In this article:
• 6 Common types of perinatal mood disorders
• Steps to help prevent PMDs for new moms
• Free mental health resources available 24/7
You just brought your newborn home and you’re loving every moment, breastfeeding your little love like a pro, maintaining your marriage and “bouncing back” effortlessly. Everything postpartum is sunshine and rainbows. After all, this is what it looks like to be a good mom on social media, right?
But the reality is you find yourself having teary-eyed moments thinking that your little one is growing too fast. Maybe you’re struggling because your family couldn’t come for a visit in the first month postpartum. Maybe you’re sobbing because you aren’t enjoying the newborn phase like everyone else seems to. Or perhaps you’re super anxious because you had to stop breastfeeding early and you’re worried about your baby’s nutrition.
These feelings are perfectly normal to a degree. Though sometimes they can be a symptom of a perinatal mood disorder (PMD), which approximately 10% to 15% of women experience, according to Postpartum Support International (PSI), an organization dedicated to increasing awareness about the emotional changes women experience from pregnancy through postpartum.
Understanding Perinatal Mood Disorders
So how do you know if what you’re feeling is “normal” or if it’s a PMD? Perinatal—the period that encompasses pregnancy through one year postpartum—mood disorders look a lot like general mood disorders with one key difference: PMDs are centered around pregnancy, giving birth or having a child, says Dr. Tiffany Wicks, a Mom-Approved licensed professional counselor and owner of The LIV Center in Dallas, a practice that focuses on reproductive mental health.
Wicks started her practice because she experienced postpartum depression with her first child and couldn’t find accessible or affordable mental health services with a perinatal specialization. “I think sometimes a lot of people will have their own experiences and then want to expand access for other people,” she says. “And so that was my goal: that other people can know about this and be able to act accordingly.”
But a quick word of caution before we dive into the specific PMDs: While it’s good and helpful to normalize the symptoms, “it’s probably less necessary for people to be able to say, this is the one I think my diagnosis is,” says Sarah Watts, a Mom-Approved licensed professional counselor at MEND Counseling in Dallas, who is certified in perinatal mental health through PSI. It’s your physician, therapist or psychiatrist’s job to determine what your diagnosis is and create the right treatment plan for you.
6 Common Perinatal Mood Disorders
1. Perinatal Anxiety
Typically, new moms experiencing perinatal anxiety have racing, intrusive thoughts that are distressing. This could be anything from worrying that you’re not doing enough for your little one or your baby getting sick or hurt to extreme fears about what could happen if someone else was watching him, Watts says. These worries can sometimes lead to disinterest in things you normally enjoy, difficulty leaving the house and wanting to control every aspect of your baby’s life and well-being. Panic symptoms, like racing heart or trouble breathing, can sometimes accompany these thoughts.
Additionally, “a big hallmark of postpartum anxiety would be trouble sleeping, even when you’re tired and you get the chance to sleep,” Watts says, adding that constantly researching is another sign of perinatal anxiety. Maybe you’re frequently pulling up Reddit, ChatGPT or Google to figure out how to sleep train your baby or whether she’s eating enough.
Other signs include fidgetiness or inattentiveness, dizziness, feeling on edge, hot flashes and nausea.
2. Perinatal Depression
Moms with perinatal depression experience sadness lasting longer than three weeks, frequent crying, feelings of guilt, shame, hopelessness or wondering if she’s a good mom. You may also have feelings of not really enjoying motherhood, trouble bonding with your baby or not feeling like you can care for your little one.
Similar to general depression, other signs of perinatal depression include loss of interest, joy, or pleasure in things you used to enjoy, like a specific hobby, seeing friends or working out; significant changes in eating and sleeping habits, either more or less; thoughts of self-harm or that people would be better off without you; thoughts of harming your baby and feelings of excessive anger or irritability.
3. Postpartum Rage
If you’re quick to excessive anger without a clear reason, feeling like you’re going from zero to 60 in an instant, you may be experiencing postpartum rage. “I hear a lot of people say, I don’t feel like myself or I feel really reactive,” Watts says. This can manifest as throwing objects, yelling, feelings of resentment, not being able to calm yourself down, feeling overstimulated frequently or torturing your partner or family members.
