The baby is fine - how are you?

You will probably experience a wide range of feelings from joy and excitement to frustration, resentment, guilt and anxiety. This is quite normal and you will need help, support and understanding from the people around you.

Sometimes, however, these unhappy feelings become so intense that you feel overwhelmed and out of control. If this happens, you may be suffering from postnatal depression and anxiety. We can picture unhappy feelings after the birth of a baby as follows.

The blues

Up to 80 percent of new mothers have 'the blues' shortly after birth. For a few days you may feel anxious, tearful, tired and irritable.

Postnatal psychosis

At the other end of the spectrum, the 'deepest blue', is a rare and very serious disorder called postnatal psychosis, which affects one or two mothers per thousand.

The mother's thinking becomes seriously disturbed and she needs immediate hospitalisation and treatment because she is a danger to herself and those around her.

Postnatal depression and anxiety

Between 10 and 30 percent of all mothers, in all circumstances, suffers from this middle range depression.

Unlike the other disorders, PND is less easy to identify and may develop slowly any time during the first year of the baby's life.

Every mother is different, and may have different combinations of symptoms.

She may be more anxious or irritable than sad. It may be quite mild or very severe. Often mothers are afraid that they are 'going mad'.

Sometimes a mother has been depressed ever since her pregnancy and sometimes 'the blues' don't go away.

Sometimes a mother seems to manage well for a while and then her mood becomes darker and darker.

What causes PND?

There is no single cause. It is not 'just hormonal' because fathers and adoptive mothers can suffer from it too.

It is our belief that a combination of factors contribute to the condition, such as being a perfectionist, lack of support, a traumatic birth, financial and other stress, loneliness, an unsatisfactory relationship with the baby's father, a previous history of depression.

A woman is vulnerable when she has recently given birth and the combination of too many stress factors at this time causes some women to develop PND.

Treatment of PND

PNDSA recommends a combination of three approaches in the treatment of PND
· Medication; psychotherapy and individual or group support.
· Being with other women who really understand how you feel is a great help.
· Psychotherapy is expensive, but helpful in addressing underlying psychological and relationship difficulties.

What helps when you are feeling depressed?

Don't be fobbed off with others telling you to "pull yourself together" and "you should be grateful ... "

* Speak to someone - your clinic sister or doctor, a postnatal support telephone network.

* Speak to your partner or a close friend.

* Accept that this is not your fault.

* Ask for help from others.

* Plan for enough rest and time off.

* Drop your standards; you can't do as much as you used to around the home.

* Join a support group where you can share this experience with others who understand how you feel.

* Take one step at a time.

Why do so many mother suffer in silence?

They hide their real feelings because they feel ashamed and guilty.

They may feel more anxious about the baby than depressed.

They may receive help for the physical symptoms of PND, like insomnia or tiredness, without examining the underlying causes.

Society expects a woman to be happy after the birth of a baby and it's hard to admit to being miserable.

Health professionals may not recognize the depression, or may not take it seriously.

Partners and families may not understand how the mother is feeling and may try to tell her, "Pull yourself together."

Does this sound familiar?

I'm so irritable and confused ..

I feel like crying for no apparent reason.

I feel exhausted all the time.

I feel helpless, inadequate and unable to cope.

I worry all the time about the baby.

I feel scared and panicky at times.

I feel ashamed and guilty.

I don't know who I am anymore.

I have no interest in anything.

I can't sleep the way I used to.

I don't eat the way I used to.

I don't have any feelings for the baby.

I don't want sex anymore.

I sometimes think of hurting the baby or myself.