FAQs about PMD
Read the answers to frequently asked questions about Postpartum Mood Disorder.
Four in five mothers will experience the “baby blues”. It usually begins on the third or fourth day after having your baby. You may feel sad, tearful, irritable, exhausted and overwhelmed and have changes in your sleeping or eating patterns. The baby blues are considered a normal adjustment to parenthood, not a disorder and usually disappear in about 1-2 weeks without any treatment.
You may feel like you are not a good mother, that you are the only one who is feeling this way and that no one will understand how you are feeling. By talking to others about how you are feeling you will realize you are not alone.
One in five women will experience a mood disorder during their pregnancy or after the birth or adoption of a child. PMD is the most common complication of childbirth. Postpartum depression and anxiety are the most common mood disorders. Symptoms can start suddenly or they can happen gradually and get worse; this is often when a woman starts to realize that what she is feeling is more than the blues. If you haven't been feeling like yourself for more than two weeks you need to talk to your health care provider.
Up to 12% of women will experience a mood disorder during pregnancy. While some mood swings are normal during pregnancy, intense sadness, anxiety, lethargy, self-doubt, inability to sleep, extreme worry about the baby's health and isolation are not normal. When symptoms interfere with your daily functioning and take all the joy from your pregnancy, it is time to get an assessment.
If left untreated PMD can interfere with a mother’s ability to interact with her infant in healthy and consistent ways. A woman who suffers from PMD can have a much harder time developing a bond with her baby and her baby’s development can be affected. There are programs that can help a mother interact with her baby in healthy ways.
There are effective treatments for mood disorders, but many women do not seek help for a variety of reasons. These include a mother:
- Not realizing she has a disorder and assumes her struggles are a normal
part of parenting
- Not knowing where and how to get help
- Feeling ashamed of having a mental health problem because of the
stigma associated with mental illness
- Being afraid of what might be involved in treatment
- Being afraid child protection agencies getting involved
- Not having transportation and child care to get to counselling sessions or
- Lacking of motivation and energy to attend appointments (symptoms of
- Having cultural or religious reasons for not discussing feelings
The period around having a baby is a time of increased risk for mood disorders in women. Any woman can be affected yet the causes are not fully understood – hormonal changes, lack of support, stress, and the demands of the new role as a mother may all have an impact. Click here for PMD Fact Sheets.
Any woman can experience PMD, but there are factors which may put you at an increased risk:
- Depression or anxiety during pregnancy
- Personal or family history of mental illness
- Stressful recent life events such as job loss, unplanned
pregnancy, moving, loss of a loved one
- Lack of support from family and friends
- If you generally worry a lot or are an anxious person
- Relationship problems
- Not feeling good about yourself
- Financial problems
- Complications during pregnancy or delivery
If you are experiencing any the following symptoms that last for more than two weeks you may be experiencing a postpartum mood disorder:
- Worn out, but unable to sleep
- Sad and tearful
- Overwhelmed and can't concentrate
- No interest or pleasure in activities you used to enjoy
- Restless, irritable or angry
- Extremely high and full of energy
- Anxious, you may feel this as aches, chest pain, shortness of
breath, numbness, tingling or "lump" in the throat
- Not feel yourself
- Ashamed, hopeless or frustrated
- Feel you are a bad mother
- Not bonding with the baby, afraid to be alone with the baby
- Have repeated scary thoughts about yourself or the baby
Click here for a postpartum mood disorder symptom checklist
While there is no sure way to prevent PMD, if you plan to become pregnant, you are pregnant or you have recently given birth, talk to your healthcare provider about what your risk factors may be. There are screening tests to help you and your healthcare provider determine if you are at risk or if you have developed a postpartum mood disorder.
Postpartum Psychosis is rare. It can often start suddenly, usually in the first 48 hours to 2 weeks after giving birth, but can occur later, too. Risk factors for postpartum psychosis are bipolar disorder and a personal or family history of postpartum psychosis. If a new mother is psychotic she may have the following symptoms:
- hinking and possibly planning on harming herself or her baby
- Hearing or seeing things that are not there (hallucinations)
- Believing people or things are going to harm her or her baby (paranoia)
- Feeling confused and out of touch with reality (delusions)
This is a medical emergency. Women need treatment immediately and should not be left alone or alone with the baby until she has been seen by a healthcare provider. She needs to be brought to the local hospital emergency department (refer to crisis support )
Screening does not diagnose a condition but rather identifies individuals who are at risk of developing the condition or are experiencing symptoms. There are a variety of screening tools developed for Postpartum Depression. The most commonly used is called the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a 10-item questionnaire which is scored. When a woman scores above a certain number, it is recommended she be referred to a qualified health care provider for further assessment.
