Maternal mental health and the myth of endurance

I’d really like to talk with my fellow women.

There is a courtroom in Plymouth, Massachusetts where a jury is deciding whether a mother is criminally responsible for the deaths of her three children. This mother was a labor and delivery nurse. She had a five-year-old, a three-year-old, and an eight-month-old. Her defense says she was in the grip of postpartum psychosis. The prosecution says she knew exactly what she was doing.

I am not here to try that case (may these innocent babies rest well). Twelve people are doing that, and they have been at it for days without agreement, which tells you something about how hard it is.

I’m here because of what I saw outside that courthouse. Women. Dozens of them, week after week, in pink. Not because they were confused about right and wrong. Because something in that story reached into their chest and squeezed, and they recognized the grip.

That is what I want to talk about. Not the verdict. The recognition.

We were raised into this

As a woman, you’re raised to do certain things by expectation. You’re raised to be the one who takes care of the children automatically, for the most part. There are cases where men do it, but 80, 90 percent of the time, it’s the woman’s responsibility. You’re raised to be quiet, poised, obedient to your husband if you’re married to a man. You’re raised to not be too ambitious, and if you are, don’t be too loud in the room. You’re raised to be present for every recital, every game, every milestone, even while you’re climbing a career ladder. You’re raised to have children young, have them quick, so you have time to spend with them. One kid, maybe two. When is the third one coming? Maybe four. And you’re raised to juggle all of it while maintaining your sanity.

But the question we don’t get asked often enough is: How are you managing? Not “How are you doing?” How are you managing?

Let me go first

I have four children. Nineteen, sixteen, five, and a newborn.

I can say categorically that at every point in each of their lives, they need me as a mom. There is no stage where the need ends. It only changes shape.

I was recently taking my nineteen-year-old back to college. I had so much work to do. I was hoping I could get away with, “Get on the plane, I’ll send whatever you need.” He’s independent. He can handle himself.

He looked me in the eye and said, “No, Mom. Please. I need you.”

So I went. I set up his room. Those two days were beautiful.

But even inside those two beautiful days, I was managing my company. Being a wife. Caring for a newborn. Making sure my five-year-old was OK. Video-calling everyone. Juggling.

Always juggling.

And this is your everyday mother, working or stay-at-home. It’s not a job you can clock out of. It’s not a vacation you can take. It’s an obligation.

And we love it. We absolutely love taking care of our children.

And also: It is breaking some of us. Both of those things are true at the same time. We have to get comfortable saying them in the same breath.

But did you know postpartum depression can happen when you don’t even realize it? The snapping. The checking on the baby all night. The anxiety that never quite turns off. We’ve accepted these as the norm. But these are subtle signs that maybe we need more support than we’re getting.

The six weeks that break us

Picture this. A thirty-one-year-old woman. According to society, “Her clock was ticking.” She finally found the love of her life, got married. The first thing society expects: Have a kid. Great. You’re also a career woman climbing the ladder, and you don’t want to let that go. It’s your identity. You don’t want to lose who you were before you were a mom. And then you get six weeks. Six to eight weeks if you’re lucky, in the United States, for maternity leave. By the third week, you’re just starting to adjust to a basic routine. By the sixth week, you’re just feeling comfortable, if that. And then you’re expected to go back to work. You put a newborn, sometimes less than two months old, in daycare. You go to work. You do what you’re supposed to do. But your heart stays with your family. You ache. You go into the bathroom and cry. Maybe you pump. Maybe your job says, “We’ll accommodate you as a mom.” But none of that replaces the psychological weight of being separated from your newborn. You champ it through because the bills have to get paid. It becomes normal. And then you decide to try for another baby, before you’ve processed what happened to your body, your mind, your career, your marriage. And postpartum depression and anxiety can last up to three years after pregnancy. So now you’re pregnant again with two babies under three, and the world says: Your mothers did it. Your grandmothers did it. You can do it.

But here’s what nobody tells you. The strength we inherited isn’t just endurance, it’s the permission to ask for help. Our mothers and grandmothers survived. They didn’t always thrive. And thriving is the standard we get to set for ourselves.

