The Two Most Common PMADs: An Introduction
You feel awful, but you can't quite put your finger on it. Are you sad, or are you just worried all the time? Is the pit in your stomach from hopelessness, or is it from a constant sense of dread? In the overwhelming fog of the postpartum period, trying to untangle your feelings can feel impossible. This is especially true when it comes to the two most common Perinatal Mood and Anxiety Disorders (PMADs): Postpartum Depression (PPD) and Postpartum Anxiety (PPA).
While they are distinct conditions, their symptoms often overlap, and many people experience both at the same time. Understanding the key differences between the heavy weight of postpartum depression and the frantic buzz of perinatal anxiety can help you find the right language to describe your experience and get the most effective treatment.
You're Not Alone: How Common Are PPD and PPA?
PPD affects as many as 1 in 7 new mothers, while PPA is believed to be at least as common, if not more so. These are not rare disorders; they are widespread complications of the massive life transition that is becoming a parent.
Why It's So Hard to Tell Them Apart
The confusion is understandable. Both conditions can cause irritability, difficulty sleeping, and changes in appetite. Both can make you feel like you are failing at motherhood. Furthermore, the experience of living with one can easily trigger symptoms of the other, creating a tangled web of symptoms that is hard to sort through on your own.
Understanding Postpartum Depression (PPD): The Weight of Sadness
Postpartum depression is a mood disorder characterized by a persistent feeling of sadness and a loss of interest in activities you once enjoyed.
The Core Feeling: Hopelessness and Emptiness
At its heart, PPD is often about a heavy sense of hopelessness. The world can feel gray and colorless. You may feel empty, numb, or profoundly sad, believing that things will never get better. It’s a feeling that is more than just a step beyond the baby blues; it is a persistent and impairing mood state.
Key Symptoms of PPD
- A depressed mood or severe mood swings
- Crying excessively
- Feeling worthless, ashamed, or guilty
- Loss of pleasure or interest in most activities
- Overwhelming fatigue or loss of energy
- Withdrawing from friends and family
- Thoughts of harming yourself or your baby
Understanding Postpartum Anxiety (PPA): The Buzz of Fear
Postpartum anxiety is characterized by excessive worrying, a sense of dread, and a feeling of being constantly on-edge.
The Core Feeling: Dread and Catastrophic Worry
The engine of PPA is fear. Your mind is stuck in a loop of "what if?" scenarios, nearly always ending in catastrophe. You may have a constant feeling that something terrible is about to happen to you or your baby. This isn't just normal new-parent worry; it's a level of anxiety that is intrusive and debilitating.
Key Symptoms of PPA
- Constant, racing thoughts that you can't control
- A persistent sense of dread or impending doom
- Inability to relax or sit still
- Physical symptoms like a racing heart, dizziness, shortness of breath, or nausea
- Panic attacks
- Obsessive fears about the baby's health and safety
The Overlap: Can You Have Both PPD and PPA?
Yes. In fact, it's incredibly common to experience both conditions at the same time.
The Reality of Co-Occurring Conditions
Research suggests that at least 50% of people with postpartum depression also have a co-occurring anxiety disorder. For many, it's not a clear case of one or the other, but a distressing mix of symptoms from both.
How One Can Trigger the Other
It's easy to see how a cycle can develop. The constant, exhausting worry of PPA can wear you down, leading to feelings of hopelessness and depression. Conversely, the low energy and negative self-talk of PPD can make you feel incapable of protecting your baby, which can trigger intense anxiety. The shared causes of postpartum depression, like sleep deprivation and hormonal shifts, are also triggers for anxiety.
Why Getting the Right Diagnosis Matters
While the treatment paths have similarities, understanding the primary driver of your distress helps tailor your care.
Tailoring Treatment to Your Specific Needs
If anxiety and racing thoughts are your primary struggle, a therapist might focus on cognitive-behavioral techniques to challenge catastrophic thinking. If deep sadness and lack of motivation are the main issues, therapy might focus more on behavioral activation and processing feelings of grief or loss. Getting the right diagnosis ensures you get the right tools.
How to Talk to Your Doctor About Your Symptoms
When you talk to a provider, try to describe the core feeling. Do you feel more weighed down by sadness, or more activated by fear? Do your thoughts tend to dwell on the past and present, or are they constantly racing toward a catastrophic future? Giving these specific details will help your provider understand the nuances of your experience.
You Deserve to Feel at Peace
Whether you are struggling with PPD, PPA, or a combination of both, the most important thing to know is that you don't have to live this way.
The Path to Healing for Both Conditions
Both PPD and PPA are highly treatable with therapy, medication, and strong social support. The path to healing involves learning to manage the symptoms while addressing the root causes.
Finding Comprehensive Support
Because these conditions are so intertwined, finding a therapist who is an expert in perinatal mental health is key. They will understand the complex interplay between depression and anxiety in the postpartum period and can create a holistic treatment plan that addresses all of your symptoms.
You don't have to untangle these feelings on your own. Schedule a free, confidential consultation with a Phoenix Health care coordinator to find a specialist who can help you feel calm and like yourself again.