“When a Smile Hides a Struggle: Spotting the Signs a Mom May Not Be OK”

Aug 31

Part of the #isMOMok Maternal Suicide Awareness and Prevention Campaign by Cherished Mom

From the outside, she looks like she’s adjusting beautifully — smiling in baby photos, showing up at school drop-off, or laughing politely when someone says, “Enjoy every moment!” But behind closed doors, she’s drowning.

Every day, mothers put on a brave face to meet the world’s expectations. But sometimes, that smile is a mask — hiding pain, exhaustion, isolation, and in some cases, life-threatening despair.

That’s why Cherished Mom’s #isMOMok campaign is asking all of us to look deeper and listen closer. Because when it comes to maternal mental health, not every struggle is visible.

Maternal Suicide: The Hidden Crisis

In the U.S. and other high-income countries, suicide is one of the leading causes of maternal death — especially in the first year postpartum. Yet conversations around postpartum mental health often remain surface-level. Many moms are suffering in silence, afraid of judgment, rejection, or losing custody of their children if they speak up.

This silence can be fatal.

We have to change the conversation — starting with understanding the signs that a mom may not be OK, even if she says she is. Even is she is functioning. Even if she is smiling.

What Maternal Mental Health Struggles Can Look Like

Postpartum mental health struggles don’t all look the same. While some women experience classic postpartum depression, others may suffer from postpartum anxiety, OCD, PTSD, or even postpartum psychosis.

What’s important to know: struggling doesn’t mean a mother doesn’t love her child. It simply means she needs help — and deserves compassion, not judgment.

🔍 Warning Signs to Watch For

Here are some signs that may indicate a mom is silently struggling:

1. Withdrawing or Isolating

She stops answering texts or calls
Avoids social situations or visitors
Doesn’t seem interested in connecting, even with close friends

2. Changes in Mood or Behavior

Increased irritability or anger
Seeming numb or detached
Excessive crying or flat emotional responses

3. Expressing Overwhelm or Hopelessness

Saying things like “I can’t do this” or “They’d be better off without me”
Talking about feeling like a failure or a burden
Expressing fears of “messing up” the baby

4. Changes in Sleep or Appetite

Insomnia even when the baby sleeps
Sleeping too much or not at all
Not eating, or binge eating as a way to cope

5. Excessive Worry or Guilt

Constantly second-guessing herself
Overwhelmed by fear something bad will happen
Feeling guilty for not feeling “grateful” or “happy”

6. Physical Complaints with No Clear Cause

Frequent headaches, nausea, or fatigue
General sense of feeling unwell

7. Subtle (or Not So Subtle) Mentions of Suicide or Self-Harm

Saying things like “I just want to sleep and not wake up”
Talking about disappearing or running away
Increased talk of death, dying, or being a burden

💬 What You Can Say and Do

As a friend, partner, neighbor, or family member — you don’t need to have all the answers. You just need to show up with love, patience, and willingness to ask the hard questions.

Here are some ways to start the conversation:

Ask More Than “How Are You?”

Try:

“I know things have been tough — how are you really doing?”
“What’s been the hardest part lately?”
“You don’t have to be strong with me — I’m here.”

Listen Without Judgment

Sometimes the bravest thing a mom can do is admit she’s struggling. Let her talk without rushing to offer solutions or downplaying her feelings.

Offer Specific Help

Instead of “Let me know if you need anything,” say:

“Can I bring you dinner tomorrow?”
“I have an hour Thursday — want me to hold the baby while you nap?”
“Want to go for a walk and talk, just us?”

Encourage (But Don’t Force) Professional Help

If she seems open, gently recommend she talk to her OB, a therapist, or a maternal mental health specialist. You can also share resources like Postpartum Support International (PSI) or Cherished Mom.

If she mentions self-harm or suicidal thoughts, take it seriously. Encourage her to contact a crisis line or help her get emergency support.

if she starts exhibiting signs of psychosis, have someone take care of the baby and bring her to the closest Emergency Room. This can quickly escalate into a mental health emergency.

**What Not to Say**

“But your baby is healthy — you should be happy!”
“All moms feel that way.”
“You just need sleep.”
“You’re overreacting.”
“At least you’re home with the baby.”

Even with good intentions, statements like these minimize her experience and may make her less likely to reach out.

Compassion Can Save Lives

The #isMOMok campaign is a call to action — not just for moms, but for everyone around them. We all have a role in creating a culture where it’s safe for mothers to be honest about how they feel.

One check-in. One honest question. One act of care.
It could be the lifeline a mom is waiting for.

So next time you see a smiling photo, a school drop-off, or a mom going through the motions, ask yourself: Is she really OK? Then ask her — and be willing to truly listen.

Because sometimes the strongest moms are the ones holding it together by a thread. And they shouldn’t have to do it alone

If you or someone you know is struggling with maternal mental health or suicidal thoughts, you are not alone.
Reach out for help:
📞 988 Suicide & Crisis Lifeline

📞 Maternal Mental Health Hotline (1-833-TLC-MAMA)

#isMOMok #CherishedMom #MaternalMentalHealthMatters #YouAreNotAlone #EndTheSilence #SupportMoms #momsmatter #PPP #PostpartumPsychosis #PostpartumDepression

Kristina Dulaney