Understanding Pmads Perinatal Mood and Anxiety Disorders
A psychoeducation and reflection worksheet
What are PMADs?
PMADs (pronounced P-Mads) is a clinical term that includes a range of emotional challenges that can affect birthing parents during pregnancy and after birth. PMADs include depression, anxiety, OCD, PTSD, and in rare cases, psychosis. While the term “postpartum depression” is more widely known, PMADs can begin during pregnancy, and many people experience symptoms without realizing what they’re going through.
What do PMADs feel like?
1 in 5 new or expecting mothers/birthing parents will develop a PMAD. 50% of PMADs begin during pregnancy - not after. PMADs are the #1 complication of childbirth and the leading cause of maternal mortality. 80% of PMADs go undiagnosed and untreated - often due to stigma, guilt, or fear. For some, PMADs can feel like deep sadness, numbness, irritability, or guilt. Others experience racing thoughts, panic, and constant worry about their baby’s health or safety. Some may feel disconnected from their baby or overwhelmed by thoughts they can’t control. These symptoms can affect a person’s ability to function, rest, or feel connected to themselves or others. In rare cases, people may feel confused or detached from reality, which can signal a more serious but treatable condition called postpartum psychosis. While each person’s experience is unique, PMADs often lead to feeling like something is wrong-but not knowing how to fix it.
Why are PMADs important to recognize?
One in five mothers or birthing parents will experience a PMAD, and yet most won’t receive the support they need. PMADs are the leading complication of childbirth and the number one cause of maternal mortality. Treatment can be life-changing, especially when started early. Getting help does not mean you are failing-it means you are being proactive about your health and your baby’s well-being. The earlier you recognize what’s happening, the sooner you can feel better.
Reflection Questions
Have you experienced sadness, guilt, panic, or scary thoughts that have made daily life harder since becoming pregnant or giving birth? Write about what you’ve noticed.
Reflection Questions
When did these feelings begin-for example, during pregnancy, in the first few weeks postpartum, or later?
Reflection Questions
How have these thoughts or feelings affected your ability to care for yourself, connect with your baby, or relate to others?
Reflection Questions
What do you tell yourself about your parenting when these feelings are present? For example, do you feel like you're not doing enough, or that you should be feeling something different?
Reflection Questions
If someone could fully understand what this experience has been like for you, what would you want them to know?
What to Do Next
PMADs are real, common, and treatable. If what you wrote above feels familiar, it may be time to speak with someone who understands perinatal mental health. Support may include talking with a trained therapist, joining a support group, or starting medication that’s safe for pregnancy or breastfeeding. You do not have to wait until things get worse to get help. It’s okay to speak up.
Where to Find Support
Postpartum Support International offers free peer support and professional referrals at www.postpartum.net or by calling 1-800-944-4773.
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