Podcast

Perinatal mood and anxiety disorders affect about 20% of women. It’s important we prepare parents-to-be for the possibility that they may experience this, and the symptoms to look out for. In this episode, I’ll be discussing the different forms of PMADs – postpartum depression, postpartum anxiety, postpartum bipolar disorder and postpartum psychosis, and a few others. I’ll also share who is most at risk for developing these during and after pregnancy and what you can do if you or someone you love is experiencing any of these symptoms. 

Dr. Sarah (00:00):

If you walk away with just one takeaway, I really hope that it’s the fact that PMADs are nobody’s fault and that they can be treated effectively if you get help for them.

Dr. Sarah (00:15):

If you’re listening to this podcast, you’ve probably heard of postpartum depression, but did you know that that is only one of the disorders that can occur during and following birth? It is so important that we, as a collective culture, change and expand the conversations surrounding postpartum to cover all the types of anxiety and mood disorders that can be triggered by the pregnancy experience and changes that it brings about in both our bodies and our environments. Perinatal mood and anxiety disorders, which are also referred to as PMADs can occur anytime during pregnancy or within the first year of birth. While this includes postpartum depression, it also encompasses kind of a much larger umbrella of disorders, including antepartum depression, which occurs during and not after pregnancy and actually affects about one in 10 women.

Dr. Sarah (01:10):

It includes postpartum anxiety, postpartum, bipolar disorder, and postpartum psychosis. It’s critical that new parents know that there’s more than just postpartum depression so that they can learn what to look out for and how to get the proper support if they, or someone they know are experiencing any of these symptoms. In this episode, I’m going to cover the different forms of PMADs and discuss the symptoms associated with each. I’m going to talk about who is most at risk for developing these and offer solutions of where you can go to seek treatment and support. And here’s the most important part. These are temporary, these are treatable, and absolutely none of these are caused by something you did or didn’t do. So let’s get into it.

Dr. Sarah (02:02):

I have a question for you. Have you read all the baby books and followed every parenting, social media account out there only to feel more confused now than when you started? Do you have a new baby and are finding that while, yes you love parenthood that it’s also exhausting and hard and not exactly what you had imagined it would be? Or do you simply wish there was a single trusted resource you could turn to for learning everything you need for your baby’s first year of life, without having to spend hours searching for the advice that you need? I hear you, and I’ve heard so many other parents just like you express these same struggles, myself included.

Dr. Sarah (02:41):

And that is exactly why I created The Authentic Parent, a course about finding your confidence in your child’s first year. This is a virtual six week guided course. In it I break down the psychological principles of brain development, behavior, relationships, personality development, mental health, and resilience, to name a few things through a series of weekly videos that you can watch on your own time workbooks that guide you through integrating these concepts into your own life. Live weekly coaching sessions with me in an intimate group setting, as well as access to an exclusive non-Facebook community platform where you can chat independently with other members from your course and where you’ll learn everything you need to know for your first year of parenthood. By the end of the course, you’ll understand the foundational framework of the psychological and neuro-biological development of your child so that you can calmly and confidently respond to any problem that arises. You can connect authentically with your child and truly enjoy parenting. And with our weekly coaching calls, you’ll receive personalized guidance on all of your parenting challenges from the week, as well as learn what other parents in your group are dealing with, getting you started to form your own tribe to share joy, support and lift you up when you need it most.

Dr. Sarah (03:58):

I really want everyone to get personalized attention. So I’m limiting each group to 12 families and with three possible time slots, that means this offer is only open to 36 families. So space is limited. Sign up now so you don’t miss the chance to reserve your spot. 

You can go to my website, drsarahbren.Com/TAP that’s drsarahbren.com/TAP. And add your email to the waitlist, so you can tune out the noise and learn how to confidently tune into your child, allowing you both to relax, connect, and enjoy the journey.

Dr. Sarah (04:38):

Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. I’ve built a career dedicated to helping families find deep connections, build healthy relationships, repair attachment wounds, and raise kids who are healthy, secure, resilient, and kind in this podcast. I’ve taken all of my clinical experience, current research on brain science and child psychology and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights to help you understand the building blocks of children’s social, emotional, and cognitive development. So you can tune out the noise and tune into your own authentic parenting, voice confidence, and calm. This is Securely Attached.

