I was extremely happy when my daughter was born, I was finally able to hold this precious baby in my arms that I had loved and nurtured for the last nine months. Within hours though all the joy turned into a profound sadness that lasted for 18 months and that I had no explanation for. I'm not a very eloquent person but I am going to try and share this story,  I hope it is helpful to you in some way no matter how small.

Jasmine's Birth
Jasmine's was born in July 1997. Her birth was very traumatic for me, it certainly didn't compare to some women's birth experiences but I found it traumatic and although I had tried to be open minded and prepared for anything it turned out to be very different from what I expected. I was booked into my hospital's Family Birth Centre and was preparing myself for what I hoped would be a birth with total midwife care and very little medical intervention, in a home like setting .... it wasn't to be. I went into labour at 7:30am Wednesday morning but by 5pm the contractions had become so irregular a midwife recommended I take 60mls of castor oil over 3 hours ... I spent the next 6 hours on the toilet crippled with diarrhoea. At 1am exhausted, sick and no longer able to cope with the pain I had a pethidine injection which I promptly threw up. At 7:10am I couldn't deal with it any longer so I asked for an epidural (spinal block) but because they only do "low intervention" births in the birth centre they couldn't give me the epidural and I had to be moved to the delivery suite. By 7:30am the epidural was working and the freedom from pain was a blessing (although I now regret that I have no idea what it actually feels like to give birth) . At 10:40am Jasmine made her entry into the world and I was on the receiving end of 27 stitches!. During my whole labour my best fried Emily was there by my side (she is an Angel ) Jasmine's dad on the other hand slept most of the night and then actually missed her birth when he disappeared 10 minutes before she was born (I should have known then).

The aftermath
I knew within 12 hours of her birth that something wasn't right, I just didn't feel .... for want of a better word ..... "normal". I was miserable, exhausted, scared,  anxious about everything including the smallest silly little things, and I felt terribly alone. The first obvious sign though  was when she woke at 1am our first night in the hospital ward and I took her to the nursery for a feed. I felt ridiculously incompetent and every time I took her off the breast she would scream so I would put her back on, I was still sitting there bawling my eyes out when the nurses changed shifts at 7:30am ... and not one nurse seemed to think that there was a problem.

We went home 3 days after she was born, things seemed ok although I still had this baby that would only sleep in 20 min - 2 hour stretches and breastfeed for 3 - 4 hours at a time. (Though I am pleased to say that by 6 months I mastered breastfeeding and because it was the one thing I felt I really was doing right as a mother I kept doing it and breastfed Jazz until she was 3 years old!)  But I digress, when she was 4 weeks old I burst into tears in my Maternal & Child health Nurses office, I told her how useless and scared I felt, how even though I was exhausted I couldn't sleep, and that some things made me smile but I never really laughed, I just mostly felt unhappy. She made me fill out an Edinburgh Postnatal depression scale (which indicated I was severely depressed), she was convinced that I had PND and promised to send some people out to see me. That night 3 members of what is known as the CAT (Crisis Assessment Team) came to see me for a "chat". They decided that I didn't have PND just "adjustment difficulties" and that everything would sort itself out in a couple of weeks.

Five weeks later nothing had changed, if anything I was sinking further and further into a pit of hopelessness, I felt my life was out of my control and everything around me seemed surreal like I wasn't really here but just watching as life went on around me. Desperate for help I called Tweddle Family Centre and they got us in on an emergency booking. Although they don't actually treat PND they do help with behavioural difficulties in babies and young kids which can lessen the strain on a mum and help her feel more in control .... but I had been told I didn't have PND and I was basically just lacking in mothering skills so Tweddle seemed like the ideal place to go. We spent a week at Tweddle and during this time I was taught settling techniques and given advice on how long Jazz should sleep and feed and go between feeds. These valuable skills left me feeling much more competent in my new role as a mother and I went home with renewed energy and a faith in myself that I hadn't had before. But it didn't take long for the old misery to settle back in. Little did I know Tweddle was just a band-aid solution, although the long feeds, screaming and short sleep cycles didn't help the baby was not the problem, I was. I was the one that needed help and no one seemed willing to give it to me.

