S26-208 Understanding Perinatal Mood and Anxiety Disorders

Instructor

Agenda & Learning Objectives

AGENDA:

12:50 – 1:00 pm Log on  

1:00 pm – 2:30 pm  

Part 1: Understanding PMADs  

• Welcome, Introductions & Icebreaker 

• What Are PMADs? Definitions and Diagnoses 

• Baby Blues vs. PMADs: Understanding the Difference 

• Breakout Group 

Part 2: Prevalence & Disparities 

• PMAD Statistics: Women, Men, and Partners 

• Racial and Cultural Disparities in Diagnosis and Access 

• Exploring Systemic and Cultural Barriers 

2:30 pm – 2:45 pm Break 

2:45 pm – 4:15 pm  

Part 3: Risk Factors, Screening & Cultural Considerations  

• Common Risk Factors: Biological, Psychosocial, Cultural 

• Screening Tools: EPDS, PHQ-9, GAD-7, MDQ 

• Interpreting Results and Next Steps 

• Strategies for Culturally Responsive Communication and Engagement 

• Breakout Clinical Scenario: Cultural Lens 

Part 4: Treatment, Referral & Conclusion  

• Evidence-Based Therapies: CBT, IPT, Peer Support 

• Pharmacological Treatment: SSRIs and Perinatal Safety 

• Identifying and Responding to Postpartum Psychosis 

• Referral Pathways & Community Resources (e.g., PSI, warm lines, local services) 

• Final Quiz, Reflections, and Evaluation 

4:15 pm Adjournment 

LEARNING OBJECTIVES:

Upon the completion of this workshop, participants will be able to:

• Identify and understand the key risk factors, signs, and symptoms of PMADs to improve early detection and intervention.  

• Evaluate evidence-based treatment options for PMADs, including psychotherapy, medication, and support networks, and understand how to apply these treatments in clinical practice.  

• Develop cultural competency in providing care for individuals experiencing PMADs, focusing on addressing stigma; understanding diverse experiences; and offering inclusive, sensitive support. 

Bibliography & References

BIBLIOGRAPHY & REFERENCES

American College of Obstetricians and Gynecologists. (2023). Treatment and management of mental health conditions during pregnancy and postpartum: ACOG Clinical Practice Guideline No. 5. Obstetrics & Gynecology, 141(6), 1262–1288. https://doi.org/10.1097/AOG.0000000000005240

American College of Obstetricians and Gynecologists. (2023). Treatment and management of mental health conditions during pregnancy and postpartum. https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/06/treatment-and-management-of-mental-health-conditions-during-pregnancy-and-postpartum

American Psychological Association. (n.d.). Postpartum depression: Causes, symptoms, risk factors, and treatment.Retrieved August 22, 2025, from https://www.apa.org/topics/women-girls/postpartum-depression

Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). (2022). Perinatal mood and anxiety disorders position statement. Journal of Obstetric, Gynecologic & Neonatal Nursing, 51(3), 231–234. https://doi.org/10.1016/j.jogn.2022.02.005

Bauer, A., Parsonage, M., Knapp, M., Iemmi, V., & Adelaja, B. (2020). The costs of perinatal mental health problems. Journal of Affective Disorders, 274, 76–83. https://doi.org/10.1016/j.jad.2020.05.019

Cameron, E. E., Sedov, I. D., & Tomfohr-Madsen, L. M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders, 206, 189–203. https://doi.org/10.1016/j.jad.2016.07.044

CAMH (Centre for Addiction and Mental Health). (2023). Pharmacotherapy for perinatal mood and anxiety disorders. https://www.camh.ca/en/professionals/treating-conditions-and-disorders/perinatal-mood---treatment/perinatal-mood---pharmacotherapy

Center for Maternal Mental Health. (2023). Maternal mental health fact sheet. Policy Center for Maternal Mental Health. https://policycentermmh.org/maternal-mental-health-fact-sheet/

Cox, R. C., & Olatunji, B. O. (2022). Circadian rhythm disruption in postpartum mood disorders: An integrative review. Sleep Advances, 3(1), zpac012. https://doi.org/10.1186/s41606-022-00081-x

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). American Psychiatric Association. (See specifier: “with peripartum onset”).

