PMADS: Have I lost my mind?


I had never heard the term Perinatal Mood and Anxiety Disorders (PMADS) before, and to put this into perspective, I was 3 kids in already. I assume, like most people, I had heard about postpartum depression. Randomly though, hence it had a very distant “it-won’t-touch-me” ring to it. Until it did. If this is any consolation to you, as it was to me, PMADS are in fact quite common, with a prevalence rate of approximately 20% (possibly more) covering the period from pregnancy up to 1 year postpartum. 

What are PMADS? 

Perinatal Mood and Anxiety Disorders (PMADS) is a term used for the symptoms reflective of disorders which may occur during the perinatal period. For some, symptoms experienced will fit into one specific category, for example, only having feelings of despair, disinterest, and not wanting to participate in anything you once found pleasure in. This may be indicative of a mood disorder, such as depression. However many struggle with a cocktail, ranging from, the said, disinterest, as well as intrusive thoughts and disturbing flashbacks of the birth experience, which would then cut across both mood and anxiety disorders.  Neither is better or worse. The consolation is the growing awareness around the mixed experience and knowledge that for some of us, it isn’t depression, rather, we just cannot shake the idea that something bad might happen to the baby, and that makes it impossible to “get some rest when the baby naps.”

Baby Blues or PMADS?

While baby blues often cause a sudden dip in emotions a few days after giving birth, emotions soon re-stabilize within hours to days, no longer than a week. PMAD symptoms tend to last longer. Depending on the individual symptoms may include:

  • Feelings of despair and disconnection
  • Paranoia
  • Confusion 
  • Hallucinations
  • Flashbacks 
  • Extreme highs, followed by crippling lows

Amongst many other symptoms. Lack of sleep is a slippery one to nail, because most new parents don’t get to sleep either way. However if the opportunity to sleep presents itself and you still cannot fall asleep, (past the sweet days of fixation over how precious your little one is) this may be something you shouldn’t overlook. More so if you feel a reduced need for sleep.  

Help for PMADS

For years I assumed that mental health was a foreign concept to Africa. When I dug deeper I came to understand that it wasn’t that. It was simply a different perception and way of handling it. One of the key attributes in helping a new mother experiencing PMADS heal is for her to have a strong and present support system. In Africa, we had this on lock once upon a time. In fact, we worked it in from prevention. Which isn’t always as easy now as it used to be when family members lived closer to one another. 


More healthcare providers are starting to screen expecting women during pregnancy and after childbirth. Sadly, many others aren’t there yet and often our healthcare systems are stretched too thin to be able to do so. Screening online, will take less than 10 minutes of your day, and you will get your results by email. It’s important to keep track of how you’re doing emotionally and psychologically, and to know when you need help.   

Talk to someone 

The approach anyone takes concerning their health and well-being is very personal. The first step towards your healing is acknowledgment that you are not feeling well. But here is an important aspect; you cannot just talk to anyone and expect them to know how to listen or what to say. Sometimes the closest people to us aren’t emotional geniuses and other times, they just don’t know what to do either…so they say all the wrong things. When you look for someone to talk to, you may want to start with someone who knows about PMADS and will understand what you are going through.  I didn’t know who to talk to when I started having intrusive thoughts, and at the time it was mentally impossible for me to go to a healthcare provider because I simultaneously had trauma. I found PSI online which was really convenient because that’s where most new mommies get a glimpse of life out there. They were an immeasurable resource in my healing. You need to know what’s going on. And you need to know you will make it through, with the right help. 

Support Groups  

Human interaction is crucial to our well-being. For some of us, this is the version of support we can access today. PMADS support groups will often be a small group ( approximately 10) mothers/ mothers to be. These groups create a safe environment to share, sometimes to vent and other times to just breathe. Face to face groups are an awesome reason to get some air outside the house, but fortunately for those who can’t or prefer not to you can find online support groups as well. Like medicine, you might not feel better the first time you go, but community is essential to your healing. 


Talk therapy/ counselling where available and accessible is a method of treatment for PMADS. Sometimes this may entail couple therapy/ family therapy, which can also help to sensitise loved ones to what you are experiencing and how best they can support you. Where possible, finding a therapist who specialises or is experienced in perinatal mental health will serve you well.   


Depending on severity of the PMADS and other health factors, a doctor may prescribe medication to support your mental health on your journey to recovery. Like all medicine some types may take getting used to, others may work well with one individual and be downright awful for another. Keep the goal in mind and exercise your right to ask as many questions you need to. If your doctor is dismissive of your concerns, you may need to find another one. 

Alternative Therapy/ Healing 

For many reasons alternative therapy/ healing will be a chosen route. For some they will use this concurrently with other forms of treatment. Alternative healing can be PMAD informed exercising, for others it may be meditation and mindfulness to handle intrusive thoughts. What is important is to do what works for you.

Where Am I? 

You are not lost. I hoped, so often, to be who I used to be again. I did get better, I did find exciting moments in life again. I was never the same though. I came out of my experience with a deeper understanding of how vast an individual I was, with emotions so powerful. Now I can safely relate to another mommy in the depths of PMADS and dive right in to remind her You’ve got this momma!”