Postpartum Depression • Postpartum Anxiety • Prenatal Mental Health • Infertility • Pregnancy Loss
Perinatal Mood and Anxiety Disorder (PMAD) Therapy in Birmingham, Alabama
What You Are Feeling Has a Name. And It Is Not Your Fault.
You love your baby — or you're trying to have one, or you've lost one — and none of it feels the way you expected. Maybe you feel sad when you're supposed to feel grateful, anxious when you're supposed to feel at peace, disconnected when you're supposed to feel bonded.
Whatever you're carrying, we'll say it clearly: you are not a bad mother. You are not broken. You are not alone. What you're experiencing is a recognized, common, and highly treatable medical condition. It has a name, it responds to treatment, and 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, with in-person sessions in Birmingham and online therapy throughout Alabama.
You May Recognize Yourself Here
PMADs look different for every woman, and not always like what you've seen in movies or read online. You might relate to:
- Feeling sad, empty, or numb in ways that don't lift
- Constant anxiety — worrying something terrible will happen to your baby, your family, or yourself
- Intrusive thoughts that horrify you, even though you don't want them there
- Feeling disconnected from your baby, your partner, or yourself
- Rage or irritability that doesn't feel like you
- Trouble sleeping even when your baby sleeps — or sleeping far too much
- Feeling like you're failing at something everyone else does naturally
- Flashbacks, nightmares, or hypervigilance after a traumatic birth
- Grief that has no 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've lost yourself entirely in the transition to motherhood
You don't 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're the result of hormonal shifts, neurological changes, life circumstances, and a culture that dramatically underestimates how hard this season is. The shame that keeps so many women from seeking help is not deserved — and it's 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 Acceptance and Commitment Therapy (ACT). In practice, that means you won't be asked to think more positively, push through, or feel better before you can start living again. Instead, you'll learn to make room for the hard things — to carry them without being controlled by them — while slowly reconnecting with what matters most: your values, your relationships, your sense of who you are.
Recovery isn't about returning to the person you were before. It's about finding yourself again — in a new form, in a new season — and discovering she was there all along. Sessions are available in person at Empower's Birmingham office and online throughout Alabama.
Meet Your Therapist
Anna Mills Fleenor, LMSW, specializes in perinatal mental health and women's issues — she came to this work because she believes every woman deserves support through the seasons no one fully prepares you for. She creates a steady, unhurried space where you can say exactly what you're 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.
Understanding What You Are Going Through
Every woman's experience is different. Some arrive knowing exactly what they're dealing with. Others know only that something is wrong and they can't keep carrying it alone. Either way, you're 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)
One of the most common complications of childbirth, affecting approximately 1 in 8 women, and yet dramatically underdiagnosed and undertreated. It can show up anytime in the first year after birth and is far more than the "baby blues" — persistent sadness, numbness, loss of interest in things you used to enjoy, difficulty bonding with your baby, exhaustion sleep doesn't fix, and a quiet voice telling 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're the only ones who feel this way. Research tells a very different story — and these experiences are not signs that something is wrong with you. They are human responses to genuinely hard things.
Why so Many Women Never Seek Help
Women believe they should be happy and feel ashamed they're not. They worry about being seen as unfit or ungrateful. They don't know what they're 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 →
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)
How ACT Treats PMADs
Acceptance and Commitment Therapy (ACT) is one of the most well-researched approaches for perinatal mental health. Rather than trying to eliminate difficult feelings before you can move forward, ACT teaches you to make room for the painful ones — 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 for perinatal depression and anxiety, with improvements in psychological flexibility, symptom severity, and quality of life.
You are not alone. Let's begin.
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.