When Westport, CT-based influencer Julia Dzafic welcomed her first child, motherhood wasn’t what she expected.

“I didn’t feel bonded to my baby at all,” Dzafic, 37, remembers. “I didn’t want to be with her.” 

A pediatrician and OBGYN screened Dzafic for perinatal depression (PND) — a condition similar to postpartum depression (PPD) but slightly different in that PND can affect women during pregnancy and after childbirth while PPD only affects women after childbirth. After Dzafic’s doctor analyzed the results of her screening, the PND diagnosis didn’t entirely seem to fit.

“I didn’t have the ‘normal’ PND symptoms, so I thought it was just me,” she remembers. “I thought I was just a terrible mom and not cut out for motherhood.”

Experiences like this are one reason mental health professionals want expecting and new parents to be aware of perinatal mood and anxiety disorders (PMADs) — a range of mental health conditions, including PND, that can begin during pregnancy or up to a year after giving birth. 

When Dzafic was diagnosed with a combination of perinatal depression and anxiety, she was able to get the support she needed. Years later she had a son and was prescribed selective serotonin reuptake inhibitor (SSRI) medication throughout her pregnancy and postpartum year. 

“I fell in love with my son immediately,” she says. “While I was tired and definitely stressed at times, my postpartum experience was light-years better than the first time.” 

One in seven

PMADs are “incredibly common,” says Tiffany A. Moore Simas, MD, chair and professor of obstetrics and gynecology at UMass Memorial Health and UMass Chan Medical School. At least one in seven moms and one in 10 dads will experience a mental health condition. The most common PMADs are anxiety and depression, but others include obsessive-compulsive disorder and posttraumatic stress disorder.

Postpartum psychosis, while another known PMAD, is far less common in comparison. About .1 to .2 percent of new moms experience it. It is also entirely different — and typically more severe than — other PMADs.

“In both depression and anxiety, what is real is real,” explains Moore Simas. “In postpartum psychosis, there’s often delusions, which are thoughts or beliefs that are not true or unlikely to be true.”

While postpartum psychosis is rare, it does happen. “If you think somebody is having postpartum psychosis, that is an emergency,” Moore Simas says. She recommends reaching out to an OBGYN, primary care doctor, or emergency room immediately. 

What PMADs look like

Symptom lists for PMADs are available through Postpartum Support International, but individuals’ experiences can vary.

For Jillian Amodio, 32, perinatal and postpartum depression was “this complete overwhelm, complete panic, and complete guttural sobbing of ‘I am not good enough.’” At her lowest, Amodio experienced suicidal thoughts. “I would literally fantasize about driving my car off of a bridge because my kids deserve someone better than me,” she says.

For Maria Carola, 51, who experienced perinatal depression for years after a pregnancy loss and the birth of her two kids, it was a lonely and hollow feeling.

“When I knew that the kids were safe, either in their cribs napping or with the babysitter or a family member, I was either in the closet or bathroom crying, just always crying,” says Carola, a PR consultant based in New York and Connecticut. 

One day, curled up under a desk, she called her OBGYN for help. With regular therapy and medication, Carola’s condition vastly improved.

“How the hell did I fall through the cracks?” she remembers thinking. “If I’m falling through the cracks, imagine the other people who are.”

While it can be difficult for mothers experiencing PMADs to silence the negative self-talk in their heads, vice president of behavioral health at Point32Health Jill Borrelli reminds new moms that, “it is important to understand that postpartum depression is not a character flaw or sign of personal weakness. Postpartum depression can affect any woman, regardless of her culture, age, race, or economic background.”

Risk factors and early intervention

“If somebody has any risk factors, we should be putting supports in place for them prenatally,” says Divya Kumar, a perinatal psychotherapist and cofounder of the Perinatal Mental Health Alliance for People of Color. “We should make sure that we create a safety net of support services that birthing people and families cannot fall through.”

Risk factors that can increase the likelihood of developing a PMAD include:

• Lack of social support
• History of mental illness
• Adverse life events
• Present/past pregnancy complications 

Screening moms and dads for PMADs is vital for early detection and treatment. “The sooner you tackle it, the better it works out,” says Tamika Simpson, a care advocate coordinator at Ovia Health, a suite of women’s health, pregnancy, and parenting apps. Through the apps, members are prompted to complete a screening survey periodically or can opt to take it more often. “If someone is experiencing signs and symptoms of what could be [a PMAD], then we can connect them to resources very quickly,” Simpson says.

There is a growing effort to educate more providers, too, Kumar notes. “We need every person who touches a pregnant person or a new parent, every professional across the board, to know about perinatal mood and anxiety disorders, to know what the symptoms are, to know how to screen, and know how to connect somebody to support services.”

PMADs are sometimes mistaken for the “baby blues,” a common mental low period in the first few weeks of parenthood. 

“The baby blues are not uncommon, however, if the symptoms persist or are at a level of intensity that does not abate, it is important to encourage the new mom to seek help,” Borrelli says. 

Seeking support

Parents looking for support can reach out to their OBGYN, join a support group, or connect with a mental health services provider.

Ovia Health members with participating health plans, including Harvard Pilgrim Health Care and Tufts Health Plan, can use each app’s asynchronous messaging service to ask trained mental health coaches questions anonymously and get connected to in-network providers.

Other resources include:
• Health Resources & Services Administration’s National Maternal Mental Health 24/7 Hotline: Call or text 1-833-943-5746
• Perinatal Support International HelpLine: Text “Help” to 800-944-4773 

Mental health awareness and support are essential for new parents during this time of change. “People want to rush and provide love, support, and attention to the baby, but it’s important to remember that the baby is not the only new life that has been born. The life of the mother has also just been born,” Amodio notes. “She needs to be tended to, cared for, and supported.”

Point32Health is a nonprofit health and well-being organization, guiding and empowering healthier lives for all. Throughout all of life’s stages and challenges, our family of companies inclusive of Harvard Pilgrim Health Care and Tufts Health Plan support members and their families with whole-health benefits and solutions.