You have a beautiful new baby, you’ve recovered well from the birth, but you feel low, you can’t sleep, and find yourself crying for no reason at all.

It’s understandable: you’re physically and emotionally exhausted, after all, and getting to grips with the reality of looking after a baby. But some mums – anything from one in ten to around half, depending on which survey you read – have the more serious problem of postnatal depression, or PND.

More than the baby blues

This isn’t the same as the “baby blues”, which the majority of mums experience in the first few days after the birth, often coinciding with the day their milk comes in.

• Postnatal depression starts in the first weeks or months of a baby’s life, and lasts much longer than the baby blues.
• Post natal depression symptoms include exhaustion, loneliness and isolation, low energy levels, extreme mood swings, sadness, aggression, irrationality, being neurotic, feeling anxious, and even thoughts of or actual self-harm or harming the baby. 
• You may feel overwhelmed by everyday tasks, and some mums find it difficult to bond with their baby.

The expert says

Elaine A Hanzak, a leading authority on postnatal depression (www.hanzak.com), says: “Often mums suffer needlessly because they think their low mood and difficulty in functioning after the arrival of a baby are ‘normal’. Do not ignore it. There is no need to feel ashamed about it, it is not a sign of weakness, and you are not a bad mother. You are unwell.”

If you suspect you are suffering from PND, talk to your GP or health visitor as soon as you can. There is lots of help and support available, including medication, counselling, support groups, or self-help methods.

A mum's view

Mum of one Bernadette, says: “I could remember how I felt before the baby was born so knew that I wasn't right. A last straw scenario finally forced me to make an appointment with my GP and then it was straightforward to get help. If only I had realised earlier that I only had to ask for it.”

It is often those close to the mother who notice something is not quite right. Dads should look out for symptoms of depression which include:

• Extreme changes in behavior
• Obsessive habits such as checking the baby repeatedly
• Not wanting others to hold or take the baby
• Extreme tearfulness, expressing feelings of being a failure, or not wanting to leave the house or get out of bed.

Mum-of-two Maddy, who was diagnosed with PND when her first child was seven months old says: “My partner noticed before I did that something was wrong - I didn’t actually feel depressed. But I had slowly become more and more anxious and angry, and was obsessive about my daughter’s routine. After I hugely overreacted to something at a family dinner, my partner called my health visitor and GP. I just wish I’d acknowledged earlier that something wasn’t right.”

If you are a dad and suspect your partner is showing signs of PND:

• Offer plenty of emotional and practical support.
• Find out more about the condition and encourage your partner to talk to health professionals.
• Don’t take it personally or accuse her of being lazy: she is ill and needs help to get better.

There are many possible causes of PND, including:

• Hormonal changes
• A family or personal history of depression
• Traumatic birth experience
• Stresses in the last three months of pregnancy such as bereavement, moving house; or marital or family conflicts.

So is there anything you can do to avoid it?

Elaine Hanzak suggests the best thing you can do is be kind to yourself: “We put great pressures on new mothers to be slim, active and possibly working again within months of giving birth, with a perfect home and content child. This simply isn’t the reality and we set ourselves up for feelings of failure."  Try these tips to help you cope.

Tips to cope with PND

How to look after yourself and get the support you need:

• Ask for help, and delegate as much as you can.
• Take time to rest and for 'me time.'
• Eat a good diet.
• Get some fresh air every day, and take gentle exercise.
• Keep talking: to your partner, friends, family, other new mums, your health visitor or GP.

If you have a history of mental health problems or have suffered PND with a previous baby, seek help before the birth and put plans in place for maximum support in the early weeks to ease your worries.

Postnatal depression counselor Lisa Tanner adds: “Please don’t suffer in silence. Ask for help as soon as possible, as the sooner PND is detected, the sooner it can be treated.”

Above all, remember that it is not your fault, you are not alone and you will get better.

Where to get help:

• Speak to your health visitor and/or GP first
• The Association for Postnatal Illness (APNI): http://apni.org/ or call 020 7386 0868
• There are also many books and websites for information and support, including Elaine Hanzak’s ‘Eyes without Sparkle – a journey through postnatal illness’. (Radcliffe, 2005).
• www.mothersvoice.org.uk offers support and information to anyone affected by postnatal depression. You can chat online anonymously.

Puerperal psychosis

This is the most extreme form of mental illness after the birth of a baby. It’s very rare, affecting just one in 500 newly-delivered mums. Symptoms include hallucinations, agitation, confusion and even urges to harm yourself or your baby. It is frightening for everyone involved, and it is important to get urgent medical help. For more information go to http://www.puerperalpsychosis.org.uk/

Book release

“The Mother of All Journeys: Coming to terms with having a baby”, by Helen Bells, is a compelling account of her struggle to cope with pregnancy, postnatal depression and motherhood.

The poignancy of the book centres particularly on the fact that the author felt like an outcast who had nothing in common with other pregnant mothers and new parents. How could she feel so low when everywhere around her were books and "experts" telling her how wonderful motherhood was and how overjoyed she should be feeling?

With the support of family, friends and a long-suffering husband, this young woman is a happy, caring mother of a beautiful son who is loved unconditionally. And she is back to normal.

Helen hopes that sharing her experiences will help others in similar circumstances and show them that there is light at the end of the tunnel.

More information about the book and the author can be found at www.themotherofalljourneys.co.uk