Somehow I plundered on like this until she was 4 months old.  I can't explain how it feels to be going about your day to day life feeling dead inside, really literally running on Autopilot, feeling totally and utterly disconnected, it's devastating. But,  somehow I managed to continue functioning  like this for 4 months until one day something happened that was the last straw. We had been in financial difficulty for some time as when I was in the early stages of pregnancy Andrew (with impeccable timing) had left his very well paid job in the Australian Army and been unemployed for a few months before taking a job that was less than half his previous wage, he was now earning about $300 a week (our rent was $175 a week). Then when I was about 7 months pregnant he crashed our uninsured car rendering unsafe to drive (we couldn't afford to get it fixed but it was by no means a write off). He also did about $1000 damage to the other vehicle. Just before Jazz was born our car was repossessed and then on this particular day we got a letter from the  company we'd had the car loan with telling us that because the car was so damaged they had sold it to a wreckers for $300 and we still owed $5000 on our car loan: Due IMMEDIATELY. This was the straw that broke the camels back, hysterical I called the mother baby unit at the Mercy Hospital, I poured my thoughts and feelings out, I told them everything that had happened in the past few months and that I didn't know what to do. They only wanted me to answer one question "did I have any thoughts of harming myself or Jazz or suicide?" I said yes thoughts suicide and of harming myself only but that the thoughts had been brief and that I would never act on them. They said they wanted me to come in and see them right away and to bring a packed bag just in case. So I did and after speaking with a doctor for a little while and telling her everything they decided to admit me right away. 

The Road to recovery?
Jazz and I spent 5 weeks in the Unit during which time I participated in a number of different therapies including group "mum & baby" sessions and individual counselling ... Andrew refused to attend couples counselling even though I was desperately unhappy with our relationship and positive we could only benefit from it. I was also prescribed 100mg a day of Zoloft (an antidepressant). At the beginning they rated me as severely depressed and quite detached from the world but they did tell me that an oddity was that even though I had a high level of detachment I was very attached to Jazz. Often PND mums have poor bonds with their babies (which improves markedly with treatment & time) and this just wasn't the case with me.  I had a very strong bond with Jazz which was probably my salvation and also my undoing. Salvation as she was the reason I kept going, in my mind she was all I had to live for and but for her needing me I may well have became a statistic. But by the same token it was that bond that was my undoing because I WAS the perfect mother, I put everything I had into her and in the end there was nothing left for me, I couldn't keep up with the standards I had set for myself and my own expectations of how a mother was meant to be. Gradually though with the combination of therapy and medication and quite a great deal of willpower on my part I began to regain confidence in myself and I stopped feeling scared of everything (including Jazz) . Slowly but surely I started to feel human again, instead of feeling like I was walking around in a dream world.

I remained on the Zoloft for 1 year, until Jazz was 16 months old. I also attended a weekly group/therapy with other mums with PND at the local community house (this was invaluable ... never underestimate the importance of connecting with people who understand what you are going through). I had many ups and downs over those months and it was a long struggle to get back on track but when I did start to feel well again I weaned myself off Zoloft slowly (gradually lowering the dose) . Not long after that I left Andrew, it was something I had considered doing many times in the months prior but I just don't think I had the courage to do it when I was ill ... I didn't believe in myself. Even though I had felt good enough to go off my medication it was still some time before I felt really well, and that life would be ok after all, but it was an uphill battle.

Today
That was over 6 years ago when I stopped taking Zoloft. These days I have some down days where I feel sad and I cry alot (but I think that's hormones more than anything!). I don't have that terrible profound sense of misery that was inescapable ............... and I never want to have it again.

There are 3 different types of Postnatal Disorder, these are 
briefly described below in order of severity from left to right.

Postnatal "blues" Occurs between the 3rd and 10th day after delivery and  is associated with rapid changes in hormone levels in the body. The "baby blues" is a common and well known condition experienced by approximately 50-80%  of new mothers. It is characterized by mood swings, tearfulness, 'feeling down' and very tired and distressed. The "blues" is a transient state that usually begins within a few days of birth and lasts only from 2-14 days. It almost always goes away on its own requiring no treatment apart from support understanding and patience.

