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Published in: JOURNAL, mental health, postpartum

Is This Postpartum Depression? with Therapist Nikki Lively

Nyssa spoke with Nikki Lively, Emotionally-Focused Couples Therapist, about PMADs and Postpartum Depression, including the importance of language and how it helps us contextualize our experiences. 

We asked: Postpartum Depression has become a kind of catch-all term that doesn't adequately capture the nuances and dynamism of the postpartum experience. What would you like to see change, specifically in terms of language? 

I think this is problematic not only because it doesn’t represent everyone’s experience of mental illness postpartum, but also because there is a connotation about the word depression— usually that it means someone is predominantly down in the dumps or sad and potentially unable to function in their daily lives.

This leads to many women saying to themselves, ‘well, I don’t feel sad, so I don’t have postpartum depression’ or ‘well, I’m getting out of bed everyday, so what I’m feeling must be something wrong with me’ and then they may stay quiet about their symptoms even though they are very much struggling.

It’s important that we see ourselves and our experiences reflected in our language — otherwise it can be extremely difficult to reach out for help or even to have a way to describe what you need help with!

My field has come up with the term Perinatal Mood and Anxiety Disorders (PMADs, pronounced Peemads) in an attempt to be more inclusive— it reminds me of the acronym LGBTQIA— as a culture moving to represent previously invisible identities surrounding sexuality and gender we’ve developed a way with these letters to begin to acknowledge more fully the lived experiences of people outside the heteronormative mold.

Though there are still some categories of experience not represented in the acronym PMAD, it serves a similar function for women that is definitely more encompassing of the most commonly occurring mental health struggles that can occur during pregnancy and postpartum.

I’d like to see ‘PMADs’ be the default term used and that we add more letters to this acronym as needed to raise awareness of the diversity of experiences for which women need help and support.

 This article was originally published on 12/22/12 as part of a longer piece titled "Postpartum Q&A with Emotionally-Focused Couples Therapist Nikki Lively"

Read the rest of our conversation with Nikki Lively: 

Navigating Your Fourth Trimester Identity & Relationships with Therapist Nikki Lively

The Transition to Parenthood: Common Struggles & Taboos with Emotionally-Focused Therapist Nikki Lively

artwork: kit agar


Nikki Lively, Emotionally-Focused Therapist and Director of the Transition to Parenthood Program

When we started Nyssa, one of the first connections we made was with a wonderful therapist, Nikki Lively, who later joined our Board of Advisors.

As Clinical Director of the Transitions to Parenthood program at the Family Institute of Northwestern University in Chicago, IL, Nikki is particularly passionate about supporting people throughout the matrescence/patrescene journey.

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Did you know that PMADs (Perinatal Mood and Anxiety Disorders) affect 1 in 5 birthing people? 


It's also the # 1 complication of pregnancy and childbirth ( 

We love this resource from Postpartum Support Virginia that outlines symptoms, predictors & risk factors, and treatment options for an array of Perinatal Mood and Anxiety Disorders. Don't forget, partners are susceptible, too. And symptoms in new dads often look different than for new mothers. 

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