Postnatal depression Heather Welford Postnatal depression is more than the 'baby blues' so many women go through in the first days after birth. Recognising the symptoms can lead to prompt treatment.

In this article

Baby blues Signs of postnatal depression

Getting help Advice for partners

Puerperal psychosis

It's normal to feel tearful and down two to three days after the birth and for these feelings to last a day or two. This is the result of exhaustion and hormone surges. This phase is often called 'the baby blues'.

Postnatal depression (PND), however, is longer lasting and more debilitating in its effects.

Research shows that ten to 15 per cent of new mothers are depressed after the birth, with many more experiencing weeks or months of intermittent feelings of depression.

Some women experience depression before they give birth

Some women experience depression before they give birth. Your health visitor or midwife can support you if you think you have antenatal depression or PND.

Some experts see PND as a spectrum of feelings, ranging from severe symptoms of depression at one end, to spells of feeling low, isolated or very tired at the other.

Often, the mother doesn't recognise that she's suffering from depression. Instead, she keeps waiting for her mood to lift and for her to be more like other mums she meets. Even those close to her may not see how difficult life is for her.

If you have PND, you might recognise some (but not necessarily all) of the following:

• You find you need to put on a front to the world
• You're tearful for no obvious reason, very frequently
• You long for sleep, yet wake unrefreshed each morning
• You find it hard to get to sleep
• You sometimes lose your sense of time - you can't tell the difference between ten minutes and two hours
• It's hard for you to see the funny side of life
• You see others organising themselves and their babies and think "I could never do that"

If you think you have PND, talk to your doctor, midwife or health visitor. There are a number of different forms of help available:

• Drug treatment with antidepressants (there are some that are safe to take while breastfeeding)
• Counselling/psychotherapy
• Social support and friendship

Some doctors feel PND is to do with falling hormone levels and treat it with progesterone or oestrogen.

Untreated PND can have an effect on babies

It's important to get help, as untreated PND can have an effect on babies. A depressed mother is less able to respond to her baby and feel attached, which has an impact on learning and development. Research shows that behavioural issues - especially with boys - can be long-lasting.

A woman with PND needs lots of love, as well as practical support. You may find you start feeling depressed, too. This is perfectly normal, but don't ignore such feelings. If you need support, confide in friends and family, as well as your partner. Things will get easier in time.

Sometimes, men experience depression after the birth, and they're at a higher risk if their partner has PND. It may be that you both need help from your doctor.

One or two new mothers in every 1,000 have this serious mental illness after childbirth. Clinically, it's quite different from PND. Treatment may need to be administered in hospital.

Mothers with this condition can act very strangely and have very strange thoughts. Symptoms include depression, mood swings, bizarre behaviour or ideas, delusions and hallucinations with paranoia.

Most women make a full recovery, but women who have had one instance of puerperal psychosis are at a higher risk of it recurring after a subsequent birth.

If you think you, or your partner, has puerperal psychosis, it's important to get help from your doctor or health visitor as soon as possible. Urgent treatment is needed to prevent harm to mother or baby.

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