Experts say 15 percent of women experience postpartum depression following a pregnancy.
Donna Montague, volunteer coordinator for the Coalition Against Rape and Domestic Violence, has gone through it twice.
"I had my first child at age 24 in 1995," Montague said. "I realized at about the three or four weeks mark that something was horribly wrong."
Montague stopped sleeping. She became paranoid about her child's safety and fearful she couldn't provide for her son.
"In this case, because I was unsupported medically at that time and it was my first (child), I had postpartum psychosis," she said. "After about two or three visual psychosis incidents, I realized that this was something I wasn't going to be able to turn off in my mind."
Luckily, Montague said, when she sought medical help her physician recognized the symptoms. He referred her to a mental health professional, who prescribed medications to treat the depression. While she was unable to nurse her child while on the medication, her overall mental and physical well-being slowly improved.
"It probably took me about as long to begin to be well as it did to be pregnant," she said.
During her second pregnancy 13 years ago, she and her obstetrician hoped she could avoid another bout of postpartum depression or psychosis. Montague was told her odds were about 50/50 she would develop the condition again, so she made regular visits with a psychiatrist and began taking a preemptive antidepressant.
She was also in a more stable socio-economic situation, she said, and thus under less stress.
"Then, 13 years ago, I gave birth to my daughter and learned she had Down syndrome," Montague said. "I did have a second postpartum depressive episode, but because of the intervention I was receiving, it didn't develop into postpartum psychosis."
While Montague is glad she avoided psychosis - the experience was so horrific she doesn't like talking about it - the depression took a toll.
"I don't have a functioning memory of my children's lives for about the first six months," she said.
While she recognizes herself and her children in photos from those days, she said her smiles look fake.
"(You believe) that as a new mother, everything's supposed to be wonderful, and you're supposed to feel really in love with your life and your baby," she said. "When you're struggling with postpartum depression, it's having a flattening effect (on your emotions). I felt very devoid of my normal emotional response to anything. If you have an awareness that you're supposed to feel one way and you don't, it's very isolating."
Montague is passionate about helping other women avoid what she went through.
"Had I maybe been more aware of those risks, I would've been able to prevent how far these things went in the first pregnancy," she said. "In '95 or 2004, there wasn't any screening process that I was involved in.
"I think someone should be checking in on these moms throughout their postpartum period, during the traditional six to 12 weeks that we're home and more isolated."
While she accepts mental health screenings aren't usually within a pediatrician or obstetrician's purview, she said they are in the best position to spot early signs of postpartum depression. She added symptoms don't always show up right away.
"I think that it's really critical that the immediate family ups their support and availability and being there for this mom," she added.
To moms struggling with postpartum depression, Montague offered a message.
"I want them to know that it's real, that they're not alone, and that it's okay," she said. "I'd encourage them to share how they're truly feeling and doing with a professional. In the absence of anyone asking them how they're doing, it's okay to need support, it's okay to need intervention."
Postpartum depression isn't just "in your head," Montague and health professionals agree, it is a biological and chemical condition. Factors like thyroid problems, a history of anxiety and depression or past traumas can make women more prone to developing it.
At CARDV, Montague said the focus is on supporting survivors of domestic and sexual violence. So she's doubly passionate about raising awareness of postpartum depression, because many of her clients may be more likely to face it.
"CARDV has trauma-informed therapists," she said. "I hope and believe that those care providers here at our agencies would be in tune with (postpartum depression) and able to make those connections and referrals, and help advocate for any of our clients."
CARDV's helpline can be reached at 573-642-4422. For more info about postpartum depression, go to bit.ly/2wFEWHO or attend the Callaway Resource Network's documentary screening on Nov. 8.