Perinatal mood and anxiety disorders

Adjusting to the physical and emotional demands of motherhood is challenging for any woman. Some moms may feel overwhelmed, exhausted, inadequate, anxious, sad, confused, angry — even terrified. Many suffer in silence from fear or shame.

However, Postpartum Depression, known now as Perinatal Mood and Anxiety Disorders (PMADs), are the most common complication of childbirth. These have a very real biological basis and are highly treatable. 

What are perinatal mood and anxiety disorders (PMADs)?

The term "postpartum depression" has been commonly used for a number of years to describe symptoms of depressive disorders occurring after childbirth however there are actually a spectrum of mental health disorders that can occur with significant frequency both during pregnancy and following childbirth.  

About 10% of new Dads/Partners may also experience anxiety and depressive symptoms.  Untreated symptoms can have long term negative effects on mom/partner as well as baby.

  • Baby Blues - up to 80 % of all women experience the blues after delivery.  This condition is often attributed to hormonal changes, fatigue and interrupted sleep as well as a wide range of related psycho-social factors.  Now that you have survived childbirth, life has suddenly and completely changed.
  • Perinatal Depression and/or Anxiety - 15-20% of women experience moderate to severe symptoms of depression and/or anxiety. This can occur soon after childbirth but the frequency often increases at 8- 12 weeks after delivery, coinciding with a new Mother's return to work outside of the home or in the transition from working Mom to stay-at-home Mom (SAHM).  New mothers, with a previous history of depression or anxiety may be more at risk following childbirth.
  • Perinatal Panic Disorder - up to 11% of new Moms experience panic, a form of anxiety manifested by symptoms of multiple fears and worries along with recurring panic attacks that can feel like having a heart attack.
  • Perinatal Obsessive Compulsive Disorders - occurring in 3-5 % of new Moms and manifesting in persistent thoughts/fears/obsessions, particularly regarding baby's health.  This can be extremely disturbing for a new Mom.
  • Postpartum Post-traumatic Stress Disorder - between 1 and 6 % of women experience PTSD following childbirth due to unanticipated traumatic birthing and post- delivery experiences to include medical complications effecting mother and baby.
  • Postpartum Psychosis - this rare but very serious illness only occurs in 1-2 of every 1,000 deliveries but requires immediate treatment to insure the safety of both Mother and baby.  Symptoms may manifest suddenly primarily in the first four weeks after delivery  and can include loss of contact with reality, strange beliefs, hyperactivity and decreased need for sleep.

Symptoms of perinatal mood disorders

Postpartum blues symptoms include:

Weepiness
Anxiety
Insomnia
Mood swings
Difficulty concentrating and fatigue
Patients describe being overwhelmed, confused and nervous, having their feelings hurt rather easily, and most troubling, a lack of feeling for the baby. 

PMAD symptoms include:

Depressed mood most of the day
Noticeably decreased interest or pleasure in activities almost every day
Abnormal weight loss or gain
Decreased or increased appetite
Insomnia or sleeping too much
Fatigue
Agitation or apathy
Guilt
Feelings of worthlessness or inadequacy
Inability to concentrate
Headaches
Panic attacks
Lack of feeling for the baby
Thoughts of hurting the baby, death or suicide
 

Postpartum psychosis symptoms:

Hyperactivity
Confusion
Agitation
Inability to sleep
Mood swings
Rapid speech
Delusions or hallucinations both auditory and visual. 
Due to loss of contact with reality, new mothers experiencing psychosis may cause themselves or their babies harm. 

Treatment for perinatal mood and anxiety disorders

It’s important to understand that mood disorders are not something you can “snap out of.” Depression and anxiety develop when chemical changes in the way your brain works begin to affect how you feel. It’s a medical problem, and it requires help from a doctor and/or counselor.

