Expert advice from Milli Hill, author of The Positive Birth Book, on the signs to watch out for if you think you or someone you know might have postnatal or postpartum depression

The transition to motherhood can be tough. I defy any woman to say she was not blind-sided by the overnight, overwhelming transformation to her life when she had her first baby.

It’s normal to feel this way, but while some may get a buzz from their new sense of purpose, others have mixed feelings, and around one in 10 will develop postnatal depression, also known as postpartum depression, or PND.

The baby blues
Many women experience low mood or feel tearful, often around the third or fourth day after the birth, which is usually when your milk also comes in. It’s normal to feel this way, as not only is there a lot going on with your hormones at this time, you’re also probably just settling back down to earth after your birth experience, and taking stock of your new situation as a 24-hour carer of an utterly dependent creature! Not easy, and totally normal to feel emotionally a bit all over the place.

Postnatal depression
For some women, however, the blue feeling may lift but then return with greater strength, or simply persist and worsen. If this happens to you, you may have PND.

Like all mental health issues, there is often a stigma with postnatal depression, perhaps made worse by the fact that early motherhood is widely publicised as a time of great joy and fulfilment.

For those who do not find this to be their experience, or who even have negative thoughts about the baby they are presumed by others to be doting on, it can be hard to speak out. However, the help and support is out there, so if you think you may be suffering, take heart, and read on.

Firstly, it’s helpful to know the signs of PND, for example:

• Always feeling sad or low and being unable to find the positives
• Not enjoying life, and not being interested in anything
• Feeling like you are not bonding with your baby, or interested in them (however, you can be depressed and totally in love with your baby, too!)
• Feeling isolated from others, or not wanting to make contact with others
• Thoughts that worry or upset you and are unwelcome or involuntary, for example, thoughts of harming your baby (these are sometimes called ‘intrusive thoughts’)

You may also feel tired a lot or have trouble sleeping, but of course this is quite common for all new mothers! However, getting some rest can be very helpful to your mental health, so, if you feel your sleep deprivation is affecting your mood, try and get some support. Have a few hours sleep while your partner or other family member looks after your baby.

Who gets PND?
Anyone can get PND. If you have had any previous history of depression or other mental health issues, or have family members who have experienced depression, you may be more at risk.

You may also be more likely to become depressed if you have a lack of support from friends and family, if you have issues in your relationship with your partner, or if you have gone through a difficult life event, such as a bereavement.

However, you can still get PND if none of these things apply to you, and if you had a positive birth experience.

How to get help
Sometimes PND happens so gradually that it is hard to recognise in yourself, and it is your partner or other people in your life who express concern about you. If you or those close to you think you may have PND, speak to your doctor or health visitor.

Most health professionals are well trained in the signs of PND, and what to do to help you. If you are advised that what you are experiencing is ‘just a phase’, the ‘baby blues’ or that you should ‘focus on your healthy baby’, get a second opinion, or contact one of the PND charities or support networks.

Try the organisation PANDAS or #pndhour on twitter. Generally, the sooner you get help and support with PND, the better.

How is PND treated?
There are many ways to move forward and out of the ‘long dark tunnel’ of PND, including:
• Antidepressant medication
• Talking therapies like CBT, counselling, and psychotherapy
• Self-help methods such as running, resting, healthy eating, time out for an activity you enjoy, meditation and mindfulness, and more support in the home.

Have you had experience of postnatal or postpartum depression? Tell us how you got through it on the Supernanny Facebook page.