Dr. Sarah (05:29):

In this episode, we are going to talk about PMADs, which stands for perinatal mood and anxiety disorders. And I think most people who have listened, who are listening to this podcast are probably familiar with the idea of postpartum depression. But I, I think it surprises me even to find out just how few people are aware of what PMADs are, which is kind of the big umbrella term under which postpartum depression. There are other postpartum mood and anxiety disorders though, beyond postpartum depression. So we’re going to talk a little bit in this episode about all of them and why it’s so important for us to know about these disorders, what they mean, where they come from, what, how we help people through them. So first of all, let’s go over this. So PMAD is perinatal mood and anxiety disorders. This is not just postpartum depression, but it does include postpartum depression. It also includes postpartum anxiety, postpartum OCD, or obsessive compulsive disorder, postpartum PTSD, or post-traumatic stress disorder, bipolar mood disorders, and postpartum psychosis.

Dr. Sarah (06:49):

15 to 20% of women experience a PMAD during or after the birth of a child. And partners, the non-birthing parent can also experience PMADs. This is the really important thing that I really want you to take away from this episode, PMADs are temporary and they’re fully treatable with informed care. We really need to start talking more as a community about perinatal mood and anxiety disorders, because the reality is is people can get help. And a lot of people don’t in part because they don’t even realize what they have might be a PMAD. And the other reason often is that people are afraid to get help or ashamed to get help, or they don’t think that help will do anything. So that’s one big thing. One myth I really want to dispel in this podcast. So let’s talk a little bit about these. Let’s get informed.

Dr. Sarah (07:45):

Let’s start with postpartum depression. Now, postpartum depression is often mistaken for the baby blues, but baby blues and postpartum depression are different. Okay? So when we have a baby, our bodies go through tremendous changes, physically neurologically and hormonally. We are physically healing. Our brains have literally gone through metamorphosis. I might need to do a podcast episode just on the brain changes that happen during and after pregnancy. But then also besides actual changes in the structures of our brains, all of these hormones are changing our estrogen and progesterone levels, peak, and then crash. And then our oxytocin and prolactin spike. This makes for quite the massive mood swings, believe me, plus there are new kinds of stressors that we’ve never contended with pressure from family and friends, and, you know, keeping a very helpless human alive, plus we’re not sleeping much or at all. And we often don’t get enough water or nutrients.

Dr. Sarah (08:51):

And we’re often very overstimulated postpartum. There’s tons of new stimulation after you have a baby so much touch, we’re pulled on, we’re sucked on, we’re clung to, we are hearing lots of crying and there’s lots of smells. Really, it’s a tornado of sensory input and we can get very easily overwhelmed and overstimulated. When you put all this together, it’s not surprising that many women’s mood is negatively impacted after you have a baby, but that doesn’t mean you have PPD, right? PPD is distinguished from baby blues, primarily by severity and duration, 60 to 80% of new moms experience the baby blues. The baby blues tend to start about one to three days after giving birth. And they can last either like, you know, from a few days to a few weeks during which mood swings are very common, including increased irritability, sadness, and fatigue. But if your mood symptoms are sticking around past two weeks and they’re getting in the way of your daily functioning, then you are moving into postpartum depression territory, and it’s worth checking in with your OB or your primary care physician or mental health professional.

Dr. Sarah (10:09):

So let’s talk a little bit about postpartum depression. You’ve had your child, your mood symptoms have been persisting for more than two weeks. And by the way, it doesn’t have to come on, right when you’ve had the baby for many women, it can happen later on often coinciding with hormonal changes or other stressors. So think weaning off of breastfeeding or getting your period back, or your child having sleep progressions or returning to work. A woman can be diagnosed with postpartum depression any time in the first 12 months after giving birth. So keep that timeline in the back of your head. Also, if you do experience PPD, you’re not alone. More than 15 to 20% of women experience this. That’s one out of every five to seven women. So think about a group of female friends. If it’s at least five to seven people large, then it’s highly probable that at least one of you will experience postpartum depression. Just to give you some context.

