"I have a beautiful baby, so why do I feel so sad?" (postpartum depression)

For as many as one in ten women, postpartum depression follows a normal pregnancy and uneventful delivery of a healthy infant. The first few days may just be the "baby blues," with such symptoms as impatience, irritability and crying. As time goes on, however, these common, mild symptoms become more intense, followed by other symptoms that may overwhelm the patient.

These more severe symptoms include appetite loss, prolonged crying spells, feelings of helplessness or loss of control, overconcern or no concern about the baby, fear of touching the baby, little or no concern about personal appearance, sleeplessness, and suicidal thoughts.

The cause of postpartum depsression is unknown, although it may stem from emotional and physical adjustment to having a baby. It can start within the first week after delivery or may develop only after weeks or even months. Also, it does not limit itself to first-time mothers, affecting as well mothers who had no depression after the births of previous children.

Friends and family members should make every effort to convince the mother that these symptoms are not a sign of weakness or inadequacy. They also should keep an eye on a new mother who shows marked behavioral changes.

It is important that medical care be given under the direction of a family physician or general internist experienced with the condition. Some hospitals offer a well-developed system of care for postpartum depression. The various levels of care may include:

--A new mothersh network, which meets to educate new mothers and discuss their concerns.

--A new mothers' support group, which looks at adjustment issues and "baby blues."

--Outpatient therapy on an individual or group basis to provide ongoing treatment for mild to moderate depression.

--An intensive outpatient program or partial hospitalization program for intensive treatment of more severe cases or mothers with chemical dependency.

--An inpatient program for the most severe cases.

With proper treatment, the mother begins to enjoy her baby and resumes a normal life. Most women recover fully, although about one-fourth of women will have a recurrence if they bear another child.