Parenthood has its ups and downs for everyone - but what happens if the downs become overwhelming? Your Family looks at where you can turn for help

You've just become a mum and have a beautiful, healthy baby. Everyone says that you must be delighted - so why are you feeling so low? Although it may feel like it, you're not alone - thousands of parentes have these feelings. For some it's a simple case of baby blues, while for around one mum in ten these feelings may be a symptom of post natal depression (PND).

It's normal to feel tearful, irritable or overwhelmed in the first days of your baby's life. Around half of all new mums get the 'baby blues' two or three days after giving birth, but this is different from post natal depression (PND). The blues make you tearful and irritable, one minute happy, the next weepy, but these feelings usually go by the 10th day after childbirth. They are caused by exhaustion after labour and hormone surges, but you don't need medical treatment, just support, reassurance and rest.

Unlike the baby blues, PND usually kicks in four to six weeks after the birth, but can strike immediately or much later, at any time up to a year after childbirth. Usually, it tails off after six months, although some women still have symptoms for a year or more. Nobody is sure what causes it. Some doctors think it is to do with hormone inbalances, others disagree. You are certainly at greater risk if you have a history of depression, if the pregnancy was unplanned or the birth traumatic, but any woman can get it and there is often no obvious reason. You may have all the ingredients for happiness ­- a loving partner, financial security, a straightforward pregnancy - but still get PND.

The first year in your baby's life is a massive period of adjustment and many women find this time extremely challenging, even those who have always wanted children. They struggle with their loss of freedom and increased dependency on their partner. They feel isolated by life with a baby. It's no wonder some women feel depressed. 'People often get depressed when they come across major life changes, like a new job or bereavement. They feel inadequate to the demands placed upon them. This can happen post natally, too,' says Heather Welford, author of the National Childbirth Trust's book Feelings After Birth.

Additional stresses like tiredness, money worries, lack of support and relationship problems can cause low feelings, as can the pressure of being a single parent or one caring for a disabled or poorly baby. 'The lack of sleep, demands of breast feeding and having no time or energy for anything other than keeping the show on the road for everyone else was hard,' says Laura, who experienced depression with Maya, now 4 and Miles, 15 months.

Technically, there is no difference between depression and postnatal depression. 'PND has the same profile as depression, it's just diagnosed post natally,' explains Heather Welford. Feeling tearful, struggling to concentrate and not enjoying anything are common symptoms, but with PND there may also be worry about the baby. You might feel anxious about its health, or guilty about lack of love for it. You may feel inadequate, comparing yourself unfavourably with other mums and may even think about harming the baby or yourself, although this rarely happens. There are many other symptoms (see below). You don't need to have all of them to have PND and they can vary in strength from day to day.

It can be hard to reach out for help when you have PND. Many mums don't recognise that they have it - they just keep waiting for their mood to lift - and even partners and family may not spot it. 'It can be difficult to tell the difference between depression and just being a mum,' says Dr Jim Bolton, Consultant Psychiatrist at St Helier Hospital in South London. 'Not getting a good night's sleep, loss of libido, fatigue - these are some of the symptoms one looks for in depression, but are also part of the normal experience of being a parent.' Melissa, who first got PND when her second child, Dylan, now 18 months, was two months old took several months to realise how poorly she was. 'I kept thinking, I'm just really tired, that's all, when the baby is sleeping better I'll be back to normal,' she says. 'It was true up to a point, but actually my unhappy feelings went beyond just lack of sleep.'

Other women are reluctant to be labelled depressed. 'Women often see having postnatal depression as proof that they are not a good mother,' says Heather Welford. They may hide their feelings instead, caring for their baby and appearing fine, but feeling miserable. They may also feel embarrassed about not enjoying motherhood - after all, this is meant to be one of life's most rewarding experiences. 'When I was at my lowest there were certain friends I avoided, because they always seemed to enjoy being a mum, no matter how tired they were,' says Rachael, who experienced PND with her first child, Jack, now 4. 'It made me feel a failure for not coping like them.'

If you feel you may be depressed, speak to your health visitor or GP and remember, it is not a sign of weakness to admit that you are low. 'The key thing is to spot it early and listen to yourself,' says Diane Nehme, secretary of the Association for Post Natal Illness (APNI). 'If you are not feeling yourself and it continues for longer than a week, go to the doctor.'

The good news is PND can be successfully treated. A GP can prescribe antidepressants, which help lift your mood. He may also refer you to a counsellor, who can help you talk about your feelings, and you might like to contact one of the support groups run by mums who have been through PND and will understand how you are feeling.

