Course Content
This course is specifically aimed at pregnant and postpartum mothers. It is designed to support women who are navigating the complex and often challenging mental health landscape that can accompany pregnancy and the postpartum period. The course targets mothers who might be experiencing anxiety, OCD, birth trauma, or other mental health concerns related to their maternal journey. Given my specialization and the course content, it is also likely suitable for mothers who are interested in proactive mental health strategies, mindfulness practices, and those seeking to understand and manage the psychological transitions associated with pregnancy and motherhood. Additionally, the course could be beneficial for mothers seeking community and support, as it likely offers a space for shared experiences and learning in a safe and understanding environment.
Defining Perinatal Mood Anxiety Disorder (PMAD)
a. Perinatal - conception through the first year postpartum b. Mood - Depression, Bipolar Disorder, psychosis c. Anxiety - Generalized, Panic, OCD, PTSD, and Social d. Disorder - when symptoms impact day to day life for longer than 2 weeks (good general rule of thumb) e. These disorders can affect people at any time but there is an increased risk during the perinatal period and symptoms often have a unique presentation
Who is Affected
Who is affected a. 1 in 7 new moms b. 1 in 10 new dads c. limited data on same sex couples, adoptive parents and surrogates but we know they experience PMADs at a higher rate than is diagnosed d. PMADs do not discriminate (universal), they can impact anyone and money/socioeconimic status are not protective factors
Why Is It Important? Risk of Untreated PMADs
Risk factors a. Biological i. personal history or family history of PMADs ii. personal or family history of depression, anxiety, OCD, eating disorder, bipolar disorder iii. fertility treatments iv. thyroid changes v. severe premenstrual syndrome vi. lack of sleep b. Environmental/Social i. life changes such as new home, new job, change in work status ii. loss of a loved one iii. isolation or lack of social support iv. history of trauma v. domestic violence vi. systemic racism vii. substance use viii. financial stress ix. barriers to communication c. Psychological i. perfectionist tendencies ii. difficulty with transitions iii. unrealistic expectations iv. relationship issues v. low self esteem vi. anxious or highly sensitive personality vii. feeding baby 6. Why is it important? Risk of untreated PMADs a. According to ACOG Consensus Bundle on Maternal Mental Health from 2017 i. Relationship problems ii. poor adherence to medical care iii. exacerbation of medical conditions iv. intimate partner violence, separation, divorce v. loss of interpersonal and financial resources vi. child neglect/abuse vii. developmental delays, behavioral problems viii. infanticide, homicide, suicide 7. what is the difference between pregnancy symptoms,
What is the Difference Between Pregnancy Symptoms, Baby Blues and PMADs?
What is the difference between pregnancy symptoms, baby blues and PMADs) a. Common symptoms across most PMADs i. feeling sad, hopeless, overwhelmed ii. feeling anxious, panicky iii. regret having the baby iv. trouble sleeping even when the baby sleeps v. thinking her family would be better off without her vi. fear of leaving the house or being alone vii. isolation from family and friends viii. unexplained anger or irritability ix. fearful that she might harm herself or the baby x. trouble coping with daily activities of living xi. difficulty concentrating or making simple decisions xii. feeling “out of control” xiii. feeling guilty xiv. relentless worry xv. significant self doubt b. Physical symptoms that might be present: i. nausea ii. dizziness or lightheadedness iii. racing heart iv. persistant headaches v. chest pain vi. shortness of breath vii. numbness of hands or feet c. Words you might hear them say: i. This is supposed to be the happiest time of my life… why am I so sad? ii. Everything would be better if I got a good night’s sleep iii. I feel like the worst mother in the world iv. I’m having thoughts that are scaring me v. Why am I such a failure? vi. I worry all of the time vii. Why can’t I snap out of it? viii. I want to run away d. Table? Pregnancy vs Depression i. Pregnancy ● mood - easily tearful, emotional ● self esteem stable ● sleep - disrupted by bladder or heartburn, but able to fall back to sleep ● no suicidal ideation/intent ● Energy - tired, but restores with rest ● Appetite - might increase ii. Depression ● mood - gloomy, irritable, agitation, rage ● self - esteem - lowered, guilt ● sleep - difficulty falling and staying asleep ● suicidal thoughts, plans or intentions ● energy - rest does not restore ● appetite dysregulated iii. Baby Blues ● Affects 60-80% of new moms universally ● peaks around day 3, resolves around day 14 postpartum without treatment other than social support ● tearfulness, exhaustion ● generally happy, self esteem remains stable ● able to care for self and baby as would be expected
Anxiety – General
Perinatal Psychosis – a TRUE MEDICAL EMERGENCY
Perinatal Psychosis - A TRUE MEDICAL EMERGENCY a. 1-2 out of every 1,000 deliveries (or 0.1% of births) b. Of those with PPP, there is a 5% infanticide rate or suicide rate c. Risk factors: i. first baby ii. discontinuation of mood stabilizers iii. obstetric complications iv. perinatal or neonatal loss v. previous bipolar episodes, psychosis or postpartum psychosis vi. family history of bipolar disorder or postpartum psychosis vii. sleep deprivation d. Symptoms - usually within first 2 -4 weeks postpartum, rapid onest not necessarily consistently present (can cycle through psychosis and normalcy) i. Hallucinations ii. Ego-syntonic intrusive thoughts iii. Thoughts of harming self or baby with plan and/or intention iv. poor concentration, disorientation v. agitated, hyperactive, aloof, lack of self care vi. mood is elated, and less often depressed vii. speech is rambling viii. disorganized thought, flight of ideas e. Treatment i. Postpartum psychosis is temporary and treatable with professional help BUT it is a TRUE EMERGENCY ii. Inpatient hospitalization iii. Medication iv. Social and psychological support once discharged to home
Introducing Perinatal Mood Anxiety Disorder (PMAD)
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Intro and objectives 

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