Perinatal Mood and Anxiety Disorders

Perinatal mood and anxiety disorders (PMADs) are a range of emotional and psychological conditions that can occur during pregnancy and the postpartum period (clinically defined as one year after birth, but around here we think it’s much longer than that). These disorders affect not only the mother but also her partner and the overall family dynamics. It is estimated that up to 1 in 5 women experience a perinatal mood or anxiety disorder, making them the most common complication of pregnancy and childbirth. Despite the prevalence rates, symptoms of PMADs are often overlooked and ignored, leaving new moms to suffer (often in silence) and question not only their sanity, but also their ability to be a good mom.

At Modern Motherhood Therapy, we believe that early identification and intervention are crucial for the well-being of not just the birthing person, but also the baby and entire family unit. We strive to create a space where you can come just as you are-messy bun, covered in spit up, dropping “f” bombs if you need to, babe in your arms if that’s what feels good. And also a space where it’s not only safe but encouraged to say the scary thoughts out loud, a space that greets you with an unconditional “hell yes it is” when you talk about how being a new mom is hard, and a soft place to land when you finally say out loud for the first time that it’s not what you expected or were told it would be and you’re struggling.

Understanding the signs and symptoms of perinatal mood and anxiety disorders is essential in recognizing when help is needed. Symptoms may vary person to person, but below is an overview of the most common symptoms associated with each PMAD according to Postpartum Support International.

Please know, the adjustment to motherhood in and of itself is a significant enough reason to reach out to a trained provider, even if you are not experiencing many of the symptoms listed below. Adjusting to all your new roles, navigating friendships and relationships, returning to work after maternity leave, challenges with feeding your tiny human, balancing the mental load, establishing new boundaries…all of those things are easier with support! While matrescence (the physical, emotional, hormonal and social transition to becoming a mother) isn’t a code found in the DSM-5-TR, you are worthy of feeling supported throughout this dynamic journey, because we were never meant to do it alone!

Symptoms of PMADs

    • Feelings of anger or irritability

    • Lack of interest in the baby

    • Appetite & sleep disturbances

    • Crying & sadness

    • Feelings of guilt, shame, or hopelessness

    • Loss of interest, joy, or pleasure in thing you used to enjoy

    • Possible thoughts of harming the baby or yourself

    • Constant worry

    • Feeling that something bad is about to happen

    • Racing thoughts

    • Sleep & appetite disturbances

    • Inability to sit still

    • Physical symptoms like dizziness, nausea, and hot flashes

    • Obsessions (intrusive thoughts) which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and frightening

    • Compulsions, where the parent may do certain things over and over again to reduce her fears or obsessions

    • A sense of horror about the obsessions

    • Fear of being left alone with the infant

    • Hypervigilance in protecting the infant

    • Parents with perinatal OCD know the thoughts are very scary and are unlikely to ever act on them.

    • Intrusive re-imagining of a past event

    • Flashbacks or nightmares

    • Avoidance of stimuli associated with the event, including people, places, thoughts, feelings, and details

    • Persistent increased arousal (irritability, difficulty sleeping, hyper vigilance, exaggerated startle response)

    • Anxiety and panic attacks

    • Feeling a sense of unreality and detachment

    • Periods of severely depression mood and irritability

    • Periods of mood much better than normal

    • Rapid speech

    • Little need for sleep

    • Racing thoughts, trouble concentrating

    • Continuous high energy

    • Delusions (often grandiose, but including paranoid)

    • Impulsiveness, poor judgment, distractibility

    • Grandiose thoughts, inflated sense of self-importance

    • In the most severe cases, delusions and hallucinations

    • Periods of severe depressions

    • Periods when mood much better than normal

    • Rapid speech

    • Little need for sleep

    • Racing thoughts, trouble concentrating

    • Anxiety, irritability

    • Continuous high energy

    • Overconfidence

    • Manic episode is less apparent than Bipolar I; the highs and lows are not as extreme

    • Delusions or strange beliefs

    • Hallucinations (seeing or hearing things that aren’t there)

    • Feeling very irritated

    • Hyperactivity

    • Severe depression or flat affect

    • Decreased need for or inability to sleep

    • Paranoia and suspiciousness

    • Rapid mood swings

    • Difficulty communicating at times

    Psychosis is temporary and treatable with professional help, but it is an emergency and it is imperative that you receive immediate care. If you are experiencing these symptoms, proceed to the nearly emergency department or contact a crisis line (1-833-TLC-MAMA).