It's normal to feel a bit down after the birth of your baby, particularly two to four days after the birth. Many women get a touch of the baby blues. Doctors suggest this may be brought on by sudden changes in hormone levels. You may feel very emotional and prone to tears, find it hard to rest and lose your appetite, too. You may feel anxious and afraid that you're not a good mother. All of this is perfectly normal.
But if these feelings persist, it's time to talk to someone. Bridget O'Connell, head of information at Mind, the mental health charity, answers some common questions.
Q. What can I do to minimise the risk of getting PND?
A. 'There is nothing you can do to totally protect yourself, but there are things that can help you manage and help you feel better if you do suffer,' says Bridget. 'Take moderate, regular exercise (getting out with your baby in the pram is ideal), and give yourself time to deal with your feelings. Accept all offers of help - don't struggle on alone.'
But remember, PND can strike anyone at any time. It's not your fault and is nothing to feel ashamed or guilty about.
Q. I had a difficult birth and went on to develop PND. Could it be because of my birth experience.?
A. As with many mental health conditions, there is no single recognised cause of PND. Bridget says, 'There is some evidence that if you've had a difficult birth you are more likely to get PND. That said, women who've had a positive birth experience can suffer too.'
Q. If I tell my health visitor I'm not coping, will she think I can't look after my baby?
A. This is a fear expressed by lots of mums who suffer from PND. Bridget says, 'Many women suffering from PND worry about their baby coming to harm, or have frightening thoughts that they may harm their baby in some way. The very fact that you are asking for help means that you are trying to do the best thing for you and your baby.'
Q. I don't want to take antidepressants. Is this the only treatment available?
A. There are lots of ways to treat PND. Counselling and psychotherapy can help, as can massage and aromatherapy. But it's important to talk to your GP, health visitor, midwife or all three, and let them diagnose you. If your GP thinks you need antidepressants, but you're worried it may affect breastfeeding, there are some that are safer to take when you're breastfeeding.
Q. My husband is showing some of the signs of PND. Can men get it?
A. They can! PND in men is a medically unrecognised condition. 'It is far rarer in men than it is in women, but it does happen,' says Bridget. 'Men also undergo big changes in their relationship and lives when a baby arrives. They may feel overwhelmed by the responsibility.' The best way to support your husband is to keep communicating and finding ways to be close to one another.
Q. I suffered from depression during my pregnancy. How will this affect my baby?
A. A new study has found that mothers who are depressed in pregnancy can have babies who cry a lot, have disrupted sleep, are clingy and may even be more prone to depression themselves in later life - which is even more reason, then, to seek help early on. Some antidepressants are safe to take during pregnancy, too.
Q. I've been to see my GP who has recommended I go for counselling, but there is a long wait. What else can I do?
A. 'There can be long waiting times,' says Bridget. 'Talking can really help during this time - talk to your partner or friends from your antenatal classes.' Organisations like Mind can offer counselling outside the NHS. Be proactive in getting help, and get your partner involved too. 'The recovery rate from PND is very good,' says Bridget. 'And women who have suffered with PND do bond with their babies. Just get help, and get it early.'