At a time when they expected to feel joy, these mothers feel terror, desperation and inadequacy. Family members and doctors might not even notice, because the moms seem to have it together.

At a time when they expected to feel joy, these mothers feel terror, desperation and inadequacy. Family members and doctors might not even notice, because the moms seem to have it together.

Postpartum depression is common - some estimates say it happens after one in five pregnancies - but it remains underreported.

The malady is a mood disorder that varies from woman to woman, but can be characterized by sadness, anxiety and feelings of worthlessness. Some women have uncontrollable thoughts about how their baby could be harmed, such as falling out of their arms.

Many women go without support and treatment, which can include counseling, lifestyle changes such as getting plenty of sleep and exercise, and medication.

The new leader of the American College of Obstetricians and Gynecologists has made it his mission to boost recognition of postpartum depression by both doctors and new mothers. "I wanted to bring it out of the closet for them, to let them know it's not them, it's a physical thing, and we can do a lot about it," said Dr. Gerald Joseph Jr., who works at the Ochsner Health Center in Covington, La. He took over as president of the influential doctors group in May.

He also wants his group to better study the disorder, including finding ways to help doctors accurately determine who is suffering and what type of help might be most beneficial to a particular woman.

This comes as welcome news to Tonya Fulwider, a leader in bringing recognition and support to Columbus-area mothers through the nonprofit group POEM (Perinatal Outreach and Encouragement for Moms). She and two other women began their effort to create POEM in 2004.

The members of POEM want to help stop the damage that postpartum does to the mother, her child and her family. The group focuses on mom-to-mom support, Fulwider said. The group also guides women to medical and mental-health professionals. And Fulwider works to educate doctors, nurses and others most likely to help women recognize what they're going through.

Heidi Sommer McAlister, a Columbus psychotherapist who specializes in postpartum depression, said recognition has increased in recent years, but misconceptions persist. "When the public hears postpartum depression, they generally think of a psychotic mom that is going to hurt her baby. In eight years of therapeutic work, I've never had a case like that."

What she does see are women who have anxiety, including panic attacks. Some feel they're out of control and are terrified about their baby's safety. She sees women who are overcome by guilt, or weighed down by sadness.

"I was completely worthless. I wanted my husband to find a better wife. I wanted my children to have a better mother," said Jobie Krantz, a Powell woman who has experienced postpartum depression twice. She found POEM the second time, after the birth of her daughter Evelyn. "If I was holding the baby, I would think, 'What if I drop the baby on the stairs?' Things that weren't logical to the outside world."

She choked up recently as she explained how far she's come, how joyful she was to be preparing for Evelyn's second birthday party.

Through POEM, and a combination of therapy and medication, Krantz has come out of the dark, she said. She now mentors other mothers. "To have somebody to relate to - 'We've been there, we've done that, we've survived' - is invaluable, absolutely invaluable," she said.

For Fulwider, recovery came long ago and involved the help of a grassroots group of mothers that operated under the name Depression after Delivery. She has two daughters: Veronica is 11, and Sarah is 8.

When she was suffering, everything she looked at represented failure: the laundry, the dishes, her daughter, Fulwider said. Now, she cherishes her happiness and mental health, and is honored to educate the community and to take the calls of other mothers, she said. "The first thing we say is, 'Pat yourself on the back because you called a perfect stranger to delve into one of the most frightening secrets you've ever had.' "

For help, or more information about postpartum depression, call (614) 315-8989 or visit www.poemonline.org.