The birth of a baby is usually associated with wonderful feelings of excitement and eager anticipation for this bundle of joy coming into your life. Many new mums, however, are sucked into an emotional vortex of heightened anxiety and/or depression, not to mention confusion and sometimes guilt.

    Up to 30% of women may experience postnatal distress (PND). As you can see, I refer to the condition as postnatal distress because more often than not women feel more anxious than depressed so to label it only as depression is a misnomer.


    We have all heard of the ‘Baby Blues’ – this is experienced by 85% of women and occurs in the first few days after childbirth. It is caused by hormonal shifts induced by pregnancy, delivery and lactation. You may feel sad, overwhelmed, tearful, a little anxious, agitated and unable to sleep. Don’t worry, this should only last a couple of days and it is not PND. If it continues for longer than two weeks then you should have yourself assessed by a professional.

    On the other end of the spectrum is postnatal psychosis. This is very rare and is associated with disturbed thinking, delusions, hallucinations, agitation and manic behaviour. This is a medical emergency and requires hospitalisation. It is definitely not PND.

    So what is PND? PND exists on a spectrum from mild to severe. For some, the symptoms don’t feel extremely distressing and may simply be adjustment difficulties – settling into a new chapter of your life which is unnavigated territory. For others the symptoms may feel overwhelming. At its essence PND refers to a period of time following the birth of a child when a mother feels that she is not quite herself. Of course every single mother will feel different once she’s had a child, but with PND there is a sense that you have to make a concerted effort to be the ‘you’ that you and everyone else knows you to be. There may be a sense of loss, a sense of things not being as you thought they would be, but you can’t actually put your finger on it. So you talk yourself into believing that the feeling is normal and that all moms must be experiencing this.


    Even though you may feel alone, you are not. Many women hold up the mask of motherhood, portraying themselves as loving every bit of it and coping well. They look good, they say they’re doing well but I assure you, everyone has their dark moments in early motherhood. The problem is that no one talks about them for fear of being judged for not managing or, even worse, for not being a good mother. There is a conspiracy of silence around PND because of the shame associated with it. After all, you may have many blessings such as a healthy, undemanding baby, a supportive partner, domestic help, family nearby etc., but when you are suffering from PND none of these blessings make a difference to what you are feeling. You know all your blessings and you are deeply grateful for them and that is why you may not be getting the help you need – you feel too ashamed to admit to the pain you may be going through. That is why I called my book When Your Blessings Don’t Count.


    If you feel as though you may have PND, you need to be proactive in restoring your wellness not just for yourself but for your child. As hard as it is to hear, a well mother makes for a well family. And the good news is that everybody can recover from PND if you get the right help.

    PND symptoms

    First of all you need to take care of yourself. Harvard Medical School designed the NURSE Program specifically for women and it is simple enough for anyone to implement every day:


    Nourishing and Needs:

    Eat nutritious food, take multivitamins, omega-3 fatty acids, any supplements you may need (iron, calcium and/or folic acid).


    Your feelings and experiences affect your body and you may need psychotherapy to guide you through your healing.

    Rest and Relaxation:

    Sleep is vital to your wellness and if you are exhausted you need to let in support from your partner, family members, friends or hired help in order to replenish and self-preserve.


    This relates to having any experience that gives you joy, whether it is going for a walk, prayer, listening to music, doing something creative, reading or doing good deeds.


    This is crucial for the release of endorphins, the natural ‘feel good’ hormones which en- hance your mood.


    Psychotherapy with someone who is familiar with PND is invaluable in the recovery process. It provides a non-judgemental, open and safe space to express yourself, work out practical plans and explore what feelings may have been evoked for you by motherhood.


    These groups are probably one of the most powerful avenues for healing from PND. To be able to share with other mothers who are in the same position as you not only normalises your experience but also makes you realise that you are not alone.


    PND is not a choice – no one would wish it upon themselves. You are not to blame. You need to give yourself permission to surrender to motherhood and address any distressing feelings as soon as possible. When you are in the midst of PND you won’t believe this, but I assure you that you will get better and, furthermore, you may even feel grateful for what PND has taught you in terms of who you are and what is really important to you and your family.

    NURSE programme

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