At my six-week checkup after the birth of my fifth child, the soft-voiced midwife asked how I was doing. Tears welled up in my eyes and poured down my cheeks. I couldn’t even begin to frame an answer to her question. How could I possibly convey the depth of agony and darkness I faced each day as I struggled to care for my young children, meet the needs of a newborn with severe acid reflux who literally vomited up every meal, and support my husband in his seventh grueling year of graduate school–with no end in sight? How could I vocalize the thoughts that haunted me about how I was living my darkest fear as a mother–recreating my own childhood experience with a mother who suffered from undiagnosed depression until well into my teenage years? How do I explain that something as simple as a dropped plate of food left me sobbing on the kitchen floor and absolutely unable to visualize the first step in cleaning up the mess? My inability to deal with the most basic aspects of my life was gut-wrenching to me, as I had always excelled at anything I tried and had never met a problem I found insurmountable. If anything, I felt even more isolated by my previous success, as everyone around me often spoke admiringly of my abilities and left me no space to admit my own inadequacies. I felt utterly and completely alone, defeated by the needs of those around me. I awoke every morning crying in despair before I even opened my eyes.

After seeking medical help, I left the office with a prescription for Sertraline and the business card of a therapist specializing in traumatic birth. I was amazed at how quickly the medication transformed me back into the energetic and optimistic person that I’d been years previously–and shocked to realize that I had been dealing with undiagnosed postpartum depression since the birth of my fourth child. The summer after my fifth child was born was transformative. It was still hard, but the medication gave me the space to think rationally again. It gave me the energy, the willpower, and the motivation to get up in the morning instead of cowering in my bed. I tackled home improvement projects that I’d put off for years. I trained for and ran my first marathon before my son was a year old. I found so much strength in the shared experiences of other women who had gone through similar experiences with depression and shared their stories, their grief, and their triumphs with me–it helped me to feel that not only was I not alone, but that I was normal. After a year, I weaned myself off the Sertraline. Running, which I had taken up after the birth of my second child, became an incredibly vital part of my life that helped me to maintain a sense of self while still caring for my family. Hours and hours on the running trails have helped me to keep the demons of self-doubt and anxiety at bay.

As I write this, I am 20 weeks pregnant with our sixth child. After our fifth child was born, I did not ever think I would have the courage and the strength to undergo another pregnancy, or the ensuing period of darkness. I worried that I would not be able to emerge from that abyss a second time. It took years to summon up the courage to start on that path again, but I am hopeful that this time will be different.