This article originally appeared in “Chicago Tribune.”

Recently, a close friend revealed to me her experience with postpartum depression. After giving birth to her first child six years ago, she’d felt lost and empty, as if all of her happiness and energy had been replaced by a “dull sense of duty and dread.” Her words:

“I thought that was just what my life was going to be like from now on. I though that was what it meant to be a mom, that it was a big, horrible, ugly secret that nobody ever told you and that you, like everyone who came before you, would keep for yourself, locked away in the darkest part of your heart.”

At the time, she had no idea she was depressed. As her friend, with a new baby of my own, I had no idea she was, either. And understandably – that first year was a blur for both of us. The deepest our conversations ever got was regarding how much sleep each of us was getting and when I should expect the next tooth. But even if I hadn’t been braving first-time motherhood myself, I don’t know if I would have recognized that something wasn’t right.

Postpartum depression affects one in seven women who give birth, according to the American Psychological Association, which means there’s a good chance one of your friends (and/or you) have been or will be affected by it. These numbers don’t take into account unreported cases, and among reported cases, only about 15 percent seek treatment. I spoke to therapist Hillary Pilotto, whose counseling services aim to help women cope with pregnancy, infertility and perinatal mood and anxiety disorders, about how to recognize signs of postpartum depression and help a friend who is in need.

Q: Why do you think so many women don’t report PPD or and/or don’t seek treatment for it?

A: PPD can be a really isolating illness. A lot of times, a woman isn’t sure how she’s feeling and doesn’t necessarily know she’s depressed – she just knows she’s not feeling how she thought she’d feel. She may think, ‘There’s something wrong with me,’ or, ‘I must not be doing this motherhood thing right.’ There’s kind of a stigma in admitting these feelings. Society says new moms should feel a certain way, and if not, there can be guilt around that.

Another issue is that health care providers tend to label PPD as something that can only happens within the first six weeks postpartum. You fill out a PPD questionnaire at week two and week six, and if you haven’t shown cause for concern on it, you don’t talk about it again. There’s no mention that PPD can happen during pregnancy or any time afterward, throughout the first year postpartum. There are so many things that come into play – from hormonal triggers related to weaning, to complications with the physical healing process after birth, to going back to work after maternity leave.

Q: So what signs can I look for to tell if a friend is dealing with PPD?

A: It’s not something you’re necessarily going to notice at a play date, so you might have to ask questions. I would be really honest. Genuinely ask her, ‘How are you doing? How are things going?’ And then normalize what she may be feeling. With clients, I’ll usually say something like, ‘Many of the moms I’ve worked with have times when they’ve felt really sad, alone and overwhelmed. Some days they’ve questioned whether they’d made the right decision. Have you ever felt like that?’ Because in some way or another, we’ve all been there. Sharing your own story normalizes what she may think she’s alone in experiencing, and gives her an opportunity to open up.

Q: If I suspect a friend is dealing with PPD, how can I help her?

A: You want to make sure you’re not stressing her out or adding another thing to her to-do list, so try to make it easy for her to get help. You can say, ‘I’ve heard it can be really helpful to talk to someone when you’re feeling this way, and I already have some names of women who could meet with you if you’d like. I could baby sit while you go to your appointment.’ Make sure to reinforce that you don’t think she’s a bad mom. You could even say, ‘I wish I had done this when I was a new mom. I think it would have really helped me.’ As a friend, you just want to normalize and validate what she’s feeling and get her information.

Q: What general recommendations can I give my new mom friends for helping them cope with the feelings of motherhood?

A: It’s common to feel lonely as a new mom, so it really helps if they can find a supportive group of moms to spend time with – whether through the hospital, a local mommy group or even virtually through Facebook. Just talking to another mom and realizing, ‘Oh, you’re not sleeping, either?’ Or, ‘You can’t find time to shower, either?’ can help – there’s comfort in commiseration. I also think it’s good if first-time moms can spend time with more experienced moms, who can let them know that what they’re feeling is normal and that everything is going to be OK.

Nicole Radziszewski is a freelance columnist. She lives in River Forest and is a certified personal trainer and mother of two. Check Nicole out on Facebook at