Dr. Sarah (11:07):

So let’s talk a little bit about the standard symptoms of postpartum depression. This is what we look for as mental health professionals when we’re making a diagnosis. And I also should note that a diagnosis isn’t just a symptom checklist. It also, we’re also taking into consideration things like the frequency, intensity, and duration of symptoms, as well as the impact of these symptoms on your overall functioning. So the symptoms are intense, prolonged feelings of sadness, anger, irritability, and or guilt, lack of interest in your child, changes in appetite or sleep, a loss of interest in things you formally enjoyed feelings of hopelessness, guilt, or shame, and even sometimes thoughts of harming your child or yourself. Now you can also have antepartum depression, which is depression during pregnancy. So you have postpartum depression, which is after you’ve had the child and antepartum depression, which is while you are pregnant. About 10% of women experience antepartum depression, and also not talked about that much, which is a shame because it’s relatively common.

Dr. Sarah (12:14):

One in 10 women. Also, so many women who experience antepartum depression and sometimes postpartum depression due to breastfeeding are under the mistaken impression that they cannot be on antidepressants. A lot of times when people are either trying to conceive or they are pregnant or they’re nursing, there is a myth that you cannot be on antidepressants. Now I’m not suggesting that you should go ahead and take any medication that you have in your cupboard that you were previously prescribed. It’s very important that you speak with your OB/GYN and a perinatal psychologist. So if you do decide to take an antidepressant, either during pregnancy or while nursing, that it can be done safely, but it is definitely not true that you have to white knuckle it through your pregnancy and not take a medication that can be very beneficial to keeping you mentally healthy and well because your mental health as a in pregnancy and in the postpartum period has also a very significant impact on the health of your child.

Dr. Sarah (13:22):

So, you know, we need to look at the big picture when we’re thinking about medication and we need to bring in the professionals to help us make that decision and, and figure out how to execute it in a safe way. But this is a way to treat antepartum and postpartum depression that sometimes women don’t know they have that option. So off my soap box about that. So also in the – and I’m going to talk about sort of treatment for all of this in a little bit, but first I just kind of want to cover all the different diagnoses and the symptoms so you kind of get a sense of what these look like. So remember we’re talking about postpartum mood and anxiety disorders, another disorder in that sort of mood category is postpartum bipolar disorder. That is much less common than postpartum depression, but it’s often misdiagnosed as postpartum depression because the manic episode that is the marker of postpartum bipolar disorder is often harder to catch than the depression symptoms often.

Dr. Sarah (14:24):

This is because people who experienced manic episodes in the moment often don’t go see a doctor. It’s usually because their symptoms get so bad that other family members notice and bring them in which is why sometimes we miss it diagnostically. We just see the depression. We think it’s postpartum depression. We don’t see the manic episode, or it’s not reported by the person experiencing it. And so gets, has to kind of get really bad for the family members notice and say, Hey, this doesn’t feel right. Let’s get you some more help. And then we get the accurate diagnosis. So it’s really important. And I think, you know, if you’re a mental health professional, listening to this podcast too, is to sort of make sure we’re screening from, for any symptoms of mania or history of mania. When we’re talking to patients who are presenting with postpartum depression symptoms.

Dr. Sarah (15:14):

So what does postpartum bipolar disorder really look like? Signs of a manic episode. So that’s what really distinguishes bipolar from depression is the manic episodes. Symptoms of a manic episode include elevated mood, which could look like euphoria. It could also look like agitation. It looks like a decreased need for sleep, which by the way, is different from the sleep deprivation that often accompanies postpartum life. Instead, it’s like, you’re not feeling tired at all. And you do not feel the need to sleep. Other symptoms include racing, thoughts, pressured speech, lots of energy, kind of feeling like you can go, go, go and starting lots of new tasks, but rarely finishing them. This is also different from that really common experience of after having a new baby of being interrupted mid task, and then forgetting to come back to it. This kind of starting lots of new tasks is more like you think you’re getting tons and tons done, but to others, you might actually look quite erratic and scattered. These symptoms need to last four to seven days to meet diagnostic criteria for either bipolar one or bipolar two. And if you or your partner are experiencing any of these symptoms it’s really important to get evaluated by a mental health professional right away.

