After Peggy O'Neil Nosti gave birth to the youngest of her three children, postpartum anxiety kept her from eating, sleeping and going outside, and made it hard for her to care for her infant son.
She felt confused, ashamed and isolated.
She didn't want other women to feel so alone.
Three years ago, the art teacher from Escondido came up with a symbol to send a subtle message of support.
The round, sky-blue magnet or sticker could be stuck to the back of a car. On it was a Web address, thebluedotproject.org, where women could go to find information and support.
Nosti's dream, she said at the time, was that the blue dot could become as universally recognized for maternal mental health awareness as the pink ribbon is for breast cancer.
Although it's not yet that well-known, her blue dot is now the official international symbol for maternal mental health, and it's being used this month in a national social media campaign to encourage friends, family and spouses to reach out to moms who might be hiding secret pain.
Gretchen Mallios, president of San Diego's Postpartum Health Alliance, said Nosti's blue dot has become a major force in creating public awareness.
"What she did is huge," said Mallios, whose nonprofit organization provided support when Nosti launched The Blue Dot Project. "She put into action what every person who intersects with this issue says: that we need a stigma-busting symbol that's simple, elegant and approachable with a website so beautiful that mothers feel safe venturing into the conversation, which is the first step in getting better."
Nosti and her husband, dentist John Nosti, are the parents of three children: Ella, 10, Charlie, 8, and Theo, 6. Because she didn't have any problems with the births of her first two children, Nosti said, she didn't understand why her mental health went into a downward spiral when Theo was born. She struggled to cope with everyday tasks.
"I couldn't get my shoulders away from my ears because I was so incredibly tense all the time," she said.
Two months after the onset of symptoms, she sought help at UC San Diego's Maternal Mental Health Clinic, where she was diagnosed with postpartum anxiety. With medication and therapy, she was back to her old self within a few months, and she vowed to help other moms bring the little-discussed malady out of the shadows.
According to the national studies, 1 in 7 women will get postpartum depression or a related illness. In low socioeconomic areas, the proportion increases to 1 in 4. Mothers aren't the only ones who suffer. It can affect marriages, family dynamics and the child's health.
A 2009 study by the Harvard Center on the Developing Child found that children who experience maternal depression early in life can develop weak brain architecture that affects their learning, behavior and mental health.
Mallios, a licensed clinical social worker, said many mothers with postpartum symptoms don't tell their family or doctor about their feelings because they're embarrassed that their maternal experience isn't as wonderful as they believed it should be.
She also said she has seen more cases of postpartum anxiety lately because women are juggling so many responsibilities and are bombarded with alarmist parenting news stories on social media.
"There's a lot of self-blame out there," Mallios said. "There's still that barrier about getting screened because women don't realize it's not their fault and they have something that can be treated."
Nosti first got the idea for her project after Junior Seau's suicide at his Oceanside home in May 2012. Family and friends said they had no idea the former San Diego Chargers linebacker was in crisis.
Nosti wondered how many mothers with perinatal disorders felt desperate and alone and might find comfort in talking to others. A discreet bumper sticker in a school parking lot could become a spark for conversation and healing.
Her blue dot, she said, was simple, easy to replicate, a soothing color, visible from a great distance and still subtle enough that it didn't scream "mentally ill mom on board."
Her project launched a few years later, with the Postpartum Health Alliance's support and grant money from the Mason Hirst Foundation.
Through the initial sale of more than 400 blue dots, Nosti and her all-volunteer team provided a couple of grants for groups on the East Coast that help low-income moms with depression and anxiety. Then two years ago, the national networking group Postpartum Support International hosted a design contest to create a universal symbol for maternal mental health. After a close vote, Nosti's blue dot was chosen.
She has sold nearly 1,000, but she said the goal is to raise awareness, not money. She's delighted to see blue dots popping up everywhere, including as the logo for county public health programs in Santa Clara, Humboldt and Butte counties.
The blue dot also was adopted by the National Coalition for Maternal Mental Health for its annual May campaign and appears on social media with the hashtag #askher.
Nosti's next goal, she said, is to expand the pool of those who see the symbol.
"In my opinion, we need to start getting it recognized by healthy women and women who are mothers-to-be," she said. "The more people we can reach, the more mothers we can help."
Kragen writes for the San Diego Union-Tribune.