Postpartum can be both boundless love and breathtaking sadness. It shouldn’t mean silence

It was hard to admit that a mental health crisis had crept up on me, just weeks after one of the happiest days of my life. I told myself that I was exaggerating my own symptoms, that I was just overtired. Many women have it worse, I thought. I could make it work. And yet, even as I was “making it work,” I was pierced by moments of breathtaking sadness. I was underwater before I saw the tide coming in.

I loved my baby more than it was possible to describe. I also had postpartum depression and anxiety. It was hard to square those facts.

Worry was a constant companion. It was especially present at certain times — when hooked up to a pump in the “mother’s room” at the office, typing out work emails while fretting that I was not producing enough milk. At night, I watched the baby asleep in the bassinet next to me, my brain too electrified to sleep. During my commute, I thought about how for nine months she had traveled with me on the train, in me, and how now leaving her felt like having a limb removed, only to be reattached each night when I returned home.

I shared my feelings in an online group for working mothers. Within hours, I had more than 20 replies. “High functioning depression,” someone wrote, a term I learned for the first time. A mental health professional in the group wrote that she frequently saw patients discount their own suffering — that this itself was a symptom. Others mirrored the conflict I felt between loving parenthood and feeling lost within it. Later, I’d hear similar sentiments in conversations with friends.

And these, I would come to realize, were the other truths: Postpartum depression is not uncommon, and yet many parents are scared to talk about it.

Depression and anxiety affect approximately 15 percent of women in the postpartum period, according to the Centers for Disease Control and Prevention. The classic symptoms include depressed mood, trouble sleeping or sleeping too much, feelings of guilt, worthlessness, even thoughts of self-harm. Exhaustion, life stress, and lack of social support — all factors common to women who have recently given birth — can increase the risk of developing postpartum depression and postpartum anxiety.

My personal health history had put me at elevated risk, and I was monitored closely by my hospital midwives both before and after giving birth.

I took a test called the Edinburgh Postnatal Depression Scale twice, with no signs of trouble. The third time, nearly four months after giving birth, there was no question that something had changed. The hazy exhaustion and ecstasy of new parenthood had given way to constant worry and declining mood.

I felt persistently nervous. I cried every night.

I was crushed by the anxiety of realizing that I was physically and financially responsible for my family; that I had a career I didn’t want to screw up; and that, simply put, I missed my baby — a child I loved desperately and felt incredibly fortunate to have.

At times I felt like multiple people inhabiting the same body. One Saturday, my husband and I spent the morning with friends and our kids. We had a nice lunch, good conversation. Just a few hours later, I was too mentally exhausted to make basic decisions — crippled by the thought of putting together a simple dinner or preparing a bath for my older daughter. I was consumed with the idea that my family would be better off without me. That I was damaging my children. The next morning, I woke up and felt more or less OK.

It would have been easy to not get help, and many new mothers don’t — or can’t. Of women struggling with postpartum depression, only an estimated 15 percent access treatment.

I asked Dr. Lisa Hollier, the president of the American College of Obstetricians and Gynecologists, why so few. Among the largest hurdles, she told me, was the inconsistent availability of mental health providers and social services.

This I understand.

I was able to obtain a one-time appointment with a psychiatric consultant. But doing so required weeks of back-and-forth phone calls, the ability to take a morning off work and to find care for my children during this time. It also required the will to physically get myself to a hospital two hours from my home.

I have advantages many women do not — good prenatal and postnatal care, 12 weeks of parental leave, family support. I have the flexibility to work from home when needed. I have good health insurance. I live in a city with some of the best hospitals in the world. And, still, finding help felt insurmountable at times.

My baby is 6 months old now. I am just starting to come out of the fog with the help of some medication, better rest, and the good fortune of nearby childcare that allows me to spend more time with my daughter. I am lucky that these simple changes have made a difference. I will soon have my first appointment with a provider that can manage my care long term. But even with the help of a case manager, I went months without being able to find a clinician that accepted my health insurance and is accepting new clients.

Having a baby is an experience both extremely common and shockingly dramatic. It is a time you may learn that you are capable of both boundless love and the darkest kind of sadness — often at the very same time. Childbirth causes physical pain well beyond the hours, or days, of labor contractions. Women are left with both literal and emotional scars as well as all the anxieties and joys that come with parenthood.

I have pushed myself to acknowledge how I actually feel with friends and family rather than cover it up. More often than not, people respond by revealing their own struggles. But the stigma of these conditions is overwhelming — and the shame keeps us quiet.