Perinatal Mood & Anxiety Disorders

What are Perinatal Mood & Anxiety Disorders (PMADS)?

PMADs affect at least 1 in 5 birthing individuals during pregnancy and/or during the first year after childbirth. These illnesses – also known as perinatal mood and anxiety disorders, or PMADS — are the #1 complication of pregnancy and childbirth.

Perinatal mood and anxiety disorders are defined by distressing feelings that occur during pregnancy and throughout the first year after pregnancy. Feelings can range from mild to severe. Without treatment, symptoms may last a few weeks, or several months to years, depending on the severity. In all cases, help is available.

Perinatal mood and anxiety disorders, if untreated, can lead to both maternal and infant
complications including:

Who is affected by PMADs?

1 in 5 mothers and 1 in 10 fathers are affected by a perinatal mood and anxiety disorder.

PMADs most commonly impact the birthing person, but fathers, partners, adoptive parents can also experience anxiety, depression and other mood disorders after the baby arrives. Individuals of every culture, age, income level, and race can develop PMADs.

Onset of symptoms may be gradual or sudden, but should never be ignored. The good news is that PMADs can be treated with some combination of self-care, social support, talk therapy, and, if necessary, medication.

Signs & symptoms of PMADS

• Feeling overwhelmed by everyday activities
• Not experiencing joy or pleasure in your usual activities
• Feeling like you’re not doing enough or that you’re a “bad parent”
• Feeling irritable, angry or resentful
• Feeling numb or unable to feel emotions
• Crying/weeping even at times that you can’t explain
• Having difficulty bonding with your baby or having a lack of interest in them
• Constantly worrying about your baby
• Having obsessive, distressing thoughts that pop into your mind repeatedly and interfere with your ability to cope (i.e. “intrusive thoughts”)
• Having frightening thoughts about you or your baby getting hurt
• Feeling afraid to be alone or alone with your baby
• Having thoughts of suicide or “running away from it all”
• Feeling overwhelmed by anxiety or panic attacks
• Having a loss of appetite or overeating
• Having difficulty sleeping or staying asleep, feeling tired and exhausted
• Feeling like you’re alone or have no support
• Having trouble concentrating, experiencing brain fog
• Changing your substance use patterns (ex. drinking more alcohol)
  
  

PMADS risk factors

• Personal or family history of anxiety or mood disorders
• Lack of adequate social support, including support caring for your child
• Lack of a culturally sensitive support network
• Complications for you, your child or both of you during pregnancy and delivery
• Newborn medical complications or hospitalization
• Loss of a pregnancy
• Financial stress
• Lack of sleep
• Shifts in identity from pregnancy to parenthood
• Contrast between expectations and the reality of caring for a new baby.
• Hyperthyroidism or hypothyroidism or other medical issues that you may have
  
  

Different types of Perinatal Mood and Anxiety Disorders     

Baby Blues: Most birthing people — up to 80% — experience a wide range of emotions, including sadness and irritability, during the first few weeks after baby is born. Often referred to as the “baby blues,” this is not a mood disorder but rather a normal adjustment as pregnancy and postpartum hormones calibrate. Symptoms usually last no more than 2 weeks and resolve without medical intervention. If it lasts longer than 14 days, it is more than the blues. 

Perinatal Depression: A person experiencing perinatal depression during pregnancy or the first year postpartum might have social withdrawal and feelings of anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, and feelings of hopelessness and sometimes even thoughts of harming the baby or themselves. Early assessment and treatment are crucial to prevent it from becoming a chronic condition. Learn more about depression including risk factors, symptoms and treatment options.

Perinatal Anxiety: A person with anxiety may have extreme worries and fears, often over the health and safety of the baby and experience insomnia as a result. Some birthing people have panic attacks and might feel shortness of breath, chest pain, dizziness, a feeling of losing control, and numbness and tingling. Learn more about anxiety, including risk factors, symptoms and treatment options. 

Perinatal Obsessive-Compulsive Disorder (OCD): People with OCD can have repetitive, upsetting and unwanted thoughts or mental images (obsessions), and sometimes they need to do certain things over and over (compulsions) to reduce the anxiety caused by those thoughts. These moms find these thoughts very scary and unusual and are very unlikely to ever act on them. Learn more about OCD, including risk factors, symptoms and treatment options. 

Perinatal Panic Disorder: This is a form of anxiety in which the sufferer feels very nervous and has recurring panic attacks or feels unsettling physical symptoms such as trembling, numbness, restlessness and agitation. During a panic attack, she may experience shortness of breath, chest pain, claustrophobia, dizziness, heart palpitations, numbness and tingling in the extremities. Panic attacks seem to go in waves, but they are temporary and resolve without assistance. 

Postpartum Post-Traumatic Stress Disorder (PPTSD): PPTSD is often caused by a traumatic or frightening childbirth, and symptoms may include flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event. Learn more about PPTSD, including risk factors, symptoms and treatment options.  

Psychosis – a TRUE MEDICAL EMERGENCY and requires immediate medical help:  Individuals experiencing psychosis sometimes see and hear voices or images that others can’t, called hallucinations. They may believe things that aren’t true and distrust those around them. They may have persistent thoughts of harming self or baby that are spurring them to act or to make a plan to act. They may also have periods of confusion and memory loss and seem manic. They often have profound agitation and extreme sleep deprivation. This severe condition is dangerous, so it is important to seek help immediately. If you or someone you know may be experiencing postpartum psychosis, call a doctor or go to the nearest hospital emergency room. People with severe perinatal postpartum psychosis may require hospitalization and medication. Learn more about psychosis, including risk factors, symptoms and treatment options.