To start out, please read this list of paraphrased statements and questions I’ve heard relating to misconceptions of PMADs:
- “If I’m struggling emotionally, does that mean that I don’t love my baby enough?”
- “I’m pregnant. I can’t get depression now because I’m not in my postpartum period.”
- “I was so excited about this baby that there’s no way that I can be depressed.”
- “I didn’t feel an immediate connection with my baby, so something must be wrong with me.”
- “It’s been more than 3 months and I still don’t feel the connection with my baby that people describe. I care about him but I’m not ‘in love’ with him.”
- “Good mothers don’t feel negative things about being a mother.”
- “I have so much support. A lot of moms go through this postpartum period basically on their own, so why is it so hard for me when I have a lot of help? I should be grateful.”
- “We wanted this baby so badly and went through fertility treatments to get her. I feel so guilty saying that I’m struggling after the time, money, and emotions we spent.”
- “I see people on the news who have this, and they hurt their babies! I would never do that, so I must not have it.”
- “I thought this would be such a happy time! This is nothing like I thought it would be.”
- “People say that this is one of the best things that can happen to a person. So what’s wrong with me that it feels more overwhelming than happy?”
- “I’ve never struggled with depression or anxiety before, so that’s probably not what I’m experiencing now.”
- “After several miscarriages, I’m so thankful to have a healthy baby. Why can’t I enjoy this?
- “I don’t need help to feel better, I just need time.”
- “I’m afraid to ask for help because I don’t want people to judge me.”
- “Only moms can experience a PMAD. As a man, my hormones haven’t changed so I can’t have it.”
- “It must be the ‘baby blues’.”
- “As an adoptive parent, I can’t get a PMAD.”
- “I don’t want to take away from what my wife/female partner is going through. If I speak up about my struggles it will look like that.”
To provide some background information, Perinatal Mood & Anxiety Disorders is the current term for what we used to call Postpartum Depression (PPD). The PMAD umbrella encompasses anxiety, depression, OCD, and/or psychosis during a window of time before and after having a baby or becoming a parent. The term ‘perinatal’ typically refers to a year before someone births/parents/adopts a baby and up to two years following. The CDC reports that 1 in 8 women (roughly 10-15%) meet the criteria for a PMAD. Those statistics were obtained from studies that involved women who self-reported related information, so it is thought that the number of women who struggle with a perinatal mental health disorder is much higher than that. Why would it be higher than what is reported? The combination of PMADs being “hush-hush” in many societies, people not being aware of the criteria for these disorders, and the stigma placed on people experiencing them complicate things; they contribute to people’s lack of awareness that they or someone they know meet the criteria for PMADs or they do not feel comfortable giving honest feedback about their experiences. These lead to common misconceptions about what PMADs actually are and the rates at which they are experienced.
In discussing the misconceptions of PMADs, it is important to note what it is not. The ‘baby blues’ is a common term to describe the postpartum period the couple weeks after birth where a woman’s hormones fluctuate significantly, often causing sadness, anxiety, irritability, weepiness, and fatigue. This is not considered a PMAD. If symptoms continue past a couple of weeks or worsen after this time period, a woman should be evaluated for PMADs. The time frame and intensity of symptoms are considered in diagnosing PMADs.
The hormonal component of perinatal disorders is another misconception, at least in terms of it needing to be present as a cause of PMADs. I don’t want to downplay the effects of hormones! For some people at certain times, hormones play a very real role in their emotional state and mental health. This can absolutely include mothers in the perinatal period. However, it is not the only or most significant component to a perinatal disorder for many people.
This leads to another common misconception about PMADs, which is that only women who have been pregnant with and birthed a baby can experience them. Fortunately, there has been a push to include pregnant women, fathers, and adoptive parents as populations that experience PMADs. Changing the language from ‘postpartum’ to ‘perinatal’ has carved out a larger timeline for people’s symptoms to be considered, and this very much includes pregnancy. During pregnancy, the hormonal, physical, and emotional load of growing a child and becoming a mom or adding a child to the family can make for a very overwhelming experience!
I have also heard fathers struggle to find their place in the PMAD world and I’m glad that we are acknowledging that pregnancy of a partner, becoming a father, adding a child to the family (via pregnancy of a partner or via adoption) also affect men and their mental health. It can often be tough for men to find a voice in a situation where their bodies and hormones aren’t affected and where they are caring for their partners. Yet, the gravity of caring for a little one, their partner, and being a dad can be heavy. There is often a struggle for men to find their place in the post-birth and parenting struggle.
Last, but certainly not least, we often have the misconception that adoptive parents aren’t included in these PMADs and related disorders. There absolutely does not have to be a biological connection to a pregnancy or child for a person to experience symptoms of anxiety or depression with the addition of a baby to their lives. Post-Adoption Depression carries its own unique set of struggles, such as the guilt for the happiness that sometimes seems to coincide with a birth parent’s grief; the fear of having a child taken from you that you have already formed an attachment to before the adoption is finalized; and grief that the journey to parenthood looks different than you anticipated, to name just a few. However, many of the emotional struggles are the same for parents who become parents by birthing or adopting their child. At the heart of it, the journey of becoming a parent (whether that be for the first, second, or third time) carries an emotional weight and ups and downs that are shared between all types of parents.
We have to do better (and I believe we are) in acknowledging that the time before and after becoming a parent or adding a child to the family is TOUGH, at least at times! It can be a beautiful experience, but that doesn’t make it any less mentally, emotionally, and physically taxing! My hope is that we continue to find space to validate and support people facing PMADs and related struggles. Let’s continue to normalize that struggling with a PMAD in no way reflects the type of parent you are or will be, nor does it reflect the love for your child or how capable you are as a person!
It can be tough for women. It can be tough for men. It can be tough to be pregnant. It can be tough for adoptive parents. Why or how a person ends up struggling with a perinatal mood or anxiety disorder as a part of their journey can look a million different ways. The important part is that we look out for our family, friends, and neighbors. Let’s encourage them to seek help and remind them that healthy parents equal healthy children. PMADs are very treatable with help and support!!! I’m encouraged to see the expansion of populations that are included in these conversations and excited to see where these conversations take us!