Postpartum Depression & Anxiety

What are perinatal mood and anxiety disorders?

Perinatal mood and anxiety disorders, also called PMADs, are defined as a group of mood and anxiety disorders that parents experience between conception and the first 12 months of a child’s life, including

  • Postpartum depression (perinatal depression)
  • Postpartum anxiety (perinatal anxiety)
  • Perinatal bipolar disorder
  • Perinatal obsessive-compulsive disorder (OCD)
  • Perinatal post-traumatic stress disorder (PTSD)1

Whether the problem started or got worse during pregnancy or after the baby was born, the disorder typically causes distressing feelings and gets in the way of living a healthy life. PMADs are very common and may affect between 11%-21%% of parents, or 1 in 7 parents.2


What are perinatal mood and anxiety disorder symptoms?

Each person will have different symptoms, and some amount of readjustment is normal with a new baby. However, when symptoms start to get in the way of taking care of oneself or being able to parent, a disorder may be present. Some possible symptoms include

  • Extreme sadness, feeling down, or hopelessness
  • Mood swings
  • Crying – maybe for no apparent reason
  • Irritable mood
  • Elevated mood – very high self-esteem or increased risky behaviors that worry friends and family
  • Anxiety, worry, or panic without good reasons
  • Intrusive and frightening thoughts
  • Loss of pleasure in activities – favorite hobbies don’t seem fun anymore, neither does sex
  • Sleep problems – including trouble falling asleep even when the baby is asleep, feeling fully rested after only a few hours of sleep, or nightmares
  • Appetite changes
  • Headaches
  • Thoughts of hurting yourself or others
  • Seeing, hearing, or otherwise sensing something that isn’t really there2,3,4

Its unlikely that any one person would experience ALL of these things. But even just one symptom is enough to make an appointment to discuss it further because PMADs are very treatable conditions – people do get better with treatment.


Are perinatal mood and anxiety disorders serious?

In a word, yes. Even though they are common, perinatal depression and anxiety can be very serious. When PMADs are left untreated, parents and children can experience

  • Increased substance use (drugs, alcohol, smoking, etc.)
  • Worsening of medical problems
  • More trouble with breastfeeding
  • Suicide
  • Infanticide (when a parent accidentally or intentionally kills their baby)2

Because these disorders can have severe consequences, it’s important for parents and those around them to take symptoms seriously and find effective treatment.


How are perinatal mood and anxiety disorders treated?

Like other people with depression, anxiety, or other mood disorders, treatment can include a variety of options.

  • Medications
  • Talk therapy
  • Natural remedies including an exercise program or light therapy
  • Massage
  • Support groups

Each person will likely benefit from an individualized approach to treatment.1


How long do perinatal mood and anxiety disorders last?

Although each person will have a unique experience, research suggests that PMADs can have very long-ranging effects, particularly on children. Because human brains develop so much between conception and age 3, very young children try to absorb everything about their world – including some of the negative effects of parental mood disorders. Infants whose parents suffer from depression or other disorders tend to have slower cognitive and emotional development, which can form a poor foundation for their future lives.2

So, instead of asking how long PMAD’s last, the better question may be how soon can a parent find help for these treatable conditions. If you are a parent looking for more support, please contact us.


References:

  1. Nillni YI, Mehralizade A, Mayer L, Milanovic S. Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: A systematic review. Clinical Psychology Review. 2018;66:136-148. https://doi.org/10.1016/j.cpr.2018.06.004
  2. Kendig S, Keats JP, Hoffman MC, et al. Consensus bundle on maternal mental health: Perinatal depression and anxiety. Obstetrics & Gynecology. 2017;129(3):422-430. https://dx.doi.org/10.1097%2FAOG.0000000000001902
  3. ACOG committee opinion no. 757: Screening for perinatal depression. Obstetrics & Gynecology. 2018;132(5):e208-e212. https://doi.org/10.1097/aog.0000000000002927
  4. Dominguez M, Burgos L, Bergink V. Perinatal mood and anxiety disorders. In: Sperling R, ed. Obstetrics and Gynecology. 1st ed. Wiley; 2020:127-132. https://doi.org/10.1002/9781119450047.ch16

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