Beyond the Baby Blues: Unpacking Postpartum Depression

November 12, 2026

I started seeing a mental health therapist in 2018 for anxiety, and I’m so glad that I was still seeing this therapist while my husband and I were trying to conceive. I felt it was so helpful to have a safe space to talk about the frustration, anger, guilt and intimacy issues that not being able to conceive brought about. 

In 2023, we were blessed with a positive pregnancy test. I was considered a high-risk pregnancy due to auto-immune disorders that I have, this required weekly check ups and daily at home heart rate monitoring. Thankfully, I didn’t end up with any physical health issues during the pregnancy. I felt like I was still managing my general anxiety pretty well. Of course, having the standard thoughts of how I was going to manage my healthcare career and spend enough time with my family, how do I be a mom, etc. My therapist promised me that these were all common thoughts women have while pregnant. 

While in the hospital, we spent most of our time learning how to do the basics- diaper changes, breast feeding (that didn’t work out, and that’s OK!), remembering what the schedule was, etc. I remember it was just a couple hours before I was discharged from the hospital, a nice nurse finally asked me about my mental health. I responded, “Well, YES I am feeling overwhelmed, anxious and I don’t know what I’m doing!  Thanks for asking!” She encouraged me to make an appointment with my mental health therapist and ensured I wasn’t having any feelings of self-harm.

Throughout the first month of being home I noticed that my thoughts and emotions weren’t returning to what they had been. It was in a random and unpleasant interaction with my husband that I realized that I needed to talk to a medical professional.  I was in the kitchen with my husband, while washing his hands he used the “wrong” towel to dry his hands. I just lost it on him and started crying and yelling. I, still to this day, have no idea why I thought it was the wrong towel and you should’ve seen the “deer in headlights” look on his face…we can laugh about it now…I knew after this interaction, that I wasn’t myself. I would never treat anyone like that, especially my husband. 

I would go between feeling bored and useless and ready to return to work to feeling dreadfully overwhelmed with motherhood causing tears and uncontrollable worries. I had consistent thoughts that I wasn’t being a good enough mom and that I was letting my husband down. Thoughts that maybe everything would be easier if I just wasn’t here causing problems. I was also struggling significantly with my memory, this was very frustrating not being able to remember where I put things or what I had or had not done. Whenever anyone would visit I would prefer to hide away in the bedroom and isolate. I would regularly start crying and feeling sad about random things. 

My therapist and I had talked about my increased risk of postpartum depression because I already had anxiety. But, while pregnant, I would always hear about “the hormones” or “the baby blues.” So, how was I supposed to know if what I was feeling was normal or postpartum depression? Well, the good news was that I didn’t have to be the one to know! I just had to share how I was feeling to a provider that would listen. 

I ended up sharing my thoughts with my therapist during our weekly sessions. She had me complete the Edinburgh Postnatal Depression Scale. This was an objective way that we could review my concerns to better understand if what I was experiencing was postpartum depression. Once this was completed and with my therapist’s clinical evaluation, she recommended that I talk with a medical provider about starting an anti-depressant. 

Our first plan was to address my mental health concerns with my OBGYN at a postnatal checkup. At this visit, I completed the PHQ-9 depression scale while I was sitting in the waiting room. Having given this depression scale to my own healthcare clients, I knew I had scored in a range where I needed to seek help. Unfortunately, during my postnatal checkup, the doctor did not look at my PHQ-9 results or ask about my mental health. I had to bring it up to him and ask for clarifying information. He recommended I wait and see and let him know if it got any worse and continue with my mental health therapy. I left this appointment feeling unheard and questioning myself if I was just overreacting and if these feelings were normal after having a baby. 

Later that week I attended my daughter’s well check with her primary care provider. Thankfully, my daughter and I share a family medicine primary care provider who is absolutely amazing. It was a great appointment that my husband was also able to attend and my daughter was doing very well. Then, our doctor looked at me and authentically asked me, “How are you?” That’s all it took and I had a tear-filled honest conversation with my primary care provider about my mental health struggles. We completed the PHQ-9 depression scale together and were able to pinpoint areas that I was struggling with and use this information to start an anti-depressant. This was also the first time that I had shared my internal thoughts and feelings out loud with my husband present. This was another “deer in headlights” moment for him, but in a caring way of wanting to help. 

Looking back, I wish I would have shared my struggles sooner with my providers and started taking medication earlier. As a healthcare provider, I regularly recommend mental health therapy and medication, as needed, to others. I needed to take my own advice and get over the stigma surrounding medication for mental health. I also wish I would have opened up to my friends and family sooner about my postpartum depression. There were many other women in my life who experienced it and could relate to my situation. It was a relief knowing I wasn’t alone in this struggle.

Looking forward, I continue to share my story to build hope and let others know that they are not alone. I take time to educate healthcare providers on how to support patients who are struggling with their mental health. I volunteer my time and make donations to Mindspring and other local non-profits that provide mental health education and awareness to eliminate the stigma surrounding mental health. I take time to talk with my legislators to discuss the mental health issues surrounding my community. I do better at checking in on the moms in my life, we are not all FINE! 

There are many ways to help, a good first step is to authentically ask someone, “How are you?”

Ashley Adams, MOT, OTR/L
Mindspring, Past President & Board Member
Optimae Rehabilitation Services, Director
*Mom of a sassy two-year-old and wife to an amazingly patient and caring husband

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