When I was pregnant, I was distinctly aware of the possibility that I may struggle with postpartum depression—especially because I was already prone to depression. I promised myself and my family that I would ask for help at the first inkling of something being wrong. But, initially, I didn’t seem to have any major symptoms.

Then, as the sleepless nights wore on, the familiar feelings of depression came back to me.

I often felt overwhelmed by little things: A tangled car seat strap became an insurmountable struggle and a sign that I should just stay home. Simply thinking about showering during any spare time seemed to zap my energy. I struggled to see myself as anyone outside of “mom.”

In the days before my next scheduled wellness appointment, I thought of what I would say to signal I needed help. But this time our nurse didn’t ask the depression screening questions, and the anxiety that was already constricting me prevented me from bringing up the subject.

Next thing I knew, I was smiling and waving goodbye with one arm, balancing my baby in the other. I walked out of the exam room feeling as burdened as I had going in.

I’m hardly alone. According to a recent study published in the Maternal and Child Health Journal, one in five new moms experiencing postpartum mood disorders doesn’t disclose her symptoms to healthcare providers.

“Our study finds that many women who would benefit from treatment are not receiving it because they don’t tell anyone that they’re dealing with any challenges,” says Betty-Shannon Prevatt, the study’s lead author. According to Prevatt, 10 to 20 percent of mothers experience postpartum mood disorders (PPMD).

The goal of the study was to determine how many of us aren’t disclosing our feelings to our healthcare practitioners—and how we can all work together to improve those outcomes. Prevatt’s team surveyed 211 women who had given birth in the previous three years. The researchers asked the women if they felt PPMD symptoms, and, if so, whether they had disclosed these symptoms to a healthcare provider. The results showed 51 percent of the moms surveyed had symptoms of a PPMD. Yet, 21 percent of those moms didn’t tell their healthcare providers.

“With so many women in our study not disclosing PPMDs to their providers, it strongly suggests that a significant percentage of these women did not disclose their symptoms even when asked,” says the study’s co-author, Sarah Desmarais, an associate professor of psychology at North Carolina State University, who added there are national guidelines intended to help healthcare professionals detect PPMDs among patients.

But as I know from my experience, that may also be because the right questions were asked at the wrong times—and then never again.

What’s more, the research suggests women experiencing the highest levels of stress were the most likely to ask for help while many others (myself included) brush off symptoms that don’t seem “bad enough” to warrant getting help.

We need to help women feel more comfortable discussing mental health during new motherhood—not just in times of crisis.

As for me, I wish I’d spoken up on the day I wasn’t asked. Instead, I plodded along on my own for months before picking up the phone and booking an appointment with a therapist. When I finally did open up about my feelings, the relief was pretty much instant. We worked on some coping techniques I could use when feeling overwhelmed and talked about how a lot of my anxiety was stemming from an unfounded fear of being a bad mom. For other women, the solution for PPMDs may involve medication or other forms of treatment.

If a mom in your life seems depressed but isn’t speaking up for herself, you can help.

Here are a few tips:

  • Acknowledge how hard early parenthood is, without minimizing her experience by comparing it to yours or others. (Remember that the experience of every parent, even those who share a child, is different.)
  • Ask open-ended questions and let her know that you’re there to support her. If she wants help, offer to watch the baby while she goes to the doctor or to therapy.
  • Partners should remember to be patient, too. It takes time to recover from postpartum depression, but with support, she’ll get through it.

Regardless, it all begins with a conversation. You won’t regret it.