It was as if I were being buried alive, sinking in quicksand, unable to find my way out. That's how I felt after the birth of my sixth child.

I was irritable; I cried; I was exhausted, yet had trouble sleeping. Getting through each day seemed nearly impossible. My own children avoided me; my husband tiptoed around me. I was convinced that my family and the world would be better off without me.

PPD was something that happened to other women Although I was a certified nurse midwife at that time, my lack of experience and understanding of postpartum depression matched that of the average layperson and, unfortunately, most medical professionals. Postpartum depression (PPD) was something that happened to "other" women who already had psychological problems.

Anyway, PPD would never happen to me. I was too "happy"! I was always the type of person that people viewed as so capable, energetic, and positive. But I suddenly realized that if PPD could happen to Michal Finkelstein, it could happen to anyone.

After my sixth child was born over twelve years ago, I suffered from PPD. It was only after this birth that my doctor and I realized that I had probably suffered from PPD after the births of my five other children. I had found it difficult to cope, but chalked it up to having many children close in age, to being overwhelmed, and to lacking household help. I didn't even know that my extreme frustration and anxiety weren't a "normal" part of being a young mother. Thankfully, I had a good marriage, good friends, and a cohesive community. This support, along with my sheer will, helped me to pull myself out of these milder episodes of depression.

However, this time, after number six, I was feeling really bad! I still shudder when I think back to those horrible, lonely feelings. I felt so alone. We had just moved, and my familiar support systems and dear friends were far away. I imagined that my husband, my children, and the whole world were against me. Intellectually I knew that the thoughts going through my head were unrealistic, but I could not control them. At the same time, I was mortified at the thought of discussing the ferocity of my anger and bitterness with anyone.

Finally, four months postpartum, an older friend suggested I see a therapist. Thank G‑d I did.

The usual outlets would not be sufficient The dark, heavy cloud slowly lifted during the following months. It was a hard process over time, with many ups and downs. At first, I tried talking with a psychologist. However, we soon realized that cleaning help at home, proper diet, exercise, and all the usual outlets that helped in the past would not be sufficient to remedy the situation this time. The psychologist referred me to a psychiatrist who prescribed an antidepressant. Medication, along with counseling, provided the relief I needed. It took a few weeks for the medicine to kick in, and I felt worse before I felt better. It was so frustrating until the old me slowly returned. I can honestly say that it took up to a year until I felt 100% better!

We all know of someone who has suffered from PPD to some degree. Just mention Postpartum depression and you will get an onslaught of reactions and personal confessions. While I was in line at the drug store, a woman overheard me talking about this topic with the pharmacist and told me she had to send her daughter to England for six months for treatment and rest while she had to take care of the grandchild herself. Another woman admitted to me that until a friend helped her, she spent five months at home in her bathrobe without leaving or talking with friends. A more extreme expression of PPD was an unforgettable experience with a young woman after the normal, healthy birth of her first-born son. Two days later, she became catatonic, incapable of showering, dressing, and even feeding herself, let alone caring for her baby.

Postpartum depression is a pervasive and poorly understood phenomenon, not only in the medical world but also in Jewish circles. So many women are afflicted with some level of emotional distress after childbirth. There are many shades of this "darkness." A woman many not be suicidal or dangerous to her children; she may even get up and go to work every day, make dinner for the family and put on a happy face, but her internal sadness and despair are eating her soul away. She lives with these feelings in solitude.

Her internal sadness is eating away at her soul PPD is all the more serious in our Jewish world because bringing down Jewish souls is such an important part of our culture, and building large families is a common goal. Moreover, not only the woman suffers; her husband, her children, and her community also suffer.

I can offer three practical suggestions to get through this difficult time: first, focus on accomplishing only the most important task(s) of the day; second, keep the lines of communication open with your spouse, family, and friends; and third, speak with an objective third party who can help you direct your thoughts in a more positive and realistic manner.

We have to talk about PPD, discuss our stories, and share our experiences. The more we research, discuss, diagnose, and treat PPD responsibly, the more we can improve the quality of life for countless mothers and their families.

For more information on understanding the symptoms of PPD, please click here.

This article has been excerpted from the book Delivery from Darkness: A Jewish Guide to the Prevention and Treatment of Postpartum Depression by Rabbi Boruch Finkelstein; Michal Finkelstein RN, CNM; and Doreen Winter, MSW.