Bringing a new life into the world is often portrayed as a time of joy and celebration. But, for many individuals, the perinatal period—the time during pregnancy and up to a year after childbirth—can also bring unexpected emotional challenges. Perinatal mood and anxiety disorders (PMADs) encompass a range of mental health conditions that can significantly impact the well-being of both the parent and the child. 

Often misunderstood or dismissed as "baby blues," these disorders are real, diagnosable, and treatable medical conditions. Recognizing the signs, understanding the risk factors, and fostering a supportive environment are essential steps in ensuring the health and recovery of those affected. 

Here, Tammy Mylcraine, labor and delivery nurse at Riverside Healthcare, shares her expertise on this very important topic.

More Than the Baby Blues: Varying Issues That May Arise

The baby blues are common, affecting up to 85% of women shortly after childbirth. While not a psychiatric disorder, they typically begin within the first few days postpartum and resolve on their own within 10 to 14 days. Symptoms may include mood swings, trouble sleeping, irritability, crying easily, and appetite changes. 

In contrast, PMADs are more serious mental health conditions that can occur during pregnancy or up to a year after delivery. These include mood disorders, anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and postpartum psychosis, and they often require clinical intervention and support.

“Anxiety and depression often present together. And, unfortunately, many people already have anxiety and depression. Left untreated, mood and anxiety disorders can lead to increased maternal morbidity, failure to adhere to medical care, substance use and abuse, and failure to bond with the infant after delivery,” cautions Mylcraine. “In severe cases, these disorders can lead to suicide.”

She also notes the urgency related to postpartum psychosis, the most severe and rare form of PMAD—which is a psychiatric emergency. It may involve hallucinations, delusions, and dangerous behaviors, including potential harm to oneself or the baby. Anyone with a history of mental health conditions should closely monitor their symptoms, attend appointments, and maintain prescribed treatments, as pregnancy and postpartum can alter the course of these conditions.

How Common Are Perinatal Mood Disorders?

Perinatal depression affects approximately one in seven women during or after pregnancy, making it the most common perinatal mood disorder. Other disorders, including postpartum psychosis, are less common. Postpartum psychosis affects about one in 1,000 women, while other conditions vary from 0.02% to 10% in prevalence. All women are at risk, especially those with preexisting mental health issues. 

To identify those who may be struggling, healthcare providers often use the Edinburgh Postnatal Depression Scale—a 10-question screening tool—both in the hospital and during early postpartum visits. Pediatricians may also use this tool during infant checkups. However, it’s important to note that this scale is a screening tool, not a diagnostic test.

Key Risk Factors to Watch Out For

Perinatal mood disorders can be influenced by a variety of factors, including hormonal changes, preexisting mental health conditions, fatigue, physical discomfort, age, and major lifestyle shifts. Additional contributors include lack of partner or family support, financial strain, and socioeconomic challenges.

“I think inability to bond with a newborn infant is a large concern for all women. Whether or not you have anything going on, you’re tired, you're sore, you have disrupted sleep patterns,” notes Mylcraine. “But, having a mood disorder further complicates that bonding process. New parents can feel inadequate to meet the baby's needs, not sure how to proceed with what they're wrestling with. And, they're struggling to meet their own needs. It's important to know that support is available.”

Support, Support, Support: The Strategy New Parents Need

Managing perinatal mood disorders involves a combination of self-care, professional support, and community encouragement. Helpful strategies include accepting support, getting rest, eating well, staying hydrated, spending time outdoors, and seeking therapy or medical treatment when needed. 

Follow-up care is critical. Yet, up to 30% of women with mood disorders skip their appointments—highlighting the importance of ongoing support and encouragement. Resources like the National Maternal Mental Health Hotline offer confidential help. 

Most importantly, loved ones can make a meaningful impact through simple acts of support—checking in, helping with tasks, or just being present. Avoid minimizing their experience. Instead, listen with empathy and offer nonjudgmental companionship.

“I think there is sometimes still a stigma with mental health. Many women feel they have to ‘get over it’ alone, or they may have an elder or someone else tell them that it's normal to feel the way they’re feeling. I promise, no one needs to suffer alone,” assures Mylcraine. “Waiting too long into the disorder can hinder potential treatment. Please don’t be afraid to talk with your provider to see what help you need the most.”

For more information about women's health services at Riverside visit myrhc.net/womenshealth.