The term "baby blues" is often used to describe a short period of mild depression which many women experience after having a baby. But, sadly, between 8 and 15% of new mothers go on to develop full-blown postnatal depression (PND).
Many new mothers experience this severe depression without recognising it or realising that it is a treatable illness. This causes needless distress which also affects family and friends.
A small minority of women may develop puerperal psychosis - an acute condition which occurs suddenly within the first six weeks after childbirth.
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PND can develop when the "baby blues" become worse. Or the depression can develop more slowly and may not be noticeable until several weeks after the baby's birth.
There are many symptoms of PND. You may feel you can't cope with your baby and so feel guilty because of this. Or you may feel very sad and cry frequently. Some mothers with PND feel anxious and worry about their own health and that of the baby. They may suffer from panic attacks and feel tense and irritable all the time. Most depressed mothers feel tired and lack energy. They may feel unable to concentrate or find simple tasks confusing. Some mothers experience pains with no apparent cause (other than tension and anxiety). Many have problems sleeping and a poor appetite. Many depressed mothers lose interest in sex.
The symptoms of puerperal psychosis may include manic behaviour. You may feel excited and elated and may talk very fast. You may be hyperactive - not sleeping and rushing about. Others may comment that you are unusually bossy and demanding and that you become angry and aggressive if crossed. Some sufferers become severely depressed or have both manic and depressive phases. Other possible symptoms include hallucinations and delusions.
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If your depression lasts longer than a few days, you need to see your doctor and describe all of your symptoms. PND is a real illness and can be treated successfully.
Forms of drug treatment vary, but they usually involve the use of anti-depressants, which are not addictive. These drugs work slowly and improvement is gradual, but if several weeks of treatment doesn't lead to an improvement, ask your doctor for a stronger dose or a different drug. If you find your depression is worse just before or during your period, it may be worth asking about progesterone therapy.
Mothers with puerperal psychosis need to be treated by a psychiatrist. It may be possible for you to be treated at home, but hospital admission is usually necessary - some hospitals have specialist mother and baby psychiatric units. Treatment is usually with anti-psychotic and anti-depressant drugs.
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Family and friends need to be very understanding. Although the illness is temporary and very treatable, you may need lots of help and support before you recover. Everyone around you needs to accept that you are unwell and they need to treat you as if you had a physical illness - this is not something you can be chivvied out of.
Family can help make sure you are getting treatment from your doctor and can give you support if you need to go back and ask for your medication it to be changed.
Rest will also help recovery, so let family and friends take on as many of the everyday jobs that you can give up. But when your are feeling better, do as much as you want to. It's common to have bad and good days with this illness.
If you hate being left alone, ask family and friends to try and organise for someone to be with you for much of the time. Physical contact from a partner in the form of hugging and cuddling can also be very reassuring - especially if the sexual side of your relationship has been affected.
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If you've got PND it's very beneficial to be able to talk about your illness and its symptoms. Chats with friends and family can be helpful, but it's also worth asking your doctor, midwife or health visitor about professional counselling.
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More than anything, you need to believe that you will get better in the end - even if your recovery seems slow. Try to look after your self, rest as much as you can and try not to worry about various aches and pains. Eat well - it's especially important not to go without food for long periods. If you feel lonely or isolated, the organisations listed below can offer friendship and support.
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Written in 2001
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