‘Postnatal illness is a chemical imbalance that stems from pregnancy and delivery’, says Diane Nehme, secretary of the Association for Post Natal Illness (apni.org). ‘Some think it’s due to the huge hormonal changes your body undergoes, while others think it’s down to the physical and emotional stress of looking after a new-born baby. The only thing we can say for certain is that it’s a depression that’s entirely related to pregnancy’.

PND affects one in 10 women and usually develops in the first four to six weeks after in childbirth, but can sometimes appear after several months. The main symptoms are a persistent sadness, a loss of interest in the world around you, anxiety, a lack of energy, poor concentration, low confidence and guilt.

It’s important to remember that post natal depression is an illness: it’s not your fault, you’re not alone and you will recover.

‘Postnatal illness is a chemical imbalance that stems from pregnancy and delivery’

‘Postnatal illness is a chemical imbalance that stems from pregnancy and delivery’

Treat it: the most important thing you can do is recognize you have a problem, so get your PND diagnosed by your GP. Here’s what you can expect to happen:

§  Your doctor will ask you a series of questions to identify whether it’s PND and may also perform a blood test to make sure there’s nothing physical to blame for your lack of energy and low mood, such as anaemia or an under-active thyroid.

§  Antidepressants are often prescribed, as these work by balancing mood-altering chemicals in your brain, so can really help you to get back on track and start enjoying motherhood. They take between two and four weeks to start easing symptoms and it’s vital that you take the whole course or the depression may return.

§  Cognitive Behavioural Therapy (CBT) is available on the NHS and is really useful for PND. Your doctor can usually provide up to six sessions. CBT helps sufferers challenge the way they think and replace those worries, anxieties and lack of confidence with positive thoughts, helping them feel they can cope with motherhood.

Signs of PND

If you answer ‘yes’ to one or more of the following, you should see your GP:

1.    Do you generally feel sad the majority of the time?

2.    Do everyday tasks seem like huge mountains to climb, and you either have no energy or simply cannot be bothered?

3.    Do you feel like everyone else is thrilled by your new baby but you’re not fussed about him/her? Do you feel like you’ve ‘disappeared’?

4.    Are you anxious about everything and feel guilty that you are a bad mother?


‘Grief is the normal and natural reaction to loss; unlike depression which is an illness that can have a physiological cause’, says Carole Batchelor, MD of Grief Recovery UK (griefrecoverymethod.co.uk). ‘Doctors often believe people should recover simply because time has passed, and if they don’t they’re labeled “depressed” and medication follows. But, unless the grief is resolved, nothing is likely to be successful’.

You can’t put a time limit on how long it takes to get over losing someone, and grief doesn’t just morph into depression, so it needs to be treated differently. Also, grief isn’t just limited to losing a loved one. Grief Recovery UK has identified over 40 life the death of a pet, divorce, and even the failure to achieve a long-held dream.

‘Grief is the normal and natural reaction to loss; unlike depression which is an illness that can have a physiological cause’

‘Grief is the normal and natural reaction to loss; unlike depression which is an illness that can have a physiological cause’

Do you need help for grief?

If you’ve suffered a loss and answer ‘yes’ to any of these questions, think about seeking help:

1.    Do fond memories lead to painful thoughts and feelings?

2.    Do you find yourself ‘what events in a never-ending loop?

3.    Do you feel guilty about things you had no control over?

Treat it: don’t mask your grief, or expect it to simply fade with time ask for help.

§  Ask your GP for a list of your local grief counselling services.

§  Contact Grief Recovery UK (see above), whose methods to target loss can relieve sadness and teach strategies to help you cope.

§  Turn to the charity, Cruse Bereavement (crusebereavementcare.org.uk), which provides a phone line and branches around the UK where you can go for support and practical advice.

§  Speak to your employer many provide help and/or counselling for bereaved employees.

Seasonal affective disorder (SAD)

We all feel a bit how on a gloomy winter morning but, for some, the lack of daylight causes a biochemical impalance in the hypothalamus, the part of the brain that controls mood, sleep and appetite. As daylight hours shrink, SAD sufferers lack energy, sleep badly and feel down.

Treat it: your GP may suggest standard depression treatments such as counselling, CBT or even antidepressants, but as the cause of SAD is a lack of bright light, the best solution is light therapy.

Seasonal affective disorder (SAD)

Seasonal affective disorder (SAD)

Seasonal Affective Disorder expert Dr Lance Workman suggests:

Chasing the sun: head out of a 30-minute walk at lunchtime every day and get a light box. Visit sad.org.uk for advice on which lamp to buy and how to use it. and swap your main holiday to mid-winter to get two weeks of ‘real’ sunshine on a beach or even the ski slopes.

Taking supplements: you can’t enough vitamin D3, which can enhance mood, from sunlight and food alone through winter.

Eating brighter: eat more raw fruit and vegetables, soya and brown rice and cut down on protein, red meat, caffeine and alcohol. Also, make sure you get plenty of omega-3s from oily fish, nuts and seeds, as this type of diet may reduce the risk of SAD.


If you’re suffering low mood, with no obvious trigger, there are a few possible causes. One is dysthymia, which is a mild but ongoing low mood. ‘Unlike more severe forms of depression, sufferers manage to get on with their daily life, but lack energy, have low self-esteem and feel sad’, says Dr Layla McCay, assistant medical director at Bupa. Another cause could be an underactive thyroid. The main symptom is often low mood, muscle aches, weight gain and lack of concentration. It can be spotted with a blood test. The other cause is simply depression – no fancy name, nothing that would show up in a blood test, no trigger just an illness that can strike anyone, at any time.

Treat it: treatment depends on the severity of your illness.

Many people have difficulties with SAD, and/or mild depression.

Many people have difficulties with SAD, and/or mild depression.

Mild or dysthymia

Lifestyle changes can help. Your GP may recommend exercise – she can refer you to a PT or give you access to your local gym, and may also recommend a local support group.

Mild to moderate

You can benefit from talking therapy. The best options are: Interpersonal therapy, which focuses on your relationships with family, friends, partners and colleagues; online CBT, where you talk to a qualified therapist remotely; or counselling, where you talk through problems with a counsellor at your doctor’s surgery. The NHS offers up to 12 weeks.

Moderate to severe

You may need a combination of the above alongside antidepressants. There’s a huge range available and they’re not addictive. You usually feel better after four to six months, but people who suffer ongoing, severe depression may continue using them for five years or more.

Depression checklist

Concerned you may be depressed? If you experience four or more of these symptoms for more than two weeks, talk to your GP.

§  Tiredness

§  Prolonged sadness

§  Low self-esteem

§  Poor concentration

§  Anxiety

§  Avoiding friends and family

§  Feeling helpless or hopeless

§  Poor sleep

§  Difficulty functioning at work

§  Feelings of guilt or worthlessness

§  Loss of appetite

§  Loss of sex drive

§  Suicidal thoughts

§  Self-harm

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