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A third of depressive disorders and a quarter of anxiety disorders begin during pregnancy.

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With heightened attention on postpartum depression, anxiety, and psychosis, a critical truth has been missed: A significant percentage of “postpartum” mental health disorders actually begin in pregnancy.

Often termed PMADs, Perinatal Mood and Anxiety Disorders encompass depressive, anxiety, and bipolar disorders. (The latter is often linked to postpartum psychosis—a rare and poorly treated variant.) The perinatal or peripartum period means “surrounding birth,” and includes the entire pregnancy and year after.

Research suggests that a third of perinatal depression cases begin during pregnancy. Anxiety disorder symptoms during early pregnancy are actually more prevalent than postpartum, with a quarter of pregnant women experiencing anxiety in early pregnancy, dropping to 20 percent during the remaining peripartum. Perinatal obsessive-compulsive disorder (OCD) is experienced by about 8 percent of women during pregnancy, and about twice that number experience it postpartum. New-onset bipolar is rare in the peripartum period, but over 50 percent of women who have bipolar before pregnancy experience at least one episode peri-partally.

Women and their loved ones need to be aware of the risk of early-onset PMADs. Frequently, women have been struggling with anxiety, depression,........

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