Treatment for a woman diagnosed with PMD is based on her needs and preferences, the severity of her symptoms and the availability of services. The sooner treatment can begin the better. Most women with PMD are successfully treated and recover. Mild to moderate PMD may respond to counselling and increased support, such as that provided by support groups and help from friends and family. Severe episodes usually require antidepressant medication prescribed by the woman’s doctor along with support and therapy delivered by a trained professional.
This depends on the severity of your symptoms and when you get treatment. The sooner you get treatment, the sooner you will begin to recover. As each woman's illness is unique, treatment plans or recovery periods will be different. It is damaging to make comparisons to others you have known who recovered in a week or a month as it may take longer. While mild mood disorders may go away witout treatment, more serious mood disorders need treatment in order for you to get better. Women who don't get treatment for their mood disorder often remember this experience as a very difficult time in their life. If a mood disorder is not treated , it can last a much longer time than if treated.
Antidepressant medications are prescribed by a doctor to help treat depression and anxiety disorders. Women with PMD may be prescribed these medications during pregnancy or after their baby is born. Current research suggests that, as a group, antidepressant medications are quite safe to take during pregnancy and breastfeeding and that women should not suddenly stop taking her medications. A woman should always discuss any concerns about the safety of medications during pregnancy and breastfeeding with her doctor. You can also consult with Motherisk, which is Canada's source on the safety of medications during pregnancy and breastfeeding.
In addition to consulting your health care provider there are some useful self-care strategies that can help you with your recovery from PMD such as;
- Getting as much rest as possible by limiting visitors, letting others
know when you are resting
- Asking and accepting help in preparing food, caring for baby, doing
- Eating well, encouraging visitors to bring food, stocking up on healthy,
- Getting moderate exercise by taking it slow, going for walks with the
baby, or trying out postpartum yoga or fitness classes
- Building a strong support network by getting out of the house as much
as possible. Make and effort to meet other mothers with new babies
and keep in touch with family and friends
- Involving your partner as much as possible
- Participating in calming activities such as deep breathing, repeating
positive statements, relaxing tense muscles, taking a bath or shower
For more information about self care strategies click here
There are a variety of supports available in the Region of Peel check out community resources for more information.
Fathers can experience a mood disorder after the birth of a baby and if their partner has PMD they are at an even higher risk of a mood disorder. It is important to consult a healthcare provider if dad has symptoms of a mood disorder. Postpartum Men and Postpartum Dads are sites dedicated specifically to fathers’ concerns.
Dealing with postpartum mood disorder is very demanding for everyone involved. Listen and support her feelings. Don't tell her to "Snap out of it," or "You should be happy to have a beautiful, healthy baby." This will only make her feel worse. There are some things you can do that will make it easier for your partner and yourself to overcome this very difficult time.
- Reassure your partner of your love and concern
- Listen to your partner without judging her
- Allow your partner to verbalize her feelings to you
- Encourage her to seek professional help and offer to go with her to
appointments for added support
- Be involved with her treatment; women recover faster if their partners
are involved and supportive
- Develop your relationship with the baby
- Ask her how you can help
- Avoid misunderstanding and frustration by communicating with her
- Help with housework
- Provide nourishing meals,encourage friends to bring food
- If there are other children, help care for them
- Reassure your other children that their mother will be okay
- Be patient! Recovery may take time.
Mothers who are experiencing PMD are often lonely. A mother may be cut off from friends and family because of the demands on her time. Help and support her in whatever way she needs it most. Mothers need to know that you are still there for her and that you still care for her.
Here are some things that new mothers may find helpful:
- Encourage mom to find a compassionate health professional to talk to
and offer to go with her to her appointment for added support
- Watch the baby while mom has a nap or shower
- Play with the older children or take them out
- Limit visitors or look after them when they come
- Clean up or do things around the house
- Do the laundry
- Get the groceries
- Make meals
- Sit with her and listen
- If you can't visit personally call her and ask how she is doing
- Educate yourself about postpartum mood disorders
- Be patient. You may also need to talk to someone for support
What Does NOT Help:
- Criticizing or judging makes mom feel guilty and ashamed, it’s not her
- Denying her problem by saying “You should be happy to have this baby”
will not make it go away, it will only make mom feel worse about the
- Telling mom to “snap out of it” will also make mom feel worse. If she
could “snap out of it”, she definitely would. Postpartum mood disorders
are definitely not due to lack of mental strength
- Withdrawing your support will only make mom feel rejected, she needs
to know that you accept her no matter what happens
- Do not tell her what to feel and what not to feel, she needs you to
accept her feelings
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