The birth of a child should be one of happiest moments of a mother’s life but for some, the arrival of their new baby may be the start of post-natal depression (PND). Sometimes, there may be an obvious reason for the PND - often there is none. But around one in every ten women have PND after having a baby. If untreated, it can last for months, or sometimes longer.

The symptoms include feeling unhappy for much or all of the time; irritability with other children and, occasionally, with the baby; exhaustion bordering on feeling physically ill; no interest in eating and a lack of enjoyment or interest in anything, She may find that she is afraid to be alone with her baby. Instead of feeling close to her baby, she may feel detached and anxious, even if she has strong loving feelings for her baby.

A mother with PND very rarely harms her baby. Occasionally, through utter tiredness and desperation, she might feel like hitting or shaking her baby. Many mothers (and fathers) occasionally feel like this, not just those with PND. The problem is more likely to be your worry that you might harm your baby, rather than actually doing so.

About half the women who give birth feel a bit weepy, flat and unsure of themselves on the third or fourth day after having a baby. This is known as the ‘Baby Blues’, and it passes after a few days. Most cases of PND start within a month of the birth, but it can start up to six months later.

Little is known about why women get PND or who will or won’t suffer from it. There is probably no single reason, but a number of different stresses may add up to cause it. A mother is more likely to have PND if she:

In spite of this, mothers can still suffer from PND when none of these things have happened and there is no obvious reason. In some cases, PND may have something to do with the large hormone changes which take place at the time of giving birth. No real differences have been found in the hormone changes of women who do and do not get PND. It may be that some women are more sensitive to these changes than others.

A great deal can be done to treat PND but first the depression must be recognised. In the past it has often been overlooked or dismissed as the ‘baby blues’.

There are also ways that mothers can help themselves – by saying how they feel: If they feel miserable, irritable, incompetent, frightened and not all that keen on their baby, then they should tell someone. A mother should not be frightened by the diagnosis and it can actually be a relief when someone tells them that they have PND. It is not a long term problem if treated.

Other people can help too: Don’t be shocked or disappointed if your wife, partner, or sister reveals that she has felt awful since the birth of her baby. Take time to listen sympathetically and make sure that she gets the help she needs.

Most women will get better without any treatment after a period of weeks, months or sometimes longer. PND spoils the experience of new motherhood, and will strain the mother’s relationship with her baby and partner, so it is advisable to diagnose and treat PND as soon as possible.

It can be a great relief just to talk to a sympathetic, understanding, uncritical listener - this could be a friend, a relative, a volunteer or a professional. There are also more specialised psychological treatments and these can be arranged through a GP with a community psychiatric nurse, a psychologist or a psychiatrist.

For more severe depression, or if it has not improved with support and reassurance, an antidepressant drug will probably help.

We don’t yet know enough about PND to prevent it in the first place, but certain principles make sense:

Mothers’ rules

	DON’T try to be ‘superwoman’. Try to do less during your pregnancy and make sure that you don’t over-tire yourself.
	DON’T move house while you are pregnant or until the baby is six months old.
	DO make friends with other couples who are expecting or have just had a baby.
	DO find someone you can talk to.
	DO go to ante-natal classes - and take your partner with you.
	DO keep in touch with your doctor if you have suffered PND before. Any signs of PND can be recognised early and you can start treatment at once.

	DO take every opportunity to sleep.
	DO get enough nourishment through healthy foods.
	DO find time to have fun with your partner.
	DO let yourself and your partner be intimate if you can.
	DON’T be afraid to ask for help when you need it.