You Are Not Alone: Let’s Talk About Perinatal Mood and Anxiety Disorders
As a pelvic floor physical therapist, I spend a lot of time with my patients—typically a full hour at each appointment. That’s a rare gift in today’s fast-paced healthcare system, and I don’t take it lightly. It means I get the privilege of truly listening—to your story, your concerns, your struggles, and your triumphs.
One thing I’ve learned: healing isn't just physical. And when it comes to the perinatal period—pregnancy through the first year postpartum—the emotional and mental load can be just as heavy, if not heavier, than the physical one.
That’s why I want to talk to you about Perinatal Mood and Anxiety Disorders (PMADs)—because you don’t have to suffer in silence.
What Are PMADs?
Perinatal Mood and Anxiety Disorders are a group of emotional and psychological conditions that can occur during pregnancy and after birth. These include:
Postpartum Depression
Postpartum Anxiety
Postpartum OCD
Postpartum PTSD (often after a traumatic birth)
Postpartum Bipolar Disorder
Postpartum Psychosis (a rare but serious condition)
While postpartum depression gets the most attention, anxiety disorders are actually just as common—if not more so. And these symptoms don’t always look like what you might expect.
Signs and Symptoms May Include:
Feeling overwhelmed or hopeless
Racing thoughts, constant worry
Trouble sleeping (even when the baby sleeps)
Intrusive thoughts you’re afraid to share
Panic attacks
Rage or irritability
Feeling numb or detached from your baby
Guilt or shame about how you're feeling
PMADs can affect anyone, regardless of age, background, or birth experience. And they are not a reflection of your strength, love for your child, or ability as a parent. They are medical conditions—and they are treatable.
Why This Matters in a Physical Therapy Setting
You might wonder, “Why is my pelvic floor PT talking about mental health?”
Because when you’re in pain, leaking, recovering from birth trauma, or navigating the physical changes of pregnancy or postpartum life, your mental health matters. It affects your recovery, your energy, your motivation, and your sense of self.
And because physical therapists—especially those of us in pelvic health—often get more time with you than most other medical providers. We aren’t rushing through 7-minute appointments. We sit with you. We listen.
So if something feels off, even if it seems unrelated to your pelvic floor or your physical recovery, please tell us.
My Own Story
This topic is incredibly personal to me because I experienced postpartum anxiety. Despite my training and background in physical therapy, I was caught off guard by the intensity of childbirth and the postpartum period. The constant worry, the racing thoughts, the feeling that something was always just slightly out of control—it was exhausting and overwhelming.
I’m so grateful that I reached out and worked with a mental health provider. That support helped me reconnect with myself, build the tools I needed to feel grounded again, and truly begin to enjoy my experience as a new parent. I want that same relief and support for you, too.
You Deserve a Team—And We Can Help Build It
You don’t need to have all the answers. You don’t even need to know exactly what’s wrong. You just need to speak up. And when you do, we can connect you with the right resources—mental health providers, support groups, OBs, midwives, psychiatrists—who specialize in perinatal mental health.
Your wellness is not just about muscles and mechanics. It’s about you—as a whole person.
Final Thoughts: You Are Not Alone
Motherhood can be beautiful, but it can also feel dark, lonely, or terrifying. If you're struggling, please know this: you are not broken. You are not weak. You are not alone.
You deserve to feel better. You deserve support. And sometimes, it starts with a simple conversation during your PT session.
Let that hour be a safe place—not just for healing your body, but for supporting every aspect of what makes you you.
If anything in this post resonates with you, I’m here to talk—no judgment, no pressure, just support. You are not alone, and you don’t have to figure this out by yourself.
Written by: Dr. Byanca Madrigal