Postnatal Depression (PND) is common after child birth. When people talk about it they could mean one of three things:
Post-baby blues, a mild tearfulness lasting only a few hours or days.
Postnatal Depression, which saps self-esteem, energy and enthusiasm.
Puerperal psychosis, a severe but very rare illness which needs hospital treatment.

PND is different things to different people. Many women don't even realise they have it. But Postnatal Depression is a real condition - it is not a women's fault that she feels the way she does.

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Between four and ten days after giving birth you may suddenly feel tearful and irritable for no obvious reason. Trivial things may upset you or make you cross. More than half of all women feel like this.

The 'blues' may last for a few hours or a few days - but they are usually over by day ten, disappearing just as suddenly as they arrived. All that is required is a little tender loving care from the people around you, a good night's sleep - if possible- and some peace and quiet.

If someone you care about has the 'blues', keep things quiet as possible, do as many chores as you can without undermining her confidence and reassure her that you care. Remember, the 'blues' are short lived, but a little support may ward of postnatal depression.

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You may have PND if;
You are persistently sad. Some women feel so low that they avoid meeting other people, and some cry easily.
You feel you are the only mother who cannot cope.
You feel a failure, and feel guilty because of it.
You are anxious and irritable. Many women worry over trivial problems or world problems. Maybe you cannot leave your baby with others, yet cannot cope with the crying.
Either you can't sleep even though you are exhausted, or you endlessly crave sleep.
You are off your food. Some women nibble all day on whatever comes to hand. Others cook food for the family but can't eat anything themselves.
You can't cope with daily chores or do the most trivial tasks, such as deciding on what to wear.
You suffer a variety of physical symptoms. There may seem to be an endless stream of aches, pains and illnesses. Some women have only physical symptoms.

HOW CAN YOU HELP YOURSELF?

You can do a lot to help yourself through postnatal depression.
If you feel that you have postnatal depression, accept that you cannot carry on as usual.
Accept that your needs are important and can be met.
Build time for yourself into every day.
Seek and accept help wherever possible. Don't feel guilty asking for what you need. Professionals, family and friends can all help, as can people who have suffered postnatal depression.
Take one day at a time. Don't dwell on the past. Concentrate on the here and now. Set yourself goals, such as 'I will meet a friend'.
Eat properly. Little and often is best. Fast food does not have to be junk food. An apple and cheese couldn't be simpler.
Rest as much as possible. If you can, get help with the chores.
Do the jobs you must do in the morning. PND is often worse as the day wears on.
Write your thoughts down or make a tape recording of how you feel on a good day, to play back on your bad days and remind you that you felt better.
Talk things through with people you trust, including your doctor, health visitor or midwife.
If you wake at night, relax by doing something you enjoy, like reading or listening to music.
Try not to worry if you cannot sleep.
Reward yourself when you have done something successfully, however small.
Accept that there will still be bad days, even when you are on the road to recovery. It will take time.

If you think that someone you care about has PND, try to:
Accept that she cannot carry on as before.
Show you care. Without feeling loved, she may find it hard to get better.
Listen. Let her tell it in her own way. She may need you to listen to the same story many times before she has it in perspective.
Read her body language. There may be things she feels she cannot say.
Accept the good and the bad feelings. Saying 'You don't mean that' may make her keep that thought to herself in the future. A bad feeling, unexpressed, grows.
Do not be judgmental or dismissive. Saying 'Pull your socks up' or 'Everyone feels this way' is neither helpful nor true. She already feels guilty.
Do give time - it's your most precious gift.
Encourage her to seek professional advice if she has not already done so.
Try to find out if there is a PND support group in your local area, through your GP.
Show confidence in her. She may not believe in herself right now, but she will want to believe what you tell her.
Persuade her to give time to herself. Every mother has a right and a need for personal time.

Many women find that some form of talking therapy, combined with practical support, helps. Some feel comfortable talking to their health visitor or family doctor. Others ask their family doctor to refer them, or they refer themselves to one of a range of professionals. Psychiatrists, community psychiatric nurses, counselors, therapists or marital counselors may all help.

If you feel unable to ask for professional help, ask someone to come with you to see your family doctor.

• IF YOU THINK THAT SOMEONE YOU CARE ABOUT HAS PUERPERAL PSYCHOSIS, THEY SHOULD GET MEDICAL HELP IMMEDIATELY.
• PREPARE FOR A SLOW RECOVERY WITH THE POSSIBILITY OF REPLASPES. IT COULD TAKE A FEW MOTHS UNTIL SHE CAN COME HOME TO VISIT, A FEW MORE UNTIL SHE IS HOME FOR GOOD AND UP TO TWO YEARS UNTIL SHE IS FREE OF MEDICATION.
• REASSURE THE MOTHER THAT SHE WILL RECOVER.

Place your baby on the back to sleep from the very beginning. This will reduce the risk of cot death. Side sleeping is not as safe as sleeping on the back. Healthy babies placed on their backs are not more likely to choke.
Cut out smoking during pregnancy -fathers too, Smoking in pregnancy increases the risk of cot death. It is best not to smoke at all. Don't let anyone smoke in the same room as your baby.
Don't let your baby get too hot (or too cold) Overheating can increase the risk of cot death. Babies can overheat because of too much bedding or clothing, or because the room is too hot. Remember, a folded blanket counts at two blankets.
When you check your baby, it he or she is sweating or their tummy feels hot to the touch, take off some of the bedding. Don't worry it baby's hands or feet feel cool, this is normal.
Keep baby's head uncovered- place your baby in the 'feet to the bottom of the cot' position.
Babies whose heads are covered accidentally with bedding are at an increased risk of cot death.
Sleep your baby on a mattress that is firm, flat, well fitted and clean. The outside of the mattress should be waterproof, like PVC.
Cover the mattress with a single sheet. Use sheets and lightweight blankets but not duvets, quilts, baby's nests, wedges, bedding rolls or pillows.
To prevent your baby wriggling down under the covers, place your baby's feet at the foot of the cot or pram. Make the covers up so that the reach no higher than the shoulders. Covers should be securely tucked in so they cannot slip over the baby's head.