There are also different degrees of PPD, notes Dr. Dalfen. Women who are not enjoying motherhood but can go through the motions of taking care of the baby and themselves may have mild PPD, but are getting by. Those who feel down all the time, have trouble connecting with their baby, and find it hard to get through every day have a stronger case of the illness. Severe PPD sufferers are extremely depressed and unable to take care of themselves or their babies. All of these women need treatment, Dr. Dalfen emphasizes.

Scientists still don't know the exact mechanics of PPD, but they do know it is the brain's complex reaction to several forces beyond a woman's control. "The hormones progesterone and estrogen drop after the baby is born," explains Dr. Dalfen. "These hormones interact with brain chemicals such as serotonin, which controls your mood." For some women, PPD symptoms begin during pregnancy. Moms with a personal or family history of depression, or a history of premenstrual syndrome, are at increased risk.

Social factors come into play, too: Women who have a conflicted relationship with the baby's father, have limited finances and health care, have limited social support (friends, a sister, a mom to help with the baby), or who give birth to multiples or a demanding, colicky infant are also at higher risk for depression.

Getting the Right Help
The first step in treating PPD is to see your health care provider or find a specialist on postpartum.net. Therapy and, in some cases, medication, as prescribed by a doctor, can be essential. Several antidepressants, including Zoloft and Paxil, are effective and safe for breastfeeding women. "The top priority is for the mom to get well so she can care for her baby," notes Dr. Dalfen.

On the home front, new moms need to take care of themselves (get more sleep, eat healthier, take breaks from babycare) and ask for the help that makes that possible. Emotional support is also crucial: A recent study in the British Medical Journal found that simply talking on the phone with other mothers who had recovered from PPD helped at-risk new moms cut their chances of developing depression nearly in half. Find a support group in your area at Postpartum.net. Or log on to our community board on babytalk.com.

When Betten's husband finally convinced her to see her doctor, an antidepressant brought quick relief from her six-month siege. "Within a week it evened out my moods and gave me a lot more patience," she says. "If the baby started screaming, I didn't freak out and start sobbing myself. I thought, 'Okay, he can cry for a minute and then I'll pick him up.'?"

Now expecting her second baby, Betten is prepared to ask for help: "Now I realize that anyone who has ever had a kid understands that you can't do it alone."

Marisa Cohen is a mom and the author of Deliver This! Make the Childbirth Choice That's Right for You.

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