It’s Not Just Depression: Understanding Perinatal Mood Disorders (PMD) (2024)
What we’ll cover in this post:
Most people have heard of postpartum depression, but there are so many more perinatal mood disorders to be aware of.
It’s important that we learn about these so we can easily identify a perinatal mood disorder in ourselves or in a loved one.
What is perinatal mood disorder?
Most of us have only heard of postpartum depression, but there is so much more that can go on during the perinatal period.
Mental health has a history of being very misunderstood and sometimes a taboo subject that isn’t talked about often.
In recent years, more people are talking about their experiences and shedding light on perinatal mood disorders. This is great because it helps people feel less alone and less ashamed about what they may be going through.
A perinatal mood disorder is any mood disorder that occurs during pregnancy or the postpartum period.
As if being pregnant and having a baby doesn’t affect your hormones enough, you can also develop perinatal mood and anxiety disorders.
It’s important to learn about these disorders, their symptoms, and how to find help whether you’re the pregnant person, their partner, or a friend or loved one.
The perinatal mood disorders we are going to discuss are:
Mood disorders during pregnancy
Postpartum depression
Postpartum anxiety
Postpartum psychosis
When can perinatal mood disorders happen?
A perinatal mood disorder can occur anytime during the perinatal period. The perinatal period is defined as the time period during pregnancy and up to a year after delivery.
Who is most at risk for perinatal mood disorders?
Those most at risk of developing a perinatal mood disorder include those who:
Have a history of a mood disorder prior to pregnancy
Have a family history of mood disorders
Have a lack of support
Weren’t able to prepare for the postpartum period
Are pregnant with an unplanned pregnancy
Have experienced the loss of a pregnancy/child
Are experiencing financial stress
Have a history or birth trauma
Are having partner relationship issues
Are experiencing a high-risk pregnancy
Have a baby in the NICU
Already have high expectations of yourself (aka you are a perfectionist)
Who it effects
You may think that perinatal mood disorders only affect the pregnant person, but they can also affect the pregnant person’s partner and other loved ones.
Most people tend to think of new mothers when it comes to postpartum depression and other mood disorders.
What we don’t tend to think of is the huge changes that dads and partners also go through after the birth of a baby.
Partners experience:
A new human to help care for
A change in their environment
The “loss” of a portion of their partner as they also become a new parent
The possible feelings of financial pressure if they are not the primary caregiving parent
The feelings of being unsure how to help, especially if their partner is breastfeeding/chestfeeding
A change in their relationship; specifically a lack of intimacy and/or attention
Difficulty in forming a bond or attachment with the new baby
These feelings and changes can contribute to a partner developing a perinatal mood disorder.
“Baby Blues” versus Postpartum Depression
Is it depression or just hormones? When do you need to worry?
After having a baby, it’s important to remember that your body has just gone through a TON of change; physically, mentally, emotionally and hormonally.
Your body is trying to heal, your breasts/chest are beginning to lactate, you have a new little life that you’re responsible for, your uterus is trying to shrink back down to pre-pregnancy size and your hormones are trying to regulate. Anyone going through all of that would be crying!
So, what’s the difference between postpartum depression and baby blues?
“Baby Blues” timeline
The first difference is the timeline. If you’re experiencing some emotions and excessive crying and you’re about 2-3 days postpartum, it’s likely baby blues. With baby blues, you’ll feel like you’re on a roller coaster. One second you’re totally fine and the next second you’re crying just looking at your baby because you love them so much or because you’re feeling totally overwhelmed in your new role.
You should start feeling better once your baby is about 1-2 weeks old.
If you are not feeling better after about 2 weeks and/or your symptoms are worsening, you may need to make an appointment with your healthcare provider to talk about postpartum depression.
Postpartum depression timeline
While the baby blues tends to cause waves of sadness, postpartum depression is more of a steady stream. Some signs that you’re experiencing postpartum depression and not just baby blues are:
Feelings of hopelessness, worthlessness or sadness
Crying a lot
Isolating yourself
You are having a hard time bonding with your baby
You are having difficulty eating, sleeping and taking care of yourself
You feel constantly overwhelmed
You have frequent anxiety and/or panic attacks
Postpartum Depression versus Postpartum Psychosis
So, now that we’ve covered a bit about postpartum depression we’re going to talk about the less common/less talked about perinatal mood disorders.
