Although times have changed in that regard, postpartum depression still has enough of a stigma that some women are reluctant to get help and may find themselves feeling overwhelmed and adrift.

Feingold has written a new book, “Happy Endings, New Beginnings: Navigating Postpartum Disorders,” that offers advice, including when to seek medical help. But it also encourages women to view postpartum depression as they would any other difficult times in their lives that would give them an opportunity for personal growth and transformation.

Q: You’ve said you wrote your book because nobody was talking about the positive outcomes from postpartum depression.

A: Some women get very hopeless when they’re going through this. My feeling is that if they knew they wouldn’t only get over this, but this could be one of the biggest growth experiences in their life, it would give women hope. They wouldn’t have to go down the path where some consider taking their own life. Out of the dark challenges, people make changes and start to re-evaluate their life. In time and with help, women can put the pieces back together and look at the meaning of the experience.

Q: We like to think this illness is all hormones or brain chemistry, but it can be different for different women, right?

A:It’s a complex disorder. We tend to ask: What are the symptoms and how do you get well? Those are important questions, but no one looks at what happens down the road.

Q: You write about how your severe postpartum depression changed your life. Explain that.

A: I was pregnant with my second child while I was working as a staff psychologist in the Veterans Administration. I worked in stress management with men, and I did a lot of work with post-traumatic stress disorders. That work would later be helpful because a lot of women are traumatized by their postpartum experience and are afraid of what will happen if they have another child.

I was pretty happy at the VA, and I think I was figuring I would stay in that environment, but then after my son was born, I had severe postpartum depression. I had trouble finding someone to help me. A lot of people were giving me wrong information or not taking it seriously. So it became my mission to help women go through this.

Q: There was a groundbreaking study on postpartum depression — the largest ever — published earlier this month in the journal JAMA Psychiatry that shows 1 in 7 women suffers from this illness. Interestingly, about 20 years ago when you decided to start treating these women, your colleagues didn’t think you’d have enough patients to support a practice.

A: That’s right. Many of my colleagues said there aren’t enough women suffering from this to make a career on. But about 10 to 20 percent of women who give birth suffer from a postpartum disorder. The general public hears the most sensational reports of women who kill themselves or their children. But they’re such a small percent of the women with postpartum disorders, and most often they have postpartum psychosis. Still, it makes women afraid to speak up out of fear of being linked to someone who killed her child.

Q: People are much more informed about postpartum depression but there are still symptoms associated with the illness that some new mothers might not connect to a postpartum disorder. What are the symptoms?

A: Symptoms cluster in four areas. There’s the depression cluster, where the woman may be feeling an overall lack of joy. She might not be able to sleep or perhaps she wants to sleep all the time. She might have a loss of appetite. Women sometimes feel numb, and they take that as a sign they’re not bonding with their baby.

Then there’s an anxiety cluster that can include insomnia, tension headaches, extreme worry, irritability and anger. A mother might have racing thoughts and can’t settle down because she’s scared of everything.

The third cluster is panic disorder. Some women get panic attacks that even mimic a heart attack. And the fourth cluster is associated with obsessive thoughts. The ones more commonly reported are thoughts of hurting the baby, or that there’s something wrong with the baby. This is often the most secretive of the disorders.

A woman could have symptoms from one or all of the clusters. The course of treatment is individualized, and includes therapy and often, medication.

Q: In the book, you tell stories of women who entered therapy to get help with postpartum depression, but used the time to work on pre–existing issues. For example there was the woman who was so busy being a perfectionist that she wasn’t spending quality time with her family. She was able to work on that while in therapy.

A: She was successful, but she wasn’t enjoying her life. Once her postpartum symptoms were under control, she could look at what else wasn’t right in her life.

Because postpartum depression is such a difficult experience, it makes women more introspective. I hope people see this illness not only as a mental illness or psychiatric disorder, but as a catalyst for personal growth.

dtrice@tribune.com