September is Suicide Awareness Month. Not only do the leaves change color in September, but kids go back to school, schedules become filled with activities, meals are eaten in the car on the way to soccer practice, and feelings of overwhelm and loneliness can set in. September is a period of change. And for my friend, and many other women, sudden change—no matter how prepared you think you are—can be jolting to the system.

I became pregnant with twins in late 2006 after one round of IVF. My husband and I knew we were lucky to get pregnant so quickly and while the thought of twins was a little overwhelming, it was still very exciting. Pregnancy was great. I was 30 years old (which carried a certain sense of maturity, no?). I had graduated medical school in 2002 and had a resounding four years of clinical experience. That made me an expert right? I was well versed in each trimester of pregnancy.