Perinatal Mood and Anxiety Disorders

Perinatal Mood and Anxiety DisordersDuring and after pregnancy, women can expect to experience many different emotions. Many women talk about the “glow” of pregnancy. Many others describe feeling happy one minute but worried, down, or tired the next, particularly in the first few days or weeks after giving birth. When these symptoms are mild and resolve on their own inside of two weeks, they may be referred to as the “baby blues” and may not necessarily constitute a psychiatric illness. But, when those feelings worsen or persist beyond two weeks in duration, it’s time to seek professional treatment.

While postpartum depression is the most common, and probably the most widely known, post-pregnancy psychiatric illness (see more below), it’s only one of five illnesses Psychiatrists and Obstetricians may refer to as perinatal mood and anxiety disorders, or PMADs.

Postpartum Depression

Women report diverse emotional experiences during and after pregnancy. There are rapid physiologic changes throughout pregnancy, delivery, and the postpartum period. Additionally, women are adjusting to many weighty emotional and environmental issues during this very same time. Some may be adjusting to their new role as a mother for the first time, or managing parenting several children and a newborn. Pregnant woman and new mothers are adjusting to new bodies, as well, and may struggle with feeling less attractive. New mothers are, of course, sleep deprived to varying degrees.

Becoming a mom can also mean breast-feeding for many, but it may also mean struggling with breast-feeding for many. Pregnant women and new mothers frequently grapple with new financial realities, and may receive widely varying amounts of emotional and child care support from their partners and loved ones.

Is it any wonder, then, that the transition to motherhood is not without its challenges? One in five women are diagnosed with a postpartum mood disorder, and increasingly, we understand that many struggle throughout their pregnancy as well.

Postpartum depression is a perinatal mood disorder that is more severe than the “baby blues”. Up to 20% of new moms will experience “postpartum” depression, and as many as 50% will have their depressive episode begin during pregnancy.
Symptoms of Perinatal or Postpartum Depression include:

  • Difficulty bonding with the baby
  • Frequent crying
  • Insomnia
  • Feelings of guilt, shame, or inadequacy
  • Severe mood swings
  • Withdrawal from family and friends
  • Anhedonia or inability to enjoy almost all activities
  • Thoughts of suicide and/or infanticide

Postpartum Anxiety Disorder

A healthy level of anxiety comes with the territory of being a new mom. But, when that anxiety begins to interfere with your ability to care for yourself or your baby, it’s time to seek treatment. Approximately 10% of new moms develop a significant anxiety disorder after pregnancy. Some symptoms of postpartum anxiety disorder are:

  • Inability to relax and be still
  • Racing thoughts
  • Constant worry
  • Nausea, dizziness, weakness
  • Changes in sleep and appetite

Postpartum Obsessive Compulsive Disorder (OCD)

Obsessive-compulsive disorder is classified as having unreasonable thoughts and fears leading to repetitive behaviors. Developing OCD during or after pregnancy can be frightening for women for a number of reasons but mainly because of the intrusive thoughts. Roughly 3-5% of new moms will experience OCD during or post-pregnancy. Examples of intrusive thoughts include:

  • What if I drop the baby?
  • What if I forget the baby?
  • What if I stab the baby?

Postpartum Post-Traumatic Stress Disorder (PTSD)

As miraculous as it is, childbirth can also be a traumatic event for some. Post-partum PTSD is more common in women who have had a complicated childbirth (including unplanned C-section, prolapsed cord, forceps delivery, or transfer of the newborn to the NICU) and in women who have fears of childbirth, prior childbirth trauma, or history of PTSD. Some of the symptoms of Postpartum PTSD include:

  • Persistent anxiety
  • Nightmares
  • Avoiding people, places, thoughts, and feelings that bring back memories of the traumatic event
  • Flashbacks

Postpartum Psychosis

Postpartum psychosis affects 0.1-0.2% of women. A history of prior postpartum mood episode as well as a history of depression or bipolar disorder confers a greater risk of postpartum psychosis. Command auditory hallucinations to kill the baby and delusions that the baby is possessed are particularly concerning. This often leads to psychiatric hospitalization in order to keep both mother and baby safe. Some of the symptoms of postpartum psychosis include:

  • Paranoia
  • Mood swings
  • Hyperactivity
  • Delusions
  • Hallucinations

It’s important to seek treatment from a Reproductive Psychiatrist if you are experiencing any of these symptoms. Your Psychiatrist will work closely with you and often your Obstetrician, to find the right treatment for your specific symptoms.

Women may put off seeking help, or even under-report their symptoms to Physicians out of feelings of shame or guilt. PMAD is not a mother’s fault. The right treatment is different for each mother, but perinatal mood and anxiety disorders are common and treatable. With early and proper treatment, mother and baby will have the best health outcomes.

Be well,
Dr. Amanda Itzkoff
dr. amanda






Dr. Amanda Itzkoff is trained in Psychotherapy and Psychopharmacology in New York, and can help you cope with perinatal mood and anxiety disorders. If you are looking for more information perinatal mood and anxiety disorders, please feel free to contact us via email. schedule a consultation, please contact our office at 917-609-4990..

Comments are closed.