Postpartum Depression isn’t Just About Hormones, and 4 other facts you probably didn’t know about PMADS


Postpartum Depression isn’t Just About Hormones, and 4 other facts you probably didn’t know about PMADS


Postpartum Depression isn’t Just About Hormones (and 4 other facts you probably didn’t know about PMADS)

As professionals working with pregnant folks and parents, it is essential to know about Perinatal Mood and Anxiety Disorders (PMADs). Therefore, we have put together a list of 5 facts you should know about PMADs. Navigating a PMAD can be difficult and can feel lonely, however having informed and caring professionals can make it much less stressful.


Fact #1 – PPD is not just about hormones

There is a misunderstanding surrounding postpartum depression, the assumption being that it is solely linked to hormonal fluctuations due to pregnancy and postpartum. The truth is that the causes of PPD are not well understood. What we do know is that there are a number of risk factors associated with PPD and some clear ‘predictors’ leading to the probability of a birther experiencing it.

These risk factors include:

  • Relationship dissatisfaction
  • Limited support
  • Stressful life events
  • Unwanted/unplanned pregnancy
  • Young/advanced maternal age
  • History of intimate partner violence
  • Difficult infant temperament
  • History of thyroid issues
  • Trouble nursing (if that is important to the parent)
  • Weaning
  • Birth and reproductive trauma
  • Challenging pregnancy
  • Premenstrual Dysphoric Disorder (PMDD)
  • Challenges with fertility
  • History of addiction
  • History of eating disorders
  • Unhappiness with baby’s assigned sex at birth
  • Financial concerns or unemployment
  • Solo parenting
  • Experiences with discrimination


Related: Workshop Perinatal Mood and Anxiety Disorders (PMADs), Lack of Disclosure and Racial Disparity

Related: How Having a PMAD Made Me a Better Doula


Fact #2 – Non birthing parents can develop a PMAD

Partners can also experience PPD. Although partners do not experience the hormonal and physiological changes that birthing parents do, they have many postpartum and new-parent life adjustments.


These adjustments include:  

  • Increased responsibility 
  • Changes in lifestyle 
  • Changes to their relationship 
  • Emotional adjustment 
  • Financial adjustment 
  • Change in sex life 


PPD is not something that parents should have to ‘suffer through’, or try to overcome on their own. It is not a normal part of a parent’s role of “Primary Caregiver”, and it should be treated. 


Treatment can include seeking out a professional (Public Health Nurse, Doctor, Counselor, or Psychologist), and being prescribed medication. Parents can also seek out support groups to attend which also aid in the recovery of PPD.  New parents (and others around them) need to respect the ‘nesting-in’ period after the baby is born. 


Related: Processing Trauma: The time I f*cked up and posted a blog I shouldn’t have


Workshop Perinatal Mood and Anxiety Disorders (PMADs), Lack of Disclosure and Racial Disparity

Postpartum Depression isn’t Just About Hormones (and 4 other facts you probably didn’t know about PMADS)


Face #3 – Postpartum Anxiety affects approximately 1 in 5 birthing parents

In recent years the discussion around Postpartum Depression has increased and it is becoming somewhat more understood. However PMADs include many other disorders that are not specific to PPD (however there is a high morbidity between depression and other disorders). One of the most common Perinatal Mood Disorders is Postpartum/Perinatal Anxiety with between 17-20% of birthing parents experiencing it during pregnancy or postpartum.  


The symptoms of anxiety during pregnancy or postpartum might include:

  • Constant worry
  • Intrusive thoughts of harm coming to the baby or themselves
  • Feeling that something bad is going to happen
  • Racing thoughts
  • Disturbances of sleep and appetite
  • Inability to sit still
  • Physical symptoms like dizziness, hot flashes, and nausea



Related: Top 5 Things To Do When Your Client Feels Like They’re Failing


Fact #4 – Media is mislabelling PPD for Postpartum Psychosis (and this is a serious issue)

We know that the purpose of movies and television is for entertainment, and therefore scenarios and circumstances within them need to be dramatic. But when it comes to portrayals of postpartum depression, the media is doing us a strong disservice. As mentioned at the top of this blog PPD is not uncommon and has a long list of potential symptoms. However what we are seeing represented as PPD in mainstream media is actually Postpartum Psychosis (PP-P) and they are very different. 

