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Perinatal Mood and Anxiety Disorders (PMAD)

Your body and mind go through many changes during and after pregnancy. Depression and anxiety are debilitating conditions that strike 1 in 7 women during pregnancy and the year following childbirth. It affects women across all cultural, ethnic, and socio-economic boundaries.

These disorders include:


Baby Blues – Not a mild form of depression. Mothers feel sad, worried, or tired within a few days of giving birth. For many women, the baby blues go away in a few days.
If these feelings don’t go away or you feel sad, hopeless, or anxious for longer than 2 weeks, you may have Postpartum Depression (PPD).

Anxiety & Panic Disorders

  • Anxiety symptoms
  • Agitated, irritable
  • Inability to sit still
  • Excessive concern about baby’s or her own health
  • On high alert
  • Appetite changes
  • Rapid weight loss
  • Sleep disturbances
  • Difficulty falling/staying asleep
  • Constant worry
  • Racing thoughts
  • Shortness of breath
  • Heart palpitations

Obsessive-Compulsive Disorder (OCD)

(Most under-reported & under-treated disorder of childbirth) Classic symptoms include:

  • Obsession with germs and cleanliness
  • Checking on baby, hypervigilance
  • Intrusive, repetitive thoughts, usually of harm coming to baby
  • Tremendous guilt & shame

Panic Disorder symptoms

  • Episodes of extreme anxiety
  • Shortness of breath
  • Chest pain
  • Sensations of choking or smothering, dizziness
  • Excessive worry or fear
  • Restlessness, agitation
  • Irritability
  • Hot or cold flashes
  • Trembling
  • Rapid heart rate
  • Numbness or tingling sensations

Post Traumatic Stress Disorder (PTSD)

  • Reliving past traumatic events
  • Flashbacks & flooding
  • Distressing memories, thoughts, feelings, or external reminders of the event(s)
  • Spontaneous memories of the traumatic event(s)
  • Recurrent dreams/nightmares
  • Avoidance of triggers
  • Isolation from family/friends/providers
  • Persistent & distorted sense of blame of self or others
  • Numbing
  • Hyperarousal/Hypervigilance
  • Dissociation
  • Markedly diminished interest in activities

Bipolar Disorders

  • Several types of bipolar and related disorders
  • Cause extreme mood swings that include emotional
  • Highs® Mania or Hypomania
  • Lows® Depression


  • Most severe and rare postpartum reaction
  • Occurs in 1-2 in 1000 postpartum women
  • Onset usually within the first 2 weeks postpartum
  • 50% of first-time mothers with psychosis had no previous psychiatric hospitalization
  • Bipolar depression poses a huge risk
  • Psychosis occurs in 20% to 30% of women with known bipolar disorder

Postpartum Depression

The exact cause of PPD is not known and may be the result of many different factors, but hormonal changes may trigger symptoms of postpartum depression.

Symptoms of PPD begin within one year after delivery and last more than two weeks. Many mothers feel overwhelmed when a new baby comes home. But if you have any of the following symptoms of PPD for more than two weeks, call your doctor, nurse, or midwife:

  • Feeling angry or moody
  • Feeling sad or hopeless
  • Feeling guilty, shameful, or worthless
  • Eating more or less than usual
  • Sleeping more or less than usual
  • Unusual crying or sadness
  • Loss of interest, joy, or pleasure in things you used to enjoy
  • Withdrawing from friends and family
  • You cannot care for yourself or your baby (e.g., eating, sleeping, bathing)
  • Thoughts of harming the baby or yourself

What to do if you are experiencing a PMAD:

In addition to talking to a health care professional, here are some ways to begin feeling better or getting more rest:

  • Rest as much as you can. Sleep when the baby is sleeping.
  • Don’t try to do too much or to do everything by yourself. Ask your partner, family, and friends for help.
  • Make time to go out, visit friends, or spend time alone with your partner.
  • Talk about your feelings with your partner, supportive family members, and friends.
  • Talk with other mothers so that you can learn from their experiences.
  • Join a support group. Ask your doctor, nurse, or midwife about groups in your area.

The Tucson Postpartum Depression Coalition (TPDC) seeks to support maternal emotional health through education, support, and advocacy.

To learn more, access resources, or sign up for the mailing list for the quarterly educational meetings, visit tucsonpostpartum.org

Teresa Wilson MS RN
Teresa Wilson MS RNhttps://www.tucsonpostpartum.com/
Teresa Wilson, MS, RN, has worked as a perinatal and maternal-child nurse for 40 years. Her goal has always been to care for mothers and their families whenever she encounters them. Wanting to learn more and to do more to improve maternal mental health, she joined the Board of Directors for the Tucson Postpartum Depression Coalition (TPDC). As a board member, Teresa strives to improve the recognition of anxiety and depression and find solutions for mothers affected by mood and anxiety disorders.



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