What Are Perinatal Mood and Anxiety Disorders (PMADs)?
Bringing a baby into the world is often imagined as a joyful, magical time—but the reality can be far more complex. Many parents find themselves overwhelmed by emotions they didn’t expect: sadness, fear, guilt, or a sense of disconnection. These experiences are more common than many realize and often fall under the umbrella of Perinatal Mood and Anxiety Disorders, or PMADs.
PMADs can occur during pregnancy and in the first year after birth, affecting both birthing and non-birthing parents. They’re not a sign of weakness or failure—they’re real, treatable mental health conditions, and support is available.
Common PMADs: Anxiety, Depression, and OCD
While postpartum depression is the most well-known, PMADs actually include a range of emotional challenges. Let’s look more closely at the three most common:
Perinatal Anxiety
Anxiety during the perinatal period often shows up as constant worry or fear, racing thoughts, or physical symptoms like tension, restlessness, or a racing heart. Parents may feel like they can’t "turn off" their minds, and their thoughts often center around their baby's health, safety, or their own adequacy as a parent.This kind of anxiety can be exhausting and isolating, but it’s also one of the most treatable PMADs.
Perinatal Depression
Perinatal depression can include persistent sadness, irritability, low motivation, feelings of guilt or worthlessness, and disconnection from the baby, oneself, or the world. It can affect sleep, appetite, and energy levels—and make even the simplest tasks feel overwhelming.
This isn’t just “baby blues,” which usually pass within a couple of weeks. Perinatal depression lingers and interferes with daily life and bonding—but it’s also highly treatable with the right support.
Perinatal OCD
Perinatal Obsessive-Compulsive Disorder (OCD) involves distressing, intrusive thoughts (obsessions) and repetitive behaviours or mental rituals (compulsions) intended to reduce anxiety. These thoughts often center on the baby and may include fears of harm, contamination, or making a mistake.
Parents with perinatal OCD are often deeply disturbed by their thoughts, which go against their values. It's important to know that these thoughts are not a sign someone will act on them—they are symptoms of anxiety, not intent.
How PMADs Affect All Parents
While birthing parents are most commonly diagnosed, non-birthing parents and partners are also vulnerable to PMADs. Identity shifts, sleep deprivation, relationship changes, and the emotional load of new parenthood affect everyone in the family system.
Non-birthing parents may feel pressure to "stay strong" or may struggle with feeling disconnected from the baby, unsupported, or unsure of their role. Their mental health matters just as much.
Coping Strategies That Can Help
Here are a few supportive tools that can ease symptoms of PMADs:
Talk to someone you trust. Naming what you’re feeling—without judgment—is often the first step toward healing.
Prioritize rest where possible. Sleep deprivation worsens anxiety and depression, so lean on support to get breaks.
Limit overstimulation. Reduce background noise, social media, or anything that fuels stress.
Practice grounding techniques. Deep breathing, mindfulness, or simply stepping outside can help calm the nervous system.
Build small routines. Structure, even in tiny amounts, can help life feel a bit more predictable and manageable.
Evidence-Based Treatment Options
Therapy is one of the most effective tools for PMAD recovery. Common, research-supported approaches include:
Cognitive Behavioural Therapy (CBT): Helps identify and shift unhelpful thought patterns and behaviours.
Acceptance and Commitment Therapy (ACT): Focuses on helping parents accept difficult thoughts and feelings while taking meaningful steps toward their values.
Behavioural Activation: Encourages small, manageable actions that increase connection, joy, and a sense of accomplishment—especially helpful for depression.
Exposure and Response Prevention (ERP): A highly effective treatment for OCD that helps reduce the power of intrusive thoughts and compulsions.
Medication: In some cases, antidepressants or anti-anxiety medications may be recommended, in collaboration with your healthcare provider. Many are safe to use during pregnancy and breastfeeding.
You’re Not Alone—Support Is Available
PMADs are incredibly common—1 in 5 mothers and 1 in 10 partners experience them. They are nothing to be ashamed of. With the right support, parents can feel more grounded, connected, and confident again.
If you’re struggling, you don’t have to do it alone. Therapy offers a safe, supportive space to explore your feelings and find tools to cope.
Reach Out for Support
At Internal Nesting Wellness, we provide warm, evidence-based therapy for parents navigating perinatal mental health challenges. Whether you're experiencing anxiety, depression, or intrusive thoughts, you deserve support.
