Therapy for Perinatal Mood & Anxiety Disorders (PMADs)
You prepared for so much.
The nursery, the birth plan, the tiny onesies folded in the drawer. What no one fully warned you about — what's almost impossible to prepare for — was feeling like this.
Maybe you're not bonding the way you expected. Maybe the anxiety is relentless, even when the baby is safe and sleeping. Maybe you're having thoughts that scare you, or a rage that shocks you, or a sadness so heavy you can't imagine it lifting. Maybe you just feel completely unlike yourself — and you're not sure who you are anymore, or if you'll ever find your way back.
What you're experiencing has a name. It is incredibly common. And it is treatable. You don't have to white-knuckle your way through this.
This Isn't What You Expected Parenthood to Feel Like
Perinatal mood and anxiety disorders — PMADs — are the most common complication of pregnancy and the postpartum period, affecting up to 1 in 5 women. They can begin during pregnancy or emerge any time in the first year after birth. And they look very different from person to person.
You might recognize yourself in one or more of these experiences:
Postpartum depression — persistent sadness, numbness, hopelessness, or feeling disconnected from your baby or your own life
Postpartum anxiety — constant worry, racing thoughts, an inability to rest even when the baby sleeps, a sense of dread that won't quit
Postpartum rage — anger that feels disproportionate or overwhelming; snapping at your partner or other children; feeling ashamed of yourself afterward
Perinatal OCD — intrusive, unwanted thoughts (often about harm coming to the baby) that feel deeply disturbing and out of character, accompanied by compulsive behaviors to manage the anxiety
Postpartum PTSD — flashbacks, nightmares, hypervigilance, or emotional shutdown following a traumatic birth or pregnancy loss
Prenatal anxiety or depression — symptoms that begin during pregnancy, not just after the baby arrives
If you're experiencing intrusive thoughts, please hear this: having a thought is not the same as wanting to act on it. Intrusive thoughts in the postpartum period are extremely common — they are a hallmark of perinatal OCD and postpartum anxiety, not a sign that you are dangerous or a bad mother. This is one of the most treatable presentations in perinatal mental health, and specialized therapy can bring real relief.
What Therapy for PMADs Addresses
Our work together will move at your pace and focus on what matters most to you right now. Depending on what you're experiencing, therapy for perinatal mood and anxiety disorders may include:
Understanding what's actually happening in your brain and body — because knowledge is one of the most powerful tools we have with PMADs
Building practical skills to manage anxiety, intrusive thoughts, and emotional overwhelm in daily life
Processing a traumatic birth, a NICU stay, or a pregnancy loss that is still affecting you
Working through the complicated feelings around bonding, feeding, sleep, and the gap between what you expected and what you're living
Rebuilding your sense of self and identity as you navigate new motherhood (also called “matrescence”) — including the grief of who you were before
Addressing the perfectionism, self-criticism, or people-pleasing patterns that can make the postpartum period feel impossible
Exploring how your relationships — with your partner, your baby, your own mother — have shifted
I also work collaboratively with OB-GYNs, midwives, and perinatal providers. If medication may be a helpful part of your care, I'm glad to coordinate with your medical team or help connect you with a perinatal psychiatrist who specializes in this area.
How Therapy for PMADs Works
I take an integrative approach, drawing from several evidence-based methods depending on what's most helpful for you — including cognitive behavioral therapy (CBT and I-CBT) for anxious thought patterns, Internal Family Systems (IFS) for the parts of you that are struggling, somatic approaches that work with the nervous system, and trauma-informed therapy when birth trauma or pregnancy loss is part of the picture.
What stays consistent across all of it is this: the relationship we build together. Research on what actually makes therapy work points consistently to the therapeutic relationship as one of the strongest predictors of healing. My goal is to create a space where you feel genuinely seen — not managed, not minimized, and absolutely not judged for what you're experiencing.
Sessions are available both in person in Charlotte, NC and online throughout North Carolina, South Carolina, and Missouri via secure video. Many new parents find that virtual sessions are a lifeline — no childcare to arrange, no commute, just support from wherever you happen to be.
Most clients begin with weekly sessions. As symptoms improve and you feel more resourced, we'll adjust the frequency to fit your life and your schedule.
Common Questions About Therapy for PMADs
Am I dealing with PMADs, or am I just struggling to adjust?
Both can be true at the same time — and either one is enough reason to reach out. The adjustment to new motherhood is genuinely one of the hardest things a person can go through. PMADs exist on a spectrum, and you don't need to hit a clinical threshold of suffering before you deserve support. If something feels wrong, that feeling is worth taking seriously.
I'm having scary thoughts about my baby getting hurt. Does that mean I'm dangerous?
No — and I want to say that clearly. Intrusive, unwanted thoughts about harm are extremely common in the postpartum period and are a key symptom of perinatal OCD and postpartum anxiety. They are not a sign that you are dangerous or want to act on them. In fact, the distress these thoughts cause is one of the clearest indicators that they are ego-dystonic — meaning they go against who you are and what you want. This is very treatable. Please reach out.
However, if you are having thoughts of wanting to harm yourself or your baby, please immediately call 911 or go to your local emergency room. You need urgent support.
My partner thinks I just need to push through. How do I explain that I need help?
PMADs are medical conditions — not mindset problems, not weakness, not a failure to appreciate your baby. You wouldn't push through a broken leg. Many partners shift their perspective quickly once they understand what's actually happening. Sometimes it helps to have them join a session, or to share resources from Postpartum Support International at postpartum.net as a starting point for that conversation.
Can I start therapy while I'm still pregnant?
Yes — and in many cases, I'd encourage it. Prenatal anxiety and depression are significantly underdiagnosed and undertreated. Addressing them during pregnancy can reduce both their severity and the risk of postpartum symptoms. You don't have to wait until after the baby arrives to get support.
Do you work with postpartum rage specifically?
Yes. Postpartum rage is one of the most common — and most under-discussed — presentations of perinatal mood disorders. Many mothers experience anger as the primary symptom rather than sadness, and feel deeply ashamed of it. It is real, it is common, it is treatable, and it is something I work with regularly.
Do you take insurance?
I operate as a private-pay practice, which protects your privacy and allows me to focus entirely on your clinical needs. Superbills are available upon request for potential out-of-network reimbursement.
You Are Not a Bad Mother — Let's Talk
The fact that you're struggling doesn't mean you're failing. It means you're human, you're in one of the most demanding seasons of life, and your brain and body are asking for support. That's not a character flaw. That's biology meeting circumstance — and it responds to treatment.
Getting help for yourself is one of the most loving things you can do for your baby, your family, and for you.
I offer a free 15-minute consultation call so we can connect before you commit to anything. No pressure, no obligation — just a conversation about where you are and whether I might be the right fit to walk alongside you.
You can reach me at 980-272-0647, by email at ginny@ginnylupkacounseling.com, or through my contact form to schedule. I typically respond within one business day.
If you are in crisis or need immediate support, please call 911, call or text the Suicide & Crisis Hotline at 988. You’re also welcome to contact the Postpartum Support International “warmline” at 1-800-944-4773 for non-emergency support.
Not sure this page describes exactly what you're experiencing? Take a look at related pages on birth trauma, pregnancy loss, infertility, and anxiety — or simply reach out and describe what's going on. We'll figure out the right path together.
Questions?
You can learn more about me and my counseling approach or explore the services I offer if you’d like to get a better sense of how I support clients. If you have more questions, check out the FAQ’s or contact me so we can schedule a free 15-minute phone consultation.