Our experts can help provide a combination of treatments and supportive therapy so you can get back to living life and enjoying motherhood. If you are experiencing any symptoms that concern you, here’s how to get help:

Call the Mom's Line at 630 527-7294

  • This is a phone line dedicated to women or anyone concerned about a woman, who may be experiencing signs or symptoms of postpartum depression
  • A specialist can provide information on PMADs and/or treatment
  • Messages on this line are checked daily and calls will be returned within 24 hours

Find a counselor

  • We have clinicians who specialize in maternal mental health within our system and in the community

Go to a Support Group

  • Nurturing Mom - a support group for women experiencing postpartum depression and anxiety. Groups meet at Edward and Elmhurst hospitals
  • SHARE - A support group for parents who have lost a baby through miscarriage, ectopic pregnancy, stillbirth or early infant death.
  • Sharing HOPE - A support group for couples who have experienced a miscarriage, ectopic pregnancy, stillbirth or neonatal death and are now pregnant or considering pregnancy. 

Support groups meet at a variety of times and locations.

Can PMADs be prevented?

If you've experienced a perinatal mood disorder before, you have a 50-80 percent chance of experiencing this again. Women who have had major complications during pregnancy are twice as likely to have PMADs compared with those who had a relatively easy pregnancy. There is a 15-25 percent risk of PMADs in women with a prior history of depression or bipolar disorder, which significantly increases when moms discontinue medications during pregnancy.

If you had PMADs after past pregnancies, your doctor may prescribe antidepressant medication after you deliver to reduce the chances of PMADs returning. While perinatal mood and anxiety disorders cannot be prevented, here are some ways to help yourself:

  • Plan ahead - Find someone who can help with household chores and the baby during your first week home from the hospital; choose child care so you get a break on an ongoing basis; and decide ahead of time what you need to have on hand when the baby arrives.
  • Educate yourself - Take prenatal classes to teach parenting skills, reliance on assistance from support personnel including spouses, family members, friends and neighbors.
  • Stay on top of symptoms - Screening questionnaires may help detect depression or risks for depression early. Do your best to answer screening questions honestly so that your behavioral health provider can help you.
  • Talk about your feelings - Talk about your fears and anxieties before the baby arrives, and continue these discussions after delivery. Meeting with a professional counselor, attending support groups, and having good social support from loved ones can all help to reduce the symptoms of PMADs.
  • Planning for baby Tip Sheet

FAQs

View frequently asked questions about perinatal mood disorders.

I've been feeling wonderful ever since I brought my baby home a month ago. Is this good feeling going to go away and lead to depression?

Most likely, no. While the "baby blues" are common and some women get perinatal depression after delivery, you’re probably out of the woods. The majority of postpartum blues starts the first week after giving birth and postpartum depression and anxiety sets in after the second week.

That being said, postpartum anxiety and depression has been known to develop anytime within a year after giving birth. This is because there are multiple factors that influence its development, including hormonal changes and life stressors. Sometimes it is a culmination of factors over time that result in its development.

If you feel sad, anxious, overwhelmed or any of the other symptoms that won't go away after two weeks, you should contact your doctor.

What about my baby's dad? Can he get postpartum depression, too?

New fathers, especially first-timers, may also have feelings of sadness or anxiety, especially about feeling left out when all of the attention is focused on the mother and baby. They also eventually suffer from lack of sleep and exhaustion as they care for the baby and try to manage work as well.

Now is a good time to talk to each other about being new parents. Try to spend some time alone together, even if it's just for an hour. Many parents try to plan a regular date night so they can be together without the baby. Keep in mind that dads can get depressed and anxious too, and should seek help if they have any of the symptoms of postpartum depression.

Is it safe to take antidepressants while breastfeeding?

You should talk with your doctor and lactation consultant. Most medicines that moms take do show up in their breast milk. However, there are usually behavioral health medications that you can take safely while breastfeeding.

Discuss the options with your doctor. Some women benefit from therapy and don’t need to take medication, while others really need medical treatment. Make sure you find a treatment that works for you.