Postpartum depression is a hard topic to write about. No one really expects it, since for most people, the days leading up to and having baby are spent feeling hugely happy and hopeful. The switch to feeling overwhelmed, hopeless and alone is stunning. It’s so stunning that you don’t realize it’s your hormones, and not you, your husband or your baby to blame. That’s why it can be so hard to reach out and get help. Things are supposed to be vastly different after having a baby. Your whole life is supposed to change, and it’s easy to feel like this change just wasn’t the change you imagined.

I experienced postpartum depression with my first child, but not with my second and third. The difference is huge between seeing baby through those hormones and being clear of that dark veil. I think I would have gotten help much sooner if I had that experience with my second baby and not my first. But, I also experienced depression while weaning my third child. Even with all that experience with mothering and children and knowing I was capable, I still doubted myself when depression clouded my perspective.

Here is a list of the warning signs of post-partum depression, but what I am adding to it here is how it manifested itself, not in medical speak but in terms of real life fears and emotions, how it snuck up on me, and looking back, how I rationalized it in the moment.

• Unable to sleep/Fatigue – This was confounding since I felt so totally mentally and physically exhausted. When I would lay down or try to nap, nothing happened. My mind raced, I made to-do lists, listened for phantom baby sounds, imagined terrible things happening to the baby or the house while I slept, or checked the clock every few minutes. With my first child, the insomnia was so bad that I started to feel depressed when evening came because I knew the entire night would be a struggle.
• Anger toward the baby or other family members – The main difference I noticed in the newborn period with my second baby is that her crying didn’t make me mad. I felt sorry for her when she cried. This was new to me, because with my first I was depressed enough that the baby crying put me over the edge. I didn’t feel empathy for her, I felt anger, and I didn’t know that wasn’t normal. I was just so tired and frustrated and out of ideas of how to care for this child. Looking back, it was pretty scary. When you stop empathizing with your baby, step back. Take a break. Call in help.
• Sadness/hopelessness – When you’re in your right mind, it makes sense that the odds of everything in your life going wrong at once are pretty slim. Usually, things fall one at a time. But when I’m depressed, I feel like everything is going wrong in every area all at once. It’s like I am unable to see good anywhere in my life. Although it feels genuine when you’re in it, I try to remember that it’s not likely to actually be happening in every area at once, and those thoughts have now become part of my red flags collection.
• Feelings of doubt or guilt – This always came out of me in the form of, “I can’t do this,” “I’m just not cut out for this,” “I’m not meant to be a mom,” “Anyone else could do a better job than me,” and other expressions of self-doubt. During these times, I simply could not be on social media at all. Every post felt like knives aimed at my heart.
• Loss of interest in things you love – As a new mom, it’s easy to tell yourself that you don’t have time for any of the activities that you used to enjoy. When I am depressed, the desire to go for a run is the first thing to go. If my husband suggested that I go for a walk or run because he knows how great it is for my mental health, I would get angry and make excuses. Even taking a shower, doing my hair and putting on makeup for the day felt like a huge effort that I just didn’t have time for.
• Thinking about suicide – Sometimes my mind would wander this way. Not in a way that I was seriously planning it, but I would fantasize about what would happen to everyone. Would they be financially stable? Would my husband be able to find childcare? How long until everyone was in school—could I wait until then? At the time it didn’t feel like that was a dangerous thing to think about, I guess because I wasn’t making plans for me, I was thinking about them. But it’s the same thing–you are imagining yourself out of the picture. I think a precursor to suicidal thoughts may be when you just don’t want to go home. You might dread turning into your driveway, or imagine yourself just driving right on past your house. For me anyway, this feeling preceded my depression.

If you have experienced depression before, try to remember how you felt, what your red flags were when you looked back and recognized behavior that wasn’t normal. Try to make your own personal checklist and share it with those closest to you—because no one exhibits behavior in a strictly clinical way.

You can also do an online postpartum depression assessment with your partner, a family member or close friend to help determine if you are exhibiting signs or symptoms of PPD. I highly recommend completing it with another person—when you’re depressed, even when it’s pointed out to you in black and white, getting help just seems so out of reach, so much work, another thing you don’t have time to do. It’s a huge step you may not want to take, and having accountability can help you get the help you need.

Erin Burt is a freelance writer and mother of three girls. She lives and writes in Queensbury, New York.