Postnatal depression manifests in more than one way, writes Amanda Ngudle

So, you finally laid eyes on your bundle of joy but the tears flooding your face don't indicate happiness.

You can't pinpoint anything particularly sad to explain the loss of appetite, the mood swings and the fountain of tears that constantly threaten to sweep you off your feet.

The chances are high that you have baby blues, if you are lucky.

Those not so lucky find that the birth of their babies herald Postnatal Depression (PND), a more severe version of baby blues.

Midwife Onica Matlala says PND disorders are split into three categories:

l Baby blues, which occur a few days after delivery

l Postnatal depression, which can continue for months, and

l Postnatal psychosis.

She says postnatal depression usually lasts up to six months, but some symptoms could remain for a year after the baby's birth.

"Some women might not feel depressed, but suffer from an anxiety disorder or panic disorder instead. They might have symptoms of intense anxiety, rapid breathing and heart rate, shaking and dizziness. Some women also suffer from obsessive compulsive disorder after a birth."

Matlala says that baby blues attack within 72 hours of giving birth and though they leave a mother totally overwhelmed and unstable, they are nothing compared with PND.

Up to 30percent of new mothers in South Africa, or an estimated minimum of 50000 mothers a year, are clinically ill with depression or anxiety disorders.

They are unable, through no fault of their own, to respond adequately to their infant's needs, says Postnatal Depression South Africa (PNDSA), a non-profit organisation dedicated to supporting mothers who suffer from the condition.

Mothers, especially younger mothers, must know about PND because it can be so dangerous that it has played a role in new mothers killing their babies.

"I want to appeal to parents, guardians and relatives of young mothers to keep their eyes open about this condition because unless young mothers receive the necessary support, the consequences can be deadly," says Matlala.

"The socioeconomic, domestic and relationship adversities are often against young mothers and being in that vulnerable situation with raging hormones causing the depression can only worsen the situation. I cannot rule out that the spate of young mothers killing their babies has a link with this condition."

Appropriate instrumental, emotional and social responsiveness is crucial to the healthy development of the child.

Pregnancy, and the first year after birth, are critical developmental periods, and if the primary caretaker, for whatever reason, is unable to attend to and satisfy the needs of the child, there will be long-term negative consequences.

Thousands of women receive help from PNDSA each year via telephone and face-to-face counselling, support groups, hospital visits, information packs and referrals to the medical profession and other professional caregivers.

PNDSA also gives information talks upon request, and lectures and training workshops for support volunteers and professionals. A resource library is available for members for research and general information. Volunteers regularly visit maternity hospitals to inform new mothers about their services.

They also give informal talks on the subject of antenatal and postnatal depression and anxiety at childbirth education and antenatal classes, and other meetings attended by parents of young children.

The following symptoms could indicate postnatal depression:

l being over anxious;

l easily upset, tearfulness;

l poor appetite;

l being tired but unable to sleep;

l worry about the baby's health;

l guilty about inadequate mothering or lack of love for the baby;

l problems coping with the baby and domestic routines;

l loss of interest in sex;

l fear of harming the baby; and

l thoughts about harming yourself.