What expecting parents need to know about perinatal mood disorders, and how to treat them

Most of us have most likely heard of the term postpartum depression. In fact, several types of mood disorders may be experienced during or after pregnancy — and these disorders are catalogued under the term perinatal mood disorders, or PMADs.

To better understand them, and why prioritizing mental health in general is so important for expecting parents, we spoke to Janelle S. Peifer, assistant professor of psychology and a licensed clinical psychologist, of Inclusive Therapy + Wellness.

What are perinatal mood disorders?

Most of us are familiar with postpartum mood disorders — that is, those experienced after childbirth. Perinatal mood disorders are those experienced during and shortly after pregnancy.

“Perinatal mood disorders, or perinatal mood and anxiety disorders (PMADs), refer to clinical levels of distress, impairment or changes in functioning that occur in the pregnancy and up to two years after birth (postpartum),” Peifer explained. “These feelings can impact both birthing parents and their partners.”

What should parents-to-be know about perinatal mood disorders?

“Parents should know that PMADs are normative and can occur in 1 in 5 new parents,” said Peifer. “Having a support system that recognizes and knows how to respond effectively to PMADs is crucial for healthy functioning and recovery. Increasing your knowledge of signs and symptoms of PMADs will help you identify risk factors and areas of concern for yourself and loved ones.”

According to experts at Postpartum Support Virginia, expecting parents experiencing PMADs may:

  • feel sad, hopeless, or overwhelmed
  • feel anxious or panicky
  • regret having a baby
  • have trouble sleeping, even when the baby sleeps
  • think their family would be better off without them
  • fear leaving the house or being alone
  • isolate themselves from friends and family
  • have unexplained anger or irritability
  • fear they might harm themselves or their baby
  • have trouble coping with daily tasks
  • have difficulty concentrating or making simple decisions
  • feel “out of control”
  • feel guilty for feeling this way
  • feel relentless worry
  • feel tremendous self-doubt

Physical symptoms of PMADs include:

  • nausea
  • dizziness or lightheadedness
  • persistent headaches
  • racing heart
  • chest pain
  • shortness of breath
  • numbness in hands or feet

Expecting parents experiencing PMADs might think or say:

  • “This is supposed to be the happiest time in my life. … Why am I so sad?”
  • “Everything would be better if I got a good night’s sleep.”
  • “I feel like the worst [parent] in the world.”
  • “I’m having thoughts that are scaring me.”
  • “Why am I such a failure?”
  • “I worry all the time.”
  • “Why can’t I snap out of it?”
  • “I want to run away.”

For parents experiencing PMADs, or those who are in crisis, Peifer recommends calling the 24/7 perinatal mental health hotline: 1 (833) 943-5746.

Why aren’t perinatal mood disorders much talked about?

While many of us are familiar with terms like postpartum depression, perinatal mood disorders isn’t a term one often sees in parenting groups or forums.

“Many parents don’t talk about PMADs because of shame, fear of judgment and lack of knowledge,” explained Peifer. “The more we normalize and destigmatize conversation around mental health, the better we are positioned to support families through a significant, and often disruptive, life transition.”

How can perinatal mood disorders be treated?

“Many therapies — including cognitive behavioral therapy, dialectical behavioral therapy, medication management and family-centered interventions — have been found to be highly effective for reducing depressive and anxious features,” explained Peifer.

To find providers with specialized training and skills working with birthing parents and their families, Peifer recommends Postpartum Support International (PSI), an organization that has compiled lists of resources to help parents in need.

In addition to seeking professional support, parents experiencing PMADs should seek the support of other parents in their community.

“Supportive group therapies are a wonderful option to connect with other new parents and create social connections to manage the stressors of new parenthood and PMADs,” she said.

What other mental health concerns should parents, or parents-to-be, be aware of?

Because pregnancy and childbirth can bring about many unexpected challenges, Peifer recommends seeking mental health support early.

“Having a good relationship with a psychologist or therapist prior to birth can help you get support should something unexpected arise (e.g., birth trauma) with someone who knows you and who you’ve already established a relationship with before birth.”

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