Postpartum psychosis is the most rare PMAD affecting less than 1% of gestational parents. It is considered a true medical emergency and requires immediate intervention. 


PP-P is very dangerous for the primary caregiver and for the baby. It is extremely important for not only the primary caregiver, but also the partner or other support to be aware of the symptoms of PP-P and act upon recognition of them.



  • Similar symptoms as PPD, as well as: 
  • Hallucinations 
  • Manic episodes 
  • Disconnection between actual and perceived events 
  • Suicidal thoughts or violent thoughts towards the baby 



  • A personal or family history of psychosis, bipolar disorder, or schizophrenia 
  • Previously experienced PPP (20-50% chance of reoccurrence) 
  • Changing hormones 
  • Lack of social and emotional support 
  • Low self-esteem 
  • Feeling inadequate as a parent 
  • Feeling isolated or alone 
  • Financial trouble 
  • Going through a major life change (career change, moving, etc.) on top of becoming a new parent 



  • PPP is considered a medical emergency and immediate attention is required. Most birthers need the help of their partner or other support to help them get the attention they need.
  • Treatment usually requires the birther to be hospitalized, and administered antipsychotic drugs, antidepressants, and sometimes anti-anxiety medication.


Related: I am most proud of things that you cannot see


Postpartum Depression isn’t Just About Hormones (and 4 other facts you probably didn’t know about PMADS)



Fact #5 – You can developed a PMAD up to 3 YEARS Postpartum

The development of a Perinatal Mood Disorder can happen anywhere between pregnancy and up to 3 years postpartum. This is a really important distinction to make, because the lack of awareness around this directly impacts how parents are or aren’t seeking treatment for their mental health. 


When most people think of postpartum they assume it is the immediate 6-12 months after giving birth. But postpartum can actually be considered the first 3 years after childbirth. Many parents who develop a postpartum mood disorder past 12 months after giving birth will dismiss their symptoms and not seek out treatment, this making their symptoms more severe. 


PMADs are very treatable with the right support and so it is imperative that parents know they can develop symptoms up to 3 years after their child is born. 


It is hard to recognize or identify perinatal depression or anxiety for several reasons. Each pregnant person experiences a unique situation and unique symptoms. Some of them are sad and teary; some feel overwhelmed and irritable; some bond well with their babies while others feel distant; some sleep all the time while others have insomnia. The up-and-down nature of symptoms also makes it difficult to recognize or admit perinatal depression or anxiety.


If you are a professional working with pregnant folks and families, and wondering how you can support clients that you suspect may have Perinatal Mood and Anxiety Disorders (PMADs). Or what are the available treatment options for PMADs? Why are some communities experiencing higher rates of PMADs than ever before? Why are some parents choosing to suffer in silence rather than disclose how they are feeling? How can we do our best to be culturally sensitive while supporting clients with PMADs?


We encourage you to join us for the upcoming workshops: “Shining a Light on the Silent Epidemic: Perinatal Mood and Anxiety Disorders (PMADs), Lack of Disclosure and Racial Disparity”. We have created this workshop to give you the tools, information, and resources to be able to support your clients with PMADs, and gain a deeper understanding of the complexity of Perinatal Mood and Anxiety Disorders (PMADs).


If you, a client, or someone you love is in danger, seek help immediately by dialing 911, or using one of the options below:

  • National Suicide Hotline: 1-800-273-TALK (8255)
  • Crisis Text Line: Text CONNECT to 741741 in the United States
  • PSI Warmline 1-800-944-4773 (#1 En Español or #2 English) or Text “Help” to 800-944-4773 (EN), o envía un texto en Español al: 971-203-7773

The #bebobabes!




Your future is created by what you do today — that's why we created a completely FREE mindset mini-course to help doulas and birth workers find bliss in their business!

Leave a Comment