Woman and babyPregnancy is a wonderfully exciting time, yet it can also be daunting. After the roller-coaster ride of emotions, not to mention surging hormones, it's perfectly natural to feel low after the birth of your baby.

Adjusting to life and sleepless nights can be tough for both mum and dad – but how can you tell whether you have a case of the baby blues or something more serious?

How common is it?
More than half (60-70 per cent) of new mothers experience the baby blues and feel weepy and sad for a few hours or days after giving birth.

One-in-seven to one-in-10 women will experience postnatal depression (PND), which is more pronounced and lasts longer than the baby blues.

In rare cases (one in 500), new mums may experience hallucinations or delusions. This psychiatric condition is known as puerperal psychosis, and is more likely to affect women who have a history of mental illness.

Baby blues or post natal depression?
Women who have the baby blues are likely to feel low, tearful and irritable, especially in the first week or so after giving birth. If your symptoms are more severe or last for longer than a couple of weeks, it's important to speak to your GP, community midwife, or health visitor, as you could be suffering from PND.

Postnatal depression can affect any new mother and can begin at any time in the first days, weeks or months after the birth. It often lasts for more than three months and sometimes as long as a year or more, especially if the mother doesn't receive the right treatment.

Common symptoms of PND:
- Feeling sad and weepy for no apparent reason
- Feeling a failure as a mother
- Anxiety, irritability, worried about things you can't control
- Feeling unable to cope with your baby's crying
- Being unable to enjoy yourself
- Lack of energy, exhaustion, craving for sleep
- Loss of appetite or over-eating for comfort
- Feelings of guilty
- Being afraid to be alone with your baby
- Difficulty making decision, even about simple things
- Feeling that life isn't worth living

What causes PND?
The exact cause of PND isn't known but research suggests that the condition is linked to genetic and hormone factors. Other studies have shown that a mother's experience of birth, how she adjusts to the demands of motherhood and the support she receives, can play an important role.

Women who have had PND before, have a personal or family history of depression or severe PMS, or have had a complicated pregnancy or sick baby are more susceptible to the illness.

Seek help
If you have had PND previously, or any other kind of depressive or mental illness, it's important to talk to your health team in pregnancy, so that they can offer you help immediately after birth should you need it.

Once your doctor has diagnosed PND they will be able to offer you appropriate treatment, which may include medication and talking therapies. Although some women do get better without intervention, treatment will speed up the recovery process.

Some women may go through PND without realising it – until they wake up one morning and feel like 'a cloud has lifted' or that 'a part of them has returned.'

Medication
Antidepressants take a couple of weeks to start working and are generally taken for four to six months. Research shows that between 50-70 per cent of women who take antidepressants find their PND symptoms ease within a few weeks of starting treatment.

The most commonly prescribed antidepressants for PND are fluoxetine (Prozac), sertraline (Lustral), and paroxetine (Seroxat). Your doctor will check whether you are breastfeeding to ensure you take medication that's safe for you and your baby.

Some people get withdrawal symptoms when they stop taking them (though this is less common with modern anti-depressants). Talk to your doctor before stopping any medication, as they can ensure you come off them gradually.

Mother on phone and laptop with baby on her lapTalking therapies
Talking therapies such as psychiatric counselling, group therapy and Cognitive Behavioural Therapy can help you to explore how you think about yourself and gain new insight on problems from your past as well as the present.

As well as speaking to your GP, community midwife, or health visitor, it's a good idea to seek support from other new mums, especially those who have experienced PND themselves.

A study published in the British Medical Journal (BMJ) found that mothers who receive psychological support from health visitors or other new mums are less likely to develop postnatal depression, or if they do, are more likely to see their symptoms improve.

The National Childbirth Trust (NCT), offers 'early days' postnatal classes designed to help new mums and dads adjust to parenthood and give them confidence with feeding, sleeping and crying.

Kate Williams, Director of Parent Services, NCT, says: "This study shows how important it is for new parents to receive that much-needed support, particularly from other parents. Whilst everyone is aware that having a baby will change their life, exactly how the change will affect them varies from one person to another. Our NCT classes offer new parents that much-needed support and valuable help in learning how to care for a new baby."

How to help yourself through PND
There are things you can do to help yourself. First and foremost, be kind to yourself and accept that you cannot carry on as normal. Seek help and don't feel embarrassed about taking it – whether it's a shoulder to cry on or help with the housework.

Self-help advice:
- Take regular exercise – many people find activity helps alleviate depression
- Set aside time each day for yourself, to enjoy a bath, read a book, or go for a walk
- Eat healthily. Make sure you get enough wholegrains and fruit and veg
- Rest if you can. Don't feel embarrassed to accept help with the chores
- Do jobs in the morning – PND is often worse latter in the day
- Set small goals and reward yourself when you have done something successfully
- Find time to have fun with your partner
- Meet up with other new mums, especially those who have had PND
- Talk about how you feel with someone you trust
- Accept that it will take time to recover and trust that things will get better

It can happen to anyone
It's important to remember that PND can happen to any woman after the birth of a child. It's no reflection on your ability as a mother and doesn't mean you're weak or 'not like other women.'

In fact, lots of celebrities have suffered with PND, including Brooke Shields, who has written a book about her experience, and American actress Lisa Rinna, who says: "I had severe post-natal depression after both births. With my first child, I didn't know what hit me. I felt horrible and didn't understand why.

"That first bout lasted about 15 months. With my second child, I was able to get help right away. So I'd say that if you notice any signs, call your doctor immediately. You've got to take care of yourself".

Fern Britton has also spoken openly about her PND. The TV host has four children - twin boys and two daughters - and says of her post-natal depression: "I've had times when I've wished I wouldn't wake up. Yes, I felt suicidal. It's a chemical imbalance. I have taken anti-depressants, but I've been really well for ages."

Model and TV presenter Melinda Messenger has also revealed she was 'unable to cope' after the birth of second son, Flynn. She told Prima Baby magazine: "Emotions are very powerful, but because they aren't physical you don't always want to admit to them. I think it is important that women realise that post- or pre-natal depression is not a weakness."

More on PND on Parentdish: Postnatal depression: It can happen to anyone

Contacts and further information:


The National Childbirth Trust is the UK's leading charity for parents, offering antenatal and postnatal courses and local support groups. You'll also find reliable information on their site, including PND and coping with baby in the early days.
http://www.nctpregnancyandbabycare.com/home

The Royal College of Psychiatrists carries up-to-date research-based information on PND.
http://www.rcpsych.ac.uk

PNI.Org is a charity support group set up and run by women who have had personal experience of PND.
http://www.pni.org.uk/

The Meet A Mum Association (MAMA) is a UK registered charity launched in 1979 by Esther Rantzen. It aims to provide friendship and support to all mothers, especially those feeling lonely or isolated after the birth of a baby.
http://www.mama.co.uk

Parentline (0808 800 2222). This telephone helpline provides support and information for parents who are under stress.
http://www.parentlineplus.org.uk/

The Association for Postnatal Illness (020 7386 0868) can put you in touch with a trained volunteer who is experienced in talking to women with PND.
http://apni.org/

The British Association for Counselling and Psychotherapy (BACP) allows you to search for a qualified counsellor or psychotherapist in your area.
http://www.bacp.co.uk/

Home Start is a family support organisation, who will visit you at home and offer friendship, support and practical help. It can also put you in touch with other parents in your area.
http://www.home-start.org.uk/homepage