PMADs-Perinatal Mood and Anxiety Disorders-are mental health disorders beginning sometime during pregnancy through ~1 year postpartum. These disorders are classified as Mood disorders (Depression, Bipolar, & Psychosis) and Anxiety disorders (Generalized Anxiety, Panic Disorder, OCD, PTSD). These disorders impact daily functioning for the individual.

Postpartum depression is often confused with the baby blues. The baby blues occur in about 80% of women and are due to hormone fluctuation at time of birth and acute sleep deprivation. Baby blues will resolve on it’s own and will last no longer than 2 weeks. When experiencing baby blues, you are mostly still happy, however may have mood swings, tearfulness, and irritability.

Perinatal depression on the other hand is characterized by depressed mood most of the day, nearly every day. Symptoms may include loss of interest in activities, feeling overwhelmed and unable to cope, difficulty concentrating, lack of connection towards baby, feelings of hopelessness or worthlessness, excessive worry or guilt, irritability, thoughts of death or suicidal thoughts, or generally not feeling like yourself.

Perinatal anxiety typically involves excessive anxiety and worry, often times about you or your baby’s health/wellbeing, with an inability to control or release these worries. Symptoms also include ruminating, irritability, restlessness, difficulty concentrating, and feeling “on edge.” Often times, a seemingly small thing may trigger a spiral of worry or fears. You may experience muscle tension or strain, racing heart, shortness of breath, or GI distress.

Perinatal anxiety may also manifest as a panic disorder. Perinatal panic disorder involves episodes (often described as “panic attacks”) of intense fear or discomfort. These episodes can include shortness of breath, chest pain, rapid heart rate, dizziness, trembling, sensation of choking, or sensations of numbness or tingling. You may feel as though you are losing control or it may even escalate to an intensity where you fear you are going to die. Additionally, you may have anxiety around experiencing another episode and feel consumed by these thoughts and worries.

Perinatal OCD is an anxiety disorder characterized by obsessions and compulsions. Common symptoms of perinatal OCD include intrusive thoughts about harm coming to your baby and a spiral of “what if” thinking. Individuals will engage in behaviors either to avoid these thoughts or fears of harm from happening, or in attempts to minimize these triggers. Additional symptoms include: intrusive thoughts, guilt and shame around thoughts/behaviors, and hypervigilence. Perinatal individuals are at 1.5-2 times greater risk for developing OCD than the general population.

Perinatal psychosis involves hallucinations, paranoia, delusions or strange beliefs, hyperactivity, decreased need for or inability to sleep, rapid mood swings, and extreme irritability. Some of the main risk factors for perinatal psychosis are a personal or family history of bipolar disorder or a previous psychotic episode. Perinatal psychosis is extremely serious and emergency intervention is necessary. **If you think you or your partner is experiencing psychosis call 911 or go to the emergency room immediately** Perinatal psychosis is temporary and treatable with the right help.

Other perinatal mood and anxiety disorders include perinatal bipolar and post traumatic stress disorder.

Perinatal bipolar involves an episode of mania, characterized by symptoms of: elevated mood, euphoria or agitation, decreased need for sleep, racing thoughts, increased productivity, pressure speech, and increased energy.

Perinatal PTSD occurs after experiencing a trauma related to pregnancy, birth, or postpartum. This can be any unexpected or unplanned for event. Symptoms of PTSD may include: re-experiencing of trauma, flashbacks, nightmares, avoiding triggers associated with trauma, increased arousal (hypervigilance, irritability difficulty sleeping), and feelings of guilt, depression, hopelessness, anxiety, and self-blame.