Not every new mother is overjoyed with the arrival of her baby. Dr Carol Cooper explains how to recognise postnatal depression and offers advice on what to do

Now you’ve finally met your baby face-to-face, you’re likely to feel great. Many new mums even say they’re on a high for the first 24 hours after the event. But some come down to earth with a bump. About 10 per cent of new mothers get some form of postnatal depression (PND) and if you include mild forms of depression, up to one mum in six is affected.

PND peaks in the first few weeks after birth but it can start any time – even six or more months later when most people assume you’re taking motherhood in your stride.

Feeling low
Most new mums feel low and tearful about the third day after delivery, roughly when milk production starts. This is the so-called “baby blues” and is probably due to fluctuating hormone levels. These symptoms only last three days at most.

PND is more severe, starts later and lasts much longer. If left untreated, it can take a huge toll on your health and how you relate to your baby.

For a condition this common, it’s strange that no one is certain about the cause. Some think hormones are the key, but research has not proved this. Besides, PND affects fathers too.

Factors that increase the risk include:
• Previous history of depression
• Unsupportive partner
• Premature or sickly baby
• Recent stresses (eg death in family)

Does PND recur?
Mums who’ve had depression often worry that it may recur if they have another baby. There is a small chance it might but it’s hard to put a figure on the risk.

If you get pregnant again, try not to worry but do get help sooner rather than later. Make sure your doctor and midwife both know about your previous history. With extra support during the pregnancy and afterwards, it’s more likely you’ll prevent a recurrence, enabling you to enjoy life as a new mum.

What to look out for
Someone with PND may feel low, exhausted, irritable and unable to cope with life. Despite being tired, they may be unable to sleep. Losing interest in sex is typical of new motherhood but with PND it’s more persistent.

A depressed mum may lose interest in food or eat for comfort. Anxiety, guilt and feeling useless are common. She may feel she can’t look after her baby properly and become obsessed with the baby’s health or her own. Some mums fear they may harm their baby, though very few ever do.

If you suffer from PND you feel unable to enjoy things – although there may be enough good days to convince you there’s nothing wrong beyond a lack of parenting skills. But PND isn’t anyone’s fault and you can’t just pull yourself out of it at will.

What to do
Talk to someone you trust. It could be your partner, friend or relative, or a healthcare professional. Talking about your negative emotions will soon show you that you’re not the only one who has ever felt like this.

In many cases, rallying your family and getting more support can really help. It will give you more time to yourself as well as with your partner.

Try to get enough rest and make an effort to eat a balanced diet. Your brain needs feeding as much as your body. Eating carbs often (small portions every three hours) can help keep your mood on an even keel.

Most importantly, avoid blaming yourself – PND is not your fault.

Seek help
Most women with PND need the help of their health visitor or GP. Your health visitor may ask questions to evaluate your risk of depression, but the Edinburgh Questionnaire, though useful, doesn’t diagnose PND. Diagnosis is usually made through talking to you and it may take more than one appointment.

Once PND is diagnosed, you are likely to be offered treatment such as counselling. This could be informally with your health visitor or GP, or with a counsellor attached to your surgery or to a clinic or hospital.

One psychological technique that can help is cognitive behavioural therapy (CBT) which can improve your thinking and moods. Your GP will be able to tell you what’s available in your area, and how soon.

Some women, especially if they’re severely depressed, benefit from drug therapy. Antidepressants aren’t addictive and can make a real difference to your wellbeing. Different antidepressants suit different people, and some are safer for breastfeeding mums. Your doctor will prescribe one that’s best for you, so talk through the options. Usually such drugs are taken for six months or more, and used alongside counselling.

A few mums delay getting help as they’re afraid their baby could be taken away from them, but this almost never happens. The bottom line is that you owe it to yourself and your baby to get treatment. It may take some time but you should soon feel like your old self again. 

•Dr Carol Cooper is a GP, broadcaster and author, and tutor at Imperial College School of Medicine.

Expert advice
• The Association for Post-Natal Illness Call 020 7386 0868 or visit www.apni.org
• The Royal College of Psychiatrists For information on PND visit www.rcpsych.ac.uk