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About Perinatal Mood & Anxiety Disorders (PMADs)

Learn how perinatal mood anxiety disorders can affect new parents and families. It’s important to seek help if you or someone you know may be experiencing a perinatal mood anxiety disorder.
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What is a perinatal mood & anxiety disorder (PMAD)?

A perinatal mood and anxiety disorder (PMAD) is a common mental health condition that can occur during pregnancy and postpartum, including postpartum depression, anxiety, and other illnesses. PMADs are characterized by a range of symptoms, such as:

  • Feelings of guilt, shame and hopelessness
  • Racing thoughts
  • Appetite and sleep disturbances
  • Intrusive thoughts
  • Difficultly bonding with the baby

It is normal for new parents to feel overwhelmed, exhausted, and fearful during or after pregnancy. However, when those feelings become too much and affect your well-being, it’s important to reach out for help. 

Any parent or caregiver including mothers, fathers, non-gestational partners, or those who become parents by adoption or surrogacy can experience a perinatal mood and anxiety disorder in the first year postpartum. A person can experience one or more PMADs at a time including:

  • Postpartum depression
  • Perinatal anxiety disorder
  • Bipolar spectrum disorder
  • Obsessive compulsive disorder
  • Posttraumatic stress disorder
  • Postpartum psychosis

Being a parent or caregiver of a newborn can be an incredibly wonderful and yet overwhelming experience, and it’s normal to feel both. If you are a caregiver of a newborn and feel more sad, tired, nervous, or distraught than you think you should be, you might be experiencing a PMAD. It's important to know that PMADs are treatable, and many resources are available to help you recover. You can find help from community supports, your healthcare provider, or other supports included here.

Postpartum depression (PPD)

Postpartum depression (PPD) is a serious clinical condition. Clinical research shows that nearly 1 in 5 of all pregnant and birthing parents experience postpartum depression. Other caregivers are also at risk of developing depression in the first year postpartum. Common symptoms include:

  • Feelings of restlessness, guilt, or despair
  • Increased crying or more often than usual
  • Lack of energy
  • Feeling anxious, jumpy, irritable, or angry
  • Sleeping too much or not enough
  • Eating too much or not enough
  • Headaches, chest pains, or other aches and pains
  • Loss of interest in family
  • Afraid of hurting oneself or their infant.

It is normal for a new parent to have feelings of being overwhelmed, exhausted, and anxious. However, when those feelings become too much and affect your well-being, it’s important to reach out for help. If you think you may be experiencing postpartum depression, call your health care provider to be screened.

Perinatal anxiety

Clinical research shows that nearly 1 in 5 pregnant and postpartum people will experience perinatal anxiety disorder. A person can experience perinatal anxiety during pregnancy and up to one year after the end of the pregnancy. Common symptoms include:

  • Feeling nervous or jumpy
  • Sleep and appetite disturbances
  • Tension in the body
  • Feeling irritable or angry
  • Panic attacks
  • Persistent worry and racing thoughts

If you think you may be experiencing perinatal anxiety, call your health care provider to be screened.

Bipolar spectrum disorder

Clinical research shows that nearly 1 in 7 people will develop bipolar spectrum disorder. Among postpartum people with depressive symptoms, the prevalence of bipolar disorder is closer to 1 in 4 people. Common symptoms can include mood swings with episodes of depression or mania to alternating periods of elation, irritability, or sadness. These feelings can also be intensified by pregnancy. Without treatment, these episodes may sometimes lead to psychotic symptoms. If you think you may be experiencing bipolar spectrum disorder, call your health care provider to be screened.

Obsessive-compulsive disorder (OCD)

Clinical research shows that 4-11% of pregnant and postpartum people will develop obsessive-compulsive disorder (OCD). Common symptoms of OCD include obsessive thoughts or intrusive fears. Individuals may also experience compulsions of doing things repeatedly, including counting, reordering things, or constantly cleaning, to reduce anxiety and fear. If you think you may be experiencing obsessive compulsive disorder, call your health care provider to be screened. You can learn more about support and treatment for OCD below:

Perinatal OCD Intensive Outpatient Program

Posttraumatic Stress Disorder (PTSD)

Clinical research shows that 1-2% of pregnant and postpartum people will develop posttraumatic stress disorder (PTSD) (also known as birth trauma) related to traumatic experiences during pregnancy, birth, or postpartum. This can be related to experiencing birth complications such as prolapsed cord, unplanned cesarean section, infant medical crisis (e.g., NICU admission), poor communication and mistreatment by providers, or other complex and traumatic experiences. PTSD can also be related to traumatic experiences that happened outside of pregnancy and can worsen during the perinatal period. Common symptoms include:

  • Flashbacks or nightmares
  • Intrusive thoughts or images
  • Extreme alertness
  • Sleeping difficulties
  • Feeling detached from reality
  • Feeling irritable or angry

If you think you may be experiencing PTSD, call your health care provider to be screened.

Postpartum psychosis

Postpartum psychosis is a true psychiatric emergency affecting 1-2 per 1,000 birthing people. Individuals experiencing postpartum psychosis need immediate treatment, which can include hospitalization. The onset is usually sudden and occurs within the first two weeks after the end of a pregnancy. Common symptoms include:

  • Rapid changes in mental status
  • Mood changes with atypical behaviors
  • Unusual thoughts and false beliefs including delusions, paranoia, and hallucinations

Postpartum psychosis is associated with increased risk of harm to the infant, including infanticide, as well as self-harm or suicide. If you or someone you know is experiencing postpartum psychosis, seek help immediately. You can learn more about support and treatment for postpartum psychosis at PSI Perinatal/Postpartum Psychosis Help.

For immediate support for postpartum psychosis:

  • Massachusetts Behavioral Health Help Line
    Call or text 833-773-2445
    Available 24/7, including holidays. Free, confidential, and no health insurance is required.​ Real-time interpretation in 200+ languages.
  • 988 Suicide & Crisis Lifeline
    If experiencing thoughts of self-harm, suicide, or thoughts of harming others including your infant, call 911 or contact 988. Available 24/7, free, and confidential. 

Resources for PMADs

Helplines

BIPOC and LGBTQ+ resources

Mental & behavioral health resources

Additional resources

Some people who experience PMADs may also experience additional health conditions such as interpersonal violence, suicidal ideation, substance use, and/or trauma history. For additional information and support, these resources may be helpful.

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