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Perinatal Mood and Anxiety Disorder (PMAD) Therapy in Birmingham, Alabama

Postpartum Depression • Postpartum Anxiety • Prenatal Mental Health • Infertility • Pregnancy Loss
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What You Are Feeling Has a Name. And It Is Not Your Fault.

You love your baby — or you are trying to have one, or you have lost one — and none of it feels the way you expected. Maybe you feel sad when you are supposed to feel grateful. Anxious when you are supposed to feel at peace. Disconnected when you are supposed to feel bonded.

Whatever you are carrying right now, we want to say this clearly: you are not a bad mother. You are not broken. You are not alone. What you are experiencing is a recognized, common, and highly treatable medical condition. It has a name. It responds to treatment. And with the right support, full recovery is possible.

At Empower Counseling, we offer specialized therapy for Perinatal Mood and Anxiety Disorders (PMADs) in Birmingham, Alabama — for women navigating postpartum depression, postpartum anxiety, prenatal mental health challenges, infertility, pregnancy loss, and every difficult season in between. Our therapist Anna Mills Fleenor, LMSW, specializes in this work and is available for in-person sessions in Birmingham and online therapy throughout Alabama.

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You May Recognize Yourself Here

PMADs look different for every woman — and not always like what you have seen in movies or read about online. You might relate to:

  • Feeling sad, empty, or numb in ways that do not lift
  • Constant anxiety — worrying something terrible will happen to your baby, your family, or yourself
  • Intrusive thoughts that horrify you, even though you do not want them there
  • Feeling disconnected from your baby, your partner, or yourself
  • Rage or irritability that does not feel like you
  • Trouble sleeping even when your baby sleeps — or sleeping far too much
  • Feeling like you are failing at something everyone else does naturally
  • Flashbacks, nightmares, or hypervigilance after a traumatic birth
  • Grief that does not have a name after miscarriage, stillbirth, or failed fertility treatment
  • The relentless emotional weight of infertility — the hope, the waiting, the loss, the starting over
  • Feeling like you have lost yourself entirely in the transition to motherhood

You do not have to be in crisis to deserve support. If any of this sounds familiar, reaching out is the right thing to do.

Our Approach to PMAD Therapy

PMADs are not a sign of weakness or a failure of love. They are the result of hormonal shifts, neurological changes, life circumstances, and a culture that dramatically underestimates how hard this season actually is. The shame that keeps so many women from seeking help is not deserved — and it is one of the first things we work to set down together.

Therapy at Empower begins where you are. Not where you think you should be. Not where you were before any of this started. Where you are right now — even if right now is hard to name.

Anna Mills works with an approach called Acceptance and Commitment Therapy (ACT). In practice, what that means for you is this: you will not be asked to think more positively, push through, or feel better before you can start living again. Instead, you will learn to make room for the hard things — to carry them without being controlled by them — while slowly reconnecting with what matters most to you. Your values. Your relationships. Your sense of who you are.

Recovery is not about returning to the person you were before. It is about finding yourself again — in a new form, in a new season — and discovering that she was there all along.

Sessions are available in person at Empower's Birmingham office and online throughout Alabama.

Anna Mills Fleenor, LMSW
Perinatal Mental Health Therapist
Women’s Therapist

Meet Your Therapist

The person you will work with

Anna Mills Fleenor, LMSW, specializes in perinatal mental health and women's issues — and she came to this work because she believes every woman deserves to feel supported through the seasons of life that no one fully prepares you for. She creates a steady, unhurried space where you can say exactly what you are feeling, without managing it or worrying about being judged.

Women who work with Anna Mills often describe feeling genuinely heard for the first time. Not assessed. Not redirected. Just heard.

Meet Your Therapist, Anna Mills

Understanding What You Are Going Through

Every woman's experience is different. Some arrive knowing exactly what they are dealing with. Others arrive knowing only that something is wrong and they cannot keep carrying it alone. Either way, you are welcome here.

Below is a closer look at what each of these experiences can feel like — not as a checklist, but as a way of saying: we see this, we understand it, and we know how to help.

