Neurobiology of peripartum mental illness

Handb Clin Neurol. 2021;182:63-82. doi: 10.1016/B978-0-12-819973-2.00005-8.


At least one in seven pregnant or recently postpartum women will experience a mental illness such as an anxiety disorder, depressive disorder, or substance use disorder. These mental illnesses have detrimental effects on the health of the mother, child, and family, but little is known about the hypothalamic and other neural correlates of maternal mental health concerns. The transition to parenthood alone is a time of remarkable neural plasticity, so it is perhaps not surprising that current research is showing that maternal mental illness has unique neural profiles. Furthermore, the neural systems affected by peripartum mental illness overlap and interact with the systems involved in maternal caregiving behaviors, and mother-infant interactions are, therefore, highly susceptible to disruption. This review discusses what we know about the unique neural changes occurring during peripartum mental illness and the role of the hypothalamus in these illnesses. With an improved understanding of the neural correlates of maternal mental health and disease, we will be better equipped to predict risk, develop effective treatments, and ultimately prevent suffering for millions of parents during this critical time in life.

Keywords: Anxiety; Hypothalamic–pituitary–adrenal axis; Hypothalamic–pituitary–gonadal axis; Maternal behavior; Maternal brain; Mental illness; Motherhood; Opioids; Oxytocin; Postpartum depression; Substance use disorder.

Publication types

  • Review

MeSH terms

  • Child
  • Female
  • Humans
  • Infant
  • Maternal Behavior
  • Mental Disorders*
  • Mother-Child Relations
  • Peripartum Period*
  • Postpartum Period
  • Pregnancy