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When people learn you are pregnant, one of the first questions they generally ask is "how are you are feeling?" It turns out that for many women how they expected to feel when they are pregnant and how they actually feel isn't quite what had been 'advertised'. And, we're not talking about morning sickness, fatigue, feeling a little emotional, and that odd smell that comes out of nowhere.
Contrary to popular belief, for some women pregnancy isn't always full of joy and magic. In fact, many pregnant and new mothers (and fathers, too) suffer from worry, depression, sleep disorders, sadness, irritability and other symptoms that get in the way of a healthy and fulfilling family life. These symptoms are more accurately reflected by the clinical term perinatal mood and anxiety disorders (PMADs). In fact, 1 in 7 women who become pregnant will experience a mental health disorder during the course of their pregnancy or in the postpartum period, making PMADs the most common complication of childbirth. Additionally, 50% of women diagnosed with PMADs postpartum had an onset of their symptoms during pregnancy. Women are at risk for PMADs anytime during their pregnancy and throughout the first postpartum year.
Although the causes of perinatal mood and anxiety disorders are not fully understood, they are generally considered to be due to a confluence of biological, social and psychological stressors. There are known factors that put a woman at increased risk such as a personal and/or family history of anxiety, depression or bipolar disorder, childhood trauma and loss or marital discord. Your healthcare provider should be knowledgeable about the risk factors for PMADs. If you haven't already done so, we strongly encourage you to have a conversation with your healthcare provider to discuss your particular risk profile.
PMADs are not always preventable, but they are highly responsive to treatment. And while, some episodes resolve on their own, others can become chronic affecting the quality of family life and significantly contributing to marital friction and divorce. With an improved level of understanding, screening and integrated physical and mental health care women and their families can benefit not only from preventative efforts but also from early intervention, which can dramatically improve the course, severity and outcome of PMADs when they occur.
With so much talk about how women are feeling in pregnancy, it's surprising how much we really don't know about what is all too commonly experienced.