Beyond the Baby Blues: Signs of Perinatal Mood and Anxiety Disorder


This post is sponsored by Missouri Baptist Medical Center

As moms, we’re often characterized as selfless, loving human beings who sacrifice many of our wants and needs for the wants and needs of our children. Unfortunately, this often comes at the expense of our own wellbeing. So, how can we expect to be good moms if we don’t take care of ourselves? 

Think of it another way: when you’re on an airplane, you’ve heard this announcement from the cabin crew: ‘In case of a loss of cabin pressure, oxygen masks above your seat will deploy. Place your mask on first and then assist your children with theirs.’

Sounds absurd, right? We’ve always been taught that our children come first. But, by helping ourselves first, we’re able to help others. It’s the same when it comes to our health – physical and emotional. If we don’t care for ourselves, how can we care for others? The truth is, we can’t. We must prioritize our needs, particularly during pregnancy and that first year after birth. 

How common are mood changes or disorders for expectant and/or new moms?

Most women (80 percent) deal with some mild mood changes – or mood swings – during pregnancy and/or after giving birth (those hormone fluctuations can certainly take their toll on our emotions). However, one out of five moms will experience more significant symptoms of depression or anxiety, which can appear at any time during pregnancy and the first year after childbirth.

Although the terms ‘baby blues’ or ‘postpartum depression’ are most commonly used, there are several forms of illness that women may experience, including depression, anxiety, OCD, PTSD, bipolar disorder, and psychosis. We now use the term ‘perinatal mood and anxiety disorder,’ also known as PMAD. 

Who is at the greatest risk for PMAD?

Any mom is at risk, but those with a history of mood or anxiety disorders, such as depression, anxiety, and bipolar disorder (manic-depressive), or those with a sensitivity to hormonal changes, are at a higher risk. Additionally, moms who are Type A or perfectionists/high-achievers tend to be more susceptible to PMAD. Those characteristics work for well for success in life but set you up for more significant challenges when it comes to being a new parent. 

What are the signs or symptoms of PMAD?

Signs and symptoms may include:

  • anxiety
  • depression
  • sadness
  • anger
  • irritability
  • confusion
  • insomnia
  • feeling overwhelmed
  • changes in appetite
  • difficulty communicating what you need

In very rare cases, one out of 1,000 women will experience postpartum psychosis, which requires immediate medical attention at a hospital. 

Often, new moms either overlook or ignore these symptoms for several reasons:

  1. New moms are usually pretty tired and trying to adjust to life with a newborn, making it that much more difficult to recognize the difference between normal exhaustion and possible depression or anxiety. 
  2. With all the pressures today (thanks to social media) of being the perfect mom or having that pregnancy glow, moms who may be struggling with PMAD may feel ashamed or embarrassed that they aren’t that ‘perfect’ after all. 
  3. Moms are also bombarded with people – from family members to total strangers – telling them what they should be doing and how happy they should be while doing it, which only makes them feel worse. 

If an expectant or new mom suspects she has PMAD, what should she do? 

First, we encourage you to do regular self-assessments by answering the following questions:

  • Are you feeling sad, irritable, anxious, or overwhelmed? 
  • Are you crying, exhausted, yet unable to sleep even when your baby is sleeping?
  • Are you having racing or scary thoughts that won’t seem to stop?
  • Do you lie down to rest, and your mind starts racing? 
  • Do you have a history of depression or anxiety?

If you answer ‘yes’ to any of these questions, you may be dealing with PMAD. The next step is to contact your OB/GYN, who knows you well. He or she won’t judge you and can direct you to the proper resource. 

So, what resources are available to help expectant and new moms who may be struggling?

First, just know that you’re not alone, and help is available. Here are some of the things we recommend:

  • Practice Self-Care – get adequate rest and proper nutrition; exercise; practice relaxation techniques; carve out time with your spouse/partner; ask for help with the baby, other children, and household chores 
  • Find Social Support – talk with others in group therapy, over the phone or online; meet with a therapist who specializes in women’s issues and/or PMAD
  • Treat the Symptoms – look into prescription medication for depression and anxiety; do yoga or meditate; monitor diet and exercise; research natural remedies

At MoBap, we also offer ‘The Fourth Trimester: Baby Blues and Beyond,’ which is a four-week program that incorporates cognitive behavioral therapy techniques, peer support, and self-care methods to provide support to women experiencing postpartum depression, anxiety or panic episodes.  Here is the link to the program:

If you’re looking for more information online, check out, which has resources, programs, and support groups that may be helpful. 

More importantly, find what works best for you. If you’re still struggling, keep reaching out until you find the help you need. If you develop PMAD, please know that it’s not your fault, you are not alone, and with help, you will get better. 


Shellie Fidell, MSW, LCSW, is a licensed clinical social worker at MoBap. Shellie specializes in psychotherapy and treating women’s issues. These include postpartum adjustment, depression during pregnancy, pregnancy and infant loss, infertility, and panic and anxiety disorders.