50 Shades of Blue: Perinatal Mood and Anxiety Disorders

fifty shades of blue: perinatal mood anxiety disorders

Did you know that as many as 1 in 4 families will be affected by mood disorders during pregnancy and afterward? Many people are surprised to find out how common it is, and we want to shed a little bit of light on some of the most common myths associated with perinatal mood disorders, along with sharing some common symptoms, so that families can be prepared to recognize when they occur, and get the help they need!

Myth: Postpartum Depression is the only mood disorder that can occur after (or even before) having a baby.

While Postpartum Depression may be the most famous of the mood disorders associated with the postpartum period. However, anxiety, OCD, and even, rarely, psychosis, can also occur, and some have totally different symptoms than you might expect with depression! Knowing what the symptoms are can help you identify when something isn't right. The good news is that all of these mood disorders are treatable, and can get better with proper help.

Myth: Mood disorders only occur after the baby is born, not during pregnancy.

Pregnancy and birth are associated with a lot of changes hormonally, which can cause an imbalance at any time. Some women may be more susceptible to mood disorders while pregnant, others don't experience anything until afterward, and some will feel off the whole way through. The name for this is PMAD: perinatal mood and anxiety disorders. We want expecting families to know that while yes, it can be normal to have some mood swings in pregnancy, anything severe should be checked out, because you can definitely  have anxiety, OCD, and depression triggered by the pregnancy itself, not just afterward (see below for some common symptoms!)

Myth: Postpartum Mood Disorders affect only the woman who gave birth.

Partners who haven't given birth can absolutely be affected by perinatal mood disorders. These can be triggered by the general stress around this major life change, and by lack of sleep, to name just a few things. As doulas, we want to make sure the whole family is supported. Sometimes partners can get lost in the shuffle as the focus is centered around the pregnant partner, and the new baby. We make sure that you and your partner are supported, and that any symptoms can be addressed.

Myth: I've never been depressed before, so I won't get postpartum depression (or other mood disorders).

Perinatal Mood and Anxiety Disorders can affect anyone, even if you have never struggled with depression or anxiety before! This can catch you off-guard if you are not expecting it. It is helpful to be somewhat familiar with the symptoms so that it is not a total surprise, and so that you can get help in a timely manner.

The Many Shades of Blue

As you can see, there are many different times and ways that Perinatal Mood and Anxiety Disorders, PMAD, can present for expecting families. Below, we count just some of the ways that families can be affected.

Also, it is important to know that many people will experience Postpartum Blues, which are normal, and will typically resolve on their own after 1-2 weeks. Normal blues are typically experienced as moments of sadness, overwhelm, worry, etc. rather than being an on-going and constant feeling that doesn't resolve shortly, or is totally pervasive. It can be tricky to distinguish between this normal dip on the roller coaster, and something that requires more help, though. If you are ever in doubt, reach out and get help! Support is available.

Please note: If you or your loved one is hearing or seeing things that are not there, is showing severe and rapid behavior changes, is talking about concrete plans for self-harm or harming the baby, or is having delusional, paranoid, or suspicious, please contact your provider right away and seek immediate treatment.
  1. You are afraid you will get into trouble, or your baby will be taken away, if you tell someone how you really feel (you won't).
  2. You constantly feel over overwhelmed.
  3. You constantly feel anxious or worried.
  4. You constantly feel sad.
  5. You cry often, and have trouble stopping, especially after the first few weeks.
  6. You have a fear of leaving your baby in someone else's care.
  7. You fear being left alone with your baby.
  8. Intrusive thoughts of hurting your baby.
  9. Intrusive thoughts of hurting yourself.
  10. Extreme guilt that doesn't go away.
  11. You feel like you can never do anything right.
  12. You can't stop worrying about your baby.
  13. You constantly feel like something bad is about to happen.
  14. You feel like something is wrong, or that you have gone crazy.
  15. Feeling like you are worthless, or totally inadequate, that doesn't go away.
  16. Feeling numb or disconnected from the baby that doesn't get better.
  17. You have a short temper, and everything sets you off, all of the time.
  18. Uncontrollable rage.
  19. Resentment that doesn't go away.
  20. You feel like there is no hope, ever.
  21. You have an irrational fear about things that can cause harm.
  22. You feel like you will never feel like yourself again.
  23. You feel isolated.
  24. You feel detached from the world around you.
  25. You feel detached from the people that you love.
  26. You are not sure if you will ever love your baby.
  27. Most days it feels like you are just going through the motions.
  28. Frequent headaches, nausea, or stomach pain.
  29. Chest pains and tightness (be sure to get this checked out to rule out other possible causes).
  30. Panic attacks.
  31. You constantly just want to escape, and fantasize about leaving.
  32. You feel like your baby wouldn't care if you were gone.
  33. You feel like no one would care if you were gone.
  34. You feel like the world, or your baby, would be better off without you.
  35. It is hard to face another day.
  36. Making decisions is totally overwhelming and paralyzing.
  37. You feel exhausted, but you can't sleep because your thoughts race.
  38. You wake up and can't fall back asleep because your thoughts keep you up, or you are worried about the baby.
  39. You feel the need to be constantly busy, and can't rest. 
  40. You can't bring yourself to get out of bed, and can't stop sleeping.
  41. Your energy is gone, and nothing helps.
  42. You feel like you just can't get out of this rut, no matter what you do.
  43. You don't have an appetite.
  44. You can't concentrate or focus, even after you have rested.
  45. You feel like you need to constantly check the baby, or other parts of the house, for safety.
  46. You feel scared.
  47. You know something is off, but you don't know where to get help.
  48. You feel weak or like a failure. You should be better at this.
  49. You feel trapped, and it's suffocating.
  50. You feel restless, and unable to relax.

This list is not exhaustive, but we hope it helps you to see: there are many ways symptoms can manifest. We want you to know that this is common, you are not alone, and that what you are experiencing can be helped. This doesn't have to be your new normal. Contact your OB, midwife, or general practitioner to start the conversation about what is going on, and start a plan of care to get back to yourself again!

The doulas of Tender Beginnings serve the Cincinnati and Dayton, Ohio region. If you need referrals to providers who can help, or information about local resources, please contact us! We would love to help. Our Postpartum Doulas are also a great addition to your over-all care plan, either to help prevent, or to help give you the time and space to heal from, perinatal mood and anxiety disorders.