What to actually watch for

Not to diagnose yourself. To know when to make the call.

• Sadness, emptiness, or numbness that stays past two weeks.
• Anxiety that won’t switch off: checking, googling, bracing.
• Rage or irritability that feels bigger than the trigger.
• Not being able to sleep even when the baby finally is.
• Feeling nothing for the baby, or feeling frightened of your own feelings.
• Intrusive thoughts that are escalating in frequency or that you’ve begun to believe rather than fear.
• Feeling like your family would be better off without you.
• Emergency: Hearing or seeing things others don’t, believing things others find impossible, confusion, or feeling commanded to do something. Do not wait. Do not “see if it passes overnight.” That is a same-day, call-someone-now situation.

Ask for help. Then ask again. If a provider tells you it’s normal and you know it isn’t, you are allowed to say: I need this documented, and I need a referral to a perinatal mental health specialist. Say it exactly like that. Take a witness.

So, how are you managing?

Not the version you post. The real one. The one who cries in the bathroom with the fan on. The one who checks the baby at 2 a.m. and then lies awake until 4. The one who loves her children more than her own breath and still, some nights, wonders if she’s enough.

You are enough. But you were never meant to carry this alone, and the fact that you have been is not proof that you should.

Here is the part they got wrong when they told you your grandmother did it. She did. She survived it. Survival was the ceiling she was handed, and she reached it with her hands bleeding so that you would not have to stop there. The strength she passed down to you was never endurance. Endurance is what you use when nobody is coming. The inheritance is permission: permission to say the thing out loud, to take the medication, to sit in the therapist’s chair, to hand the baby over, to let the house be a mess, to be a whole and unfinished woman in front of witnesses.

Thriving is the standard we get to set. Nobody is coming to raise it for us.

So say it this week. Out loud, to one person who loves you. Not “I’m fine.”

“I’m not managing. I need help.”

That sentence is not the end of your strength. It’s the first honest thing your daughters will ever hear you say, and it is the exact moment the chain breaks.

You give so much of yourself. Now tell me: Who is pouring into you?

If you need someone right now

• National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262). Free, confidential, 24/7, English and Spanish, interpreters in 60+ languages.
• 988 Suicide & Crisis Lifeline: Call or text 988.
• Postpartum Support International: Helpline 1-800-944-4773, plus free peer support groups and a directory of perinatal mental health specialists.
• If you or someone you love is experiencing confusion, hallucinations, or delusions after childbirth, treat it as a medical emergency and go to the emergency room.

Simbiat Adighije known to patients and colleagues as Dr. Sim, is a practicing psychiatric mental health nurse practitioner and the founder and CEO of Conscientia Health, a leading psychiatric and integrated care practice operating in all 50 U.S. states with a mission to make mental health care as accessible and routine as an annual physical, treating the whole person, mind and body, under one roof. With sixteen years in clinical practice, she still sees patients in person across Conscientia Health’s locations in New Jersey, New York, and California.

She is a member of the Forbes Business Council and has been featured in Forbes, USA Today, On Air With Mario Lopez, and PAPER Magazine for her work reshaping how mental health care is delivered and discussed. She reaches a combined online community across social platforms, including a verified Instagram following of nearly 50,000, where she focuses on mental health and wellness education.

Her public commentary is anchored by the question at the center of her USA Today piece: “What if mental health care were as routine as an annual physical?” She speaks frequently on panels and at industry events about the future of mental health care, health technology, and integrated care models, most recently joining a panel with Spotify at NY Tech Week 2026 on health care technology and AI innovation.

Adighije began her career as a registered nurse before earning her bachelor’s and master’s degrees in nursing, summa cum laude, from Rutgers University in New Jersey. She went on to earn her MBBS, MD, and PhD in public health from the University of Science, Arts, and Technology (USAT) in Montserrat in 2014, graduating with multiple academic merit honors. After the tragic loss of her mother, she opted out of medical residency and has held American Nurses Credentialing Center (ANCC) board certification as a Psychiatric Mental Health Nurse Practitioner since 2010.