After a woman gives birth, a series of drastic changes take place in her body and her brain. There’s a flood of hormones that are meant to help her to care and nurture her baby. Sometimes, those same hormones can contribute to anxiety or depression. Couple that with the relentless tasks of learning to take care of a newborn, sleepless nights, and it’s a pretty good recipe for slipping into feelings of sadness. “The baby blues” is the common expression we hear for moms who may be weepy for no discernable reason during the early stages of postpartum. But PPD (postpartum depression) can be challenging and even dangerous postpartum mental health disorder that shouldn’t be overlooked.

About 1 in 7 new moms experience a postpartum mood disorder, like PPD. Care providers are working to help diagnose mothers, putting more protocols in place to get them help sooner. But because there is still a stigma attached to any mental health disorder, it can be hard for moms to admit, even to themselves, that there’s a problem. We all want to flawlessly be able to take care of the babies that we grew in our bodies without asking for help. And for some moms, admitting that the challenges of a new baby are taking an emotional toll, can feel like an impossible task. But knowing the signs and symptoms is the first step to admitting there is a problem and seeking help. So we have to make sure new moms know what to look for post-birth.

Here are a few signs it might be more than the baby blues, and how to get help if it is:

1) Feeling hopeless- If you’re feeling not only sad once in a while, but the pull of dread or hopelessness, it might be a red flag that you’re struggling with PPD. While new moms are certainly expected to feel shifting emotions, have good days and bad, a recurring feeling that everything feels too hard, too overwhelming, or isn’t worth your efforts, can be dangerous and pose a threat to your own health or the health of your baby. Feeling hopeless is a clear sign that some extra support from a trusted care provider may be needed.

2) Unexpected anger or rage- Even if you don’t feel sad, or sit around crying, having explosive anger can be another sign of PPD. For everyone, depression doesn’t come out in tears or sadness. Sometimes it comes across in anger- yelling, screaming, even breaking things, or feeling like you might hurt your baby. Having outbursts that you didn’t have pre-baby will likely frighten most new moms. It can come as a shock to have feelings of such rage you didn’t know you were capable of. But it doesn’t mean you’re a terrible parent. Most likely, it means you’re suffering from PPD.

3) Inability to sleep, even when the baby sleeps- We all know knew moms are in for some sleepless nights. But when your baby is sound asleep, you should be able to get some shut eye, too. Hell, you should be so exhausted that you fall asleep the second your baby is happily dozing. But for some moms, this isn’t the case. The worry and anxiety about your baby might not turn off the second your infant falls asleep. In that case, you might find yourself tossing and turning, fretting about every horrible thing that could befall your new child. While some of this could be chalked up to new mom worry, not being able to get to sleep and restore yourself is not normal. It could be a sign of PPD or postpartum anxiety.

4) Physical aches and pains- When you are depressed or over-anxious, sometimes your body responds with physical signs and symptoms, not just emotional ones. Throbbing neck and shoulders, a tightening in your chest, heart palpitations, or just a general feeling of ache that your can’t quite describe could actually be a sign of depression.

5) Difficulty bonding with the baby- Not every mother bonds with their baby immediately. For some, it can take a days or weeks to really feel connected with the tiny new person running our lives. But if the adjustment period extends to the point where the mother is having difficulty feeling interested in her child, is constantly pawning off the baby on others, or doesn’t want to care for her child, there could be a greater problem than just a minor adjustment phase. A mother is hardwired to connect to and bond with her baby as a means of survival. So if that connection isn’t happening quite soon, it could be due to postpartum depression.

The signs and symptoms of postpartum depression and other postpartum mood disorders are not alike for every mother who will experience them. That’s why it’s so important to discuss how you are feeling with a trusted care provider. Asking for help is essential. But if you don’t feel like you can open up to your doctor, whether it be a family doctor, your OBGYN or midwife, finding a therapist can be a great option for new moms who need some relief. If you feel nervous of intimidated to talk to a care provider, start small, beginning by talking to anyone you know and trust first. It could be your partner, a friend, a parent, or anyone at all who has your best interest at heart.

Once you can get to a place of acknowledgment, you’ll be in a better position to seek treatment and find some relief soon. It might look like talk therapy, medication, group sessions with other mothers struggling with the same issues, or all of the above. Because no mother’s experience is one-size-fits all, neither is treatment. For more information on how to get help with postpartum depression or other postpartum mood disorders, visit PostPartumProgress for resources in your area.