your own. PSI offers a 24 hour hotline for those in a postpartum crisis. Google for specialists in your area that work in maternal mental health. Send an email asking for an assessment. Reach out to your doula, or trusted friend, or someone you know who works in mental health that could guide you in the right direction. Social media is full of valuable, and informative platforms dedicated to discussing PMAD’s. Don’t be afraid of what you don’t know.


Remember, education is power.

But, what I truly want to express, which is hard to do through words on a screen, is this. Yes, the nights are dark, and the days are long, but there is hope. There is help. There is no shame in needing medication. There is no shame in not being able to breastfeed due to depression. There should be no stigma in speaking up, in asking for help, or for seeking help for your family member or friend. We aren’t meant to do this work alone. This business of birthing takes guts, it’s hard, and for some of us it takes a grip on our mental health, and doesn’t want to let go. But, I can attest, from both a personal, and professional perspective, the clouds will part, and the sun does shine, and by asking for help, you are honoring your body, your mind, and your baby.

Words by Kimberly Zuleger

Photographed by Nicole Arruda, Muse. Amanda Rodriguez

Exclusively for Mother Muse print No.13 available here

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s