For years, women in pregnancy and the postpartum period have heard the phrases “baby blues” or “postpartum depression” and wondered if their feelings matched up to these diagnoses. But these terms don’t always accurately describe the condition that many new moms are battling, and several misconceptions can affect how women and their families understand their condition.

New mothers don’t necessarily experience full-blown depression. Instead, they might go through a period where they don’t enjoy activities they usually do. This lack of enjoyment, along with anxiety, can be a sign of a perinatal mood and anxiety disorder (PMAD). PMAD is a broader term healthcare providers use to describe these mood changes that can affect women during pregnancy and after childbirth.

A groundbreaking screening study of 10,000 women showed that, at 4-6 weeks postpartum, 1 in 7 women experience anxiety or depressive symptoms. Across the first postpartum year, 1 in 5 women are affected. This common but underappreciated condition may happen to you or someone in your life.

What causes perinatal mood and anxiety disorders?

Mothers who have a history of depression or anxiety disorders are more likely to develop these conditions during pregnancy or the postpartum period, but there are good psychotherapeutic interventions that can be made during pregnancy that prevent most treated mothers from developing PMAD.

Another key factor that can contributes to PMADs is the loss of pregnancy hormones when birth occurs. These hormones go to chemical receptors everywhere in a woman’s body, including the brain. Their return to pre-pregnancy levels depends on whether the mother is breastfeeding and when her normal hormonal cycling (periods) starts again.

While some women do experience transient feelings of sadness known as “baby blues,” if those feelings are constant and persist longer than 10 days, or if they have had previous depressive or anxiety disorders, it is more likely to be PMAD setting in.

What are some common misconceptions about PMAD?

Mood disorders only affect the brain. In fact, mood disorders like anxiety and depression are whole-body disorders, affecting all of a person’s physical cues as well as their emotions. Their regular rhythms of when they eat, sleep and perform other normal functions are off, and their whole body is affected.

New moms should feel a certain way after birth. Many mothers facing anxiety or depression in the post-birth days, weeks and months say they thought this was how everyone felt after their baby’s birth. In fact, women’s recovery from labor and delivery – as well as caring for their newborn – can take a toll on their mood. If they are experiencing a sad, down mood that doesn’t lift for most of the day every day, or they’re so anxious that they can’t concentrate on things they used to enjoy – that’s not okay.

PMAD only affects birthing mothers. While this is mostly a female condition, studies have shown that partners can also experience PMAD, although not at the rates of the birthing mother. What’s more, adoptive parents and those whose baby was born via surrogate, as well as surrogates themselves, can also experience PMAD symptoms. All these individuals are at greater risk if they have a history of anxiety or depression.

Medication that a pregnant or new mom takes can affect their baby. Recent studies have shown that pregnancy and infant outcomes are affected more by PMADs than by medications used to treat them. About 5 percent of American women take antidepressants during pregnancy. Very little, if any, antidepressant medication reaches the baby’s blood through breastmilk. Mothers in need of medication support for their anxiety or depression should not fear taking it – and they should know that breastfeeding their babies is safe. Most obstetricians and pediatricians are aware of the safety of medication and breastfeeding, more so today than even a decade ago.

What are the risks of leaving PMAD untreated?

Anxiety or depression during pregnancy can change a mother’s physiology and affect her fetus as well. Research has shown that these disorders increase the risk for preterm birth and change in the child’s DNA, putting the child at risk for adverse health later in life.

Additionally, when new moms can’t regulate their own functions because they are tearful, anxious or overwhelmed, it is harder to help the baby regulate to a calm state. Caregiver-baby attachment may be strained, and a child could face behavioral issues in the future.

In rare cases, about 1 to 2 in every 1,000 women experience a more severe condition known as postpartum psychosis. This condition is characterized by agitation, paranoia, delusions or hallucinations, as well as hyperactivity, mania or severe depression. It requires emergency medical attention as there is a risk of suicide and/or harm to the baby. Hospitalization, medication and psychotherapy are typical treatments, and the prognosis is generally good.

Women who are experiencing postpartum psychosis should be screened for bipolar disorder, as certain medications can escalate a person into a psychotic episode if not administered correctly. In many cases, the first time a woman is diagnosed as bipolar happens during the postpartum period.

How to get help for PMAD

While more resources are needed for the field of perinatal psychiatry, women and their families should know that help is available. For example, the Department of Health and Human Services has funded perinatal mental health services, with hotlines, screenings and more support, in 29 states.

Online screening tools can help a woman determine if she needs to reach out for help. Some of these tools include The Mood Disorder Questionnaire, The Patient Health Questionnaire and The Generalized Anxiety Disorder 7-item Scale.

Preventive programs can reduce the risk of depression and anxiety in pregnancy and the postpartum period. Postpartum Support International offers extensive information, referrals and online groups for women to connect with help. And today, many primary care doctors typically know how to treat basic anxiety and depression. Your child’s pediatrician may also put you in touch with mental health support.

If you or someone you know is facing symptoms of anxiety, depression or another mood disorder during or after pregnancy, don’t hesitate to ask for help. You are among a large number of women! Speak with your partner or a trusted family member about your feelings and reach out to a healthcare professional to connect with support.