Postpartum Depression (PPD)
PPD is one of the most common complications of childbirth, affecting approximately 1 in 8 women — and yet it remains dramatically underdiagnosed and undertreated. It can show up anytime in the first year after birth, and it is far more than the "baby blues." PPD can look like persistent sadness, numbness, loss of interest in things you used to enjoy, difficulty bonding with your baby, exhaustion that sleep does not fix, and a quiet voice that tells you your baby would be better off without you. That voice is a symptom. It is not the truth.
Postpartum Anxiety (PPA)
Postpartum anxiety is actually more common than postpartum depression — and far less talked about. It can look like worry that never quiets, a mind that races through worst-case scenarios at 3am, a body that stays tense even when everything is technically fine. You might check on your baby constantly. You might feel a sense of dread you cannot explain. You might look completely okay to everyone around you while feeling like you are unraveling on the inside. What you are experiencing is real, it has a name, and it responds to treatment.
Postpartum OCD (PP-OCD)
Postpartum OCD is one of the most misunderstood and most distressing of the PMADs — largely because its hallmark symptom is intrusive thoughts that feel horrifying to the person having them. Thoughts about harm coming to the baby. Images that arrive unbidden and will not leave. If you are experiencing this, the shame and fear can feel overwhelming. But here is what is important to know: the presence of these thoughts does not make you dangerous. It makes you someone whose brain is working overtime to protect the thing you love most. You are not a monster. You are struggling — and help is available.
Postpartum PTSD (PP-PTSD)
Not every birth goes the way you hoped. Some births are frightening, chaotic, or leave you feeling powerless in ways that stay with you long after you come home. If you find yourself replaying what happened, avoiding reminders, startling easily, or feeling detached from your own life, you may be experiencing postpartum PTSD. Well-meaning people might tell you to be grateful — you and the baby are healthy, after all. But you can love your baby completely and still be carrying something traumatic. Both things are true. Both deserve care.
Perinatal Depression and Anxiety
Depression and anxiety do not wait for the baby to arrive. Many women begin experiencing significant symptoms during pregnancy — and feel confused or ashamed because pregnancy is supposed to be a happy time. If you are struggling during pregnancy, you are not failing. You are not ungrateful. You are experiencing a medical condition that is common, recognizable, and treatable. You deserve support now. You don’t have to wait until the baby is born.
Infertility and Fertility Treatment Distress
The infertility journey is one of the most emotionally demanding experiences a woman can go through — and one of the least acknowledged. The hope and the waiting. The procedures and the grief. The way your body can start to feel like something working against you. The isolation of sitting with losses that the world does not always recognize as losses. If you are in the middle of this, you do not have to keep managing it alone. What you are feeling is not weakness. It is the weight of something genuinely, profoundly hard.
Pregnancy Loss and Reproductive Grief
Miscarriage. Stillbirth. A pregnancy that ended too soon. These losses are real — and for many women, they are carried quietly, often without the space to grieve them fully. If you are here because of a loss, we want you to know: your grief is valid. The baby you lost mattered. And you are allowed to take as long as you need.
The Transition to Motherhood (Matrescence)
Becoming a mother is one of the most significant identity transformations a person can undergo. Researchers call it matrescence — a process as profound as adolescence, involving the reshaping of your identity, your relationships, your body, your values, and your sense of self. When that transition is difficult, disorienting, or accompanied by grief for the self you were before, therapy can help you find yourself again in this new form.

You Are Not Alone

Women suffer in silence because they believe they are the only ones who feel this way. The truth, backed by research, tells a very different story.

1 in 5 Women

are impacted by a maternal mental health condition. (Hemstad, 2026)

1 in 8 Women

experience symptoms of postpartum depression after giving birth. (Carberg, 2025)

Up to 80%

of women with postpartum depression achieve full recovery with appropriate treatment. (Carberg, 2025)

Up to 52%

of women struggling with infertility experience anxiety and depression symptoms. (Kiani et al., 2021)

Women undergoing ART treatment often see stress and anxiety increase significantly due to invasive procedures and added responsibilities. These are not signs that something is wrong with you. They are human responses to genuinely hard experiences.

Why So Many Women Never Seek Help

Women believe they should be happy — and are ashamed they are not. They worry about being seen as unfit or ungrateful. They do not know what they are experiencing has a name, or where to turn for specialized help. None of those fears make seeking help less necessary. They make it more important. The data is clear: with the right support, the vast majority of women recover fully. You are exactly who this treatment was designed for.

Not sure what you are experiencing has a name? Read our plain-language guide to PMAD terms →

How ACT Treats PMADs

Acceptance and Commitment Therapy (ACT) is one of the most well-researched approaches for perinatal mental health. Unlike approaches that focus on eliminating difficult feelings before you can move forward, ACT teaches you to make room for painful experiences — the grief, the worry, the intrusive thoughts — without being controlled by them. It directly addresses the shame and self-criticism that keep so many women stuck, and helps you reconnect with your values and sense of self, even before symptoms fully resolve.

Research consistently supports ACT as an effective treatment for perinatal depression and anxiety, with demonstrated improvements in psychological flexibility, symptom severity, and quality of life.

Lean more about how act works

You do not have to keep carrying this alone.

Whatever you are navigating right now — the sadness, the fear, the grief, the exhaustion of a role that is harder than anyone told you it would be — support is available, and recovery is possible.

Anna Mills is accepting new clients beginning June 1, 2026. In person in Birmingham. Online throughout Alabama.

You are not alone. Let's begin.
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Other Services at Empower Counseling

We offer a full range of counseling services for women in Birmingham, AL and throughout Alabama — in person and online:
Anxiety Therapy • Depression Counseling • Trauma Counseling • Eating Disorder Therapy • Body Image Therapy • Counseling for Difficult Life Transitions • Young Adult Counseling • Online Therapy in Alabama