Postnatal Depression Postnatal depression is associated with a more gradual onset, resulting in mood and behaviour changes in the mother, within the first year of the child's life, but usually occurring within 2 weeks after birth. It usually lasts a few months but up to a couple of years if untreated. The mother may suffer insomnia, fatigue, lethargy, tearfulness, depression, despondency, feelings of inadequacy, feelings of loss, resentment & an inability to cope.  In Australia 1 in every 8 women are at risk of PND. treatment usually involves medication & counselling.

Postnatal Psychosis The most acute postnatal illness is called Postnatal Psychosis and is fortunately rare occurring in only about 2 in 1000 new mothers. It usually surfaces within the first few weeks after childbirth. It's characterized by severe mood swings, disturbed thought processes (delusions), disturbed perception (hallucinations), sleep disturbances & being out of touch with reality. The condition may put the mother, her baby & others at risk & requires urgent Medical attention. Medication along with hospitalisation (preferably in a mother baby unit)  is almost always required.

Below is a more defined list of possible symptoms of the two more severe of the three 
forms of the illness. You may experience a few, some, most or all of these symptoms, 
everyone  is different. 

Physical Symptoms *Hot or cold flushes *Rapid breathing *Fast heart rate *Shaking *Chest pain  *Dizziness *Increased sensitivity to noise  (even everyday noises cause stress) *Gastrointestinal, stomach upset, abnormal bowel function. *Insomnia even though the baby is sleeping well or oversleeping, nightmares Actions *Loss of control when usually competent *Inability to do household chores *Being tearful for no apparent reason *Exhaustion *Decreased energy, no motivation *Poor concentration *Poor appetite or overeating *Poor self care *Loss of libido *An inability to think clearly/ articulate *Deteriorating communication & interaction with partner  *Irrational behaviour *Impaired concentration & decision making, poor memory

Thoughts *Thoughts of running away *Exaggerated fears about the health and safety of self, baby or partner  *Thoughts of harming self or baby *Suicidal thoughts, plans or actions *She and/or baby are better off dead *Confused thoughts and feelings about mothering  *Thoughts of being a bad mother and someone will take the baby away *Debilitating thoughts of being unable to cope and of being helpless and/or useless *Thoughts that they may be "going crazy" Feelings *Poor self image *Fear of social contact, or of being alone *Fear for the baby and of the baby *Panic *Anger *Being rejected by partner *Totally overwhelmed  *Helplessness *Irritability *Guilt *Unworthiness *Extreme sadness *Shame *Intense feelings of anxiety and depression

It is not known exactly what causes PND and why some women get it and some 
do not. In the Scientific Community it is currently thought that there are indications 
of  some common Emotional & Physical factors that contribute to women developing the 
condition but they are unproven theories, there are no "black and white" 
causes identified as yet. 

Emotional factors *Adapting to the demands of parenthood *A "let down" after getting through the excitement of childbirth. *All prior thought and focus being on the birth and not thinking much about the reality of afterwards. *No longer carrying the baby inside you. *Worrying about caring for a newborn baby. *Living up to society's expectations of a mother

Physical factors *Drastic changes in the levels of hormones as a woman's body begins to make the change from it's pregnant state back to it's usual state. *Damage done to the body during labour & birth - pain, body responding & functioning differently. *Sleep deprivation and exhaustion from the demands of taking care of a new baby. *Changed routine, less exercise, less "getting out & about"

Doctors may be unsure of the exact cause of PND but
a number of risk factors have been identified.

Risk Factors for developing PND *Obsessional personality characteristics  *Previous miscarriage, abortion, stillbirth, or infant loss.  *Lack of family & or social support (being single, divorced or separated)  *Not breastfeeding *Feeling dissatisfied with some aspects of maternity care  *Adverse life events  *Having a caesarian or forceps delivery or otherwise difficult labour *Labour & birth not meeting expectations *History of depression or previous PND *Family history of psychiatric disorders *Difficult relationship with parents or partner - difficult or unhappy childhood *Assisted conception - IVF after trying for a long time, difficult/dangerous pregnancy.

