Throughout her career as a public figure, many royal family watchers have drawn parallels between Meghan Markle and Princess Diana, the mother of Markle’s husband, Prince Harry. Some of these comparisons are largely superficial (both women are glamorous, well-dressed, and omnipresent tabloid fixtures), but the bulk of the similarities stem from the fact that both Markle and Princess Diana attracted global admiration for their candor and very public refusal to adhere to the protocols established by the royal family. There is also another significant similarity, one that Markle cemented in her blockbuster interview with Oprah on Sunday: both Diana and Markle chose to use their massive public platforms to serve as advocates for maternal mental health.

Markle’s interview with Oprah contained a number of bombshells about the Crown, most notably the revelation that an unidentified individual in the family had expressed concern about her son Archie’s skin color before he was born. Another moment also went viral: her admission that she had struggled from suicidal ideation while pregnant with Archie, triggered in part by the relentless attacks from the British media.

“I just didn’t see a solution. I would sit up at night, and I was just, like, I don’t understand how all of this is being churned out,” Markle said in the interview, referring to the constant press scrutiny. “I realized that it was all happening just because I was breathing. I was really ashamed to say it at the time and ashamed to have to admit it to Harry, especially, because I know how much loss he’s suffered. But I knew that if I didn’t say it, that I would do it. I just didn’t want to be alive anymore. And that was a very clear and real and frightening constant thought.” Markle told the palace’s HR department at the time that she needed help, but “was told that I couldn’t, that it wouldn’t be good for the institution”  — meaning the Royal Family — if she were institutionalized or received psychiatric support.

This is not the first time Markle has used her public platform to speak openly about maternal mental health issues. In a 2019 interview she gave to ITV journalist Tom Bradby shortly after she had given birth, Bradby simply asked how Markle was doing, to which a teary-eyed and clearly grateful Markle replied, “Not many people have asked if I’m OK, but it’s a very real thing to be going through behind the scenes. Any woman, especially when they’re pregnant, you’re really vulnerable, and so that was made really challenging. And then when you have a newborn, you know. And especially as a woman, it’s a lot.” It was a stunningly candid and human moment, as well as a marked deviation from the stiff-upper-lipped and highly stage managed demeanor of most of the members of the royal family.

The viral clip, which prompted the hashtag #WeLoveYouMeghan to trend, particularly resonated with mothers, many of whom used it to kickstart a discussion about postpartum depression (PPD), from which one in nine women suffer (though to be clear, Markle did not specify in the interview whether she had been diagnosed with the condition). “It wasn’t that long ago that I was a new mom, and I certainly will never forget the postpartum depression,” one woman wrote on Twitter at the time. “Can’t imagine having to live under royal and public scrutiny on top of all the responsibilities.”

Many also noted Markle’s remarks echoed a similar revelation made by Princess Diana during her 1995 BBC Panorama interview with Martin Bashir. “I was unwell with postnatal depression, which no one ever discusses, postnatal depression, you have to read about it afterwards, and that in itself was a bit of a difficult time,” Diana, who also spoke publicly about her struggles with suicidal ideation and self-harm during the interview, said. “You’d wake up in the morning feeling you didn’t want to get out of bed, you felt misunderstood, and just very, very low in yourself.”

Though suicidal ideation during pregnancy is not often publicly discussed, it is far from uncommon. According to a report from JAMA Psychiatry, which surveyed more than 595,000 people who had given birth, the rate of suicidal thoughts and self-harm among childbearing people tripled between 2006 and 2017, from .2 percent to .6 percent, prompting lead study author Lindsey Admon to refer to suicide among new mothers as “a public health crisis that has silently grown worse.” The study also found that rates of suicidality among child-bearing individuals increased among black and low-income people, prompting mental health experts to call for increased screening among these groups.

Not everyone was deeply affected by Markle’s candor. On ITV’s Good Morning Britain, Piers Morgan dismissed Markle’s claims of suicidality, raging that she was attempting to position herself as a victim and tweeting, “I wouldn’t believe Meghan Markle if she gave me a weather report.” (Such a reaction was not dissimilar to how Princess Diana, in her 1995 Panorama interview, characterized the royal family’s response to her own struggles with depression, telling Bashir that “people see it as crying wolf or attention-seeking”). But on social media, the support for Markle was overwhelming. “#MeghanMarkle opening discussing depression, postpartum depression, suicide helps decrease stigma related to mental illness more than ANYONE could in a year when we are having a pandemic of mental illness,” psychiatrist Dr. Gail Saltz wrote on Twitter. “BRAVE, STRONG, LIFE SAVING.”

If you are struggling with thoughts of self-harm, the National Suicide Prevention Lifeline is 1-800-273-8255. You can also reach the  Crisis Text texting TALK to 741741.