Dr. Sarah (16:35):

Okay. Let’s talk about the anxiety piece of PMADs, the second most common perinatal mood and anxiety disorder across the board is postpartum anxiety. But despite it being so prevalent, almost no one has heard of it. Okay. So let’s talk a little bit about the symptoms in postpartum anxiety. We see constant worry, racing, thoughts, thinking something bad is going to happen and avoiding places and activity as a result of those worried thoughts. Changes in appetite or sleep. A lot of restlessness physiological symptoms like lightheadedness, hot flashes and GI issues. And then there are a bunch of subsets of postpartum anxiety that include postpartum panic disorder, postpartum OCD, and postpartum PTSD.

Dr. Sarah (17:30):

So postpartum panic disorder is sort of when you have postpartum anxiety, but it manifests itself in panic symptoms. So you are having panic attacks where you like, you know, shortness of breath, chest pain, heart palpitations, and you feel as though you are having what feels like in the moment, maybe a heart attack, but it is in fact, not due to any actual medical condition, it’s just this sort of your body is going into this heightened state of panic. That would be postpartum panic disorder. If you’re frequently having panic attacks in the postpartum period, then there’s postpartum OCD. In postpartum OCD -This is really one of the most misunderstood and misdiagnosed perinatal mood and anxiety disorders. But it’s really like when we have persistent thoughts or intrusive mental images that have to do with harm coming to the baby or harm coming to ourselves. And it’s really unwanted thoughts.

Dr. Sarah (18:36):

They aren’t fantasy is they aren’t wishes. They, we don’t want them to happen when we have these thoughts. We’re very disturbed by them. We don’t want to act on them, but it’s like these flashes of intrusive thoughts about something bad happening. And then because of those thoughts, we sometimes engage in behaviors, the compulsion to reduce those intrusive thoughts or deuce, the anxiety that comes as a result of those interests of thoughts. So that’s sort of what postpartum OCD starts to look like. Finally, postpartum PTSD is less common, but not that uncommon. About 9% of women experience PTSD following childbirth. So symptoms typically result from a traumatic childbirth experience, and then re-experiencing that trauma through thoughts or dreams or flashbacks. And as a result of these sort of re-experiencing, we tend to avoid anything that is associated with the event. So we avoid people that remind us of the event, places that remind us of the event.

Dr. Sarah (19:48):

We don’t want to talk about details of the event and then sort of this other pieces, this really intense, you know, nervous system arousal, that’s not comfortable like panic fight or flight. So a lot of irritability, difficulty sleeping, a lot of hypervigilance, an exaggerated startle response. These are all things that can we see, you see it in PTSD. We see it in postpartum PTSD, but it typically follows a traumatic birth experience. And you know, it becoming kind of encoded in the body as a trauma.

Dr. Sarah (20:20):

Finally, there is another PMAD called perinatal psychosis. This condition occurs less frequently, much less frequently than the rest showing up in about 0.1 to 2% of births, but it is worth noting as well because it’s often very shrouded in secrecy. It’s not talked about nearly enough. This disorder can be very scary if you’re experiencing it. And it requires very swift and appropriate treatment as soon as these symptoms show up. They are temporary and treatable, but we all need to know exactly what to be looking for so that we can accurately identify in the moment and get help. So symptoms of postpartum psychosis tend to occur suddenly, and they tend to occur within the first two weeks of postpartum. Although sometimes later hormone dysregulation, like we talked about sometimes when you stop breastfeeding or you get your period back, that’s other times in the postpartum period where we have big hormonal shifts that can also set off a psychotic episode in a very small percentage of the population. And typically not always, but quite typically, this comes up in people who have a history of mental illness or some history of a mood disorder that they have already kind of contended with prior to becoming pregnant. But the symptoms include delusions, hallucinations, extreme irritability, or agitation, hyperactivity, decreased need for sleep.

Dr. Sarah (21:51):

Again, this is similar to, in bipolar disorder, when we talked about this decreased need for sleep is not the same as sleep deprivation with sleep deprivation. We are tired and we want to sleep, but we can’t. Maybe because we have a new baby that isn’t sleeping and with decreased need for sleep, we feel like we can go, go, go. We don’t want or need sleep. Other symptoms include paranoia, rapid mood swings, and they may have trouble communicating coherently. They may not make sense. One of the reasons why this disorder requires such critical care is that many times the delusions that mothers can experience in a psychotic state involve hurting themselves or their baby. Now, remember we talked about postpartum OCD. We also talked about thoughts of bad things happening to the baby or thoughts of hurting the baby that felt intrusive and disturbing and unwanted.