Fischman, S. M., & Gonzalez, M. Z. (2023). The role of neuroendocrine factors in postpartum depression: A focus on estrogen, progesterone, oxytocin, and prolactin. Frontiers in Psychiatry, 14, 1296638. https://doi.org/10.3389/fpsyt.2023.1296638

Ganel, L., Glikson, E., Meiri, G., & Rappoport, N. (2024). Laboratory test dynamics across the perinatal period: A population study of 45 million tests. Nature Communications, 15, 4125. https://doi.org/10.1038/s41467-024-49991-y

Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., & Gartlehner, G. (2022). Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders, 282, 1–10. https://doi.org/10.1016/j.jad.2020.12.029

Gelaye, B., Kajeepeta, S., & Williams, M. A. (2019). Maternal depression and its impact on child health outcomes: A systematic review. BMC Pregnancy and Childbirth, 19, 120. https://doi.org/10.1186/s12884-019-2273-1

Hoekzema, E., & Barba-Müller, E. (2021). Pregnancy and the plastic maternal brain: An update. Frontiers in Global Women’s Health, 2, 743290. https://doi.org/10.3389/fgwh.2021.743290

Hoekzema, E., Barba-Müller, E., Pozzobon, C., Picado, M., Lucco, F., García-García, D., ... & Carmona, S. (2021). Pregnancy leads to long-lasting changes in human brain structure. Frontiers in Global Women’s Health, 2, 742775. https://doi.org/10.3389/fgwh.2021.742775

Karbownik-Lewińska, M., & Kokoszko, A. (2025). Endocrine changes in the perinatal period: Physiological basis and clinical implications. Acta Biochimica Polonica, 72(1), e202414241. https://doi.org/10.3389/abp.2025.14241

Kim, P., & Strathearn, L. (2021). Maternal brain plasticity: Adaptation to parenting. Annual Review of Clinical Psychology, 17, 533–554. https://doi.org/10.1146/annurev-clinpsy-081219-092630

Li, X., Laplante, D. P., Paquin, V., & O’Mahen, H. A. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety, and stress: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 299, 1–7. https://doi.org/10.1016/j.jad.2022.02.004

Liu, Y., Xu, S., Gonzalez-Martinez, A., Villalba-Martinez, A., Zhao, L., & Hoekzema, E. (2024). Tracking pregnancy-induced brain remodeling with longitudinal MRI. Nature Neuroscience, 27, 1460–1471. https://doi.org/10.1038/s41593-024-01741-0

Liu, Y., Zhang, J., Fan, H., & Li, L. (2022). Association between perinatal depression and attention-deficit/hyperactivity disorder in offspring: A population-based cohort study. Frontiers in Psychiatry, 13, 978712. https://doi.org/10.3389/fpsyt.2022.978712

McNeilly, A. S. (2022). Lactational amenorrhea: Neuroendocrine pathways and implications for fertility. Frontiers in Endocrinology, 13, 879327. https://doi.org/10.3389/fendo.2022.879327

Miller, M., Grewen, K., & Meltzer-Brody, S. (2023). Perinatal oxytocin and prolactin: Relationships with maternal mood and bonding. Journal of Clinical Medicine, 14(7), 2418. https://doi.org/10.3390/jcm14072418

Mohamed, A. O., & El-Bakry, R. (2023). Hormonal fluctuations and postpartum depression: A clinical update. Journal of Taibah University Medical Sciences, 18(4), 715–723. https://doi.org/10.1016/j.jtumed.2023.05.001

Navarro, V., García-García, D., Costas, J., Barba-Müller, E., Peró-Cebollero, M., Álvarez-López, M. J., ... & Hoekzema, E. (2021). Long-lasting neural changes in the maternal brain after pregnancy. Cerebral Cortex, 31(4), 1984–1997. https://doi.org/10.1093/cercor/bhaa327

Ngai, F.-W., & Gao, L.-L. (2022).Effect of couple-based interpersonal psychotherapy on postpartum depressive symptoms: A randomized controlled trial. Asian Journal of Psychiatry,

Nguyen, T. N., Tran, T. D., Tran, H. T., Ngo, T. V., & Fisher, J. (2020). Perinatal experiences of mothers with perinatal depressive symptoms: A qualitative study in Vietnam. BMC Pregnancy and Childbirth, 20(1), 422. https://doi.org/10.1186/s12884-020-03082-0

O’Connor, E., Senger, C. A., Henninger, M. L., Coppola, E., & Gaynes, B. N. (2019). Interventions to prevent perinatal depression: Evidence report and systematic review for the US Preventive Services Task Force. JAMA, 321(6), 588–601. https://doi.org/10.1001/jama.2018.20865

O’Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3–12. https://doi.org/10.1016/j.bpobgyn.2013.09.002

O’Reilly, C. L., & Bilszta, J. L. (2015). Perinatal mood and anxiety disorders: A review of prevalence and treatment options. Journal of Pharmacy Practice and Research, 45(1), 30–37. https://doi.org/10.1002/jppr.1070

Obeysekare, J. L., Cohen, L. S., Colvin, A., Sharkey, K. M., & Pearlstein, T. B. (2022). Longitudinal changes in sleep, biological rhythms, and light exposure from late pregnancy to postpartum: Impact on peripartum mood and anxiety. Journal of Clinical Psychiatry, 83(1), 21m14091. https://doi.org/10.4088/JCP.21m14091

