--- title: 'How Does PMDD Increase The Likelihood of Perinatal Depression?' slug: pmdd-perinatal-depression-risk lifeStage: pregnancy category: Mood medicalReviewer: 'Dr Jade Thomas, HCPC Registered Psychologist and BPS Chartered Psychologist' reviewerId: 'https://blog.bloume.com/pregnancy/medical-board.md#dr-jade-thomas' lastUpdated: '2026-07-30' primarySource: PMDD wordCount: 1388 readTimeInSeconds: 347 --- # How Does PMDD Increase The Likelihood of Perinatal Depression? If you have a history of Premenstrual Dysphoric Disorder (PMDD), you carry a higher risk of depression during pregnancy and in the months after birth. This article walks through what to watch for, when and how to tell your care team, what support you can ask for, and how to prepare, so you can move through the perinatal period with a clear plan behind you. **Q: Does having PMDD mean I will definitely develop perinatal depression?** A: No. A PMDD history raises your risk compared with the general population, but it does not make perinatal depression a certainty. Plenty of people with a PMDD history move through the perinatal period without a depressive episode. What it does mean is that being proactive helps: sharing your history at the booking appointment and having a monitoring plan in place gives your care team the ability to spot and respond to any changes early. If you have lived with Premenstrual Dysphoric Disorder (PMDD), you already know the particular weight of mood changes that arrive on a hormonal cue: the irritability that catches you off guard, the hopelessness that settles in during the late luteal phase, the tiredness that sits in you even when nothing else has changed. There is a meaningful link between PMDD and perinatal depression. If you have a PMDD history, you are more likely to develop depression during pregnancy and in the months after birth. Understanding that risk early gives you the best chance of building the right support around you. ## Why your PMDD history raises perinatal risk Mental health difficulties during pregnancy and the first year after birth are common, affecting up to 1 in 5 women. These are different from the baby blues, a milder, short-lived low mood that usually lifts within two weeks of giving birth. If low mood, anxiety, or tearfulness sticks around past that point, or feels more intense, it is worth raising with your care team. ## How to recognise the warning signs The symptoms of perinatal depression can look and feel a lot like what you already know from PMDD: mood swings, irritability, a sense of hopelessness, anxiety, and physical tiredness. Because none of this will feel entirely new to you, it can be harder to notice that something has shifted. The difference is the timing. These feelings are no longer tied to one phase of your cycle. If you notice low mood that lingers, a loss of interest, or anxiety that does not lift, those are signs to act on rather than wait out. This is not a checklist to diagnose yourself with, and a healthcare professional is the right person to make sense of what you are feeling. > **INFO**: This article is for information only and is not medical advice. Talk through your mental health history and any symptoms with a qualified healthcare professional. ## Who to tell and when Your mental health history is usually reviewed at your first midwife appointment, known as the booking appointment. This is your earliest and clearest chance to put your PMDD history on record. Tell your midwife and your GP. Be specific: describe how PMDD has affected you, how severe it has been, and whether you have had treatment. The more clearly your history is written down, the more easily your care team can set up a plan to keep an eye on things. If your PMDD has been severe or complex, a referral to a specialist perinatal mental health service may be worth considering. Not every experience of PMDD meets the threshold for that, but if your symptoms have had a real effect on your day-to-day life, it is reasonable to ask your midwife or GP whether a referral would suit you. These teams offer assessment and tailored support through pregnancy and after birth. ## If you are taking medication for PMDD If you take an SSRI antidepressant for PMDD and find out you are pregnant, call your GP or psychiatrist urgently before you change anything. Stopping an SSRI suddenly carries a high risk of relapse, and it is not something to do without specialist guidance. Whether to stay on it, adjust it, or switch during pregnancy needs an individual assessment, so this is not something to sort out alone or in a rush. Your prescriber will weigh up the risks and benefits with you. > **WARNING**: Do not stop or change your SSRI without speaking to your GP or psychiatrist first. Stopping suddenly carries a high risk of relapse. Call your prescriber as soon as you know you are pregnant. ## What to ask for and how to advocate for yourself Talking therapies, especially Cognitive Behavioural Therapy (CBT), a structured talking treatment that helps you work with unhelpful thought patterns, work well for perinatal mental health and are available through a GP referral. In England, you reach this through NHS Talking Therapies. Scotland, Wales, and Northern Ireland have their own equivalent services under different names, and your GP can point you to the local route. You do not need to wait until things feel severe to ask about a referral. If you raise your mental health history and feel your concerns are being brushed past, you are within your rights to ask for a