Four years ago, I found myself in the office of a therapist who specialized in postpartum depression.

My second child was already 18-months-old by that point and from what I had read and written about postpartum depression, there was no way I had it.

I thought moms with the condition felt sad, cried a lot and felt detached from their babies. I also thought those symptoms showed up within weeks after giving birth.

My story wasn’t like that at all.

I had a positive birth experience with a midwife and supportive husband by my side.

I felt so great in fact, that I spent only one night in the hospital.

The day after I came home, we even hosted family in our home for Easter and I was happy and energetic. I already felt like I was settling into our new life with a 2-year-old and a newborn.

Everything seemed just fine.

Two days later at my daughter’s well visit, I was asked to fill out a screening for postpartum depression and I was flippant about it. I quickly checked off the answers and thought, I don’t have time for this.

For the next year and half, I cared for my daughters, worked part-time and went to the gym regularly. I cooked our meals and made homemade baby food. I cleaned my home every week like clockwork and did everything else that had to get done.

I was high functioning for sure, not the disconnected mother I had envisioned a mom with postpartum depression to look like.

And besides, so much time had passed.

As I spoke to the therapist however, she explained that despite all that, what I was experiencing was in fact, postpartum depression.

As I did more research, I realized that I had likely had the condition since my first daughter was born and no one, not even me, picked up on it.

According to the Centers for Disease Control and Prevention (CDC), postpartum depression affects approximately 1 in 10 women nationwide and in some states, as many as 1 in 5 have the condition.

Despite how common it is however, it often goes unrecognized and is not always an easy, clear-cut diagnosis. When it is diagnosed, less than half of women get treatment, according to a February 2015 study in the journal CNS Spectrums.

Whether you’re a new mom or know someone who is, it’s important to recognize the signs—no matter how subtle they may be—and know where to turn for help.

1. Anxiety

I was no stranger to anxiety, having experienced it since childhood, but after my daughters were born it ramped up even more.

When my kids were sleeping, I constantly checked to make sure they were breathing, they were still lying on their bellies, and their swaddles hadn’t come undone, potentially suffocating them.

When I was driving, I not only worried that we would get into a car accident, but that another car would hit my car on the side where my kids sat.

It doesn’t make much sense that you can be anxious and depressed at the same time, but anxiety is actually one of the symptoms of postpartum depression. In fact, The Edinburgh Postnatal Depression Scale, the screening tool used to diagnose postpartum depression, includes questions about anxiety, panic and overwhelm.

Some moms who have the same type of irrational fears I did, can suffer from postpartum anxiety or postpartum obsessive compulsive disorder (OCD). These and other perinatal anxiety disorders, including generalized anxiety disorder (GAD) and panic disorder are about as common as postpartum depression.

2. Irritability

The weeks and months after I gave birth felt so incredibly stressful. I lacked patience for everyone and everything.

I was constantly frazzled—trying to balance interviews, writing and pumping my breast milk, all in the short amount of time I had our sitter caring for my kids.

Unlike my first daughter who would breastfeed like clockwork and be done, my second liked to nurse what felt like all the time and would cry the minute I put her down.

If you feel on edge, you’re not able to relax, or you’re short and snappy with your husband and other people in your life, take note. True, you’re already exhausted and the lack of sleep can make you feel irritable but if those feelings persist, it could be due to postpartum depression.

3. Changes in appetite

A change in your appetite is perhaps one of the most significant, but subtle signs of postpartum depression.

Despite being a chef, cookbook author and foodie, Chrissy Teigan has said that when she had no interest in cooking or eating she realized it was time to seek help for postpartum depression.

When you have a new baby, it’s rare that you’ll have time to sit down to a meal so you might find yourself skipping meals or overeating when you do have time to eat.

Yet if you have a lack of appetite or find yourself overeating or binging to decompress, cope with tough feelings or to fight fatigue, it might also be due to postpartum depression.

4. Feelings of uncertainty, insecurity and regret

There are so many decisions you have to make when you become a mom.

Whether it’s choosing to breastfeed, going back to work and picking the right pediatrician, it can all feel very overwhelming.

If you get stuck and find it hard to make decisions, no matter how minor or significant they may be, or you doubt, regret or beat yourself up about a decision you made, it could be a sign of postpartum depression.

5. Insomnia

With a newborn at home, sleep is already hard to come by. If you have other children who don’t sleep through the night, it can be even more challenging.

If you find it difficult to fall asleep, or toss and turn throughout the night, talk to your doctor because it could be a sign of postpartum depression.

6. Feeling like a failure

After the birth of my first child, I constantly compared myself to other new moms including family, friends and those I knew in the community.

Of course, photos of happy moms with their cute, “perfect” children on social media didn’t help either.

Everyone else seemed to have it all together and handle new motherhood with ease while I felt like I had no idea what I was doing.

I struggled nearly every day with feelings of inadequacy as a mom. I frequently told my husband, I’m not a good mom, I’m not cut out for this and I’m failing.

Motherhood didn’t come easy for me and I knew I wasn’t happy, but I thought it was my fault. I thought I simply didn’t know how to be a mom, but now I know that was the depression duping me.

Although I think it’s safe to say we all feel overwhelmed by motherhood from time to time and we doubt our decisions, when these feelings persist, it’s time to seek help.

How To Find Help

If you have any of these signs, or you simply don’t feel like yourself, it’s important to seek help.

Postpartum depression is not a sign of weakness or a character flaw and it doesn’t mean you’re a bad mom. It’s a real, diagnosable condition and there are effective treatments available.

Tell someone

Talk to your doctor or midwife about your symptoms, whether you gave birth 2 weeks or 2 years ago.

She can screen you for postpartum depression and refer you to a therapist who can help. If you feel like you can’t take that first step, talk to your partner, a family member or friend who can put the wheels in motion for you.

Find help

Postpartum Support International is an amazing resource for new moms. They offer phone and online support, referrals to local therapists and support groups.

Get support

Mothers of Preschoolers (MOPS) was a lifesaver for me. They welcomed me with a warm breakfast, someone to watch my kids for 2 hours and a group of real moms who listened, understood and were supportive. Although it can feel hard to be social, try to find a moms’ group that provides a safe, supportive space.

Ask for what you need

As I said, I had no idea I had postpartum depression. I was checking things off my list, going full throttle 24/7, and having an I can do it all mentality but I rarely accepted help or took time for myself.

All moms need help, but if you have postpartum depression, it’s even more important.

Ask your partner to take a feeding, cook dinner or take over some of the household duties. If you can afford to do so, hire a postpartum doula, a baby nurse or an au pair.

If your parents or in-laws have the time and offer to help, take them up on it. They can take your baby for a walk in the stroller, read to your baby, or help prepare dinner.

Say yes to any help you can get.

If you have thoughts of suicide, please don’t suffer in silence. There is help. Call the National Suicide Prevention Lifeline (800-273-8255)