Postnatal depression is an illness that you can get after having a baby. You may feel sad and anxious, and find it difficult to look after your baby. Feeling this way at a time when you are supposed to be happy can make you feel guilty too. The good news is that there are treatments that can help you feel better.

Postnatal depression feels a lot like the depression you can get at other times of your life. The only difference is how it affects your feelings about being a mother and your ability to care for your baby.

You are most likely to get postnatal depression in the first three months after your baby is born. But you can get it at any time during the first year. If you have postnatal depression, you may:

*Feel low and anxious

*Lose your interest in your life and stop enjoying it

*Have changes in your appetite (for example, not feeling hungry and losing weight)

*Feel agitated

*Have a hard time sleeping, even when your baby sleeps

*Feel 'slowed down'

*Feel tired and not have any energy

*Feel worthless or guilty

*Find if hard to concentrate or make decisions

*Think about death or killing yourself.

These are the symptoms of bad depression you can get at any time. Postnatal depression may also make you feel:

*Overwhelmed by your baby's needs

*Unable to cope or care for your baby properly

*Trapped and wanting to get out

*Angry at yourself and others, including your baby

*Alone and unable to tell anybody how you feel

*Afraid or panicky

*Despairing and hopeless

*Like you are losing your mind

*Like you might harm your baby.

The feelings you get with postnatal depression are different from those of a condition called the baby blues. The baby blues are changes in mood that many women get about four or five days after their baby is born. Baby blues usually go away by the 10th day after giving birth.  Another, more serious illness that a very few women get after they have a baby is called puerperal psychosis. This illness usually starts in the first two weeks after birth. These women get bad anxiety and feel upset and agitated. They may also think about harming themselves or their baby.

What will happen to me?

If you have postnatal depression, we can't say exactly when you will start to feel better. It depends on how bad your depression is and whether you get help.

Most women get back to normal by the time their baby is 6 months old. But about 1 in 4 women are still depressed by the time their baby is 1 year old. And some women still have problems three years after that.

If this is the first time you have been depressed, you are more likely to get better quickly than if you have had depression before. Postnatal depression usually goes away on its own. But if your doctor thinks you have it, he or she may suggest treatments. The main ones are antidepressant drugs and talking treatments (psychotherapy). They may help you feel better faster.

You may not want to take drugs for postnatal depression, especially if you are breastfeeding your baby. But talk to your doctor about the risks and benefits. Bad depression that goes on for a long time can harm your baby and your partner as well as yourself.

If you have postnatal depression, it may lead to:

*Difficulties in bonding with your baby

*Problems with your baby's development

*Problems with your marriage or partnership

*Depression in your partner

*Suicide, but this is rare.

Treatment for your postnatal depression can improve your relationship with your baby. It may also help your child's development. If you have postnatal depression, there is a chance you will get it again in a later pregnancy. If you get postnatal depression diagnosed, your doctor will know to watch for it next time.

How do doctors diagnose postnatal depression?

It is not always easy to diagnose postnatal depression. There are several reasons for this.   

*It can be confused with a common condition called the baby blues.

*Some of the warning signs, such as weight loss, sleep problems and exhaustion, are a normal part of being a new mother.

*Women are often reluctant to talk about their feelings because they worry that other people will think they are bad mothers.

But it is important to see your doctor early on if you think you may be depressed. There are treatments that may help you get better faster.

Here are some things your doctor might do to help work out if you have postnatal depression.

Tests your doctor might do

There aren't any physical tests for postnatal depression. But there are questionnaires that doctors, health visitors and other health professionals can use to help spot postnatal depression.

The most popular questionnaire is called the Edinburgh Postnatal Depression Scale (EPDS for short). If you are a new mother, you may be asked to fill in this questionnaire six weeks after your baby is born, and again after three months. The higher your score, the more likely you are to have postnatal depression. So if you have a high score, you will be sent to your doctor to see if you have the illness. This questionnaire is a kind of screening. With a screening, a doctor, nurse or other health professional tests everybody to see if they might have a condition. That means testing you whether you have clear symptoms or not.  Your doctor may also offer you a blood test to check for problems with your thyroid gland. You are more likely to get thyroid problems in the weeks and months after having a baby than at other times. Problems with your thyroid gland can affect your mood.

What treatments work for postnatal depression?

If you have just had a baby and have felt low and sad for more than a couple of weeks, you may have postnatal depression. This illness is quite common, especially in the first few weeks after giving birth. You may think it is up to you to 'pull yourself together.' You may even worry that you're a bad mother. But having postnatal depression is not your fault.

Postnatal depression usually goes away on its own. But it can last for a while. That can be harmful for you, your baby and your partner. The good news is that there are treatments that can help you feel better sooner. There are several treatments to choose from. Talk to your doctor about which ones are right for you. Some antidepressant drugs are likely to help get rid of your depression. But they get into your breast milk. You may wish to discuss with your doctor whether they are safe to take if you are breastfeeding.