Pregnancy and new motherhood are often called the happiest time of a woman’s life. For many women, it’s also one of the hardest seasons. Alongside the joy, there can be worry that won’t quiet down, sadness that doesn’t lift, or thoughts that feel scary and unfamiliar.
If that’s you, you’re not alone.
What does perinatal mean?
Perinatal refers to pregnancy through the first year after birth.1,2 It’s a season of enormous change for your body, your hormones, your sleep, your relationships, and your sense of who you are. For some women, symptoms can continue past that first year.4
What are perinatal mood and anxiety disorders?
“Perinatal mood and anxiety disorders,” often called PMADs, is an umbrella term for the mental health conditions that can show up during pregnancy or in the year after birth.2,3 They include:
- Depression: Persistent sadness, hopelessness, or emptiness, often with exhaustion, guilt, or losing interest in things you used to enjoy.
- Anxiety: Excessive worry, fear, or nervousness that’s hard to turn off.
- Panic disorder: A form of anxiety with sudden, recurring waves of intense fear, often with a racing heart or shortness of breath.
- Obsessive-compulsive disorder (OCD): Repetitive, unwanted, intrusive thoughts, often about the baby’s safety, along with an urge to do something, like checking or avoiding, to ease the distress.
- Post-traumatic stress disorder (PTSD): Trauma symptoms like flashbacks, nightmares, or avoidance after a frightening or distressing pregnancy, birth, or postpartum experience.
- Bipolar disorder: Mood episodes that cycle between lows (depression) and highs (unusually high energy, little need for sleep, or racing thoughts).
- Postpartum psychosis: Rare, occurring in about 1 in 1,000 births. A medical emergency involving a loss of touch with reality.2,3
These are simplified, everyday descriptions, not clinical definitions, and they don’t include every possible symptom.
How common is this?
More common than most people realize. At least 1 in 5 women experience a perinatal mood or anxiety disorder,1,5 and since many women never tell anyone how they’re feeling, the real number is likely higher.1 Partners can struggle too: as many as 1 in 10 fathers experience postpartum depression or anxiety.5
Baby blues, or something more?
Up to 80% of new moms experience the “baby blues”: tearfulness, mood swings, and feeling overwhelmed in the first few days after birth. The baby blues come from the sudden shift in hormones after delivery, and a lack of sleep can make them feel even harder. They usually ease within a few days to two weeks.2
It may be something more if:
- Your feelings last longer than two weeks
- Rest doesn’t help you feel restored
- You have trouble sleeping even when your baby sleeps
- You’ve lost interest in things you used to enjoy
- You feel numb, hopeless, or disconnected from your baby
- You have thoughts of harming yourself
What it can look like
Perinatal mood and anxiety disorders don’t always look like sadness. They can also show up as:
- Constant worry about your baby or your own health
- Feeling irritable, angry, or on edge
- Racing thoughts or panic
- Scary, unwanted thoughts about something bad happening to your baby
- Flashbacks or nightmares after a difficult birth
- Pulling away from the people you love
- Lack of self-care
- Physical symptoms like headaches, stomach issues, or a racing heart
A note about scary thoughts: Most new moms have sudden, unwanted thoughts of something bad happening to their baby at some point.2 When these thoughts feel upsetting and completely out of character, that’s a sign of anxiety, not a sign you would act on them. Thoughts are just thoughts, and skills can be learned to manage them.
When it’s an emergency: Rarely, a new mom may become confused, see or hear things that aren’t there, or hold beliefs that don’t match reality. This may be postpartum psychosis, and it’s a medical emergency.2,3
Help works
Perinatal mood and anxiety disorders are treatable,3 and you don’t have to wait until you’re in crisis to reach out. Therapy can help you make sense of what you’re feeling, learn practical tools to ease anxiety and low mood, give you language around your experience, and process a difficult birth or loss. For some women, medication is also part of the plan, which can be a meaningful conversation with your doctor.
Where to turn
- 988 Suicide & Crisis Lifeline: Call or text 988, anytime.
- National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262). Free, confidential, and available 24/7 in English and Spanish.6
- Postpartum Support International: Call or text 1-800-944-4773 for support and local resources, and visit postpartum.net for online support groups.7
You deserve care in this season too, not just your baby. If you’re in California and would like support, I’d be honored to walk alongside you.
Jamie
- American College of Obstetricians and Gynecologists. Clinical Practice Guideline No. 4: Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum. Obstet Gynecol. 2023;141(6).
- Policy Center for Maternal Mental Health. About Maternal Mental Health Disorders.
- Postpartum Support International. Learn More: Perinatal Mood and Anxiety Disorders.
- Torres A, Gelabert E, Roca A, et al. Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study. J Affect Disord. 2019;245:965–970.
- Maternal Mental Health Leadership Alliance. Maternal Mental Health Conditions.
- Health Resources and Services Administration. National Maternal Mental Health Hotline.
- Postpartum Support International. Get Help. Postpartum Support International website. Accessed October 21, 2026. https://postpartum.net/get-help/