Perinatal Mood and Anxiety Disorders

Q&A with PSI Coordinator Alesha Simuel

More often than not, new mothers lack access to basic care, support, and education around the perinatal period. From an overview of Postpartum Support International (PSI) to types of Perinatal Mood & Anxiety Disorders (and their risk factors), Alesha Simuel covers these common early motherhood complications while also sharing her own tips, support, and essential resources.

1. What are the critical messages for women to know about the postpartum/perinatal period & maternal mental health?

Before giving birth, it’s essential to establish a support system. Mothers should be encouraged to identify their family, friends, or any support person that they can depend on during the postpartum recovery phase before ever delivering. Check-ins and overall support for mom are just as important as it is for the baby.

Next, remember that as hard as it may be, nourishing yourself just as much as you nourish your baby is crucial. Be cognizant of taking time for yourself and practicing self-care. And although it’s easier said than done, avoid the unrealistic vision of being a “supermom” – thinking of everyone other than yourself, trying to accomplish every task on your own, never asking for help, and attempting to rule the world while simultaneously caring for your newborn.

One of the most important messages for a new mama to remember is to do what works for you and your baby. Everyone's situation is different! What works for one mother and her child, may not work for you… And that’s absolutely okay. Recognizing that the relationship you share with your baby is unique to the two of you, helps to set positive (realistic) expectations, develops your confidence, and creates an all-around better postpartum experience.  

Being aware of Perinatal Mood and Anxiety Disorders (PMADs) along with their risk factors is another important piece of the puzzle. As a mother, labor & delivery nurse, and coordinator with Postpartum Support International (PSI), I always encourage expecting women to discuss these risk factors with their OB/GYN and formulate a tentative plan prior to childbirth.

2. What is Postpartum Support International?

Postpartum Support International (PSI) is dedicated to providing mothers with access to reliable information, social support, and informed professional care to deal with mental health issues related to childbearing. We offer a variety of support outlets including:

  • Postpartum support coordinators who facilitate support in your area. Many regions in the U.S. have coordinators who specialize in helping moms find postpartum support. These coordinators can often be called, emailed, or reached by text and will respond within 24 hours. Coordinators are a great resource to utilize because they know the perinatal mental health resources (like practitioners, therapists, and support groups, etc.) in their area better than anyone else. 
  • Amazing online support group options, led by trained PSI facilitators. There are multiple support groups that range in different topics but are all helpful in regards to perinatal mental health. Here you have the opportunity to connect with people who share a similar experience & engage in non-judgemental conversation, encouragement, and support. A full list of support group options can be viewed here.
  • The opportunity to chat with an expert. During these sessions, you can connect with other moms and talk with a PSI expert about resources, symptoms, options, and general information about PMADs. 
  • Toll-free helpline. This line (800-944-4773) can be used at any time and a trained support member will assist you in English or Spanish. When calling in, you’re rapidly referred to appropriate local resources, including emergency services if needed, and as a new mom will be connected to the closest postpartum support coordinator.
  • Peer mentor program.
  • Assistance, education, and local resource information. This can all be found through the PSI website.

3. What does “perinatal” mean?

According to PSI, perinatal means the period “all-around” birth, throughout pregnancy as well as the baby’s first year.

4. What are the different kinds of Perinatal Mood & Anxiety Disorders (PMADs)?

There are many different postpartum disorders that are often masked by the most commonly known disorder, Postpartum Depression. It’s important for women, and those supporting a new mother, to be aware of all the various and possible forms of Perinatal Mood & Anxiety Disorders. Here is a list of them:

  • Perinatal (or Postpartum) Depression (PPD)
  • Major Postpartum Depression
  • Perinatal Anxiety 
  • Postpartum Panic Disorder
  • Perinatal Obsessive-Compulsive Disorder (OCD)
  • Postpartum Psychosis
  • Bipolar Disorders
  • Post Traumatic Stress Disorder (PTSD)

For more information on each one of these diagnoses, such as signs or symptoms, visit this page

5. How many new moms experience Perinatal Mood & Anxiety Disorders?

When the mental health of a mother is compromised, it affects the entire family. It’s been found that 1 in 7 women experience serious perinatal depression or anxiety during pregnancy or postpartum. Likewise, 1 in 10 dads also experience postpartum depression. 

