PMDA Blog

Welcome to our official Blog!

The PMDA Monday Blog will discuss the many many aspects of Perinatal Mood Disorders, from what they are, to how to identify them, to how and where to get help. It is our hope that all of you find this a beneficial resource!
Read it HERE every Monday!
Written by Sarah Wizel, PMDA Advocate at Large

All About Mood Disorders During Pregnancy

posted Jul 4, 2015, 7:34 PM by AndrewandSarah Witzel


Antenatal depression (depression during pregnancy) is estimated to affect at least 10% of pregnant women, and receives even less attention than postpartum depression. Women can of course experience other mental health concerns during pregnancy, such as Obsessive Compulsive Disorder and Eating Disorders.


Many symptoms of depression such as fatigue, appetite changes, and difficulty sleeping can overlap with pregnancy symptoms. However, these symptoms and other signs of depression or mood disorders should not be ignored or chalked up to “hormones.”


I believe now that I experienced some antenatal depression during my first pregnancy. However, I remained functional and my doctor believed in the inaccurate and outdated notion that pregnancy protects against mood disorders (which it doesn’t). I believe these circumstances contributed to minimal attention to my mental health during pregnancy.


During my current (second) pregnancy, I have been much more attentive to changes in my mood, which have included difficulty sleeping and staying asleep for no discernable reason, widespread irritability, difficulty concentrating, and lack of interest in socializing or my regular activities. My doctor has referred me to the maternal mental health program here, and increased my medication slightly. I have also focused more on maintaining good sleep habits, keeping up with regular exercise, and avoiding negative thought patterns.


If you do think you may be having mood problems during pregnancy, talk to your health care professional and don’t hesitate to get a second opinion if required. Depending on the severity of your symptoms, treatment may include talk therapy, a support group, and/or medications.

A Helping Hand - My Decision to Hire a Doula

posted Jun 14, 2015, 7:21 PM by AndrewandSarah Witzel


Due to my first child’s traumatic birth 3.5 years ago, I was uneasy about the thought of going through labor again with my new baby. My husband and I decided early on to hire a doula to increase our chances of having not only a physically healthy birth, but a psychologically and emotionally healthy one as well.


A labor doula is a professional birth attendant. She is not trained in the medical management of childbirth, like a midwife or doctor, but rather focuses on physical comfort and emotional support for the mother and the partner. Using a doula can reduce the need for birth interventions, and one study showed a decreased risk of postpartum depression in women who were supported by labor doulas during birth.


I wish I had known about doulas during my first pregnancy! I was surprised at how much time my husband and I spent alone during labor in the hospital (the nurses came and checked on us occasionally). The continuous support of a doula would have been helpful for this reason, plus I knew nothing of the different positions for labor and how they affect progress. Even though I took the prenatal classes offered by the hospital, I was still quite unprepared.


I met three doulas before we decided on the one we hired. It is important to meet at least a few (some families interview more) to ensure that your personalities and birth philosophies align. The fees were definitely a consideration (they range from anywhere from free to over $1500, depending on your financial circumstances, experience of the doula, your geographic region, etc), but the most important consideration was talking to the doula we chose made me feel excited to give birth inside of anxious.


References and further reading:


http://www.dona.org/mothers/index.php

http://www.researchgate.net/profile/Christine_Schetter/publication/14904420_Social_support_in_pregnancy_psychosocial_correlates_of_birth_outcomes_and_postpartum_depression/links/0912f4ff213d3baa57000000.pdf


The Second Time Around - Pregnancy After Postpartum Depression

posted May 25, 2015, 9:41 PM by AndrewandSarah Witzel

I am now 17 weeks pregnant with our second baby, and I am definitely paying more attention to my mood than the first time I was pregnant! Awareness is the first step.

Here are a few things I am doing differently this time:


  1. Staying on my medication during pregnancy (discussed with doctor) because we feel that the risk of untreated depression outweighs the risk of continued medication use.

  2. Being to alert to patterns of low mood and other symptoms of depression or anxiety. In contrast to what my doctor told me during my first pregnancy, being pregnant does not protect against mood disorders - this is an outdated belief.

  3. Addressing problems before they spiral out of control. For example, I was experiencing some work-related stressors and chose to see a counselor before my stress level and coping skills worsened.

