I finally realized I had postpartum depression the day I sat in my car for a little too long. I had just gotten home, closed the garage door, left the motor running for a questionable amount of time, and thought how nice it would be to just fall asleep.

Fortunately I possessed the minimum amount of introspective awareness needed to reason myself out of this situation. I turned off the car. I retrieved Waverley from the backseat. I went inside and cried, a real cry with heaving and gagging that leaves one puffy and nearly blind. I felt hopeless, alone, and despondent. I felt motherhood was not for me and the shame of that thought whilst simultaneously holding my healthy, happy little girl was simply too much. There was no way out. I was not myself. The magnitude of everything weighed heavy on my shoulders and I could not foresee a sliver of relief in the future. I numbly spent the afternoon contemplating life while I inattentively played with my daughter (she found great entertainment in a cardboard box that day). I finally concluded that this is not how my story ends. I’ve witnessed too many people fight desperately for life and to give it up so callously seemed unforgivable, regardless of my internal conflict and mental status. I finally acknowledged I needed help. So with encouragement (demand?) from my husband I picked up the phone, called my doctor, and made an appointment to seek help.

“Postpartum depression is a slithery snake that slowly wraps itself around you until you’re neck high in its coils, unable to move or breath and just passively watching the world go by.”

I began meeting with a counselor. As a healthcare provider, I told myself that postpartum depression (PPD) is a diagnosis much like any other that requires necessary treatment. It is no different than needing a cast to immobilize a broken arm. Yet as a consumer of healthcare, a rather stubborn person, and a mother, there was a part of me that felt like a failure for not being able to manage on my own. I felt incapable and irritatingly delicate. A week later I was prescribed an anti-depressant. A month later I felt like a new person. I was. A new person. One who had reached new depths of low– far lower than I ever thought possible for myself– and come back to life. I felt reborn. I felt strong. And, above all else, I felt a deep and unconditional love for my child that truly shook me to my core. This, I thought, is motherhood. I began to understand what all of the fuss was about.

Postpartum depression is a nasty little beast that steals the first months—or even an entire year+ in my case— of precious time. I can never go back to the moments when Waverley was itty bitty and experience them again with this newfound perspective of sanity. I can never attempt to re-bond with her in the way a mother is supposed to because my emotions were cut off and blinding me from reality. Postpartum depression is sneaky. It’s a slithery snake that slowly wraps itself around you until you’re neck high in its coils, unable to move or breath and just passively watching the world go by. If you don’t cry for help, it can literally eat you alive. Postpartum depression is real. And it happens to too many women—women who are already clamoring for survival in the all-encompassing reality of infancy.

“Scary thoughts, including fleeting thoughts of harming oneself or the baby are very common. Many women are not inclined to report these thoughts due to fear of judgment.”

My story is nothing new. It is estimated that nearly one million women or 15-20% of new mothers each year are afflicted by postpartum depression, yet the number may be even more. I “passed” my initial and six week postpartum depression screenings without raising a red flag. I was busy with a newborn, adjusting to a new life, and moving across the country. All of my feelings could be attributed to these stressors and were not necessarily indicative of postpartum depression. So it festered, like a nasty little cancer overtaking an organ. I continued to pile things high on my plate, which I misconstrued as “being productive” yet really was avoidance of the issues. Then, finally, when I had a moment to breath and slow down, the months of hopelessness and unhappiness could not be contained any longer and began seeping from my pores. They needed a way out and I no longer possessed the strength to keep them buried so deep, safely hidden from the world.

As you may have read, I recently announced I am expecting our second child in August. The most terrifying aspect of facing another newborn is not the delivery, sleepless nights, or weight gain—it is undoubtedly the potential to experience postpartum depression again. My husband and I have a game plan in place and I have continued to speak with my counselor in order to create a proactive approach after the birth. This time, I am not waiting for the warning signs because I honestly could not recognize them in myself the first time. This is why my number one piece of advice to expectant mothers is to not memorize the warning signs or symptoms of postpartum depression, yet rather I recommend printing this list off and give it to your husband/partner/significant other/whomever is in this with you. Start having open and honest discussions about postpartum depression before the baby comes and determine how he/she can recognize the symptoms in you. Promise to them you will not get mad if they caringly bring the subject up to you. Promise to yourself you will listen to them openly. Promise to your baby you will not wait until you are contemplating taking your life or your child’s life before you seek help. Don’t let postpartum depression steal your precious moments with your baby.

“This, I thought, is motherhood. I began to understand what all of the fuss was about.”

I teamed up with a good friend, Megan MacCutcheon, LPC— who is a licensed counselor, mother to two, and has had personal experience with postpartum depression– to discuss the risk factors and symptoms of PPD. Like I mentioned, I think it’s not as much about going through the checklist when you are in the throes of it, but rather being aware prior to birth and ensuring the lines of communication are already open with your parenting partner. Here Megan briefly outlines what you need to know about postpartum depression:

Postpartum depression can happen to anyone, but some common risk factors that increase susceptibility include:

• Previous experience with or family history of depression
• History of premenstrual mood changes
• History of abuse
• History of pre-gestational or gestational diabetes
• Prior miscarriage
• Childcare related stress
• Stress in relationship
• Lack of support (social and financial)
• Unplanned pregnancy or thoughts of terminating the pregnancy

The classic symptom of PPD is depression beyond those of the “baby blues,” which typically last for only a few days to two weeks.

Many common symptoms of PPD are often overlooked because they overlap with typical experiences related to caring for a newborn, including:

• Fatigue
• Difficulty sleeping
• Low libido

PPD can show up in other ways besides depression. Other, less well-known symptoms include:

• Anxiety or panic attacks
• Confusion
• Difficulty concentrating or making decisions
• Irritability and anger
• Feelings of contempt for partner
• Feelings of being inadequate or overwhelmed
• Feelings of guilt or being incompetent as a mother

Scary thoughts, including fleeting thoughts of harming oneself or the baby are very common. Many women are not inclined to report these thoughts due to fear of judgment; however, these thoughts are a normal part of PPD. Infrequently, thoughts of harm include delusions or hallucinations that indicate a more serious diagnosis of Postpartum Psychosis.

Megan runs her own counseling practice in Virginia and frequently contributes to online publications. I loved her own piece on dealing with postpartum depression from a counselor’s perspective. Thank you for contributing, Megan! If you’ve dealt or are dealing with postpartum depression, please know that you are not alone and nothing is wrong with you. You may need professional assistance to get better, but it does not make you an incapable mother. Please get the help you need! You and your family deserve the best version of you.