El Mundo Boston

Postpartum Depression in Massachusetts: The Warning Signs No Family Should Ignore

Notice: This article discusses postpartum depression, postpartum psychosis, and suicidal thoughts, with reference to an ongoing court case in Massachusetts. If you or someone you know is in crisis, call or text 988 (the Suicide & Crisis Lifeline), available 24 hours a day.

More than 1 in 10 mothers in Massachusetts reports symptoms of postpartum depression, according to data from the state Department of Public Health (MA PRAMS) and the Centers for Disease Control and Prevention (CDC).

However, that number does not tell the whole story.

In the Latino community, where stigma surrounding mental health remains high, many of these mothers never seek help.

The issue returned to the public conversation this summer in Massachusetts because of the trial of Lindsay Clancy, the former labor and delivery nurse from Duxbury accused of killing her three children in January 2023.

Her defense argues that she acted while experiencing severe postpartum psychosis. The case remains ongoing, with closing arguments expected in the coming days, and this article takes no position on its outcome.

We use it as a starting point for a broader conversation:

What is postpartum depression, when does it become an emergency, and how can a family in Massachusetts find real help—not just another appointment?

To answer these questions, Francis Concepción, from the program Hablemos on Univision New England, spoke with Dr. María Ferreras of Ferreras Counseling & Wellness Center in Lawrence, Massachusetts.

What Is Postpartum Depression?

Dr. Ferreras explains that postpartum depression appears after childbirth, although in some cases symptoms may already be present beforehand—at a time when society often expects a mother to feel nothing but happiness.

“The symptoms that become noticeable are those after a woman gives birth, which is supposed to be a moment of joy… For her, it does not become that joy, but rather sadness.”

— Dr. María Ferreras

When it comes to what causes it, Dr. Ferreras is clear that there is no single answer. Researchers are studying hormonal factors, but also a woman’s previous mental health history, life circumstances, and the support available to her.

“The causes are not really known… There are factors that professionals say may involve a hormonal issue that influences a woman’s mood, but the causes are not known.”

— Dr. María Ferreras

Warning Signs Families Should Not Ignore

According to Dr. Ferreras, depression—whether postpartum or not—is recognized by symptoms that persist for two weeks or longer:

  • Deep sadness that does not go away and affects mood day after day.
  • Loss of interest in activities that once brought pleasure.
  • Difficulty getting out of bed or functioning in daily life.
  • Major changes in appetite: eating too much or almost nothing.
  • Major changes in sleep: being unable to sleep or sleeping excessively.
  • Expressions of rejection toward the baby, or comments such as, “I don’t want to live anymore.”

“These are symptoms that last two weeks or more, where you feel great sadness, where your mood is affected, where the things that once gave you pleasure no longer do, where you no longer want to get out of bed.”

— Dr. María Ferreras

She emphasizes one important point: when a woman says that she does not want to live or that she does not want her baby, those words should never be dismissed as a passing comment.

“When people begin to express that they don’t want to live… these are expressions that people do not take seriously, but they should, especially when they see behavior that is not appropriate for the situation.”

— Dr. María Ferreras

What About Postpartum Psychosis? Why It Is Different—and Why It Is Rare

Postpartum psychosis is a different and much rarer condition than postpartum depression. It affects approximately 1 to 2 out of every 1,000 births, according to studies published in peer-reviewed medical journals.

It may include auditory, visual, or tactile hallucinations and, in the most severe cases, “command voices” telling the person to act.

“There is auditory psychosis, where you are hearing voices that are not there… tactile psychosis, where you are feeling things that are not there… command voices that tell you that you have to do this, that you have to do that.”

— Dr. María Ferreras

It is important to emphasize this: the overwhelming majority of mothers with postpartum depression, including those experiencing postpartum psychosis, never harm their children or themselves.

However, when psychosis occurs, it is a medical emergency that requires immediate attention—not a routine appointment next week.

The Stigma That Keeps Latino Families Silent

“In our community, especially in the Latino community, depression is not talked about much… There is still a culture, there is still stigma around it that harms the family.”

— Dr. María Ferreras

Dr. Ferreras points out that this stigma does not distinguish between social class or profession. Doctors, lawyers, and engineers live with anxiety or depression every day while continuing to function in their communities, often without anyone noticing.

“If you are human, you can experience a mental health condition just as you can experience a physical condition… The mind, although abstract and located in the brain, is part of your physical condition.”

— Dr. María Ferreras

The Role of the Family

For Dr. Ferreras, the people closest to someone—such as a partner, mother, or siblings—are often the first to notice a change, precisely because the person experiencing the condition may not always recognize it.

“The family is essential in helping a person with a mental health problem seek help. When that person feels supported, not mocked… things can change.”

