Before I had a baby, postpartum depression (PPD) was something I only heard about on the fringes of motherhood. It would occasionally get brought up among mom friends, but only in the tightest of circles and usually in whispered tones conveying depths of shame I couldn’t quite understand.

Every so often, I would see a magazine article citing women who admitted (again, in voices heavy with shame) that they didn’t immediately bond with their baby. That they felt soul-crushing sadness after giving birth. That they felt wholly unable to mother properly.

When PPD was mentioned (which wasn’t often), it always seemed to follow the same formula: a lack of bonding with the baby, followed by extreme sadness that could last for months―or even years after birth. And long before I ever had a baby, it was clear to me that the majority of women I knew who suffered didn’t want anyone to know about it.

Years later, and with two births under my belt, I’m grateful to say that I’ve seen some things change. Slowly, but with increasing pace, I see more and more parenting communities shaking off the stigma of PPD. I see more and more women breaking the silence and coming forward with stories of their own. I see more and more compassion for the one in every seven moms who experience postpartum depression each year—that’s over 500,000 mamas.

And, even more surprisingly, I see a greater understanding of just how varied the symptoms of postpartum depression and anxiety can be. Because, the fact is, PPD rarely looks the same for any mama―and it can be especially hard to explain feelings that feel unique to you. The experts at Allegheny Health Network get it. They’ve made it their mission to not only bring more understanding to postpartum mood disorders, but also to help every mom break their silence and remove the stigma of postpartum depression and anxiety.

Here’s what some of the women they’ve worked with want you to know.

When I say “I’m feeling lonely,” what I mean is… I feel alone in my suffering.

The trickiest part of PPD? You probably look exactly the same on the outside. In many cases, women continue to power through their daily routines so it can be easy to miss their suffering. “You feel like you’re drowning,” says Heather, a PPD survivor and an Allegheny Health Network patient. “[But] physically looking at me or at anyone that suffers from something like this, you can’t see it. That’s what makes it so difficult.”

How to help: If you know a new mama, don’t assume she’s doing okay just because her life isn’t obviously going up in flames. Check in. Ask about her health, not just her baby’s. And let her know you’re a judgment-free place to share.

When I say “I’m not feeling how I thought I would,” what I mean is… motherhood isn’t bringing me joy.

As moms, we’re expected to feel an almost blissful happiness every second of pregnancy and motherhood. But for many women, that happiness seems to evade them―and it often doesn’t come the moment they’re handed their new baby―leading them to feel like they’re already failing as a mother. “I felt so guilty because, here I am, I have this new, adorable baby who doesn’t cry and is fantastic,” says Ashleigh, a PPD survivor and Allegheny Health Network patient. “I didn’t want to seem ungrateful.”

How to help: Many mothers with PPD feel guilty for it. One of the best ways to lessen the load? Sharing your own story. It’s normal not to immediately connect with your baby (you did just meet them, after all!), and the more stories we hear of strong connections that took a bit of time, the easier it will be for new moms to talk about it.

When I say “I don’t feel like myself,” what I mean is… I’m getting overwhelmed with anxiety and/or anger.

Sadness is just one of the possible symptoms of PPD. For many women, the condition manifests itself as extreme anxiety, OCD (especially worrying about bad things happening to their babies), and even rage. “Before I personally experienced postpartum depression, I thought, that’s only for people that feel like harming themselves or harming their children,” Heather says. But the truth is, PPD can look different for everyone―and it can affect anyone. “I never thought that I personally would have postpartum depression because I like to laugh and make jokes about everything,” Ashleigh says.

How to help: Postpartum depression and anxiety doesn’t discriminate―anyone can be affected. Look for signs that your new mama pal is feeling out of sorts. She might say she lost her temper or that she feels extra frazzled, not necessarily that she’s feeling sad, but these can still be symptoms of a greater issue. You can have a more objective view of her feelings even when she can’t.

When I say “I don’t know how I feel,” what I mean is…we still have a lot to learn.

So many symptoms of PPD are similar to general depression and anxiety, it can be scary for a new mom who isn’t sure what’s wrong with her. “I didn’t know how to distinguish from it being…depression or anxiety versus it just being motherhood. I think part of the cure was just discovering that I had postpartum,” says Chrissy Teigen, who is Allegheny Health Network’s partner. “It was just such a sigh of relief that we can fix this.”

How to help: Remember that you don’t need to fix her symptoms―you just need to be there when she needs you. Be a listening ear, and remind her that there’s no shame in needing help.

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