Post-natal depression - don't suffer in silence

2. The very common condition of Post-Natal 'blues', which is a brief period of emotional distress, occurring between the 3rd and the 10th day after you have given birth, is thought to affect 50-80 per cent of all women - in some way - and stretches across all cultures and social groups.

The symptoms are attributed to the sudden change in hormonal balance that occurs following childbirth, and as soon as this manages to sort itself out, the symptoms settle.

Treatment is not usually needed but you may find some helpful advice in our article Beating the baby blues.

3. Post-Natal Depression (PND) means 'becoming depressed after having a baby'.

This condition is not usually related to any 'obvious' cause associated with childbirth - although most of those who do suffer the condition are experiencing what is certainly a common complication of childbirth.

Sometimes this may be easy to explain - the baby is unwanted or is 'abnormal' in some way. Mostly though, the depression makes no obvious sense: 'I was so looking forward to having this baby, and now I feel utterly miserable'.

PND can affect one in every ten women who do suffer an emotional disturbance after childbirth. It can happen to anyone, and is certainly not a sign of 'weakness', as so many people think.

It can vary from a very mild illness to a very severe one. It does not lead to 'madness', again, as so many people think. Many women still suffer in silence, quite unnecessarily, from the symptoms of this most common complication of childbirth.

PND can go on for months, sometimes years, and can appear at any time in the first year after the birth, though usually within the first four months.

The symptoms may resolve themselves spontaneously over this period of time but they will be shortened and rendered less severe if treatment is initiated. Studies have also shown that if treatment is not given, some disturbing symptoms can continue for several years.

There are very recognisable symptoms which are:

• Depression: the most common - feeling low, unhappy, and wretched. Sometimes the depression is stronger at certain times of the day. Some days are good, some are bad - a feature which, itself, can be upsetting.
• Irritability: resentment or anger often accompanies the depression. Sometimes shown to the new baby but more often to the partner, who just 'cannot understand what is happening'.
• Fatigue: this is quite different to the accepted tiredness of a 'new' mother. The depressed mother becomes really exhausted during the day.
• Insomnia: Despite the feeling of exhaustion, the mother finds that she cannot sleep when she does go to bed - or even if she does, there can be early morning waking.
• Loss of Appetite: Often presenting as a 'lack of interest' in food and eating. This feature can, of course, add to the general symptoms of feeling 'low'.
• General features of 'not coping', anxiety and loss of enjoyment: PND can develop even when there is a great maternal love - but then there is the accompanying development of a great unwarranted anxiety towards the baby, and the general handling of the infant. There may even be exaggerated concerns about disease and sudden infant death, in some way.