— Dr. María Ferreras

How to Know Whether You Have a Good Therapist

Finding help is the first step. Finding the right help is what can truly make a difference.

These are practical signs to consider when evaluating a mental health professional in Massachusetts:

Signs You Are on the Right Track

  • They have an active Massachusetts license. You can verify this through the appropriate Board of Registration for psychology, social work, or counseling before your first appointment.
  • They have specific experience or certification in perinatal mental health, such as the PMH-C certification from Postpartum Support International—not just general mental health experience.
  • During the first session, they explain their treatment approach and what you can expect in the coming weeks instead of simply scheduling the next appointment.
  • They coordinate, or are willing to coordinate, with your OB/GYN or pediatrician when necessary.
  • They give you time to ask questions and answer clearly, without rushing.

Warning Signs

  • The session feels rushed or more focused on billing than on listening.
  • There is no clear treatment plan after several sessions.
  • They minimize serious symptoms, such as thoughts of harming yourself or the baby, instead of responding with urgency.
  • There is no way to verify their license or credentials.

Before your first appointment, we have prepared a practical guide with key questions to ask a therapist: Checklist of Questions to Help You Choose a Therapist in Massachusetts.

Perinatal Mental Health Resources in Massachusetts

  • MCPAP for Moms — Tel: 855-666-6272 · Web: mcpapformoms.org · Connects healthcare providers, through your doctor or OB/GYN, with perinatal psychiatric consultation and referrals to screened therapists in Massachusetts.
  • Postpartum Support International (PSI) — Tel: 1-800-944-4773 (Spanish option available) · Web: postpartum.net · Emotional support line and national directory of therapists with PMH-C certification in perinatal mental health.
  • Massachusetts Behavioral Health Help Line (BHHL) — Call or text: 833-773-2445 · Web: masshelpline.com · A statewide 24/7 service, with interpretation available in more than 200 languages, that connects people with clinical assessment, therapy, and crisis care, with no health insurance required.
  • National Maternal Mental Health Hotline — Tel: 1-833-943-5746 · Web: mchb.hrsa.gov/national-maternal-mental-health-hotline · Confidential, 24-hour support in English and Spanish before, during, and after pregnancy, operated by the federal HRSA.
  • 988 Suicide & Crisis Lifeline — Call or text: 988 · Web: 988lifeline.org · Available 24/7 for any type of emotional crisis; Spanish-language services are available by selecting option 2.
  • NAMI Massachusetts, Compass Helpline — Tel: 617-704-6264 or 1-800-370-9085 · Web: namimass.org · Guidance in English and Spanish, Monday through Friday, to help people understand the mental health system and find the right resource in their area.

Frequently Asked Questions

Is the “baby blues” the same as postpartum depression?

No. The baby blues are common, mild, and usually last from a few days to two weeks after childbirth. Postpartum depression lasts longer than two weeks, is more intense, and affects a mother’s ability to function in her daily life.

How common is postpartum psychosis?

It is uncommon. It is estimated to occur in 1 to 2 out of every 1,000 births, far below the rate of postpartum depression, which affects more than 10% of mothers in Massachusetts.

Can I treat postpartum depression from home?

Yes. Telehealth now makes it possible to begin therapy from home, which can be especially important for mothers who do not have someone to care for their baby or who do not have transportation.

When is it an emergency that cannot wait until the next appointment?

When there are thoughts of harming yourself or the baby, or statements such as, “I don’t want to live anymore.” At that point, call 988 or go to an emergency room. Do not wait for your next scheduled appointment.

How do I know if my therapist is really helping me?

They should have a clear treatment plan, listen without rushing, and take any severe symptoms seriously. If you feel that they are simply moving you from one appointment to the next without meaningful support, you have the right to seek a second opinion.

Medical notice: This article is for informational and educational purposes only and does not replace an evaluation, diagnosis, or treatment by a licensed mental health professional. If you or someone you know is in crisis, call 988.

Watch the Full Interview

Francis Concepción spoke in depth with Dr. María Ferreras about this topic on Hablemos, a program of Univision New England.

This content was developed by the My Health Fair (MHF) editorial team as part of its ongoing coverage of maternal mental health in the Massachusetts community.

To explore this issue in greater depth, MHF partnered with Francis Concepción and the program Hablemos from Univision New England, with the participation of Dr. María Ferreras of Ferreras Counseling & Wellness Center in Lawrence, MA, whose clinical experience in mental health was essential to this conversation.

This article is published as part of the editorial partnership between My Health Fair and El Mundo Boston and reflects MHF’s commitment through myhealthfair.com to connecting Massachusetts communities with reliable health information and resources throughout the year.

Sources

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