Dr. Sarah (22:42):

That’s very different from postpartum psychosis when there is any thoughts around hurting themselves or their baby research suggests that approximately 5% of women who experience postpartum psychosis will commit suicide and 4% will commit infanticide. These tragic outcomes are due to the fact that when someone is experiencing a psychotic episode, they are really not connected to reality and they can experience what feels like very real delusional beliefs. Again, with OCD, we know this isn’t real. We know these thoughts aren’t wanted. We don’t want to act on these thoughts and we find them very disturbing and out of place and kind of out of body. And we don’t want to act on it in, in psychosis. Instead, we find that it’s like this alternate reality where some things feel very real and very uncontrollable. And so sometimes there are very complex fantasies around saving child by ending its life or yours.

Dr. Sarah (23:49):

So this is why it is so important that we are talking about perinatal mood and anxiety disorders. That it is some part of the just general conversation about parenthood. Not because this is going to happen and we need to be scared and we need to build her anxiety, but we want to know what’s happening out there and how to spot it and how to support it and how to treat it. And so if we all know warning signs, we’re all more likely to help any parent in our lives who might be experiencing symptoms like this, get help. So, and I also need to say to the majority of women who experience postpartum psychosis do not hurt themselves or anyone else, but because of this very small percentage, remember 0.1 to 0.2% of births have incidences of perinatal psychosis. Even within that small number, even less actually remember only five and 4% of that very small number go on to actually ending their lives.

Dr. Sarah (24:52):

But because of this very small percentage of women who do it’s critical that anyone with symptoms of postpartum psychosis be assessed and treated immediately by a healthcare professional trained in perinatal mental health. So something to just be aware of. Also another thing shifting gears a little bit that I think is really important that doesn’t get talked about a lot is that mothers or the birthing parent, they’re not the only individuals who can experience perianal mood and anxiety disorders, non-gestational parents. So that’s dads, same-sex partners, anyone who might be taking on a primary co-parenting role from the beginning, they all can and do experience perinatal mood and anxiety disorders. One in 10 fathers are diagnosed with a PMAD. And depressive symptoms tend to show up in dads more about the three to six months postpartum mark, possibly because they’re kind of holding it together in the beginning, either consciously or unconsciously, while mom is in her most vulnerable stage of postpartum.

Dr. Sarah (26:03):

And then she starts to emerge from that sort of natural cocooning. Then we start to see the partners can sort of let go of all that, holding it in. And that’s often when we can see depression or anxiety symptoms pop up, I could talk so much about dads and non-gestational parents who experienced PMADs, but I saved that for a followup episode since it really deserves its own space. So make sure that you stay tuned for an episode just about dads -it’s coming up. So while clearly PMADs can happen to anyone, they really don’t discriminate. There are some risk that can predispose someone to developing symptoms. So women who have biological sensitivity to hormone changes like premenstrual dysphoric disorder, PMDD, or a sleep disorder, or previous history of mental health challenges, or any psychological factors like your feelings about parenthood or insecurities with yourself image or a tendency towards perfectionism.

Dr. Sarah (27:12):

And then also social and environmental factors like a history of trauma, limited social support, systemic racism. There might even be some genetic predispositions at play. All of these things can increase our vulnerability to experiencing a PMAD and because you don’t know that you won’t have a PMAD it’s really important for expecting families to have a postpartum plan that addresses the steps the family can take should symptoms emerge. I always sort of say to families in this stage hope for the best, but plan for the worst. You know, you need to know, Hey, if one of us gets postpartum, depression or experiences really intensive postpartum anxiety, what’s our plan? Do we know who we’re going to call? Do we have you know, a little roster of possible mental health professionals who we could reach out to that kind of stuff is great to do when you’re planning, because we do so much wonderful work when we’re pregnant and planning our birth plan.