Pipe, A., Ravindran, N., Paric, A., Patterson, B., Van Ameringen, M., & Ravindran, A. V. (2022). Treatments for child and adolescent attention deficit hyperactivity disorder in low and middle-income countries: A narrative review. Asian Journal of Psychiatry, 76, 103232. https://doi.org/10.1016/j.ajp.2022.103232

Policy Center for Maternal Mental Health. (2023). Maternal mental health fact sheet. https://policycentermmh.org/maternal-mental-health-fact-sheet/

Policy Center for Maternal Mental Health. (2024, May). Maternal suicide in the U.S. issue brief. https://policycentermmh.org/maternal-suicide-issue-brief/Policy Center for Maternal Mental Health+1

Schiller, C. E., Meltzer-Brody, S., & Rubinow, D. R. (2019). The role of reproductive hormones in postpartum depression. CNS Spectrums, 24(1), 48–59. https://doi.org/10.1017/S1092852918001238

Siscart, J., Perejón, D., Serna, M. C., Oros, M., Godoy, P., & Solé, E. (2023). Prevalence, risk factors, and consequences of hypothyroidism among pregnant women in the health region of Lleida: A cohort study. PLOS ONE, 18(10), e0278426. https://doi.org/10.1371/journal.pone.0278426

Skoglund, C., Chen, Q., Franck, J., Rück, C., Larsson, H., & D’Onofrio, B. M. (2023). Attention-deficit/hyperactivity disorder in women and risk for perinatal mood and anxiety disorders: A population-based cohort study. Journal of Affective Disorders, 336, 274–281. https://doi.org/10.1016/j.jad.2023.07.040

Slattery, D. A., & Neumann, I. D. (2020). Oxytocin and major depressive disorder: Experimental and clinical evidence for links to aetiology and possible treatment. Pharmacology & Therapeutics, 222, 107798. https://doi.org/10.1016/j.pharmthera.2020.107798

Srisurapanont, M., & Liabsuetrakul, T. (2022). Convergent validity of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire in pregnant and postpartum women: Their construct correlations with functional disability. Journal of Affective Disorders, 299, 1–7. https://doi.org/10.1016/j.jad.2021.10.039

Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., Howard, L. M., & Pariante, C. M. (2019). Effects of perinatal mental disorders on the fetus and child. The Lancet Psychiatry, 6(10), 918–930. https://doi.org/10.1016/S2215-0366(19)30274-3

Stewart, D. E., Vigod, S., & Postpartum Depression. (2020). Postpartum depression: Pathophysiology, treatment, and maternal-child outcomes. Journal of Affective Disorders, 274, 754–761. https://doi.org/10.1016/j.jad.2020.05.025

Tamura, N., Mori, T., Yasuma, N., Watanabe, K., Okubo, Y., & Negishi, T. (2021). Perinatal anxiety, sleep, and biological rhythms: A systematic review protocol. Systematic Reviews, 10(1), 192. https://doi.org/10.1186/s13643-021-01734-1

U.S. Food and Drug Administration. (2019). FDA approval of brexanolone for postpartum depression. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-brexanolone-treatment-postpartum-depression

U.S. Food and Drug Administration. (2023). FDA approval of zuranolone for postpartum depression. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-zuranolone-treatment-postpartum-depression

Yim, I. S., Tanner Stapleton, L. R., Guardino, C. M., Hahn-Holbrook, J., & Dunkel Schetter, C. (2019). Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology, 11, 99–137. https://doi.org/10.1146/annurev-clinpsy-101414-020426

Zeng, X., Li, Y., Gao, J., Xu, X., & Luo, Y. (2023). Neuroplastic changes in the maternal brain: A systematic review of structural and functional neuroimaging studies. Neuroscience & Biobehavioral Reviews, 150, 105190. https://doi.org/10.1016/j.neubiorev.2023.105190

Zhang, Y., Zhao, X., Yang, H., & Ding, Y. (2023). Nighttime sleep duration and postpartum depression: A systematic review and meta-analysis of actigraphy studies. Journal of Affective Disorders, 335, 115–124. https://doi.org/10.1016/j.jad.2023.02.004

Zheng, J., Xu, W., Li, S., & Chen, H. (2024). Hormonal modulation of maternal brain plasticity: Mechanisms and functional significance. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 129, 110598. https://doi.org/10.1016/j.pnpbp.2024.110598

Zhou, Y., Chen, J., Li, X., & Wang, Y. (2024). Postpartum depression and the risk of attention-deficit/hyperactivity disorder in offspring: A longitudinal cohort study. Journal of Psychiatric Research, 169, 144–151. https://doi.org/10.1016/j.jpsychires.2024.07.012

Žutić, M., Matijaš, M., & Nakić Radoš, S. (2025). Dysphoric milk ejection reflex: Measurement, prevalence, clinical features, maternal mental health, and mother-infant bonding. Breastfeeding Medicine, 20(2), 133–139. https://doi.org/10.1089/bfm.2024.0172

Course Completion & CE Information

Category I Maryland BSWE Requirement

The Office of Continuing Professional Education at the University of Maryland School of Social Work is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education programs. This workshop qualifies for 3 Category I Continuing Education Units. The Office of Continuing Professional Education is also authorized by the Maryland Board of Psychologists and the Maryland Board of Professional Counselors to sponsor Category A continuing professional education. 

