Perinatal Mood Disorders

Therapy for postpartum depression, postpartum anxiety, prenatal depression, and other perinatal mood disorders. You don't have to feel this way. Support is available. Serving New York.

What You're Feeling After (or During) Pregnancy Is Not a Reflection of Who You Are as a Parent.

You thought you'd feel happy. Or at least okay.

 Instead you feel distant, tearful, irritable, numb, or terrified, or some impossible combination of all of them. Maybe you're having thoughts that scare you. Maybe you're functioning on the outside but quietly falling apart on the inside. Maybe you've been telling yourself it's just hormones, just sleep deprivation, just the adjustment and waiting for it to pass. If you're reading this, some part of you knows you need more than waiting.

Perinatal mood and anxiety disorders are the most common complication of pregnancy and the postpartum period. They are medical conditions, not character flaws, not failures of love, not signs that you shouldn't have become a parent. And they are treatable.

What Are Perinatal Mood and Anxiety Disorders (PMADs)?

PMADs is an umbrella term for a range of mood and anxiety conditions that can occur during pregnancy (prenatal) or in the months and years following birth (postpartum). They affect up to 1 in 5 birthing people and are significantly underreported, meaning the true number is likely even higher.

PMADs include:

  • Postpartum Depression (PPD): Persistent sadness, tearfulness, hopelessness, rage, difficulty bonding, exhaustion that sleep doesn't fix, loss of interest or pleasure

  • Postpartum Anxiety (PPA): Constant worry, catastrophic thinking, racing thoughts, rage, inability to rest, physical symptoms like a tight chest or upset stomach

  • Prenatal Depression and Anxiety: Mood and anxiety symptoms that arise during pregnancy, not only after birth

  • Postpartum OCD: Intrusive, unwanted thoughts, often about harm coming to the baby, accompanied by compulsive behaviors or mental rituals; these thoughts are ego-dystonic (they horrify you) and are not a sign of danger

  • Postpartum PTSD: Following a traumatic birth or pregnancy experience

  • Postpartum Psychosis: A rare but serious condition requiring immediate medical attention, characterized by hallucinations, delusions, or severe disorientation

What Therapy for PMADs Looks Like

Perinatal therapy is not one-size-fits-all. Together, we'll identify what you're experiencing, understand what's driving it, and develop a plan that actually fits your life.

Approaches I use include Cognitive Behavioral Therapy (CBT) to interrupt the thought patterns that fuel anxiety and depression, psychoeducation so you understand what's happening in your brain and body, somatic and nervous system work to help you come back to a sense of safety, and mother/parent-infant relationship support if bonding has been affected.

We can also coordinate with your OB, midwife, or psychiatrist if medication is something you want to explore. Therapy and medication together are often more effective than either alone.

Most people with PMADs recover fully.

The path there is shorter and smoother with support. You do not have to white-knuckle your way through this season of life.

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Frequently Asked Questions:

Perinatal Mood Disorders

Still have questions? Take a look at the FAQ or reach out anytime. If you’re feeling ready, go ahead and apply.

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  • This is one of the most common questions I hear, and it matters. Some degree of tearfulness, overwhelm, and exhaustion is a normal part of early parenthood and of pregnancy. What distinguishes a perinatal mood disorder is persistence, intensity, and impairment, symptoms that don't lift after a few days, that feel qualitatively different from ordinary tiredness or stress, and that are getting in the way of your functioning, your relationships, or your ability to care for yourself or your baby. The Edinburgh Postnatal Depression Scale is a commonly used screening tool; your OB or midwife may have already given it to you. But the most important signal is your own gut: if something feels wrong, it's worth talking to someone.

  • Almost certainly not. Intrusive, unwanted thoughts about harm — the baby falling, being dropped, being hurt — are one of the most common and least talked about symptoms of postpartum OCD and postpartum anxiety. The key feature of these thoughts is that they horrify you. You don't want them, you're not acting on them, and the fact that they frighten you is actually a sign that you are not a danger to your baby. These thoughts are a symptom of an anxiety disorder, not a reflection of your intentions or your character. Please reach out — this is very treatable, and you don't have to carry this alone.

  • Absolutely. Prenatal depression and anxiety are as real and as common as their postpartum counterparts, and addressing them during pregnancy can also reduce the risk of more severe symptoms developing postpartum. Pregnancy is a valid time to seek support, you don't have to wait until after the baby arrives.

  • No. Therapy and medication are not competing options: for many people, they are most effective in combination. I work collaboratively with OBs, midwives, and perinatal psychiatrists, and can help coordinate your care if medication is something you want to explore. There are also safe options for people who are pregnant or breastfeeding. You deserve a full range of treatment options, not a forced choice.

  • Difficulty bonding is one of the most painful and least discussed symptoms of perinatal mood disorders. It is also one of the most treatable. Bonding is not always instantaneous, and the absence of overwhelming love in the early weeks does not define your relationship with your child. Therapy can address the barriers to bonding directly, and many parents describe the development of connection as one of the most meaningful parts of their recovery.

  • Recovery from PMADs looks different for everyone. Many people notice meaningful improvement within 8–12 sessions. Others benefit from longer-term support, particularly if there are underlying anxiety or depression histories, trauma, or significant relationship stress. We'll evaluate as we go and adjust based on how you're doing. Most importantly: people with PMADs recover fully. You will not feel this way forever.