  4. I am exercising most days of the week. I have many reasons for doing this, but the positive effect on my mood is definitely a big one. During my first pregnancy I was mostly sedentary besides some walking.


Being aware of the possibility of antenatal depression (depression during pregnancy) and taking steps to prevent it is definitely making me feel more in control of the situation. It can be hard not to panic when I’m having a bad day and worry it will become many bad days, but so far my off days have been isolated incidents, although I experience them much more frequently than I did before pregnancy.

The Power of a Second Opinion

posted Mar 16, 2015, 9:29 PM by AndrewandSarah Witzel



Receiving an accurate diagnosis and solid treatment plan for your perinatal mood disorder is essential, but is not always easy. Because these mental health conditions are still misunderstood and likely underdiagnosed, health care professionals may fail to diagnose and treat them properly.

So what can you do when your health care worker downplays your symptoms, or gives you a diagnosis that you don’t believe is true? My OB/GYN minimized the symptoms of my mood disorder at my 6 week check-up, attributing my anxiety and trouble sleeping to just being a new mom, despite her being aware of my history of depression. I suspected that this wasn’t true, but unfortunately believed her despite my misgivings. This delayed my diagnosis.


In retrospect, I should have sought a second opinion immediately after this check-up with the OB instead of waiting for the next scheduled visit with a health professional (my daughter’s 2 month vaccinations). I could have talked to a counselor, another physician, or even told my OB about my disagreement with her. For my next baby, I will do better because I know better.


The issue may also be the proposed treatment plan, rather than the diagnosis. Some health care workers are reluctant to prescribe medication for pregnant or breastfeeding women, even though the benefit outweighs the risks in many cases. Conversely, your practitioner may hand you a prescription with no other avenues for support, such as counselling, which would also be a concern.


Sometimes women worry about offending their primary care practitioner by seeking a second opinion, from another doctor, or another health care professional altogether. Remember that you are the boss of your own health, you know yourself better than anyone else does, and an inaccurate diagnosis or substandard care plan will negatively affect both you and your family. You are entitled to a second opinion, and it may be life-changing.


Recommended reading:  


http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=ug5094

Be Prepared - Your Postpartum Plan

posted Mar 2, 2015, 8:32 PM by AndrewandSarah Witzel

Most recent or soon-to-be mothers are familiar with birth plans: a document that specifies preferences for how the birth will go, if pain relief will be offered, who will be present, etc. Equally important is a postpartum plan that covers the weeks after the baby is born.


In many cultures, a postpartum plan would be completely unneeded: women are automatically cared for according to cultural traditions. In Western society though, women are expected to cope on their own fairly early on. A plan helps spell out details rather than assuming your partner and family will know what you want, and can decrease your stress in the early weeks.


Some of the things you may wish to plan ahead for are how visitors will be handled (when can they come, and for how long), who will take care of household chores while the mom is recovering from the birth, and how any older children will be cared for. Picture your ideal postpartum period just like you would picture your ideal birth, and be clear about your expectations and desires. Assumptions will not translate into reality!


Help Is A Click Away - Online Resources for Perinatal Mood Disorders

posted Feb 2, 2015, 6:40 AM by AndrewandSarah Witzel   [ updated Feb 2, 2015, 6:41 AM ]

One of the most difficult things about perinatal mood disorders is that they can lead to deep feelings of isolation. Fortunately, online resources can be very helpful, especially when you don’t feel up to going out, or feel shy about discussing mental health in person. Of course, these resources do not replace counselling and other mainstays of recovery, but they are excellent as a starting point, a way to learn more about mood disorders, and eventually an opportunity to share your own story if you wish. Below are only a few of the available resources:

Postpartum Progress - This is an excellent blog written by a woman who has overcome severe postpartum depression, with many guest posts from other women. It features personal stories as well as helpful information and tips on handling and recovering from all kinds of perinatal mood disorders.

http://www.postpartumprogress.com


Postpartum Support International - This organization has a helpful website, with lots of information for women and their families. Most importantly, they also havea a helpline! Call 800.944.4PPD (4773) to speak to a trained volunteer about your perinatal mood disorder.

http://www.postpartum.net


Perinatal Mood Disorders Awareness Ltd - Of course I need to highlight our own website! PMDA has worked hard to develop a website with many resources. Besides information, you can also find more personalized support through our organization. See here for a list of volunteers who can provide peer support, or message us to be added to our private facebook support group.

http://www.ppda.ca

My Signs of Recovery

posted Jan 13, 2015, 7:32 AM by AndrewandSarah Witzel

Everyone’s recovery from a perinatal mood disorder is a little bit different. Some people recover more quickly than others. Some people have relapses, while others never experience this.