These statistics show us that PMADs affect many, many people. Encouraging those affected to speak up, seek help, and know that they are not alone is beyond necessary. Support options are growing and should be utilized because the best type of parent is a well parent.

6. What are the predictive risk factors to be aware of when it comes to Perinatal Mental Health Disorders?

Major predictive risk factors of perinatal mood and anxiety disorders include but are not limited to:

  • Depression or anxiety during pregnancy
  • Previous experience with or a family history of perinatal mood disorders
  • Personal or family history of any mental illness like depression, anxiety, bipolar disorder, eating disorders, or obsessive-compulsive disorder 
  • History of trauma or abuse 
  • History of sensitivity to hormonal shifts (e.g., depression or anxiety at puberty, PMS, after pregnancy loss, mood swings or sensitivity due to birth control pills or fertility drugs)
  • Social stressors such as low social support, poverty, or interpersonal violence
  • Thyroid imbalance or dysfunction
  • Diabetes 
  • Unplanned or unwanted pregnancy
  • Single parenthood
  • Multiple births
  • Military duty or spouse with military duty

7. What are exacerbating risk factors of Perinatal Mental Health Disorders?

Exacerbating risk factors are known to increase the severity of PMADs. Those risk factors include but are not limited to:

  • Perfectionism 
  • Crisis related to the health of baby or mother such as a high-needs infant 
  • History of fertility treatments 
  • Recent loss or move 
  • Difficulty or complications in pregnancy and/or birth 
  • Difficulty breastfeeding 
  • Age-related stress and hormonal influences such as puberty or perimenopause
  • Unresolved feelings about miscarriage, abortion, adoption, or infant loss 
  • Alcohol or drug use

8. How serious are PMDs?

Suicide is one of the three leading causes of maternal death. As a new mother, you are always encouraged to be as honest as possible when completing perinatal mental health screenings at your postpartum or newborn appointments. Keep in mind that the point of these screenings is to help providers establish support for your well-being when in need.

9. What resources should pregnant & postpartum women be aware of?

It’s critical to know that as a new mother or new parent, it’s absolutely okay not to be okay. If you find yourself struggling with symptoms of a perinatal mood and anxiety disorder, there is help!

Start by leaning on the support available to you. Don’t be afraid to ask loved ones, friends, family, or your partner for help. Additionally, say YES when they offer. If you’re having a hard time identifying how your partner can support you, be sure to check out this resource.

I highly recommend visiting the PSI directory to locate a postpartum support coordinator in your area (as we have coordinators in all 50 US states, Canada, and Mexico, and more than 40 other countries around the world). This can be a great tool for someone who is looking for support, encouragement, information, tips, referrals, and/or local resources, a certain provider, or for exploring overall treatment options available. Reach out as soon as possible – as we are here to help you, even before a diagnosis! 

Another resource to be aware of is many providers are now offering a two-week postpartum follow-up appointment. If this isn’t offered by your provider, advocate for a two-week follow-up instead of the typical six-week check-up. Talk to your provider about how you’re feeling, too. Both of these are especially important if you have risk factors for any PMD and can be extremely helpful in identifying a problem early on in your postpartum period. Your overall wellness and health is most important.

10. What if I need additional or immediate help?

If you are seeking urgent medical assistance, please call your healthcare provider, local emergency number, or the always available National Emergency Hotlines included below. 

  • National Crisis Text Line (Anytime, Any Crisis)
    • Text: HOME to 741741 

About the Author

Alesha Simuel is a Registered Nurse who works in the labor & delivery setting. She also has experience in obstetrics & lactation, and serves as a postpartum support coordinator in multiple North Carolina counties with Postpartum Support International (PSI). As a mother herself, Alesha works to support her community by being a resource to any woman at risk for or experiencing a perinatal mood and anxiety disorder.

Information provided in blogs should not be used as a substitute for medical care or consultation.