You may also experience feelings of rage in response to your baby—maybe you’re angry she woke up from her nap or that he spit up on another onesie.
Postpartum rage and perinatal depression can have some overlap, as rage can be a symptom of depression, Watts notes.
4. Perinatal Obsessive-Compulsive Disorder
This can sometimes look similar to perinatal anxiety, Watts says. The difference is, when a mom has an obsessive, repetitive, intrusive thought or mental image, she needs to engage in a compulsion specific to it—and she can’t turn off the compulsion.
For example, maybe you’re worried your baby isn’t breathing while sleeping in their crib, so you constantly check her oxygen levels, check her breathing, or watch her over the monitor to seek reassurance. Or perhaps you’re afraid your baby will get sick, so you don’t leave the house with him, make others wash their hands excessively and you constantly clean and sanitize.
Other signs of perinatal OCD include hypervigilance, fear of being left alone with the infant, fear of leaving the baby with someone else, awareness of unusual thoughts but inability to stop them or a sense of horror about the obsessions.
5. Perinatal Post-Traumatic Stress Disorder
If you had a traumatic or disappointing experience during pregnancy, delivery or postpartum, there’s a chance you could experience perinatal PTSD. These experiences could include pregnancy complications, unplanned C-sections, your baby going into the NICU, feelings of powerlessness or lack of support during the delivery, or severe injury as a result of a difficult delivery.
Symptoms of perinatal PTSD include flashbacks or nightmares of the traumatic event, avoiding things or people that remind you of the event, increased irritability, difficulty falling asleep and trouble talking about the traumatic event.
Many times, Watts says, perinatal PTSD goes hand-in-hand with anxiety and panic attacks.
RELATED: Are You Suffering From Postnatal Depletion?
6. Perinatal Psychosis
Unlike the previous perinatal mood disorders, perinatal psychosis is a medical emergency that occurs in 1 in 1,000 births, Watts says. You’ll want to go to the emergency room or call 911 if Mom is experiencing this.
Signs of perinatal psychosis include hearing or seeing things that aren’t there, having delusions or strange beliefs, feeling rapid mood swings, becoming suspicious or paranoid, having difficulty communicating or thinking intrusive thoughts about harming themselves or their baby but not being distressed about it. Hyperactivity without sleep is another big sign—saying, “I’m not tired” without having slept for days.
A lot of times, perinatal psychosis occurs with a second or a third birth experience, exacerbated by a previous birth experience that impacted Mom’s mental health but went untreated, according to Wicks.
A mom with perinatal psychosis “very clearly has lost touch with reality and is not a safe caregiver for their baby in that moment,” Watts says. “It’s something that’s happening chemically in the body and mind. Moms should not feel guilty if this happens to them, and they will be able to care again safely for their baby—with treatment.”
Because of the specific signs, it’s often a partner or a family member that notices mom has perinatal psychosis. That’s why it’s important for those in Mom’s inner circle to know the symptoms of perinatal mood disorders too.
Is what I’m feeling normal?
Experts estimate that 80% of new parents experience what’s called “baby blues,” according to Postpartum Support International. The symptoms are similar to perinatal depression—sadness, crying, anxiety, irritability, tearfulness or lack of joy. After all, you just went through an emotionally and physically demanding experience.
The key differences between baby blues and perinatal depression are the duration and intensity of symptoms. Baby blues tend to kick in a few days after giving birth and last around three weeks. Typically, you see minimal tears and symptoms feel manageable. “It feels like, OK, I can move through this,” Wicks says.
If you start to feel like you can’t get a handle on your feelings, your symptoms become extreme or they last more than a few weeks, it could be something more; it’s time to seek help. But “there is no need to wait until three weeks to say it has lasted long enough. Go ahead and get some help in those first few weeks, even if you’re technically still in the baby blues category,” Watts urges.
RELATED: When the Baby Blues Is Really Postpartum Depression
6 Steps to Help Prevent Perinatal Mood Disorders
Learning about the symptoms of perinatal mood disorders is certainly heavy, especially as you’re planning for the arrival of your little one. But it’s not all doom and gloom. There are things you can do during pregnancy to mitigate—and even prevent—a PMD. In fact, Wicks believes “the idea of prevention in any way is incredibly significant.”
