Children's Hospital Colorado

How to Recognize Perinatal Mood and Anxiety Disorders — And When to Seek Help

A woman with her eyes closed holds the hand of her sleeping baby.

Whether this is your first baby or your fifth, adjusting to life with a new baby comes with a wide mix of emotions. While many are positive, expecting and new parents often face challenging feelings. Along with preparing for sleepless nights and countless diaper changes, parents-to-be should be aware of the signs and symptoms of perinatal mental health issues, which can occur anytime during pregnancy or throughout the first year after birth.

Experts from our Neonatal Intensive Care Unit (NICU) share potential signs and symptoms of perinatal mood and anxiety disorders (PMAD), how they differ from the baby blues and what you can do to get help.

What are the baby blues?

In the first two weeks after your baby is born, you may not feel quite like yourself and have a bit more difficulty managing your emotions. You may feel overwhelmed, but at the same time, you’re still able to care for yourself and your baby. If you can relate to this, you are likely experiencing the baby blues. These feelings are very common, normal and should lessen once your baby is two to three weeks old.

What are perinatal mood and anxiety disorders?

Perinatal mood and anxiety disorders (PMAD) are a range of conditions or mental health issues that parents may experience during pregnancy and the postpartum (after birth) period. This can include perinatal and postpartum depression, anxiety, panic, obsessive-compulsive disorder, postpartum post-traumatic stress disorder, bipolar disorder and postpartum psychosis. PMADs are different than the baby blues as they often have more severe symptoms and last longer than two weeks after birth. In addition to the birthing parent, their partner can also be at risk for experiencing a PMAD.

What are the symptoms of perinatal mood and anxiety disorders?

Any of the following can be a sign of a PMAD:

  • Feelings of guilt
  • Irritability, anger or rage
  • Trouble bonding with or minimal interest in your baby
  • General disinterest in things you used to enjoy
  • Sleep and appetite disturbances
  • Increase in crying, worrying or racing thoughts
  • Unwanted, scary thoughts
  • Thoughts of harming yourself or your baby

What are some risk factors for perinatal mood and anxiety disorders?

Certain factors can make it more likely you will experience a PMAD, including:

  • History of mental health issues (depression, anxiety, etc.)
  • Lack of community, family or friend support
  • Pregnancy, conception, delivery or breastfeeding complications
  • Financial stress
  • History of abuse or trauma
  • An unwanted or unplanned pregnancy

How can I help prevent perinatal mental health disorders?

Everyone is different, as are their circumstances, but here are some steps that can reduce your risk of having a PMAD:

  • Care for your body and mind
  • Rest when your baby rests
  • Spend time outside, if possible
  • Talk to other caregivers
  • Join a support group to meet new parents
  • Give yourself grace (It’s OK to not be perfect)
  • Ask your family, partner and friends for help
  • Talk about how you’re feeling
  • Create time for you and your partner or support person

How has support for perinatal mental health changed since COVID-19?

The COVID-19 pandemic had a complicated impact on parental mental health that we’re still understanding. Over the past few years, awareness about the need to better support maternal mental health has increased. The pandemic has also advanced and normalized the use of telehealth mental health services and support groups. This allows parents to seek professional support from the comfort of their home, which alleviates a significant barrier.

How can I get help with maternal mental health?

If you are having thoughts about harming yourself or your baby, seek help immediately.

If you’re dealing with mental health challenges during pregnancy or after the birth of your child, there are several steps you can take to help, both inside and outside of formal care settings.

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