The "Motherhood myth" *Motherhood is a woman's ultimate fulfilment *A mother automatically and immediately falls in love with her baby *The baby will suffer long term damage if there isn't an immediate bond between mother & baby. *Motherhood is a time of sublime contentment  *Women instinctively know how to mother, it comes naturally. *Parenting means mothering *Mothers are carers, fathers are providers *Motherhood is romantic *A mother is selfish if she expresses her own needs *A baby will strengthen a good marriage and fix a bad one

Can PND be treated? How is it treated? PND can be successfully treated with medications, therapy, or a combination of both. Counselling may be all that is needed for women with mild symptoms, those with more severe cases of the disorder may need hospitalisation along with therapy & medication, this can be a frightening experience but it is usually very beneficial in the long run. Support and patience from family and friends is perhaps the most crucial factor in a woman's recovery. Talking about her feelings, particularly with other women in support groups or to a professional in individual counselling, can be very helpful. Some may require further help in the form of  relationship counselling & psychotherapy including cognitive behavioural therapy  As far as medication is concerned special consideration must be given to breast-feeding women. These days a number of antidepressants can safely be used by mothers who choose to continue nursing so there is no reason to give up nursing just because you are put on medication. (Providing the possible risks have been discussed with your Doctor and an appropriate medication has been chosen). The most commonly used drugs for breastfeeding PND sufferers are: Zoloft & Paxil.

If you have been diagnosed with a Postnatal Disorder the small list of do's & dont's 
below may be of some help. Please do not attempt to "go it alone" and try these 
strategies out in place of seeing a Doctor, these tips are meant to compliment the 
advice & treatment of your Doctor/Therapist not replace it.

Do's *Do get adequate rest. *Eat a balanced diet. *Talk worries and anxieties over with someone. *Try to meet other mothers in your area *Accept practical help when offered. *Involve your partner in your babies care. *Get fresh air & exercise every day if possible (I tried to get out and walk about 6km a day with the baby in her pram). *Try to do something just for you once a week - timeout from the baby such as a visit to friends. *Try to think positive, it's hard but you WILL recover, there is always hope. *Avoid extra pressures, avoid people & situations that upset you. *Call one of the services listed below when you need someone to talk to - whatever the hour.

Dont's *Don't bottle things up. *Get over tired *Try to do everything. *Refuse help. *Isolate yourself from others. *Feel you have to be the perfect mother. *Be too hard on yourself, try not to dwell on the things you can't do. *Don't avoid getting help if you are feeling low. *Don't spend time with people who lead you to feel worse about your self or your mothering *If possible don't make major life changes like moving/renovationg house and other highly stressful decisions, don't take on extra pressures or tasks. *Don't rush around trying to catch up on chores while your baby is asleep, use this time to nap or rest yourself.

The support of loved ones is both essential & invaluable. Sufferers of PND, 
get your loved ones to read this page or write these tips out and give them to them. 
Loved ones of PND sufferers please take the condition seriously and try your hardest 
to put the tips below into practice. Your support can make all the difference

For everyone *Try to be patient. *Try to be understanding. *Be informed, get info on PND, don't listen to others opinions, get the facts. *Remember it takes time but it will pass she won't be ill forever. *Be helpful, keep mum company, give her timeout from baby, help out with the housework. *Provide emotional support, listen to her, it helps if she can talk to someone about her worries. *Encourage her to seek help & follow advice. *Reassure her, PND is frightening, it helps to be reminded that she will recover. *Provide a supportive, loving environment.

Especially for hubbies/partners *Know that she WILL get better, try not to be impatient. *PND is treatable, you can't fix this overnight but healing will come with time, love & support. *Try not to resent her, the baby or the situation. *It is important to maintain a positive attitude to help her get better. *Don't feel sorry for yourself, you need to be the strong one right now. *If your wife/partner is on medication, pay close attention to her physical & emotional state, give feedback to her Doctor. *Expect that intimate relations may be limited or even on hold for a while & be sensitive about that fact.

Personal Stories  &  Homepages Shelley's Page (excellent site, very informative) Postpartum Depression A Lighter shade of blue Melanie's story Depression after delivery

Professional PND sites Pacific Post Partum Support Society Beyond Blue (Australian Help Site) PANDA (Post & Ante Natal Depression Ass. ) Vic. Gov. fact sheets PDF req. Acrobat reader

If you are elsewhere in Australia please contact your Maternal & 
Child Health Nurse, GP or PANDA for details of Treatment facilities in your area.

