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When we think about having a baby, the first thing that comes to most people’s minds is joy. But if we’re being honest, babies can bring a lot more than just unfettered happiness to a family. Though it’s less desirable to think about, and definitely less desirable to talk about, the perinatal period (which includes both pregnancy and postpartum) can also bring anxiety, exhaustion and sadness. For some women, it can even bring a mood disorder.

With onlookers usually delighting in the new addition, sometimes asking how mom is doing becomes an afterthought. And for many mothers, this can make it more difficult to admit that she is struggling or not feeling like herself.

We need to do what we can to help new mothers recognize their struggles so that they can help themselves heal. Part of that is getting rid of the stigma that surrounds mental health disorders, making moms feel they are failing when every part of their experience doesn’t come easy.

By spreading awareness about perinatal mood disorders, we can help open up the conversation about what is not an uncommon experience for many women in their new role as mothers.

Here are 8 things you probably didn’t know about perinatal mood disorders:

You can have a mood disorder and not feel depressed. While you’ve probably heard about postpartum depression, there are actually several types of perinatal/maternal mood disorders including anxiety, OCD and postpartum psychosis. You don’t have to feel deeply sad or depressed at all times to have a mood disorder. You may be having trouble with scary, intrusive thoughts or worry about your baby. Some women experience symptoms in pregnancy, while others do in early postpartum or in the months that follow. While many of the symptoms are similar, women can have a range of experiences on the scale of mental illness that affect them in many different ways.

Any mother or mother-to-be can be affected. Katherine Stone, founder of Postpartum Progress says “you can get postpartum depression or anxiety even if you’ve never experienced episodes of depression or anxiety prior to having your baby,” but she also notes that “it is a significant risk factor if you have had previous episodes.” Other risk factors can include a difficult or traumatic pregnancy or birth, lack of help, other major stresses, a previous loss or miscarriage or treatment for fertility. There are many risk factors but there are also mothers with no risk factors who suffer, as well.

The signs aren’t always clear. Not all women affected will know immediately they what they’re experiencing is cause for concern. This is likely because “it can be hard for moms to distinguish between the normal stress of having a brand new baby and a maternal mental illness that may require seeking professional help,” Stone says. The responsibilities of a newborn can bring tension, sadness (known as the “baby blues”) or even pangs of anxiety that were never experienced in a mother’s pre-baby life. But if a woman’s mental health is affecting her daily or altering the way she takes care of herself or her child, it is probably more than new-mom stress.

It’s more common than you think. Though we may not hear about them all that often, according to Postpartum Progress about one in every seven women (15 percent) who give birth will have be affected by a perinatal mood disorder. This fact is probably surprising because most women that are suffering tend not to bring it up at playgroup or over coffee. Many mothers prefer to suffer quietly, perhaps feeling guilt or shame at how she is coping with motherhood, which can often be even more detrimental to her well-being.

Sleepless nights aren’t always a normal part of postpartum. Getting less sleep than you’re used to is an anticipated part of the postpartum experience. But not being able to sleep when your baby is sleeping due to scary or intrusive thoughts or relentless worry about your baby can be a sign of a mood disorder, like postpartum anxiety or OCD. If you can’t seem to turn off your brain or you feel like you’re living in a state of constant or paralyzing anxiety, this can be a sign of a bigger problem.

Breastfeeding mothers don’t have to quit nursing to get help. A breastfeeding mother who is struggling with a mood disorder might neglect to help herself, assuming her breastfeeding goals may be derailed if she does. “You can absolutely be treated for postpartum depression or anxiety and continue breastfeeding,” Stone says. “Your treatment can include therapy, and it can also include certain medications that have been found to be acceptable for us while breastfeeding.”

Traumatic pregnancy or birth can impact a mother immensely. While we sometimes assume that the only important thing about a birth is the healthy baby, traumatic birth can have huge impacts on a mother in the months that follow. With high rates of birth intervention taking place in hospitals, some women experience what is called “birth trauma” which is a risk factor for postpartum mood disorders. Likewise, if a woman has had a challenging pregnancy (such as struggling with hyperemesis gravidarum or other difficult to manage health issues) that did not match her expectations of what a glowing pregnancy should feel like, this can certainly alter her experience to follow.

Help is all around. While it may not seem like it, there are  postpartum support groups popping up everywhere. (For instance.) And whether we realize it or not, we probably all know someone who has been through PPD, anxiety or OCD. It can be scary to start the conversation, or look for help, but knowing just how many mothers have been through it and come out on the other side can be a liberating thought.

Sarah Bregel is a writer, yoga teacher, feminist and deep-breather who lives with her husband, daughter and son. She blogs about the endlessly terrifying journey of motherhood at TheMediocreMama.com. Join her on Facebook and Twitter @SarahBregel.

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