Expert Voices: Christina G. Hibbert, Psy.D. on Perinatal Mood & Anxiety Disorders

Dr. Christina Hibbert

Dr. Christina Hibbert

In Part 1 of my contribution to The Advanced Maternal Age Project we discussed the emotional changes that typically accompany pregnancy and postpartum. But what happens when those “typical” emotional changes intensify?

Perinatal Mood & Anxiety Disorders

Though many families have heard about Postpartum Depression, most do not understand that there is actually a spectrum of emotional disorders that can occur in pregnancy and postpartum. The term “Perinatal Mood and Anxiety Disorders” (PMADs) describes this spectrum. At the mild end is the “Baby Blues,” a temporary condition that affects most new mothers (see Part 1); at the severe end is the more rare Postpartum Psychosis. But there are many other disorders in the middle of the spectrum that most families know next to nothing about.

This brief overview will hopefully put Perinatal Mood & Anxiety Disorders on your radar, helping you identify when your “Blues” have gone beyond normal postpartum adjustment and when you may need professional treatment.

Pregnancy Depression affects an estimated 10% of women while Postpartum Depression affects 15-20%. Symptoms vary but may include: sadness, worry, sleeplessness, appetite changes, feelings of guilt, hopelessness, and even suicidal thinking. Symptoms can start anytime during pregnancy or the first year postpartum.


Pregnancy & Postpartum Anxiety

  • Anxiety in Pregnancy affects an estimated 6% of new mothers while Postpartum Anxiety affects at least 10%. With symptoms like worry, racing thoughts, sleep and appetite disturbances, and physical symptoms like nausea or dizziness, Perinatal Anxiety can feel debilitating and overwhelming.
  • Postpartum Obsessive Compulsive Disorder (OCD) is a specific type of anxiety disorder that affects approximately 3-5% of women. These women experience obsessions (usually in the form of intense thoughts or images related to the baby), a sense of horror about these obsessions, and compulsions, or behaviors aimed at reducing their anxiety. Postpartum OCD is the most misunderstood and misdiagnosed perinatal disorder.
  • Other forms of Postpartum Anxiety include: Postpartum Post-traumatic Stress Disorder (6% of women), which is usually the result of a traumatic childbirth experience, and Postpartum Panic Disorder (10%) with predominant symptoms of panic attacks and intense fears.

Postpartum Psychosis is the most rare disorder, affecting approximately 1 of every 1000 mothers. The symptoms of Postpartum Psychosis are extreme, including hallucinations (hearing and seeing things), delusions (or false beliefs), irritability, and rapid mood shifts. Unlike the other disorders, the onset of Postpartum Psychosis is typically sudden and it requires immediate medical intervention to protect the safety of the mother and the baby. Hospitalization is the recommended treatment for Postpartum Psychosis.

The Good News

Though Perinatal Mood & Anxiety Disorders are common and can be overwhelming and challenging, the good news is that all of these disorders are highly treatable. Treatment generally includes social and practical support, psychotherapy, and medication; a combination of these is considered “best practice”. Research is also discovering more alternative treatment methods, like massage, light therapy, and nutritional supplements. (For more on Postpartum Depression Treatment visit  my site.) 

The point is that there are options for everyone and you are not alone. You can overcome Perinatal Mood & Anxiety Disorders; the more you understand about them, the smoother the recovery.

Dr. Christina Hibbert is a Clinical Psychologist, Founder of the AZ Postpartum Wellness Coalition and Producer of the DVD Postpartum Couples. A 4-time Postpartum Depression survivor, Christina had her most trying experience in 2007, when her sister and brother-in-law died, she and her husband inherited their two children, and she gave birth to their fourth baby, going from 3 to 6 kids practically overnight (an experience she shares in her forthcoming book, This Is How We Grow) A speaker, blogger, and singer-songwriter, Dr. Hibbert keeps her practice, her family, and her heart in Flagstaff, AZ. Visit Dr. Hibbert at or

Now that you’ve learned about pregnancy and postpartum emotional health, you may be wondering, “Am I at Risk?” Join me for Part 3 where I will discuss the risk factors and causes of Perinatal Mood & Anxiety Disorders, and specifically those related to women of advanced maternal age.