Recovery would be described as the symptoms of the mood disorder either being eliminated, or reduced to a very manageable level. During my recovery, I noticed the following specific changes in my mood and outlook (in addition to better sleep, improved coping skills, etc).


  1. Wishing that there were more hours in the day, rather than counting down the hours to bedtime. This was a sign that I was starting to enjoy life more, rather than just trudging through it.

  2. Renewed creativity - I wanted to do art, write, and start new hobbies. One of the signs of depression is called “anhedonia” which is a loss of pleasure in activities. Actually wanting to do things again showed that this symptom was lessening.

  3. Enjoying parenting more. One morning I remember not getting much housework done. Usually it was because I felt all blah and fatigued, but this day it was because I was having too much fun playing with my daughter - definitely a change!

Surviving January

posted Jan 5, 2015, 9:05 PM by AndrewandSarah Witzel

Ah, January. The Christmas season is wrapping up, leaving us with freezing weather and little sunlight. It is no coincidence that the founder of PMDA chose January to be postpartum depression awareness month!


I personally found the January after my daughter was born to be extremely hard. My mood was at all-time low since her birth and I finally decided to start medication and counselling. After that, it was all uphill!


What can be done to make getting through this month easier? I suggest getting outside the house as much as possible. It can be hard, but getting to a gym or even walking around the mall may help your mood. Get what sunshine you can - open the curtains, and go outside as long as weather will permit you to do so. Today in Saskatoon that’s only about 3 minutes!


Remember that Spring will come soon, and focus on enjoying this month as much as possible. Plan some activities that you will enjoy, and get lots of rest. Eating healthily is important too -  winter squash, sweet potatoes, and cabbage are all in season and are nutritional powerhouses.

New Year’s Resolutions for Perinatal Mood Disorders

posted Dec 30, 2014, 1:43 PM by AndrewandSarah Witzel



  1. Make your mental health a top priority. With work, family, and household obligations, it can be very hard to focus on your own health. If you wait for time leftover after everything else, your recovery won’t happen as quickly or thoroughly as it could. I personally am in the maintenance phase of my recovery, but that also takes time and effort. I need to make sure that I take adequate time for prayer, rest, etc.

  2. Exercise. Not to lose weight. Not to lower blood pressure, build bone strength, prevent diabetes. Exercise to enhance your mental health. It has been proven to be effective in treating depression and other mental health conditions. This is all the motivation I need! I already exercise, but this year I want to do more yoga and strength training, and do aerobic exercise more often as well.

  3. Increase your social support. Even if you are already attending a support group, or seeing friends regularly, try thinking of ways to expand or strengthen your network. I know I could work on talking to friends on the phone more rather than connecting  primarily through texting or facebook.

Social Anxiety - Beyond Shyness or Introversion

posted Dec 15, 2014, 8:09 PM by AndrewandSarah Witzel

Gradually, people are gaining awareness of postpartum anxiety as a distinct condition from postpartum depression. However, many people are still unaware that there are actually different kinds of anxiety disorders. Today I want to mention social anxiety specifically.


Social anxiety is different than shyness or introversion (needing alone time to recharge). Rather, affected people experience symptoms of anxiety such racing heartbeat, nausea, and psychological distress (ex. intense fear of embarassment or judgment) specific to  social circumstances. This differs from generalized anxiety disorder, where symptoms occur in many different circumstances.


While postpartum anxiety disorders in general are gaining more recognition, women with social anxiety may have their diagnosis missed because they function well in many other parts of their life. I was not able to find statistics on the prevalence of social anxiety postpartum. Further research in this area in regards to risk factors, prevalence, and treatment options is needed.


References and further reading:

http://www.ncbi.nlm.nih.gov/pubmed/15686858

http://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/basics/definition/con-20032524

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