More than postpartum depression: a breakdown of all perinatal mood & anxiety disorders

Updated: Jul 2, 2020

It’s maternal mental health awareness week so here I am, ready to spread some awareness.

For those of you who have had a baby, or who have undertaken the journey of trying to have a baby, you know how full of emotional and mental pitfalls that path can be.

For those of you who haven’t, you maybe have had a front row seat to a loved one’s journey. Or maybe you’re just one of those dedicated learners who likes to gain knowledge and be armed with information for your future. Cheers to you!

The postpartum period seems to finally be getting its time in the spotlight, as so many more people are willing to talk about postpartum depression. As a mental health professional, it’s a relief to see.

But also as a mental health professional, I want to open the gates of knowledge all the way and urge people to know a few crucial things about mental health & postpartum:

#1: it’s more than just depression that can come up during this period.

While people commonly use the term “PPD” for mental health symptoms after birth, there’s a host of mental disorders that can arise: anxiety, OCD, bipolar, psychosis, and PTSD. The larger umbrella term is “PMADs” or “perinatal mood and anxiety disorders.”

(To see the full list of PMADs, as well as their symptoms, see the bottom of this post.)

It’s so important to recognize this because if you feel “off” but your symptoms don’t match what you know about depression or what you’ve looked up about PPD, that doesn’t mean that what you’re going through is normal or something you have to continue to struggle with in silence. It could be that what you’re going through is a different perinatal mood disorder. Instead of thinking, “well, I know this isn’t depression so this must just be motherhood” you can realize that something else is at play, that you can get treatment, and that alleviation of symptoms is definitely on the table for you!

#2: it’s not just the immediate postpartum period we should be looking out for.

Symptoms of PMADs can occur in the days after birth through 12 months postpartum! Which means they can last beyond the baby’s first birthday.

They can also crop up during the pregnancy period, before a mom is even at the labor & delivery stage. It’s that symptoms can crop up during pregnancy that the term “perinatal” is what the “P” stands for in “PMADs.” It’s also just more accurate.

This means, similar to the point in #1, that you don’t have to tell yourself this is “just how pregnancy is” if you’re feeling off. Anxiety, depression, OCD, or bipolar symptoms may be surfacing and that’s why you are feeling out of control, “not right”, “just not like yourself”, or just out of sorts. Treatment for these symptoms is absolutely an option while pregnant.

#3: it’s not just women who are at risk of these mood disorders; dads are at risk, too!

Research indicates that 1 in 10 dads experience a mood and anxiety disorder. And that’s just of those who report, so the numbers are probably actually a little bit higher.

So what to do if any of these symptoms are present for you (if you are pregnant or postpartum) or if you observe them in someone else who is pregnant or postpartum)?

If you observe them in another person, gently start a conversation with that person about what you’ve noticed. Let them know you’ve done some research and they shouldn’t have to put up with this alone. Encourage them to talk to a professional-they can start with their primary care doctor or OBGYN-or can call a therapist. Chiropractors, doulas, sleep specialists, lactation specialists, and a host of other professionals can also point moms in the direction of appropriate help.

If you notice these symptoms in yourself, start the same conversation with the above professionals. If it seems too hard to have the conversation (you’re nervous about crying; it’s tough to describe the symptoms out loud; a phone call or face-to-face conversation is too overwhelming as a starting place), use email or your doctor’s health portal to type out a message. Sometimes, that can feel less intimidating, but still allows you to let someone know what is going on.

And here’s what else I absolutely want you to know: PMADs are absolutely treatable and they are not your fault! Through medication, therapy, or a combination of both, symptom of alleviation is truly within reach.

Therapy approaches for perinatal mood and anxiety disorders moms are often about behavioral, cognitive, and mindfulness habits that can be helpful across the lifespan. And “helpful across the lifespan” is (at least in my opinion) one of the greatest things about therapy! What you learn in that time and how you can shift your relationship with yourself is not going to be time-limited to the perinatal period of your life. You’ll be able to apply those skills, not least amongst them self-compassion, in times of high tide and low tide across the years.

These treatment options go for those dads, too: therapy, medication, and maybe a combination of both. For them, also, it’s treatable and not their fault.

Each new baby brings changes to your sense of self, your household operations, and how you interact with those around you. And with changes to those elements of your day-to-day life, comes the possibility, and very real likelihood, that your emotional health will be impacted. Take this new awareness with you on your journey, or with you as you watch others on their journey. Be there for yourself, be there for others, and use this education to makeover motherhood.

Talk to you soon!

Baby Blues



Primary Emotion: happiness

Typically resolves after about 2 weeks

Postpartum Adjustment/Postpartum Stress Syndrome

Lasts longer than 3 weeks

Can cause feelings of anxiety/self-doubt

Deep sadness, without periods of happiness

Function well & get through the day, but feel awful inside

Perinatal & Postpartum Depression

Sadness, Crying

Irritability & Anger

Hopelessness & Helplessness

Guilt & Shame

Suicidal Thoughts

Appetite Changes & Sleep Disturbances

Post Partum Anxiety

Agitated & Irritable

High Alert

Constant Worry & Racing Thoughts

Inability to Sit Still

Shortness of Breath & Heart Palpitations

Appetite Changes & Sleep Disturbances

Perinatal OCD

Intrusive, repetitive thoughts (often of harm coming to the baby)

Overwhelming guilt & shame

Horrified by your own thoughts


Engage in behaviors to avoid harm or minimize triggers

Perinatal PTSD

Flashbacks of event (usually labor & delivery, in this case)

Recurrent dreams/nightmares

Avoidance of triggers

Distressing memories, thoughts, feelings, or external reminders of event

Isolation from family/friends/providers

Distorted sense of blame of self or others



Perinatal Bipolar I

Elevated mood symptoms

Euphoria or agitation

Decreased need for sleep

Racing thoughts

Increased productivity noticed by others

Pressured speech

Increased energy

*Hypomania lasts 4 days

*Mania lasts 7+ days

Perinatal Bipolar II

Often mistaked as postpartum depression

Mood swings/hypomania but only lasts for 1-2 days

Irritability, hostility

Racing thoughts

Psychomotor retardation

Wired, or become worse, on antidepressants

Perinatal Psychosis

Delusions and/or hallucinations

Rambling speech



Rapid mood swings

Waxing and waning (feel normal for stretches of time between the above symptoms)

*mom does not recognize that these actions/thoughts are unhealthy

Marble Wellness is a St. Louis counseling practice that specializes in counseling for