Understanding Perinatal Mood and Anxiety Disorders (PMADs): What Women Should Know

The process of becoming a mother—also known as matrescence—is a profound transformation that encompasses emotional, psychological, and physical changes as a woman transitions into motherhood. Although this process can be filled with joy and fulfillment, it can also present unexpected difficulties and emotional upheavals that should be navigated with care.

Sometimes, postpartum mental health challenges go beyond the typical "baby blues," developing into more serious conditions known as Perinatal Mood and Anxiety Disorders (PMADs) that can greatly impact mother, child, and family.

The good news is, PMADs are treatable. So understanding what PMADs are and recognizing the symptoms is crucial for every new mother and her support system to be aware of so effective treatment can be sought. In this post, I’ll discuss what women should know about PMADs, how they are different from the “baby blues,” and when to seek help.

At a Glance: What are Perinatal Mood and Anxiety Disorders (PMADs)?

Perinatal Mood and Anxiety Disorders (PMADs) are a group of mental health conditions that can occur during pregnancy or up to two years after giving birth. They are characterized by a combination of social, psychological, and biological stressors, and early recognition is critical given how significantly they can affect maternal and family well-being.

PMADs include:

• Perinatal depression

• Perinatal anxiety

• Perinatal obsessive-compulsive disorder (OCD)

• Perinatal panic disorder

• Postpartum post-traumatic stress disorder (PTSD)

• Postpartum psychosis — a rare but extremely serious condition that constitutes a medical emergency

Up to 20–25% of perinatal women experience PMADs, yet they often go undiagnosed and untreated. Why? Because of the shame and stigma that comes with feeling like you're not meeting your own — or society's — expectations of what motherhood should look like.

Here's the short version of how PMADs differ from the baby blues:

• Baby blues: Common, short-lived emotional ups and downs in the first 1–2 weeks postpartum. Resolve on their own.

• PMADs: More persistent, more severe, and require professional support to treat effectively.

• They often go undiagnosed due to shame, stigma, and the pressure to appear like you're coping fine.

• With the right support — including therapy for postpartum mental health — women recover fully.

What are the Signs and Symptoms of PMADs?

PMADs can manifest in various ways, affecting both mental and physical well-being during pregnancy and the postpartum period. Signs and symptoms of PMADs include:

• Feeling depressed, numb, or hopeless

• Lack of interest in the baby or difficulty bonding

• Persistent brain fog

• Anxiety or panic attacks

• Unusual anger or irritability

• Dizziness, heart palpitations, nausea, headaches, or chest pain

• Difficulty sleeping, even when the baby sleeps

• Intrusive thoughts

• Urges to repeat behaviors

• Feelings of guilt, shame, or worthlessness

• Loss of interest or pleasure in activities

• Disturbed sleep patterns or appetite changes

• Emotional volatility, including frequent crying

• Fear of leaving the house or being alone

• Withdrawal from friends and family

• Difficulty coping with daily tasks or making decisions

• Feeling highly agitated while still being high functioning

• Working hard to put on a “front” for family and friends that everything is OK even though you’re miserable on the inside

• Thoughts of harming yourself or the baby

  • If you are having thoughts of harming yourself or someone else, call 911 or go to the nearest emergency room immediately.

• Hallucinations, (seeing or hearing things that aren’t real), delusions (strong beliefs not based in reality), extreme agitation, confusion, disorientation, rapid mood swings, paranoia, and disorganized thinking.

  • These symptoms collectively signify a psychiatric emergency that requires immediate medical attention. If you or someone you know is experiencing these symptoms, call 911 or go to the nearest emergency room immediately.

What Clients Experiencing PMADs Might Say

Here are a just some examples of what women experiencing symptoms of PMADs say:

• I feel hopelessly overwhelmed all the time

• This isn't what I expected

• I know that I love my baby, but I just can't bond with them

• I cry all the time for no reason

• I feel like I’m failing

• I’m having scary thoughts, like falling down the stairs when I’m holding my baby

• I’m scared to be along with my baby

• I’m scared to leave the house

• I'm ashamed to admit how I'm feeling

• I feel like a shell of my former self

• I feel alone

• I want to run away

• I feel like a bad mom

PMADs are NOT the Baby Blues

Many people think that suffering during the perinatal period is normal and downplay very distressing symptoms as "just" the baby blues. They might tell themselves or hear from others, "I'll/You'll get over it!" But PMADs are not the same thing as the baby blues.

