Postnatal depression is commonly undiagnosed. Very many mothers go through a period of ‘the blues’ a few days after the birth of the baby, and are reassured that shortly all will be well. A significant number however have persistent feelings of hopelessness and foreboding, with tears and exhaustion both day and night. There are often fears of inadequacy, failure to bond with the infant and increasing despair. Depression may deepen and a proportion of women develop delusional ideas and become frankly psychotic.

The three-day blues may well respond to sympathy and support. Persistent tiredness, sadness and exhaustion (often dismissed as simply a consequence of having a new baby and disturbed nights) may require treatment with anti-depressants as well as sympathy, support and understanding. Psychosis, with delusional ideas, needs expert assessment and assistance.