Psychedelics and Perinatal/Postpartum Mood and Anxiety Disorders (PMADs) with Kate Kincaid, LPC

Giving birth is a life-changing experience. Your body transforms for nine months, and then a tiny human emerges. Their life is entirely your responsibility. 

Becoming a mother can significantly reshape a woman’s identity, priorities, and sense of self. This experience provides a renewed sense of purpose and meaning in life, focusing on the care and upbringing of a child. For many women, this sudden change can also put them at risk of Perinatal/Postpartum Mood and Anxiety Disorders (PMADs).

“My first postpartum period was really disorienting and overwhelming, and I struggled with postpartum depression…I found help and support with psychedelics.”

— Kate Kincaid, LPC

Unfortunately, these concerns are often understudied and misunderstood, leading to limited effective treatment options. We spoke with Kate Kincaid, LPC, about psychedelics as a potential option for those in need.

Register for Kate’s Course: Psychedelic-Assisted Psychotherapy for the Perinatal Period

Kate runs a private practice in Tucson, AZ, specializing in LGBTQIA+ clients, ethically non-monogamous relationships, psychedelic integration therapy, and ketamine-assisted psychotherapy. A graduate of the CIIS Center for Psychedelic Studies and Research, she has applied for eligibility with MAPS PBC to offer MDMA-assisted psychotherapy. Co-creator of the Southwest Love Fest, Kate’s therapeutic style is informed by feminism and social justice. She believes many client issues stem from responses to oppressive systems and uses an eclectic approach influenced by attachment theory, humanistic psychology, somatics, and neuroscience.

Kate Entering the Psychedelic World

Ever since she was in high school, Kate has been interested in psychedelics. She has been a therapist since 2010. But then, when at Burning Man, Kate heard about the Zendo Project and how MAPS was bringing MDMA to clinical use. She started reading about past uses and learning about the future directions of psychedelics in research. Then, about four years ago, she began practicing ketamine-assisted psychotherapy.

Her Journey into Motherhood: “I Found Help and Support with Psychedelics.”

We asked Kate how she ended up having a particular interest in psychedelic-assisted psychotherapy for the perinatal period. She described her personal experience entering motherhood. She’s a mom of a four-and-a-half-year-old and a two-year-old. Kate shared:

“My first postpartum period was really disorienting and overwhelming, and I struggled with postpartum depression…I found help and support with psychedelics…I knew about psychedelics [since] I’d already had a practice of using them therapeutically, so I leaned on those tools…then I wanted to do more research on how they could help other people during those times.”

We asked Kate if she found a difference between her first and second pregnancy, given her difficult postpartum depression experience. She shared that she felt more prepared with her second because she knew what to expect. This time, she knew it was temporary and what tools to use. She was more proactive in getting support. Also, her babies were night and day. Her first one was a restless baby who didn’t sleep well, was hard to soothe, and struggled with nursing. Her second one was the complete opposite. Kate said:

“I thought I was prepared for my first one, but I think there’s not really that much you can do to prepare until you go through it.”

Perinatal/Postpartum Mood and Anxiety Disorders (PMADs): An Understood and Misunderstood Condition

Perinatal/postpartum mood and anxiety disorders (PMADs) are the most prevalent complications during pregnancy. Experts estimate that 15–21% of women experience PMADs during pregnancy and postpartum, with 1 in 7 affected by perinatal depression and 13–21% experiencing perinatal anxiety. However, PMADs are often misunderstood and understudied. 

“Perinatal/postpartum mood and anxiety disorders (PMADs) are the most prevalent complications during pregnancy.”

— Kate Kincaid, LPC

Kate shared that part of the reason for this gap is that society typically gives attention to the health of the baby, not the mother. Kate said:

“[P]eople don’t want to touch pregnancy or new moms because we’re worried about harm to the baby…the focus is more on the wellness of an unborn child or a child rather than the person carrying the child or the well-being of the mothers. I think that’s a reflection of the current state of our society that we live in here and at least in America.”

She shared how pregnant women feel like goddesses and people worship them during this time. But then, after giving birth, the mother disappears and becomes a feeding thing. They’re not the main event anymore; the baby is.

Social and Cultural Factors

Kate spoke about the social and cultural factors contributing to the lack of research in this area. 

“There’s a lot of shame [for mothers]…This is what you’re made for…so you should love this. And then there’s a lot of shame when you don’t love it, or you’re having a hard time.”

Kate mentioned that, generally, there’s not a lot of support for families. For the nuclear family, one or two caregivers primarily take care of the kids. There’s not a lot of childcare support, which puts much pressure on parents.

“There’s no time to check in with yourself. How do I feel about what’s going on with me? What do I need? You literally are just going going going…trying to keep up with these kids.” 

Kate adds that there isn’t enough focus on normalizing feelings in recovery. Society expects people to snap back and get back to work after giving birth.

Lack of Conversations Surrounding Birth Trauma

Kate explained that if there are any medical complications during birth, it increases the risk of anxiety for the mother. A lot of her clients suffer from OCD. For instance, constantly checking on the baby and watching them sleep to ensure they are okay. They become obsessive and fearful that something will happen to their baby.

She shared that during her first pregnancy, she went to birthing classes; they didn’t talk about the negative experiences, and she disagrees with this approach.