Postpartum psychosis is rather rare, only affecting about 1 in 1,000 postpartum folks. While it is less common, it is much more severe than postpartum depression.
Just like the baby blues and postpartum depression, the symptoms of postpartum psychosis typically begin within the first few days to the first few weeks after birth.
Symptoms include:
Irritability
Insomnia
Sudden shifts in moods (sometimes similar to bipolar disorder)
Feeling confused or disoriented
Thoughts and/or attempts to harm yourself or your baby
Delusions
Agitation
Bursts of energy or heightened sex drive
Paranoia or feeling suspicious
Apathy or disconnect from your baby and other things you care about
Hallucinations
Postpartum psychosis can be pretty scary because there is a higher risk of suicide and infanticide than with other mood disorders. This is due to mentally not living in reality and thinking these thoughts are normal and justifiable.
Unlike postpartum OCD, which we’ll get to down below, the postpartum person truly believes their thoughts and beliefs are real and rational.
Postpartum Anxiety
It’s important to keep in mind that, as a new parent, worrying is totally normal.
You’re not supposed to feel completely prepared and in control.
If you’re experiencing worry/anxiety that is affecting your daily life, you may be experiencing postpartum anxiety.
Some signs and symptoms of postpartum anxiety are:
Constant fear or worry that can not be eased
Feelings of impending doom or fearing terrible things are going to happen to you or your baby
Racing thoughts
Heart palpitations
Panic attacks
Hyperventilation/shortness of breath
Shaking or trembling
Feeling numbness and tingling
Postpartum Obsessive Compulsive Disorder (OCD)
The signs and symptoms of postpartum OCD can seem similar to those of postpartum anxiety.
Postpartum OCD vs Postpartum Anxiety
Postpartum OCD includes:
Racing, intrusive and/or repetitive thoughts
Compulsions; feeling the need to repeat something over and over again - i.e. Checking something multiple times, cleaning over and over again, and/or feeling the need to count and/or reorder/organize things obsessively
A sense of fear/anxiety surrounding the compulsions - i.e. “If I don’t clean this toy 4 more times, the baby will put it in their mouth and get sick”.
Fear of being left alone with your baby
Unlike postpartum psychosis, those who experience postpartum OCD are typically aware that their thoughts are odd and it is unlikely that they will act on any harmful thoughts.
Mood disorders during pregnancy
Most commonly, we hear and talk about postpartum mood disorders, but these disorders can also occur during pregnancy.
It is totally normal to have some anxiety surrounding pregnancy, labor, birth and becoming a new parent. These are HUGE events in your life.
The signs and symptoms of mood disorders during pregnancy are similar to those during the postpartum period, except the thoughts typically revolve around your unborn baby and wanting to be prepared for their arrival.
More often than not, pregnant folks who experience a mood disorder during pregnancy have an underlying mood disorder prior to pregnancy. Sometimes, those trying to conceive (TTC) or those who find out they’re pregnant, stop taking their medication for their mood disorder in fear of harming their unborn baby.
If you are taking mood stabilizing medications and you want to begin trying to conceive or you are pregnant, it is important to have a discussion with your healthcare provider prior to abruptly stopping any medications. Abruptly stopping mood stabilizing medications can be harmful.
Warning signs and when to call for help
If you or a loved one are experiencing any concerning signs and/or symptoms of a perinatal mood disorder, it’s important to seek prompt medical care.
Signs and symptoms that are appropriate for an appointment with your healthcare provider:
Mild anxiety
Mild sadness
Questioning if you may or may not be experiencing postpartum depression or anxiety
Signs and symptoms that need immediate medical attention
Hallucinations
Signs that you or a loved one are out of touch with reality
Thoughts or attempts to harm yourself or your baby
Severe panic attacks
If your situation is not emergent or urgent, you can call the Postpartum Support International (PSI) Hotline at: 1-800-944-4773
If your situation is emergent, please call your local authorities and/or reach out to the National Suicide Prevention Hotline at: 1-800-373-TALK (8255)
How trauma impacts PMD
Anyone who has been exposed to traumas throughout life are statistically more likely to develop a mood disorder.
