DEALING WITH POSTNATAL DEPRESSION Ten to 15 percent of women will develop postnatal depression in the months after the birth of a baby. Depression may also start during pregnancy, and, if untreated, continue and perhaps get worse after the baby is born. During this time mothers may experience depression and feel tearful and sad. This may prevent them from thinking clearly and result in feelings of failure and inadequacy as a mother. This normally happens in the first month after the birth of the child and most of the time mothers are not even aware that they are experiencing PND(Postnatal Depression). What causes PND (Postnatal Depression) The reason behind postnatal depression has been linked with many things like hormones, stress, exhaustion etc but it is difficult to actually link it with any of these factors. It is difficult to say why women get it and also who will get it. It seems likely that PND (Postnatal Depression) is related to the huge hormone changes, which take place at the time of giving birth, but this evidence is still lacking. Levels of oestrogen, progesterone and other hormones to do with reproduction, which may also affect emotions, drop suddenly after the baby is born, but no real differences have been found in the hormone changes of women who do and do not get PND(Postnatal Depression). Some women, though, may be more vulnerable to such changes than others. Symptoms Depression This is the most common symptom of PND (Postnatal Depression). During this time a woman feels low, unhappy and tearful all the time. Sometimes the depression is worse at particular times of the day, like mornings or evenings. She becomes emotional and tearful for no reasons at all and also harbours a feeling that noone takes care of her. Irritability Irritability is mostly caused due to frustration and depression. Irritability is often taken out on near and dear ones, for example, other children, and occasionally the baby, but most of all the husband, who may be quite taken by surprise and wonder what on earth is wrong! Exhaustion All new mothers get pretty tired and weary, but the depressed mother is so utterly exhausted that she may think that there is something physically wrong with her. Sleeplessness This is a condition, which is also experienced by women who suffer from PND (Postnatal Depression). Even if she is exhausted and sleepy but as soon as she hits the bed she just can't go to sleep - or if she does, she wakes up early, even if her husband is feeding the baby that night. While it is usual for mothers to have their sleep interrupted by a waking baby, women with postnatal depression often find they cannot sleep even when the baby is settled. For example, they may lie awake worrying about the next feed or the next day. Loss of appetite Loss of appetite is the first thing that is experienced by women who experience PND(Postnatal Depression). During this time women don't feel like eating anything and though they are concerned about the baby's health but it is quite difficult for them to eat. Some women will have increased appetite, often without taking any pleasure in eating. Loss of zest What used to be a pleasure is unappealing, what used to be of interest is a bore. This may be especially true of sex. Some women regain interest in sex (if they ever lost it) before the 6 weeks post-natal examination, but PND (Postnatal Depression) usually takes any enthusiasm away. The partner who seeks to share the comfort and excitement of intercourse meets reluctance or a rebuff. This puts further strain on the relationship. Anxiety Mothers often experience anxiety because of a number of reasons. The mother worries desperately about the child in case she should lose her precious baby through infection, mishandling, faulty development or a 'cot death'. She frets over how much weight has been (or not been) gained; she is alarmed if the baby is crying or if it is too silent - has it's breathing stopped? So there are number of small things that keep her on her toes and adds on to her anxiety list. A few do's and don'ts DON'T try to be a superwoman: having a baby may be a full-time job, so try to reduce commitments during your pregnancy. Don't bother too much about household chores. (If you are at work, make sure you eat nourishing food and don't tire yourself out. Try to put your feet up during lunch time.); DO make friends with other couples who are expecting or have just had a baby. This will help you clear your doubts in many fields and also provide you some support. DO make friends and keep close contacts with friends. This is very necessary since you will need a friend to whom you can speak with and confide in. DO take plenty of rest once the baby has arrived. Try to learn the knack of catnapping. You can ask your husband to bottle-feed the baby at night so that you can take rest at a stretch. DO get enough nourishment. Healthy foods like salads, fresh vegetables, fruit, fruit juices, milk and cereals are all nice, packed with vitamins and don't need much cooking. DO find time to have fun with your partner. Try to find a baby sitter and get out together for a meal, a show, to see friends or just visit to the pub; DO let yourself and your partner be intimate, even if you don't yet feel like sex: at least kiss and cuddle, stroke and fondle. This will comfort you both and lead all the sooner to the return of full sexual feeling. DON'T be afraid to ask for help when you need it. There is help out there for you so feel free to discuss about your problems with your doctor. Risk Factors in Postnatal Depression There are a number of risk factors, which increase the chances of developing postnatal depression. These symptoms if not treated at the earliest can develop into severe complications. Risk Factors Before Pregnancy/Birth - past history of depression or other mental health problem - tension in relationship with husband - having little social support - feeling depressed during pregnancy - having financial tensions Risk Factors Related to the Birth - birth complications, such as caesarean delivery - birth of a handicapped or ill baby. Risk Factors After Birth - feeling depressed and neglected - persisting postnatal "blues" - not wanting to hold the baby or having negative thoughts about the baby - experiencing sleeplessness - cannot cope with the baby's demands - finding difficulties feeding the baby What is most important is to identify the cause of postnatal depression and which are the symptoms that are present through pregnancy, birth and afterwards, as then only it will be possible to give her proper treatment and solve her problems. The husband, doctor or anyone involved with the treatment has to remain alert for signs of any developing depression. This is particularly important as the weeks and months following the birth are a critical time for both mother and baby to establish a good bonding relationship. A long period of depression can ruin this and cause turmoil in the whole relationship between the mother and the child as well as the couple.