Dr. Sarah (28:16):

This should be part of our postpartum plan. So what do you do if you do have one of the signs or symptoms of a PMAD that we’ve talked about? So first of all, and I think this is probably the most important. First of all, is don’t blame yourself. It is nobody’s fault. You did nothing to cause this, it happens because of the profound hormonal shifts that are happening in our bodies. It happens because of genetic predispositions. It happens because of environmental stressors. All of these things are really unavoidable in pregnancy and postpartum. You did not cause this, it happens. Secondly, don’t keep it to yourself or wait for it to go away by itself. Don’t even wait until your six week checkup. Tell your partner, tell your doctor, reach out to a support community. You need to get help. It’s okay to get help. It’s important to get help.

Dr. Sarah (29:22):

And I’m going to share some resources in the show notes. But the best place to go, if you need support is Postpartum Support International. They’re a great place to start. They have a tremendous amount of resources on their website. They have educational information, kind of giving you a lot of information about the different disorders and what you can do to sort of create a support system. They have a database of, of all of the perinatal mental health trained practitioners based on geography. So you can literally type in your zip code and get people nearby you who are trained in perinatal mental health. So go, definitely check out Postpartum Support International. They’re kind of the gold standard for getting help for PMADs, if you don’t know where to start. You can also always talk to your OB. You can talk to a mental health professional.

Dr. Sarah (30:26):

You can talk to your primary care physician. They will all have ways to get you to where you need to go. And it really is so important that anyone who is experiencing a perinatal mood and anxiety disorder gets treatment, not just for themselves, but it’s important for the entire family that you get help. Research has shown that untreated postpartum depression is associated with increased cost of medical care over time, less success with breastfeeding family, distress problems in relationships, child abuse, and neglect even, and it can affect a child’s brain development early on, and it can lead to developmental delays and behavior problems. Basically we can pass the trauma down to our children leading to intergenerational consequences. I hear so often from moms who say that they thought they were protecting their family by keeping their symptoms to themselves by being the stoic rock because they thought they had to hold it all together for their family.

Dr. Sarah (31:25):

I promise you, you are far more protective to your family by speaking up and getting support and treatment. Your family will thrive best if you can thrive and show up as the healthiest version of yourself. The former president of Postpartum Support International, Birdie Gunyon Meyer, she has this quote that I think is so appropriate. But, she says “in our lives, we have seasons of giving and seasons of receiving. As a new mother, you are in the season of receiving.” So take that in, receive, be willing to ask for help and get it. Let’s talk a little bit about what treatment for PMADs looks like. So oftentimes when you go to therapy for a PMAD the real goal is to process the full range of feelings to feel supported in those feelings, to be able to give voice to those feelings and to kind of find ways to cope with them.

Dr. Sarah (32:23):

Often times, one of the things that comes up a lot is grief, which is kind of surprising for people who are experiencing PMAD is especially in postpartum depression. I think this comes up a lot, but we mourn the losses that we might not realize we are experiencing. So I think, you know, we just had a baby, what’s the loss? But you know, new parents, there can be a lot of unexpected losses that we might not be aware of or give ourselves permission to acknowledge because we believe that we’re supposed to only be happy after becoming parents. So sometimes we refer to these as shadow losses, and that might include like a mistimed pregnancy or being sort of disappointed in the sex of your baby. Maybe you were really hoping for a girl and you had a boy or the other way around maybe you had multiples when you really weren’t ready for that.

Dr. Sarah (33:25):

Maybe having a pregnancy or birth experience that was not what you expected or hoped for, or maybe it was even traumatizing. Maybe your child’s temperament is really difficult for you to handle and cope with maybe not having that immediate sense of falling in love with your baby. That we’re sort of conditioned to think is automatic. But in fact, I believe takes a good amount of time for some families and that’s totally normal. And okay, maybe you’re finding parenthood more challenging than you expected, or you wished for feeling isolated or you’re not receiving the support you kind of need from your community. All these things are losses. And so in therapy, we really want to give voice to them with no shame, no judgment with complete compassion and permission so that we can process them and put them in their place, right? They are real, they are not the whole picture, but when we deny them or we repress them, sometimes they find a way of taking up all the space.