Regarding perinatal mood disorders, pregnant folks who have experienced trauma surrounding pregnancy, birth, loss, or sexual abuse may be predisposed to a perinatal mood disorder.
If you have experienced any trauma that may impact your pregnancy, healthcare provider appointments, labor, or birth, it is important to discuss this with your healthcare provider and birth team.
If you have experienced sexual abuse and you have fears surrounding pap smears/cervical exams/vaginal exams, have a discussion with your healthcare team prior to these exams. It is their job to help you feel comfortable and heard.
Conversations around nudity and consent can also play a large part in helping you feel safe during pregnancy, labor, and birth. Have conversations with your partner and other support people about how to recognize if you’re being triggered or in a dissociative state so they can alert your team and tell them how best to support you.
It may also be helpful to hire a doula who specializes in trauma. This may be very helpful for you while in a vulnerable position, like labor and birth.
Always remember that YOU are in control of your body and if there is something you absolutely do not want to experience, that is your right.
Ways to avoid a postpartum mood disorder
Some ways you can avoid developing a postpartum mood disorder include:
If you already take mood stabilizing medications, ask your healthcare provider to give you a pregnancy/breastfeeding/chestfeeding safe option
Have a support team ready to go
Don’t be afraid to set boundaries and stick to them
If you are already at high risk for developing a mood disorder, be on high alert for any signs/symptoms
Try to find time to yourself, even if it’s 10 minutes a day
Try to get adequate sleep
Nourish your body by preparing food in advance and/or having someone help prepare meals
Get some exercise; a 10 minute walk outside can work wonders for your brain
How you can move through PMD
So, you’ve been diagnosed with a perinatal mood disorder. What now?
The good news is, there are plenty of options!
Support systems
If you have not already identified a support team; now is the time. Find a few people you trust who can help you.
Some ways you can utilize a support system include:
Having someone hold the baby while you take a shower
Asking someone to unload the dishwasher or fold some laundry
Having someone help to prepare meals and/or do some grocery shopping
Plan for people to come and care for older children so they aren’t bored
Ask people to help with pets and other responsibilities
Do you live far away from family and friends and have a partner who works outside of the home? Are you a single parent? That may make it pretty difficult to build a support system.
It’s important to recognize that you are not alone! There are local support groups of other parents going through the same season of life you are.
A quick internet or Facebook search will help to point you in the right direction. If you are able, consider hiring a postpartum doula. Sometimes you can find doulas for sliding scale cost if this is a limiting factor.
Medications
Whether you are already taking medication or not, they may be a beneficial tool if you are struggling.
There might be stigma surrounding taking medication for mental health, but many people are working hard to normalize it!
If you are struggling and the things you’re trying just aren’t working, talk to your healthcare provider about trying medication.
If you are hesitant, remember that it does not have to be permanent and if it doesn’t work out for you, you can try other avenues.
Keep in mind that there are medications that are safe for pregnancy and breastfeeding/chestfeeding.
Therapy
Talking to a therapist may be super helpful! There are therapists who specifically specialize in perinatal mood disorders.
It helps to have an outside, unbiased person to talk to.
Other treatments
If you are seeking more help or some other things you have tried are not working, there are some other ways to help overcome your perinatal mood disorder.
Yoga
Meditation
Relaxation techniques
Massage therapy
Eye Movement Desensitization and Reprocessing (EMDR) Therapy (very helpful for trauma!)
Electroconvulsive Therapy (ECT)
The Takeaway
Perinatal mood disorders can really take a toll on you. A lot of new parents may struggle with a perinatal mood disorder.
It’s important to be able to recognize:
Risk factors
Signs and symptoms
Treatment avenues
[Josh - we could do page jumps for these maybe? Or maybe not because it’s complex and multiple signs/symptoms for each. Whatever you think!]
Raising children takes a village and Motherboard is here to help!
🤍 The Motherboard Team
