Post-natal depression - don't suffer in silence

We really don't know very much about why PND develops. It is probably more likely to be quite a complex condition, with not one single cause - but with many 'casual' associations and stresses which all act together during the post-natal period.

Certain 'risk factors' have, however, been acknowledged and these, acting together, may include:

• A previous history of emotional problems, depression during pregnancy, especially PND (one study showed 50-60 per cent chance of recurrence in theses cases).
• Accumulation of general upsetting incidents like bereavement, housing or financial problems, employment issues, relating to the partner.
• Lack of general support and encouragement from the partner.
• A sick baby (prematurity or developmental abnormality).

However, in many instances, PND can develop when none of these features apply and the condition is unexpected and unavoidable.

It is important that it is recognised. Some mothers are ashamed to admit that they are less than thrilled by new motherhood. The fact is, motherhood, even for those who find it uncomplicated, is a new role and one that has to be learned like all others.

So, don't worry that you don't feel confident about everything. There is a learning process. It may help to talk to other new mothers who are coping with post-natal depression. Meet some on our message board.

A great deal can be done, but the first step towards recovery is an acceptance of the PND as an illness - an illness that does need professional help to be treated promptly and efficiently.

Some mums do find this difficult, I know. However, trying to avoid this available help and 'waiting for the condition to settle' is not a good idea. It must be said, too, that some medical attendants just overlook or even ignore it: 'Oh, that's just the Baby Blues.'

Nowadays, fortunately, there is a general awareness of depression in general and PND should be missed less often.

Doctors don't always dismiss patients who have emotional problems just by giving them a prescription. However, sometimes anti-depressant drugs will help a lot and the medication is certainly appropriate, and necessary.

The specific anti-depressant drugs used for the treatment are extremely successful and can be life saving.

It is important to realise, however, that this form of medication does have a frustratingly slow rate of onset and good effect - up to 2 weeks - and it is necessary to continue with the drugs for many days before any improvement at all is felt.

Side effects to the prescribed medications, like fatigue and drowsiness, may also appear for a short time, and these are added to similar symptoms already present within the illness and can be somewhat frustrating to those who are suffering.

The benefits, however, will eventually far outweigh these added features and a great deal of encouragement, from all of those around is certainly needed. For your reassurances I would add that these drugs:

• are not 'tranquillisers' or 'pep' pills
• are not addictive
• do not stop you breast feeding
• do need to be continued for at least 6 months after the depression has lifted to reduce the risk of a relapse.

It is very sad that we just do not know enough about PND to be able to prevent it in the first place.

It is also so upsetting that this illness can come along, unexpectedly, and prevent you enjoying a most glorious time in your life. So, do remember, we can help, and most importantly: don't try to keep it to yourself.