What Are Perinatal Mood and Anxiety Disorders?

You may have seen the term “Perinatal Mood and Anxiety Disorders (PMAD)” bandied about on the internet; you may have even encountered it here at EmmaWell. This term can come across as clinical, unapproachable, or even scary. We are going to unpack the meaning of “perinatal mood and anxiety disorders” to make sure you understand what they are, how to recognize if you have one, and how to get help so you can feel better. You shouldn’t need a dictionary or a medical degree to know the signs of a serious mental health condition that often accompanies the rollercoaster of early motherhood.



What’s in a Name?


First off, what does “perinatal” mean? Perinatal refers to the entire span of a pregnancy and the first year after childbirth. Some other common terms are “prenatal” and “antepartum”, which indicate pregnancy or the period before birth, and “postpartum,” which denotes the year-long period following birth, ranging from the first six weeks up to a year. Whereas the medical community once attributed most emotional issues surrounding childbirth to “Postpartum Depression (PPD)”, it has now embraced “Perinatal Mood and Anxiety Disorders (PMADs)” as the catch-all term for the spectrum of mood changes that may occur during or after pregnancy.


This shift in nomenclature illustrates that many women first start to experience symptoms during pregnancy and that these symptoms cover a vast range of experiences that cannot be classified under one overarching condition. In addition to postpartum depression, there are a number of overlapping illnesses that comprise mood and anxiety disorders. These include anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar disorders, and psychosis.




What Are the Signs?


Having some difficulty adjusting to parenthood in the first few months is considered normal. About 60-80% of new mothers suffer from the “Baby Blues,” which is a mild, momentary case of depression characterized by sudden mood swings, inexplicable crying, irritability, impatience, exhaustion, loneliness, sensitivity, and vulnerability. If these symptoms interfere with a mom’s typical coping abilities, functioning, or parenting, or last beyond the first 2-3 weeks postpartum, a more serious PMAD might be to blame. It is estimated that up to 20% of mothers who suffer from “Baby Blues” eventually develop symptoms of a PMAD beyond two weeks postpartum.


Even though pregnancy is often portrayed as a period of great joy and excitement, in many cases this is not the reality. As women mentally prepare for permanent life changes and increasing responsibilities that come with a baby, some develop intense fears and anxieties related to pregnancy or childbirth. According to research in Obstetrics & Gynecology, one in five pregnant women develop a moderate fear of childbirth, and 6-13% of pregnant women experience severe, crippling fear of childbirth. Women who have wrestled with long-term infertility are particularly vulnerable for developing these feelings. Often, mood or anxiety issues that crop up during pregnancy persist and even worsen after childbirth.


Below is a summary of signs that characterize the most common perinatal mood and anxiety disorders. Keep in mind that these are not one-size-fits-all illnesses, and many women do not experience all or even most of their symptoms. Mood disorders can often be comorbid, meaning someone might have overlapping symptoms. What rings true for all women who suffer from PMADs is that their symptoms do not come and go, like a bad day that is passed over and forgotten. These symptoms last for longer than two weeks and make functioning normally, as well as enjoying everyday life, incredibly difficult.


Perinatal Depression:

  • Suppressed mood

  • Tearfulness

  • Loss of interest or pleasure

  • Robotic about daily tasks

  • Lack of energy

  • Lack of bonding with your baby

  • High levels of resentment and rage

  • Low levels of patience and hope

  • Pervasive changes in appetite or sleep

  • Difficulty with concentrating on tasks and connecting with others

  • Feeling guilt or shame that you are failing and your baby deserves better

  • Thoughts about harming your baby or somehow ending your misery

Perinatal Anxiety:

  • Uncontrollable sense of anxiousness

  • Excessive and oppressive worries

  • Doom and gloom mentality

  • Extreme fears about your baby and other children

  • Inability to shut brain off

  • Disturbances in appetite or sleep

  • Feeling loss of control

  • Dizziness, heart palpitations, shortness of breath, nausea, numbness, tense muscles

  • Panic attacks

Perinatal Obsessive-Compulsive Disorder: