What Are Perinatal Mood and Anxiety Disorders (PMADs)?
By Rachael Weir
Pregnancy and the first year after childbirth bring significant physical, emotional, hormonal, and
social changes. While mood swings and emotional ups and downs can be a normal part of this
transition, some individuals experience symptoms that interfere with daily life. These conditions
are known as Perinatal Mood and Anxiety Disorders (PMADs).
What Is the Perinatal Period?
The perinatal period spans from conception through the first year after giving birth. Although
mood and anxiety disorders can occur at any stage of life, the risk increases during this time
due to hormonal changes, sleep disruption, and the many adjustments that accompany
pregnancy and parenthood.
PMADs include a range of conditions, including perinatal depression, generalized anxiety
disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar
disorder, and postpartum psychosis. These conditions can interfere with daily functioning and
deserve the same attention and treatment as any other medical condition.
PMADs Are More Common Than You May Think
PMADs can affect anyone, regardless of age, background, or pregnancy experience.
Approximately 1 in 5 women and 1 in 10 fathers or partners experience a perinatal mood or
anxiety disorder.
These conditions are not a sign of weakness or poor parenting. Like other health conditions,
they have biological, psychological, and environmental contributors, and effective treatment is
available.
Normal Pregnancy Changes vs. Depression
Some symptoms of depression can overlap with the normal changes of pregnancy, making it
difficult to know when to seek help.
It’s common during pregnancy to feel more emotional, tire more easily, or have disrupted sleep
because of physical discomforts like heartburn or frequent trips to the bathroom. However,
depression often looks different. Persistent sadness, irritability, feelings of hopelessness, or
losing interest in activities you once enjoyed are signs that something more may be going on.
Overwhelming fatigue accompanied by persistent sadness or loss of interest, or difficulty
sleeping even when you have the opportunity to rest, may also be signs of depression rather
than normal pregnancy changes.
Most importantly, thoughts of self-harm or suicide are never a normal part of pregnancy or the
postpartum period and require immediate medical attention.
Understanding the Baby Blues
The baby blues are a normal and temporary adjustment after childbirth, affecting 60-80% of new
mothers. They are caused by the rapid hormonal shifts that occur after delivery, along with the
demands of caring for a newborn and acute sleep deprivation.
Symptoms may include tearfulness, mood swings, emotional sensitivity, and exhaustion. The
baby blues usually begin within the first few days after birth, peak around days three to five, and
resolve on their own within two weeks.
If symptoms become more severe, interfere with daily functioning, or continue beyond two
weeks postpartum, they are not considered the baby blues and should be evaluated by a
healthcare provider.
Why Early Treatment Matters
When left untreated, PMADs can affect nearly every aspect of life. They may strain
relationships, make it more difficult to keep up with medical care, worsen existing health
conditions, and impact work, finances, and childcare responsibilities.
The good news is that PMADs are treatable, and early recognition and intervention often lead to
better outcomes for both parents and their families.
Treatment may include therapy, medication when appropriate, support groups, or a combination
of these approaches. Treatment is individualized based on the specific condition, symptom
severity, and whether the person is pregnant or breastfeeding. Protecting opportunities for
restorative sleep whenever possible and accepting help from family and friends can also play an
important role in recovery.
A Medical Emergency: Postpartum Psychosis
Although rare, postpartum psychosis is a medical emergency that requires immediate treatment.
Symptoms most often begin within the first several days to two weeks after childbirth, although
they can occur later.
Symptoms may include hallucinations, delusions, severe confusion, extreme mood changes, or
losing touch with reality. Anyone experiencing these symptoms should seek emergency medical
care immediately.
You Are Not Alone
If you think you may be experiencing a perinatal mood or anxiety disorder, reach out to your
obstetric provider, primary care provider, pediatrician, or a mental health professional. Early
support can make a significant difference.
Remember, PMADs are common, treatable, and recovery is possible. With appropriate
treatment, most people improve significantly. Seeking help is one of the most important steps
you can take for yourself, your baby, and your family.
Source & Resources: This article is based on educational information from Postpartum
Support International (PSI). To learn more about perinatal mental health or connect with support
groups and additional resources, visit PSI at https://postpartum.net/
