Perinatal Mood and Anxiety Disorders

Supporting Parents Through the Perinatal Journey: A New Chapter in My Practice

I’m excited to share that I have earned my Perinatal Mental Health Certification (PMH-C) through Postpartum Support International (PSI)!

This certification recognizes professionals who have demonstrated advanced competency in helping mothers, fathers, and families experiencing perinatal mood and anxiety disorders (PMADs)—conditions that can occur during pregnancy and the postpartum period.

For me, this certification represents more than professional development—it reflects a deep commitment to supporting individuals and families through one of life’s most transformative and vulnerable times.

Understanding Perinatal Mood and Anxiety Disorders

Did you know that 1 in 5 mothers and 1 in 10 fathers experience postpartum depression?

Perinatal mood and anxiety disorders aren’t limited to “baby blues,” and they can affect anyone—regardless of gender, culture, background, or circumstance. Research shows that postpartum depression is a universal experience, with similar rates of perinatal depression seen across the world.

But depression is just one part of the picture. PMADs can include:

• Perinatal anxiety

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

• Bipolar disorder

• And in rare cases, postpartum psychosis

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These conditions are universally experienced, treatable, and nothing to be ashamed of.

Biological and Environmental Risk Factors

While every experience is unique, certain biological factors can increase risk, including:

• Endocrine or hormonal imbalances (such as thyroid dysfunction, diabetes, PCOS, or PMDD)

• Mood changes related to hormonal shifts (like those during puberty, PMS, or hormonal birth control use)

• Fertility challenges or loss

• Sleep deprivation

  
  

Social stressors—like lack of support, financial strain, or trauma—can compound these biological vulnerabilities.

Unfortunately, even though PMADs are common, they are often underdiagnosed and undertreated. A review of studies through 2015 found that while nearly 50% of women with antenatal depression and 30% with postpartum depression were identified, only 8.6% and 6.3%, respectively, received adequate treatment.

The Importance of Specialized, Evidence-Based Care

One of the biggest challenges I see in clinical practice is the misconception about psychiatric medications during pregnancy and breastfeeding. Too often, medications are stopped out of fear—sometimes even by well-meaning providers—without considering evidence-based guidance.

Discontinuing medication abruptly can lead to relapse or worsening symptoms and put mom and baby at increased mental and physical health risks. That’s why it’s so important to consult with a perinatal mental health specialist before starting or stopping any psychiatric medication.

As a PMH-C certified provider, I help patients navigate these complex decisions with compassion, collaboration, and up-to-date clinical information.

You’re Not Alone

If you or someone you love is struggling, there are safe and effective treatments available—and you do not have to face this alone.

Postpartum Support International (PSI) offers free and confidential resources for both providers and families:

• 📞 PSI Helpline: 1-800-944-4773

• 💬 Text Help: 800-944-4773 (English) or 971-203-7773 (Spanish)

• Provider Directory and Peer Mentor Program

• Virtual and local support groups

  
  

Final Thoughts

The transition into parenthood can be both beautiful and overwhelming. My hope in sharing this milestone is to spread awareness, reduce stigma, and remind parents that help is available—and healing is possible.

If you’re navigating emotional changes during pregnancy or after birth, please know: you are not alone and with the right support and care, recovery is within reach.

Tammy Johnson, PMHNP, PMH-C has a passion for working with immigrant and underserved communities stemming from her personal background and years spent volunteering with Hispanic, Asian, and rural populations. She is an active supporter of the ACLU. In her free time she is a devoted animal lover and proud mom of two dogs and a cat.

References:

American College of Obstetricians and Gynecologists Committee. Treatment and management of mental health conditions during pregnancy and postpartum: aCOG clinical practice guideline No. 5. Obstet Gynecol. (2023) 141(6):1262–88. doi: 10.1097/AOG.0000000000005202

Brooks E, Cox E, Kimmel M, Ruminjo A. Risk of untreated symptoms of PMADs in pregnancy and lactation. In Cox E. editor, Women’s Mood Disorders: A Clinician’s Guide to Perinatal Psychiatry. Cham, Switzerland: Springer (2021). p. 45–53.

Postpartum Support International (PSI). (2023). Available online at: https://www.postpartum.net/join-us/climbout/