Dr. Sarah (34:27):

So a lot of therapy is kind of about that. Also it depends on the type of therapist you have, there’s lots of different kinds of therapy. There is, you know, relational and psychodynamic psychotherapy, there’s CBT (cognitive behavioral therapy) which is, these are just different ways of approaching these things and different ways also work better for different disorders within the PMAD umbrella. So your therapist is going to do a pretty comprehensive intake evaluation, and based off their sort of conclusion on what’s going on, and what’s the primary issue. They’re going to draft a treatment plan with you collaboratively, that’s going to help address your symptoms. So another common element in therapy for PMADs is providing support for the massive identity shift and life transition that’s happening. So we really want to increase coping skills around all of these shifts. So we need to understand all that’s shaken up in us.

Dr. Sarah (35:35):

We need to understand why it got shook up in us, and we also need to increase support and reduce stresses wherever possible. That’s often a focus of treatment. A lot of times processing someone’s own family history can also be very helpful in the treatment of PMADs. And we often talk about, we talk about on this podcast a lot, but we talk about it in general, when we’re talking about postpartum mood and anxiety disorders, and frankly, any mood or anxiety disorder, the intergenerational transmission of trauma, which is kind of how families pass down traumas and trauma responses from one generation to the next, through parenting and interactions that occur in the parent child relationship. And so treatment can really help you focus on identifying these generational patterns in your own life and work to break that cycle. So sometimes this work is referred to as re-parenting, other treatments like internal family systems therapy, take this idea to a whole other level.

Dr. Sarah (36:35):

I’m going to have to do an entire episode on internal family systems or IFS therapy. It’s really worth its own episode for sure. But I certainly think it would be a very useful modality or therapy in treating certain PMADs is, especially if there’s a family history of misattunement or attachment difficulties. For postpartum anxiety and postpartum OCD, CBT or cognitive behavioral therapy is often the gold standard of treatment. Teaching mindfulness skills is also very helpful for treatment of PMADs. Mindfulness treatment often focuses on helping people to increase their nonjudgmental awareness of their internal experience of the environment around them in the present moment. So that’s sort of what mindfulness is and, you know, frankly, I think it’s something we can all use a little more of in my humble opinion, even if you don’t have a PMAD if you are a parent practicing, mindfulness can really just help on a lot of levels.

Dr. Sarah (37:35):

So that pretty much wraps things up with respect to PMADs. I hope you found this information useful and empowering. If you walk away with just one takeaway, I really hope that it’s the fact that PMADs are nobody’s fault and that they can be treated effectively if you get help for them. So please reach out to a mental health professional who’s trained specifically in treating PMADs. If you think you might be having any of the symptoms we discussed today. It is the best. And frankly, the bravest thing that you can do for yourself and for your family.

Dr Sarah (38:09)

Thanks for listening and I hope you join me in spreading this message far and wide. If you have a friend, a sister, a brother, anyone you know who is expecting right now or planning to start a family soon, go ahead and send them this episode. Or, at least commit to bringing up the topic with them. There is support out there and if we can normalize this conversation it can have a massive impact. 

If this topic resonated with you and you are either pregnant or within your child’s first year of life and you want to learn more about all the things you can expect, you may be interested in my new course – The Authentic Parent. It’s a 6 week virtual course aimed at helping you find your confidence in parenting so you can calmly and effectively respond to any problem that arises, connect authentically with your child, and truly enjoy parenting! Along with video modules, interactive workbook exercises and access to an exclusive (non-facebook) community, you’ll have weekly coaching sessions with me to work through whatever challenges you’re facing each week. I know how important it is for everyone to get personalized attention, so I am limiting each group to 12 families. There are only 3 time slots available so space is very limited! Add your name to the waitlist and you’ll receive early access to sign up for the course as soon as doors open! You can learn more about The Authentic Parent course, along with finding my free parenting resources and guides on my website drsarahbren.com. That’s drsarahbren.com. Thank you for listening to this pivotal episode and don’t be a stranger. 


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13. Beyond postpartum depression: A breakdown of all perinatal mood and anxiety disorders

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PARENT SMARTER, NOT HARDER

Keeping the peace at home in times of stress or tension.

17 Neuropsychology Strategies to Parent Smarter Not Harder:
How to Use Brain Science to Maximize Efficiency and Prevent Burnout While Working From Home with Kids During a Pandemic

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