As common as occurring in two-thirds of women, the blues hit in the first week after delivery, and are usually short lasting, and can be resolved spontaneously within a few days to weeks.

Symptoms of postnatal blues:

Postnatal blues are more commonly seen among firsttime mothers who have no previous  experience with motherhood, and those with poor support.

Most mothers with ‘the blues’ do not need medical attention, and can benefit from the support, encouragement and reassurance from loved ones. This is because the symptoms are usually short-lasting, and are not severe.

However, if their symptoms persist longer than two weeks, they should seek further advice from their doctor, as it is then likely that they may be suffering from postnatal depression.

 

Between ten to fifteen percent of the recently delivered women will develop postnatal depression. Postnatal depression usually develops within the first three to six months after delivery, although it may have a delayed onset anytime during the first year after delivery.

Some of the symptoms you may experience include low mood, irritability, poor sleep, tiredness and a loss of interest in activities, or in severe cases, even thoughts of dying. Bodily symptoms such as aches and concurrent anxiety symptoms are also common, as are negative feelings towards the baby.

Early detection and treatment are also crucial for depressed mothers as the development and well being of the child can be hampered.

Depressive illnesses can range from mild to severe. Severe depression affects about three to five out of a hundred mothers.

The symptoms of depression include:

•	Low mood, irritability, tearfulness
•	Poor sleep and appetite (or comfort eating)
•	Loss of interest
•	Loss of confidence, and feeling guilty for no good reason
•	Feeling hopeless or even suicidal in severe depression

Often, there is accompanying anxiety symptoms, such as:

•	Feeling tense
•	Palpitations, feeling breathless, chest tightness
•	Panic attacks - strong feelings of terror that come suddenly
•	Excessive worries

Some women also have obsessional symptoms, such as:

•	Intrusive unpleasant thoughts about harm coming to your baby or family.
•	Irrational fears of dirt and disease, leading to urges to clean or wash repeatedly.

The symptoms usually start soon after childbirth, but are often unnoticeable until two to three months after delivery. The symptoms may vary a lot.

Like antenatal depression, there are usually many factors that contribute to the development of postnatal depression woman: hormonal, biological, psychosocial and emotional changes.

Some of the causes for postnatal depression are:

If you have had past episodes of depression, whether if they were related to childbirth or not, or if you have a family history of depression, you may then have a higher risk of postnatal depression.

If you suffer from mild depression postnatally, you can recover with support and counselling, which may be provided by your family physician, or family and friends. However, if your depression is at least of moderate severity, you should consult a specialist for treatment.

If postnatal depression is left untreated, it can persist and worsen, and affect not only your well-being, but also the emotional and cognitive development of your infant. If you are depressed, you may see yourself as a bad or unloving mother, as your symptoms make it hard for you to care for your baby. You may also bear negative thoughts, and excessive self-blame and guilt which will then affect the bonding process and relationship between you and your child. Thus, receiving help early is beneficial.

Psychological treatments shown to be useful in postnatal depression include interpersonal therapy which focuses on interpersonal relationships, and cognitive-behavioural therapy which addresses faulty thinking and patterns of behaviour.

Many women suffering from postnatal depression have also found support groups to be particularly useful, as they provide an avenue for them to talk about their difficulties, learn coping strategies from one another, and benefit from the realisation that they are not alone in their pain.

When the depression is more severe, medication will be required. The choice of medication will take into consideration the possible side effects as well as your particular needs, especially your need to breastfeed. There are certain medications that may be used if you wish to continue nursing.

If you are pregnant and have had depression during your last pregnancy, we recommend that you seek early advice. If the previous episode of depression has been particularly severe, we advise you to consider taking prophylactic antidepressants as the risk of a relapse during a subsequent pregnancy can be as high as fifty percent.