Defining Perinatal Mood and Anxiety Disorders
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Perinatal versus postpartum
Perinatal is a word to describe the time period from conception through a year following birth. Postpartum is a term used to describe the first year after birth. Mood and anxiety disorders can arise during pregnancy or in the postpartum period.
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Mood disorders
Mood disorders describe conditions such as depression and bipolar disorder. While I treat depression, I do not currently treat bipolar disorder or other mood disorders.
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Anxiety disorders
Anxiety disorders include generalized anxiety disorder, panic disorder and agoraphobia, specific phobias, and health anxiety. Obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are related to anxiety disorders.
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Postpartum depression
symptoms include:
persistent sadness, irritability, or hopelessness
loss of interest or pleasure in things you typically enjoy
feelings of excessive guilt or worthlessness
difficulties bonding with the baby
difficulty concentrating or making decisions
slowed thinking or movement
difficulties eating or sleeping
unwanted intrusive thoughts -
Perinatal Generalized Anxiety Disorder
symptoms include:
excessive worry that is difficult to control
feeling restless, keyed up, or on edge
being easily fatigued
difficulty concentrating
irritability
muscle tension
sleep disturbance
unwanted intrusive thoughts -
Perinatal OCD
symptoms include:
unwanted intrusive thoughts or images that cause significant distress
compulsive behaviors (including things you do or things you avoid doing) to reduce the distress associated with intrusive thoughts -
Examples of common perinatal depression symptom presenations:
Feeling sad, numb, or empty most of the day, even when things "should" feel joyful
Crying more often than usual, sometimes without a clear reason
Feeling disconnected from your baby — like you’re going through the motions but not bonding
Struggling to enjoy things you used to love, including time with your baby
Withdrawing from friends, family, or your partner, even when you need support
Feeling like you're failing as a mom or that your baby would be better off without you
Irritability or anger that feels out of proportion, often followed by guilt or shame
Trouble sleeping — either not being able to fall asleep or sleeping too much
Extreme fatigue that doesn't go away with rest
Appetite changes — eating much more or less than usual
Difficulty concentrating, remembering things, or making decisions
Feeling hopeless, helpless, or trapped
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Examples of common perinatal anxiety symptom presenations:
Constant worry about your baby’s health or safety, even when everything seems fine
Racing thoughts about whether you're doing things “right” as a mom
Feeling on edge or hyper-alert, like you can’t relax — always listening for cries or danger
Trouble sleeping, even when your baby is asleep and you’re exhausted
Intrusive, scary thoughts (like imagining worst-case scenarios) that feel distressing or out of character
Avoiding leaving the house or letting others help with the baby because it feels too risky
Checking on your baby repeatedly — watching them breathe, rechecking the monitor, or googling symptoms constantly
Feeling overwhelmed by simple tasks like packing the diaper bag, choosing baby gear, or planning a nap
Irritability or snapping at your partner/loved ones, even when you don’t mean to
Struggling to concentrate or make decisions — feeling mentally foggy or scattered
Physical symptoms like a racing heart, chest tightness, nausea, or shortness of breath when thinking about baby-related concerns
Fear that something bad will happen if you relax or let your guard down
A strong need for control — needing everything to be just so to feel safe
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Examples of common perinatal OCD symptom presenations:
Intrusive, unwanted thoughts about harm coming to your baby — often violent, disturbing, or graphic
Fear that you might accidentally or intentionally hurt your baby, even though this is the worst thing you can imagine
Compulsive behaviors or rituals meant to “neutralize” or prevent harm (e.g., excessive checking, cleaning, counting)
Avoiding certain activities (like holding sharp objects or bathing your baby) due to fear of acting on intrusive thoughts
Mental reviewing or reassurance-seeking, like replaying situations in your head or asking others if everything is okay
Avoiding being alone with your baby out of fear you might lose control
Feeling intense shame or guilt over your thoughts
Hyper-responsibility, feeling like you must control everything to keep your baby safe
Ruminating on “what if” scenarios — playing out worst-case outcomes in your mind repeatedly
Fear that having these thoughts means you're a bad mother or unfit parent
High anxiety in response to your thoughts, even though you recognize they’re irrational
Feeling the need to “prove” to yourself you're safe or not a danger
Gentle disclaimers:
This list is not meant to diagnose or replace professional care. Please note that:
Everyone’s experience of motherhood is different. You don’t need to check every box to deserve help. And while often symptoms are related to your experience of mothering, they can also arise related to other domains. It is also common to experience distress about your relationship and the changes that parenthood brings to it, navigating asking for help from your partner or others in your life, setting boundaries with family members and friends, going back to paid work outside home, choosing childcare arrangements, etc.. Anxiety can latch on to a wide array of challenges during matrescence, and depression can still be present even if you are feeling very bonded with your baby. There is no one size fits all definition, and often moms experience a combination of symptoms.
If you’re reading this and recognizing yourself in any of these symptoms, please know you are not alone, and there is support available.
If you are experiencing a mental health emergency, please call 911 or go to your nearest emergency room. You may also contact the Suicide & Crisis Lifeline by calling or texting 988.