Beginner’s Guide to Perinatal Mood and Anxiety Disorders

By: Tynetta A. Smith

Did you know…

There is a term for the emotional and physical distressing feelings that make it difficult for a birthing person during pregnancy (perinatal) and throughout the first year following pregnancy (postpartum) to enjoy life and function well—Perinatal Mood and Anxiety Disorders (PMADs).  

Examples of PMADs include Baby Blues, Perinatal Depression, Perinatal Anxiety, Perinatal Obsessive-Compulsive Disorder (OCD), Perinatal Post Traumatic Stress Disorder (PTSD), and Postpartum Psychosis.  

Baby Blues

As the most common, 60-80% of birthing people will experience feelings of exhaustion, irritation, and sadness after giving birth, beginning anywhere from 1-3 days after birth and may persist up to two weeks postpartum. 

Perinatal Depression

1 in 5 (20%) birthing people who are currently pregnant or who have given birth within the past year, may experience the following: 

  • low mood or sadness, 
  • loss of interest or pleasure in things once considered enjoyable, 
  • agitation or anxiety, 
  • lack of energy,
  • difficulty concentrating, 
  • low or increased appetite or sleep patterns, 
  • feelings of guilt, shame, or hopelessness
  • possible thoughts of harming the baby or oneself

Perinatal Anxiety

It is perfectly reasonable for most newly pregnant or birthing people to become overwhelmed with all the things required to prepare for a baby’s arrival or to adjust after delivery.  However, if these anxious feelings begin to become all-consuming and interfere with the birthing person’s overall functioning, it is possible that you may be experiencing perinatal anxiety.  Approximately 15-20% of birthing people may experience symptoms that include: 

  • constant worrying
  • feeling that something bad is going to happen
  • feeling like you can’t turn your brain off
  • low or increased appetite or sleep patterns
  • physical symptoms such as:
    • heart palpitations 
    • nausea
    • dizziness

Perinatal Obsessive-Compulsive Disorder (OCD)

Approximately 2 in every 100 (2%) birthing people experience unwanted and often disturbing intrusive thoughts, images, or impulses that occur over and over again; and/or repetitive behaviors or thoughts that one uses to try to rid of the obsessions.  Symptoms may include: 

  • obsessions—intrusive thoughts that are upsetting, persistent, repetitive thoughts or mental images regarding the baby
  • compulsions—where the birthing person may do certain things to try to reduce her fears and obsessions, such as,
    • needing to clean constantly
    • checking things many times
    • counting and reordering things

It is important to note that birthing people who are aware of these thoughts and are concerned by them are unlikely to act on them.  Symptoms that would imply awareness of the bizarre nature of these thoughts are: 

  • fear of being left alone with the infant
  • hyper-vigilance in protecting the infant
  • fear about the obsessions 

Perinatal Post Traumatic Stress Disorder (PTSD)

Many birthing people experience perinatal PTSD as a result of previous trauma such as physical or sexual abuse, rape, or due to a traumatic birthing experience.  Unfortunately, due to the biases, stigma, and stereotypes that Black birthing people encounter during pregnancy and birthing, it is likely that they will experience a traumatic birth.  Symptoms may include: 

  • flashbacks/nightmares of the traumatic event
  • avoidance of triggers associated with the event
  • anxiety and/or panic attacks
  • irritability
  • changes in sleeping patterns
  • altered sense of reality

Postpartum Psychosis

While this is rare, with only 0.1-0.2% of birthing people experiencing it, it is a very serious disorder and requires immediate medical intervention.  Birthing people may experience symptoms that include: 

  • seeing or hearing things that aren’t there
  • feelings of confusion
  • disconnected from reality
  • decreased need for sleep
  • paranoia or suspiciousness
  • difficulty communicating with others

If you believe that you or someone you know is suffering from Postpartum Psychosis, call 911 immediately. 

About The Author

Tynetta A. Smith is the founder and principal consultant of Mamas Vision LLC, an organization with a primary focus on improving Black maternal health outcomes and reducing maternal health inequities by centering the needs and uplifting the voices of Black mamas through collaborative research efforts, consultation, and community relationships. Tynetta is a 2nd year Counseling Psychology Ph.D. student focusing on Black maternal health and mental health outcomes. Her research interests focus on the intersection between counseling psychology, public health, and medicine, and the impact that collaborative relationships amongst these professions will have in eliminating maternal health inequities. She seeks to explore the unique outreach efforts employed by psychologists to connect with Black women in their communities, and to highlight the inequities that these communities contend with in regard to Black maternal mental health. Tynetta explores alternative culturally responsive, appropriate, and bias-free practices to meet the needs of Black women physical and mental health during their perinatal and postpartum journeys to eradicate their poor maternal health outcomes. Through Tynetta’s position as an adjunct professor in the department of psychology at Aquinas College, she uses her passion for health equity, Black women, and education to exemplify a passion-driven and social justice-focused career.

“I’m not saying I’m gonna change the world, but I guarantee I will spark the brain that will change the world.”
~Tupac Shakur