Love. Pregnancy. Delivery. Bundle of Joy. Go home and live happily ever after, right?! Not always. In fact, 13% of new mothers experience postpartum depression, or PPD. It is typically detected in two to six weeks and can linger for up to two years.

But what exactly is PPD? Above all, it is a medical depression that is often misdiagnosed or overlooked by healthcare providers. Its typical symptoms include insomnia, lack of energy and interest, sadness and crying, change in diet, lack of concentration, and a sense of hopelessness. PPD is not to be confused with baby blues or postpartum adjustment disorder. Postpartum adjustment disorder is characterized by a deep feeling of disappointment or unhappiness. However, it is typically caused by unexpected stressors, such as having a C-section. Baby blues, the least severe form of postpartum depression, causes crying, feelings of inadequacy, frustration, and sadness.

Due to the relatively small amount of research and knowledge on the subject, many women face these symptoms, and their depression, alone. While there are continued efforts to understand the risk factors, the possible causes, and the treatments, there is not much on why it takes women experiencing PPD to speak out or get treatment.

Pregnancy and birth are arguably the most significant life changes that a woman and her partner will experience. Pregnancy and parenthood present a host of challenges for women and their partners. For the mother, there are extreme physical and emotional transitions, including profound hormonal, biological, and physical changes– all of which can impact the central nervous system.

Although PPD is relatively common, over half of the women living with PPD go undetected and undiagnosed. But why do so many cases go undiagnosed? A recent study revealed that this happens because the women do not share their feelings with their provider, family, or partner due to embarrassment or fear of institutionalization or separation from her child.

In 2002, interviews were conducted on women experiencing PPD. The study found that these women would rather separate themselves from family and friends than speak out due to fear and a lack of understanding. Taking on a passive attitude, the recovery of the illness becomes more complex and difficult to endure. The experience from one woman to the next varies significantly, although all mothers face the fear of being labeled a “bad” or non-perfect mother.

As more research is done, and more people speak out (such as Adele or Hayden Panettiere) the more the stigma of PPD will dissolve. As childbirth educators and Lamaze instructors share more about pregnancy and its complications, more women will find understanding, and ultimately their voice. By educating women and their partners in prenatal classes, it is hoped that women will be more willing to come forward with their symptoms and that their partners will be better equipped to recognize the signs and encourage the new mother to seek help.