second opinion. Any mention of a mental health difficulty should be explored carefully. Be clear: name your PMDD diagnosis, describe how it has affected you, and ask directly what monitoring or support is available to you. ## How to prepare for the perinatal period Putting a plan in place before symptoms arrive tends to work better than scrambling once they do. A plan for the perinatal period might include regular movement, attention to your sleep, eating well, and stress-reduction techniques like mindfulness. These help your overall wellbeing, though they sit alongside clinical care rather than replace it if you are at higher risk. Building a support network matters too. Talking openly with your partner, close friends, or family about your PMDD history and what the perinatal period might hold for you can help the people around you notice changes and support you more easily. Antenatal classes are another way to connect with others expecting babies. Social support is an important part of the picture, alongside professional care. > **WARNING**: If you are in immediate distress, or feel you may be a risk to yourself or your baby, call NHS 111, contact your GP urgently, or call the Samaritans on 116 123 at any time. If you have a PMDD history and are pregnant or planning a pregnancy, raising it at your booking appointment is the single most practical step you can take. From that conversation, your care team can note your risk, talk through monitoring, and point you to any extra support available in your area. --- **Q: Does having PMDD mean I will definitely develop perinatal depression?** No. A PMDD history raises your risk compared with the general population, but it does not make perinatal depression a certainty. Plenty of people with a PMDD history move through the perinatal period without a depressive episode. What it does mean is that being proactive helps: sharing your history at the booking appointment and having a monitoring plan in place gives your care team the ability to spot and respond to any changes early. **Q: Can I access specialist perinatal mental health support if my PMDD has been severe?** If your PMDD has been severe or has had a real effect on your daily life, it is reasonable to ask your GP or midwife whether a referral to a specialist perinatal mental health service would suit you. A history of severe or complex mental health difficulty may warrant specialist assessment. These teams can offer tailored monitoring and support during pregnancy and after birth. If you feel your request is not being addressed, you can ask for a second opinion. **Q: How is perinatal depression different from the baby blues?** The baby blues describes a mild, short-lived stretch of low mood, tearfulness, and emotional sensitivity that usually lifts within two weeks of giving birth. Perinatal depression is more persistent and more intense, and it can develop during pregnancy or at any point in the first year after birth. If low mood or anxiety does not ease after the first two weeks, or feels severe at any point, raise it with your midwife or GP rather than waiting. **Q: Should I stop my SSRI when I find out I am pregnant?** Do not stop or change your SSRI without speaking to your GP or psychiatrist first. Stopping suddenly carries a high risk of relapse, and the decision about what to do in pregnancy needs an individual assessment that weighs the risks and benefits for your situation. Call your prescriber as soon as you know you are pregnant so this can be talked through promptly. **Q: What talking therapies are available for perinatal mental health in the UK?** Cognitive Behavioural Therapy (CBT) works well for perinatal mental health and is available through a GP referral. In England, the route in is NHS Talking Therapies. Scotland, Wales, and Northern Ireland run equivalent services under different names, and your GP can point you to the local pathway. You do not need to wait until symptoms feel severe to ask for a referral. ### Clinical Sources - [PMDD](https://www.iapmd.org/pmdd) - [Mental health](https://www.nhs.uk/pregnancy/mental-health-in-pregnancy-and-after-the-birth/mental-health/) - [Mental health](https://www.nhs.uk/pregnancy/mental-health-in-pregnancy-and-after-the-birth/mental-health/) - [Seeking a second opinion](https://www.kch.nhs.uk/patients-and-visitors/help-and-support/seeking-a-second-opinion/) - [Bidirectional link between premenstrual disorders and perinatal depression](https://news.ki.se/bidirectional-link-between-premenstrual-disorders-and-perinatal-depression) - [Perinatal Mental Health Toolkit - RCGP](https://elearning.rcgp.org.uk/pluginfile.php/175878/mod_book/chapter/606/Perinatalmentalhealth2023.pdf) - [Mental health](https://www.nhs.uk/pregnancy/mental-health-in-pregnancy-and-after-the-birth/mental-health/) - [Summary of NICE guidance on perinatal mental health](https://maternalmentalhealthalliance.org/media/filer_public/a3/ab/a3abacfd-d33a-49af-88ed-40243fff59f1/bmj_summary_of_nice_pmh_guidance.pdf) - [Mental health](https://www.nhs.uk/pregnancy/mental-health-in-pregnancy-and-after-the-birth/mental-health/) - [Perinatal Mental Health Toolkit - RCGP](https://elearning.rcgp.org.uk/pluginfile.php/175878/mod_book/chapter/606/Perinatalmentalhealth2023.pdf) - [Mental health](https://www.nhs.uk/pregnancy/mental-health-in-pregnancy-and-after-the-birth/mental-health/) --- Reviewed by Dr Jade Thomas, HCPC Registered Psychologist and BPS Chartered Psychologist | [Medical Board](https://blog.bloume.com/pregnancy/medical-board.md) | July 2026