Like they do at The LIV Center, Wicks recommends starting this conversation and planning at 34 weeks. “It gives you enough time to plan a lot of those things that are postpartum and then add some more if you need to,” she says. Here are a few things you can do:
1. Find a professional to speak with.
“I don’t necessarily think that therapy is the only answer, but I do think that seeing someone postpartum is huge and deeply impactful,” Wicks says. It’s also a good idea to see someone during pregnancy if you’ve previously experienced a perinatal mood disorder and it went untreated.
2. Try to normalize the feelings you may have.
While it’s not something we do well as a society, Wicks notes, normalizing your negative feelings during pregnancy and after childbirth will go a long way. Your feelings are okay, they are valid, and it’s OK to not love a specific aspect of your perinatal experience.
3. Find your support system.
Think about what your potential needs will be postpartum and fill in the gaps. Consider what your parental leave looks like. Think through needing breaks when you’re home alone with your baby all day. Set yourself up for not just what your baby needs, but what you need. Maybe it’s hiring a community doula or birth worker for extra support. Maybe it’s you or your partner taking extended leave, if you’re able. Perhaps it’s having someone to help with nights, a friend to come sit with your baby while you shower or nap or even setting up a meal train to bring over dinners during the first few weeks.
Once your little one is born, build connections and community with others outside the house. Find another mom at the park to chat with, attend a social or support group at your church, make friends with someone in the neighborhood—start wherever you can to feel less alone and get out of the house
4. Get enough sleep.
Sure, we expect Mom to get very little sleep in the first few months postpartum, but that shouldn’t be the norm. In fact, Watts says a lack of sleep is a risk factor for every perinatal mood disorder listed above. “We really want sleep to be a priority for mom, for sleep to be a priority for the parents,” she says, “because a lot of providers will not even give a diagnosis for depression, anxiety, OCD, etc. if we don’t have sleep under control. It’s kind of like, we can’t really figure out and distinguish between what’s going on because sleep deprivation plays such a massive role in our mood and our ability to regulate.”
5. Understand yourself.
What brings you joy and how do you engage in happiness? How do you check in with yourself? How do you handle ruminating and upsetting thoughts? What are your points of anxiety? Understanding all of these, along with the coping skills and strategies (like journaling, going for a walk outside, chatting with a friend) that help you find comfort, are incredibly vital, Wicks says.
6. Ensure your community understands perinatal mood disorders.
If your friends and family know the symptoms of PMDs, they can catch things early, support you at home and help you get the help you need.
The Bottom Line
Ultimately, you know when you’re not OK, but we, as a society, tend to think that it’s normal to struggle as a postpartum mom, Watts says. “The main thing is just to listen to that internal voice that’s saying, ‘I’m not OK,’ but let’s pair it with this belief that, ‘and it’s not my fault that I’m not OK. With help, I can get better. I can feel better. I can feel more like myself again.’”
5 Free, Mental Health Resources
If you’re a new mom experiencing a perinatal mood disorder or just want to find a support group of moms who understand what you’re going through, these are resources you can access—for free:
1. Mental Health America of Greater Dallas
This nonprofit organization offers Mothers and Babies, a free, five-week program that helps pregnant and new moms manage stress, bond with their baby, find social support and more. mhadallas.org/mothers-and-babies
2. National Maternal Mental Health Hotline
Free, confidential and available 24/7 in English and Spanish, the Health Resources & Services Administration offers a hotline moms can call or text to speak with a professional counselor at 1-833/TLC-MAMA (852-6262).
3. Postpartum Support International
In addition to a text line and hotline, PSI offers 50 free, virtual support groups for specific experiences, including birth trauma, fertility challenges, military moms, NICU postpartum and for the various specific perinatal mood disorders. The site also has a directory of mental health professionals who specialize in perinatal mood disorders that you can search by various criteria. postpartum.net
4. PSI HelpLine:
Call 1-800/944-4773
or text “help” to 800/944-4773 (English) or 971/203-7773 (Español)
Available 8am–11pm EST
5. Suicide & Crisis Lifeline
This national hotline offers free, one-on-one assistance for individuals facing mental health struggles or emotional distress, or are a friend or family member seeking help for a loved one. Call or text 988.
RELATED: How to Help a Friend Dealing With Postpartum Depression