PUBLIC *Werribee Mercy Hospital, Princes Highway Werribee. 8  beds & an outpatient Clinic. (03) 9216 8465 *Monash Medical Centre, 6 bed unit for mother and baby. Ph: 9550 1111 *Banksia House, 7 bed unit.  Austin & Repatriation Medical Centre, Heidelberg.  Ph:9496 2199 *Tweddle - Child & Family Health Service, general postnatal care parenting advice, short term only. Ph: 9689 1577 *O'Connell Family Centre, Canterbury. General mother-baby, postnatal depression also short term. Ph: 9882 2326

PRIVATE *Albert Road Clinic 8 bed unit. Individulal, couples & family therapy.  Ph: 9256 8311. *Mitcham Private, Mother & baby unit, East Mitcham. Ph: 9210 3134 *Melbourne Clinic. Six bed unit (Private). Ph: 9429 4688 *Northpark Private Hospital. Greenhills Rd, Bundoora. Group activities and individual counselling. Inpatient therapy programs, or day patient programs  Ph: 9467 6022 *Masada Private Hosp.  5 day support program East St. Kilda Ph: 9527 5145

Contact numbers/crisis help. *Post and Antenatal Depression Association (PANDA) - (24 hours) 03 9882 5756 *Maternal & Child Health after Hours Service - 03 98853 0844 Country freecall  1800 134 883 *Women’s Info & Referral Exchange - 03 9654 6844, Country freecall 1800 136 570 *Women’s Health Victoria - 03 9662 3755

National *Lifeline - (24hrs) Ph:131114 *Mens Line Australia - (24hrs) Ph:1300 78 99 78 *Parent Line - (24 hrs) 13 22 89 *Caring (24 hrs) - Ph:136 169 New South Wales *Tresillian Parent Help Line - (24 hrs) 02 9787 5255, Country freecall 1800 637 357 *Karitane - (24 hours) 02 9794 1852, Country freecall 1800 667 961 *PND Personal Support Network- 02 9744 6646 *Women’s Information and Referral Service - 1800 817 227 Western Australia *Postnatal Depression Support Association (PNDSA) - 08 9340 1622 *Parenting Line (24 hours) - 08 9272 2000, Country freecall 1800 643 000 *Parent Help Centre - 08 9272 1466, Country freecall 1800 807 648 *Crisis Care (24 hours) - 08 9325 1111, Country callers freecall 1800 199 008 ACT *PND Support Group - 02 6286 4082 *Tresillian Parent Helpline - 1800 637 357 *Mental Health Crisis Team - 1800 629 3 54 *Postnatal Parenting Information and Referral Service - 02 6205 2000 Queensland *Postnatal Disorders Support Group - 07 3358 4224, 0417 631 066 *Crisis Care - (24 hours) 07 3235 9999 *Women’s Health Old Wide - 07 3839 9988, Country freecall 1800 017 676 *Women’s Infolink - 1800 177 577 South Australia *Overcoming Postnatal Distress - 08 8267 1191 *Parent Help Line - 1300 364 100 *Crisis Care - (24 hours) 13 16 11 *Women’s Health Statewide - 08 8267 5366, Country freecall 1800 182 098 Tasmania *The Parenting Centre - 03 6233 2700, Country freecall 1800 808 178 *Huon PND Support Group - 03 6266 3497 *Women’s Health Information Line - 03 6222 7205, Country  freecall 1800 675 028 *Women’s Information and Referral Exchange - Country freecall 1800 136 570 Northern Territory *Casuarina Community Care - Postnatal Support & Action Grooup 08 8945 4804 *Depression Support Group - 08 8985 3348 *NT Association for Mental Health - 08 8981 4128

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Please note: I am not a Doctor I'm just an everyday woman who has been there.

Nothing on this page replaces the advice of a Qualified Medical Practitioner, if you suspect you may have one of the above mentioned Postnatal Disorders please see your Doctor ASAP.

Monash Division of General Practice: handbook for GP's 1999

Information for Health Workers, Queensland Association for Mental Health, 1992 

"How to stay sane in your baby's first year" Catherine Fowler & Patricia Gornall (pages 79, 81), 1997