Inside Women's Health: In Conversation with Dr. Emily Guarnotta, Founder, Phoenix Health

Maternal mental health struggles are often invisible. Many women continue showing up every day while quietly battling anxiety, intrusive thoughts, burnout, grief, loneliness, or postpartum depression; often believing they should be able to “handle it” on their own.

As a licensed clinical psychologist, certified perinatal mental health provider, and founder of Phoenix Health Therapy, brings both clinical expertise and personal experience to the conversation around motherhood and mental health.

After experiencing challenges of motherhood, Dr. Guarnotta went on to build a practice focused on helping parents navigate the emotional realities of infertility, pregnancy loss, postpartum struggles, and early parenthood.

In this conversation, we talk about the shame and silence many mothers carry, why maternal mental health is still misunderstood, and what real support for mothers should actually look like.

1. You’ve shared openly about your own experience with postpartum depression and anxiety. Even as a mental health professional, what made it difficult to seek help in those early years?

For me, the hardest part about seeking help was getting past the stigma that seeking help meant I was failing as a mother. Everyone tells you that you should instinctually know how to be a mother, but when you're struggling with your mental health, you feel like something is wrong with you.

On top of that, when I was going through postpartum depression, it was in 2018 when telehealth was not readily accessible. I really had trouble finding a therapist who took my insurance and whose schedule aligned with mine as a working mother. Between the stigma and the very real barriers of not having access to an available provider who took my insurance and was affordable, I delayed seeking help for far too long.

2. Many mothers struggle silently because they feel shame around what they’re experiencing. Why do you think maternal mental health is still so hard for people to talk about openly?

I think maternal mental health is hard for people to talk about openly because it still feels very taboo. We're doing a better job of having open conversations and normalizing that you can struggle with your mental health, still be a great mother, be grateful for being a mother, and also get to the point of recovery. But there is still this nagging cultural belief that mothers should only be grateful and should never struggle with their mental health. As long as women fear that they'll be judged and stigmatized, they will remain silent.

3. A lot of women are told to expect exhaustion after having a baby, which can make it hard to recognize when something deeper is happening emotionally. What are some signs families and mothers themselves often miss?

One of the signs that families and mothers often miss is when the exhaustion is related to an emotional experience. Yes, it's very normal to feel physically exhausted, as you're typically running on little to no sleep and your body is recovering from pregnancy and birth. But when this exhaustion feels heavy all the time and starts impacting the way you're thinking and the way you're feeling throughout the day, or becomes a breeding ground for scary intrusive thoughts, then this is a sign that you need support.

4. You work with families navigating infertility, pregnancy loss, postpartum depression, and anxiety. What emotional experiences do you think are most minimized or misunderstood in the maternal journey?

I think what is most minimized is that this journey is not always smooth for people. For many women, it's marked by infertility, losses, sometimes multiple losses, anxiety, sadness, and scary thoughts throughout pregnancy or postpartum.

I think we have a cultural belief that assumes the journey is very linear. That a woman wants to become a mother, conceives, goes through pregnancy, and is grateful and excited. Then she has a baby and continues to remain grateful and in pure bliss. When this isn't the case for people, it leads to a profound sense of failure.

5. From your experience, how does untreated maternal mental health impact not just mothers, but relationships, parenting, and overall family wellbeing long term?

Untreated mental health affects the entire family. We know that having a partner with a postpartum mental health condition increases the likelihood that the other partner will also experience one. A family is a system or a unit, and when one person isn't well, it affects everyone else in that system.

I also want to express that when a parent struggles with their mental health and does recover, that family system also recovers. I hear women terrified that their depression or their anxiety is going to affect their children forever, feeling like they failed them from the beginning. This is the farthest thing from the truth. The best thing that you can do is recognize it and take action steps to get better. Children are very resilient, and one day this can be a story that you share with your own children, possibly as they become parents themselves.

6. Many women only enter care once they’re already overwhelmed. How important is early intervention and proactive emotional support during pregnancy and postpartum?

Proactive support is everything, and I strongly recommend this. The earlier you can catch it, the better. I also think it's very important that people be aware of their risk factors. For example, if you have a history of anxiety or depression, your family has a history of perinatal mental health conditions, or you have multiple stressors like job loss, financial stress, marital strain, etc., you are at greater risk of developing a perinatal mental health condition.

This isn't meant to scare you, but meant to make you and your loved ones aware so that you can keep an eye on it and take preemptive steps, like reaching out for support or seeing a therapist, to put yourself in the best position possible.

7. At Myri, we think a lot about continuous and accessible maternal support beyond routine appointments. How can digital health platforms help bridge gaps in maternal mental healthcare and make support feel easier to reach?

I think digital health platforms are a great way to meet people where they're at. Not everyone needs to or is ready to seek professional care, and platforms like these that are accessible from wherever you are can help provide that added layer of support. I also think these platforms can be a great adjunct to support like therapy, helping to bridge the gap in between sessions.

8. If there’s one thing you wish every struggling mother could hear, especially the ones silently convincing themselves to “just push through”, what would you want them to know?

I would want them to know that recovery is 100% possible. I've seen it firsthand in many of the clients that I work with, and I've also personally experienced it. As hard as things feel right now, there is light at the end of the tunnel. You don't have to just push through. Getting support and getting equipped with tools to help you during this time means that you will get better faster, and get to the point where you're able to feel like you're not just surviving in motherhood.