ASWB Information 

University of Maryland School of Social Work Office of Continuing Professional Education, #1611, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 2/11/2024-2/11/2027.  

To receive ACE credit, full attendance is required; no partial credits will be given for partial attendance. 

Certificate Access

To access the evaluation and certificate, click on the orange certificate button in your CPE account. Once you complete the evaluation, access to the certificate will be available.  

Live Interactive Webinars (Cat I) and Live Webinars (Cat II) - Allow up to 30 minutes post-training for attendance to be verified, then you will be able to access the evaluation and certificate. 

In Person Trainings - Please allow five (5) business days post-training for attendance to be verified, then you will be able to access the evaluation and certificate. 

Please refer to the tab "Live Interactive Webinar Policies & FAQs" for UMSSW Office of CPE policies regarding all live interactive webinar related matters. Contact our office at cpe@ssw.umaryland.edu for more information.  

Evaluation

Participants will have access to the evaluation after attendance has been verified. Evaluations will be available for one (1) week after the workshop has ended.  

After one (1) week, participants will no longer have access to the evaluation and will have to contact CPE about reactivation.

Target Audience

Social Workers, LCPCs, and Psychologists

We welcome anyone interested in the topic!

Live Interactive Webinar Platforms

LIVE INTERACTIVE WEBINAR PLATFORMS

The Office of Continuing Professional Education hosts Live Interactive Webinars through Zoom. This platform offers a high quality and user-friendly webinar platform for our registrants.

System Requirements:

• Operating Systems: Windows XP or higher; MacOS 9 or higher; Android 4.0 or higher.
• Internet Browser: Google Chrome; Firefox 10.0 or higher.

Our system is not compatible with the Safari web browser.

• Broadband Internet Connection: Cable, High-speed DSL and any other medium that is internet accessible.

**Please have your device charging at all times to ensure that your device does not lose power during the webinar.

Course Interaction Requirements:

To participate in Live Interactive Webinars, you MUST have a device that allows you to view the presentation on screen and hear the instructor at all times. We do not allow participants to call-in from their phones or mobile devices and solely listen to the presentation. Participation in Live Interactive Webinars is mandatory.

Our webinar policies can be found on our website by clicking here.

Webinar Policies & FAQs

Click The Link to View The Webinar Policies & FAQs

https://umbsswcpe.ce21.com/Page/live-interactive-webinar-procedures-policies-4129

Code of Conduct

The Office of Continuing Professional Education at the University of Maryland School of Social Work adheres to the NASW Code of Ethics. This policy is to ensure that the training environment for social work professionals remains respectful, productive, and conducive to learning. Disruptive behavior that interferes with the learning process, disrupts the training experience for others, or undermines the integrity of the program will not be tolerated.

Expectations for Participant Engagement:

In alignment with the NASW Code of Ethics and the University of Maryland Baltimore Code of Conduct, participants are expected to demonstrate professionalism, which includes respecting confidentiality, maintaining a collaborative and respectful tone, and contributing positively to the group dynamic. Disclosures made during the training (e.g., case studies or personal reflections) must be handled with care and in accordance with ethical and legal guidelines.

All participants in the training program are expected to:

• Engage actively in the learning process and show respect for the opinions and contributions of others.
• Demonstrate professionalism in both attitude and behavior, maintaining respect for instructors, peers, and the training environment.
• Maintain open communication by expressing concerns or disagreements constructively and respectfully.
• Follow the guidelines and expectations provided by instructors and facilitators.
• Support a collaborative learning environment where all participants feel valued and safe to contribute.

Instructors and CPE staff reserve the right to dismiss participants who do not adhere to ethical/professional principles and standards. If removed, CEs will be adjusted to reflect the time attended, unless otherwise specified. 

ADA Accommodations

To request ADA accommodations:

Please email our office at least four (4) weeks before the workshop. Late requests may not be accommodated.

Our email address is cpe@ssw.umaryland.edu.  

Late Fees and Refunds

The base price is $70, which includes CE credit.  

Late Fee: On 04/30/26, a non-refundable late fee of $20 is added to the base price. Late fees cannot be refunded or applied to account credit.  

Cancellations: **ALL cancellations will be subjected to a $35.00 administration fee.**  To be eligible for a refund or CPE account credit, cancellations must be made at least 24 hours before the workshop. 

For more information, please read the general policies on our website.