“I think we should talk about everything that could happen [while giving birth] so that if the worst happens, you’re not surprised. You know you’re not the only one that this terrible thing happened to…Birth trauma is a big deal because people don’t talk about it beforehand or after…[E]ven when you start to talk about it afterwards, it’s like, “Well, at least the baby’s healthy.” If your baby is healthier, you get dismissed. You just had this traumatic thing happen to your body, and you were out of control, and you need to process it.”

Current Treatment Options for PMADs

We asked Kate to speak about how the lack of research and treatment options affects those who struggle with PMADs. She explained that there are limited options for people who are struggling with postpartum depression. 

Medications 

There are the classic SSRIs. In August 2023, the FDA-approved Zurzuvae (zuranolone), the first oral treatment for postpartum depression. Kate described the limitations of the new drug.

“[It’s] a two-week intervention, but it completely disrupts breastfeeding. You can’t breastfeed on it, nurse or chest feed on it. I don’t think that supports the whole picture of the mom or her choices of what she wants to do…that’s a pretty big consequence for people who are passionate about nursing.”

Talk Therapy

Kate personally works with a lot of moms and parents who struggle with PMADs. In her experience, talk therapy has been incredibly beneficial. Kate explained:

“Talk therapy is amazing. It helps with processing, normalizing, and validating what’s going on, [especially] if there was any birth trauma, which increases the risk of PMADs. A lot of people who have birth trauma, whether they conceptualize it as that or not, don’t know it until they start processing it. Anything that happens too fast, too strong, or they don’t feel like they had control [over] during their birth can lead to feelings of helplessness.”

EDMR (Eye Movement Desensitization and Reprocessing)

Kate also practices EDMR (Eye Movement Desensitization and Reprocessing) with her clients as a type of trauma treatment. Francine Shapiro designed EMDR to alleviate the distress associated with traumatic memories. The psychotherapy technique involves the patient recalling distressing events while simultaneously undergoing bilateral sensory input, such as side-to-side eye movements, hand tapping, or auditory tones. 

Researchers think this process helps the brain reprocess traumatic memories, reducing their emotional impact and improving psychological resilience. EMDR is widely used to treat post-traumatic stress disorder (PTSD) and other trauma-related conditions.

Ketamine-Assisted Psychotherapy

Kate also recommends ketamine-assisted psychotherapy for her clients. The benefit of ketamine for postpartum depression is that it leaves the breast milk after 12 hours. 

“KAP for postpartum is an immediate intervention so people feel relief in the moment, and then they’re able to resume breastfeeding after 12 hours.”

However, more research is needed to understand ketamine on postpartum depression, including dosage, timing, and how long the effects last.

Kate’s Personal Thoughts on Microdosing

Kate thinks microdosing is awesome because it helps with hormonal issues. She microdoses with her cycle, more after ovulation and up until menstruation, helping with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMMD).

“Microdosing is life-changing. I feel like it takes this hormonal veil off. Oh, everything’s not screwed forever. It’s okay. It’s temporary…it takes off this filter of negativity and helps people feel more present and connected to themselves and their babies.”

Parallels Between Birth, Postpartum, and Non-Ordinary States

Kate spoke about the similarities between giving birth, postpartum, and non-ordinary states.

Soul-Revealing

She shared that when you think of the word psychedelic, it means soul revealing. Giving birth, postpartum, and the long parenting journey is very soul-revealing. Similar to non-ordinary states, parenting allows us to ask ourselves:

• Where am I stuck?
• What do I still need to work on?
• Where are my triggers?

“[Giving birth, postpartum, and parenting is] non-stop therapy if you’re present and aware, which is hard because you’re trying to keep up with the day-to-day…So, in that way, it’s an opportunity to really know yourself and your soul and what you’re working on in this life.”

Humbling

Kate compared her psychedelic experiences and parenting journey. 

“My psychedelic experiences are very humbling…I think I’m gonna know what I’m doing, but then…all there is to do is surrender, try to relax a little bit, and go with what’s happening, and I feel like parenting does the same thing.”

Relentless

Kate feels that with non-ordinary state experiences, particularly with ayahuasca, even though she knows they’re going to end, it feels relentless.

“I feel like that’s what birth and postpartum and parenting is. It’s relentless…you don’t really get a couple of hours off…maybe somebody takes them overnight or for a few days, but you never really get a break.”

Out-of-Body Experience

Becoming a parent makes us realize there is more to life than ourselves. Kate talks about the surreal experience that happens outside the body which also often occurs during non-ordinary states.

“I’ve heard somebody say this before…[When you become a parent], it’s like your heart is outside of your body now. I was thinking about this with pain…if I see [my child] running and they’re about to hit something, I feel it in my body. It’s so weird to have something [happen] outside of your body, but you’re feeling it in your body.”

References

American Psychological Association. (2017, July 31). Eye Movement Desensitization and Reprocessing (EMDR) Therapy. American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing.

Grant, A. (2023, August 3). FDA Approves First Oral Treatment for Postpartum Depression. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression.

Hernandez, N. D., Francis, S., Allen, M., Bellamy, E., Sims, O. T., Oh, H., Guillaume, D., Parker, A., & Chandler, R. (2022, March 27). Prevalence and Predictors of Symptoms of Perinatal Mood and Anxiety Disorders among a Sample of Urban Black Women in the South. Maternal and Child Health Journal, 26(4), 770–777. https://doi.org/10.1007/s10995-022-03425-2.