However you tackle PND, it's important to act. If you are depressed, you are less able to respond to your baby and feel attached, which can result in its development being slower. The affects can be felt long after the mother has got better, too. Research shows that children of mothers with postnatal depression - especially boys - are at increased risk of insecure attachments at 18 months and disruptive behaviour at five years. 'To brush depression under the carpet and say you're just having a bad day and the baby won't remember is to trivialise it,' says Heather Welford. The partner of a depressed mother needs to give her extra love and reassurance while she's down. He needs to listen to her feelings without being shocked and not be in a hurry for her to 'snap out of it'. He can help practically, too. 'When Carla got depressed when our baby was six months old, we decided she should always have saturday mornings off, to do what she liked, even if it was just snooze in bed,' says Jim, dad to Holly, now 14 months. 'It really helped.'

Dads dealing with a depressed partner are at risk of feeling depressed, too. 'I'm not a depressive person, but I got very stressed, trying to keep the family and my work going while I knew my wife was unhappy,' explains Mark, whose wife was depressed after their second child, Dylan (18 months) was born. 'When she was put on antidepressants by her GP I felt a failure, for allowing her to get so low. That really got me down.'

It's normal for dads to suffer, but they shouldn't ignore their feelings. Talking to friends, family or their GP is essential, or they can call the Association for Post Natal Illness which offers a support service for men. Between 70,000 and 100,000 women in the UK every year experience postnatal depression, and today, ever more people are being open about their experiences of it, including celebrities like Fern Britton and Gail Porter. In reality, only a small percentage of women experience it and for those that do, the message is positive: PND is an illness - don't blame yourself, but do get help. Mums with PND will, with the right support and a little time, make a full recovery and go on to enjoy parenting as they always hoped they would.

CHECKLIST OF SYMPTOMS OF POSTNATAL DEPRESSION
being over anxious, often about the baby - worrying unreasonably about its health
easily upset and tearful
tension and irritability, even anger
rejection of your baby or partner, feeling they are the cause of your unhappiness feeling that you are causing your family unhappiness by being around and should just disappear
feeling exhausted, but unable to sleep
feeling guilty about not being a good enough mother or not loving the baby
difficulty coping with the baby and domestic routines when previously you were managing
unable to concentrate
unable to remember anything
fear of harming the baby
thoughts of harming yourself
feeling that you should hide how you feel and put on a 'brave face'

In addition you may have less energy, disturbed sleep, poor appetite and a reduced sex drive. However, these are common and normal for a while after childbirth and on their own may not mean that you are depressed. It is normal to feel tearful, irritable or overwhelmed between the first three to 10 days of your baby's life, but this is generally just the baby blues and passes without special treatment

TOP TIPS
These steps may help to guard gainst PND, says Diane Nehme, secretary of the Association for Post Natal Illness (APNI):
1. Get some rest. Even just an hour lying on the bed while your partner takes the baby can make a difference.
2. Get practical help. Ask family members to help you with jobs like washing, cooking and cleaning in the early weeks. That way you can build your routine slowly rather than trying to take on the new role of mum and its added physical tasks straight away.
3. Take time for yourself. How you spend it is up to you - rest is advisable, but you might benefit more from being with friends, an activity like swimming or yoga or just putting your feet up while someone else cares for the baby.
4. Remember that as well as being a mum, you are also an individual with your own needs. Balancing these with the needs of your baby can be tough, but try to avoid always putting yourself at the bottom of the priority list. 

THE THREE TREATMENT APPROACHES
Dr Jim Bolton, Consultant Psychiatrist at St Helier Hospital, London, explains the three key avenues of treatment
1. Antidepressants. There are plenty that are safe to use while breastfeeding. They take two to four weeks to work and are non addictive.
2. Counselling. For most women with any sort of mild to moderate depression this can be as effective as antidepressants. It's just a question of what's available and what the woman prefers.
3. Encouraging people to get support from family and advice from others. Women often don't want to talk about their feelings, they think what they are experiencing is just part of being a new mum, or sometimes because they feel ashamed. Speaking to women who have experienced PND or just to other friendly mums is beneficial and practical help with childcare and around the house is also key.

FURTHER CONTACTS
The Association for Post Natal Illness (APNI) 020 7386 0868; www.apni.org.uk. It has a helpline, information and can put you in touch (by phone or letter) with women volunteers who have suffered depression and are now better. It also offers support for partners of depressed women.
MAMA (Meet A Mum Association) 0845 120 3746; www.mama.co.uk. A charity which provides friendship and support to mothers. It can put you in touch with existing groups or help you meet individual mums in your area. Its helpline is for men, too.

ENDS