So what are the baby blues? Following childbirth, many women experience a transient phase marked by emotional ups and downs within the first two weeks postpartum. Many women describe themselves as "feeling hormonal" during this time.

This period, while it can be overwhelming, typically resolves with time and self-care practices like adequate hydration, nutrition, and sleep (within reason for someone who has a newborn), and the supportive presence of family and friends. However, if symptoms persist beyond this initial timeframe, it may indicate a more serious condition distinct from the baby blues.

Distinguishing between the baby blues and Perinatal Mood and Anxiety Disorders (PMADs) involves considering the timing, duration, and severity of symptoms. Again, baby blues are a temporary adjustment period. In contrast, PMADs can emerge at any point during pregnancy or within the two years postpartum. Symptoms of PMADs, such as persistent mood disturbances, anxiety, intrusive thoughts, and difficulty functioning, are more severe and prolonged, often requiring professional treatment for effective management.

Want a quick visual reference? Download our free guide — More Than the Baby Blues: A Guide to PMADs — for a side-by-side comparison of baby blues vs. postpartum depression, plus a full list of risk factors.

Download our FREE guide More Than the Baby Blues: A Guide to PMADs here

When To Seek Help

If you sense that something might be “off,” trust your instincts and ask for help. Whether you are pregnant, several days postpartum, or months or years postpartum—it is more than appropriate to seek assistance if you're experiencing struggles or concerns (no matter how “small”) about your mental health! 

It’s especially important to seek help if you find yourself experiencing persistent symptoms such as overwhelming sadness, anxiety, or difficulty bonding with your baby for two weeks or longer.

Regardless of whether it's baby blues or a PMAD, you deserve to receive the support and care necessary for your well-being. Taking proactive steps to address these issues ensures you receive the support and care you need, which trickles down to your baby and family too.

Therapists at Her Time Therapy are in tune with the needs of women, including those in their perinatal period. If you're unsure where to start or need guidance, our therapists are here to provide compassionate support and personalized care to help you on your journey. Check our our website, schedule an appointment, or contact us for a free 15-minute consultation call for a free therapist match to see how we can best help.

Her Time Therapy, PLLC is an integrative group counseling practice comprised of licensed

therapists in Colorado who specialize in providing convenient and empowering online therapy for women.

You can feel confident working with a Her Time therapist because we are women who get it—we recognize that women like you experience a unique set of biological, environmental, economic, and social challenges that have a real impact on your mental health and are deserving of specialized support.

Call/Text (720) 255-1667 | info@hertimetherapy.com | www.hertimetherapy.com 

About the Author

Lauren Veazey, MA, LPCC, NCC is a Licensed Professional Counselor Candidate in Colorado and a therapist at Her Time Therapy, where she provides online counseling for women. She specializes in supporting women through prenatal and postpartum experiences, motherhood, trauma, relationship concerns, and grief. Lauren uses a feminist, trauma-informed, and client-centered approach, integrating evidence-based modalities including Cognitive Behavioral Therapy (CBT) and mindfulness-based techniques to help clients better understand their thoughts, regulate emotions, and build healthier patterns in their daily lives. Her work focuses on helping women feel more grounded, confident, and connected to themselves as they navigate major life transitions and emotional challenges. She works under the supervision and clinical direction of Meagan Clark, MA, LPC, NCC, BC-TMH, ensuring high-quality, evidence-based care aligned with Her Time Therapy's approach to women's mental health.

About Her Time Therapy

Her Time Therapy is an integrative group counseling practice comprised of licensed therapists in Colorado who specialize in providing convenient and empowering online therapy for women. We recognize that women experience a unique set of biological, environmental, economic, and social challenges that have a real impact on mental health — and that you deserve specialized, feminist-informed support. Schedule a free consultation to get started.

Disclaimer: This blog does not provide medical advice. The information contained herein is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a licensed health provider before undertaking a new treatment or health care regimen. If you are in crisis, please contact the 988 Suicide & Crisis Lifeline by calling or texting 988.

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