After she experienced a panic attack when her son was eight months old, Reiswig’s father-in-law—a family-practice doctor—encouraged her to seek help. She was taking one antidepressant for about 10 months until it stopped working and she switched to another.

Why one woman stayed on antidepressants while pregnant and nursing

“I started feeling the depression come back,” Reiswig said, “and I thought, ‘What is wrong with me? This is not normal, he’s like a year and a half [old], why am I still experiencing this? Something is really wrong with me because you don’t hear people talk about postpartum depression starting and then staying like that.’”

The severity and longevity of postpartum depression, says Snyder, hinge on a litany of factors: how quickly it is diagnosed and treated, and a woman’s sensitivity to the hormonal shifts of pregnancy and the postpartum period—as well as environmental stressors like financial hardship, a traumatic birth experience, or lack of a support system. And, of course, some women may be genetically predisposed to depression or other mood disorders.

But one thing is for sure: The longer the condition lasts after giving birth, the more likely it is that the woman will suffer from depression long-term. A study published in March found that most women who experience severe depression at two months and eight months postpartum still report depressive symptoms 11 years later.

Like Reiswig, Jessica, a mother of three who lives in Lee’s Summit, Missouri, had no personal or family history with depression prior to becoming a mom. (Jessica asked to be identified by her first name only because of ongoing legal proceedings with her ex-husband.) Then, after her first two children, twin girls, were born in 2005, Jessica started feeling anxious and overwhelmed—feelings she thought were just part of new motherhood and compounded by the fact that her then-husband was deployed overseas. As the months passed and her depression worsened, she mentioned her concerns to her children’s pediatrician. But the doctor dismissed her, telling her she had twins, so of course she was overwhelmed. Jessica continued to spiral downwards until she hit a breaking point.

“I remember very clearly both of them crying in the middle of the night and just sitting on the floor of their bedroom completely incapable of doing anything,” she says. “I was just like, ‘I can’t do this anymore.’” Her twins were a one and a half years old before she started feeling like herself again.

But the relief for Jessica proved illusory. When she got pregnant again in 2007, her obstetrician urged her to stop taking antidepressants for the health of the fetus—a recommendation that is now less common with more research about how antidepressants affect pregnancy. Jessica obeyed, but then her depression and anxiety returned almost immediately. This time, after her son was born, she didn’t hesitate to go back to her doctor.