What are Perinatal Mood and Anxiety Disorders? (PMADs)

These are a group of symptoms that can affect women during pregnancy and the postpartum period, causing emotional and physical problems that make it hard to enjoy life and function well. Mood disorders, such as depression or bipolar disorder, can include symptoms of sadness, loss of pleasure, difficulty concentrating and changes in energy. Anxiety disorders, often include symptoms such as worrying too much, panic attacks, irritability and obsessionality. See below for more specific descriptions of normal mood variations with childbirth, as well as different types of mood and anxiety disorders that can affect pregnant and postpartum women.
 

Normal Postpartum Adjustment

Becoming a new parent is stressful, and some difficulty adjusting to parenthood is considered normal. Normal postpartum adjustment may involve symptoms similar to Baby Blues (see below), and it’s likely that most new mothers experience some of these symptoms during the first few months after childbirth. However, if these symptoms are interfering with mom’s normal coping abilities, functioning or parenting, something more serious like a Perinatal Mood and Anxiety Disorder (PMAD) may be happening.

 

BABY BLUES

“I’m feeling sad, irritable, and absolutely exhausted; it’s like I can’t catch a break. Do I have postpartum depression?”

Not necessarily! It’s normal to encounter all of those feelings after delivery. In fact, between 60% and 80% of women experience what professionals describe as the “Baby Blues,” or feelings of exhaustion, irritation, and sadness after having given birth. These symptoms typically begin anywhere from one to three days post-delivery and may last between two and fourteen days. If your feelings persist past two weeks, however, contact a professional; you may be experiencing Perinatal Mood and Anxiety Disorders (PMADs).

 

POSTPARTUM DEPRESSION

“I thought I had the Baby Blues, but my feelings have persisted past two weeks. What’s going on?”

You may be experiencing postpartum depression, but you are not alone. More than 15% of women experience postpartum depression, perhaps even more given that the diagnosis goes highly unreported. Any woman who has given birth within the past 12 months can receive the diagnosis if she experiences the following symptoms:
 

  • Low mood, sadness, tearfullness
  • Loss of interest, joy, or pleasure in things you used to enjoy
  • Agitation or anxiety
  • Lack of energy or feeling slowed down physically
  • Difficulty concentrating
  • Appetite or sleep disturbance
  • Feelings of guilt, shame, or hopelessness
  • Possible thoughts of harming the baby or yourself
     

Remember, every case of postpartum depression is different. You do NOT need to meet all of these symptoms. If you or someone you know is experiencing these symptoms, please call The Motherhood Center at (212) 335-0034 for help. 

 

POSTPARTUM ANXIETY

“My mind won’t stop racing with worry and it’s getting to the point where I am having trouble completing my normal day-to-day activities. Is something wrong with me?”

Most new mothers feel as though they have a thousand things to worry about after having a baby. However, if your feelings of anxiety are interfering with your overall functioning, you may be experiencing Postpartum Anxiety. Like most of the PMADS, Postpartum Anxiety is rather common; 1 in every 10 women endures postpartum anxiety after GIVING birth and 6% of women experience it while still pregnant. Symptoms include:
 

  • Constant worry
  • Feeling that something bad is going to happen
  • Feeling like you can’t turn your brain off
  • Disturbances of sleep and appetite
  • Physical Symptoms like dizziness, heart palpitations, and nausea.


If you have given birth within the past 12 months and identify with any or all of the symptoms mentioned above, please call The Motherhood Center at (212) 335-0034 for help.


POSTPARTUM OCD

“I’ve never been diagnosed with OCD, but I am having obsessive thoughts about my baby -- that something bad will happen to him/her. Why can’t I stop thinking like this?”

Many mothers experience Postpartum OCD without ever having any previous diagnosis of an anxiety disorder. In fact, between 3-5% of mothers report feeling as though they cannot escape these intrusive, irrational and upsetting thoughts unless they engage in a repetitive act. You may be experiencing Postpartum OCD if you encounter any of the following symptoms within twelve months of giving birth:
 

  • Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images regarding the baby. These thoughts are very upsetting
  • Compulsions, where the mom may do certain things over and over again to try to reduce her fears and obsessions. This may include things like needing to clean constantly, checking things many times, counting or reordering things.
  • A sense of horror about these obsessions
  • Fear of being left alone with the infant
  • Hypervigilance in protecting the infant
     

It’s important to know that mothers with Postpartum OCD understand the strange nature of their thoughts and are disturbed by them. Therefore the likelihood of ever acting upon these intrusions is very low.

 

POSTPARTUM PSYCHOSIS

“I’m having some really strange thoughts about my baby and sometimes I feel like others know what I’m thinking. Is this a normal part of the postpartum period?”

If you are seeing or hearing things other people are not, are feeling as though others are out to get you, are hearing or seeing things that others may not, or if you are experiencing highly unusual thoughts regarding yourself or your child, you may be suffering from Postpartum Psychosis. Postpartum Psychosis is rather rare, affecting only 0.1-0.2% of all births. However, it is a serious disorder and requires immediate medical attention. Symptoms include:
 

  • Delusions or strange beliefs that feel real
  • Hallucinations (seeing or hearing things that aren’t there)
  • Feeling confused
  • Feeling disconnected from reality
  • Decreased need for or inability to sleep
  • Paranoia and suspiciousness
  • Difficulty communicating at time
     

While acts of harm to oneself or the baby are uncommon, women suffering from Postpartum Psychosis may do things they might not otherwise do given their altered state. Therefore, seeking urgent attention from professionals is paramount to keeping you and your baby safe. Please call 911 if you believe you or someone you know is experiencing Postpartum Psychosis.


Every disorder listed here is both TEMPORARY and TREATABLE. Seeking support from professionals is an act of courage and the first step to getting the help you deserve. The Motherhood Center aims to serve all women who need assistance during their postpartum period.

Call The Motherhood Center for help: (212) 335-0034. If you are experiencing an emergency, please call 911 or go to your local emergency room immediately.