FOR most women, having a baby is a wonderful experience and cause for rejoicing, but not all mothers are happy.

Dramatic postpartum hormonal changes, changing social roles and responsibilities and psychological burdens often cause melancholy for new mothers, commonly known as the "baby blues." The gloom lifts in a couple of weeks.

If the blues persist and deepen, it becomes far more serious and sometimes debilitating postpartum depression, which is indistinguishable from other clinical depression. A tiny percentage turns into postpartum psychosis.

Postpartum depression strikes everywhere and affects women of all social strata, and China is no exception. In fact, the relatively low level of mental health services and the stigma attached to mental illness and depression in general can pose a problem for Chinese mothers with postpartum depression.

Some mothers are reluctant and ashamed to admit they are sad - when they "should" be ecstatic and everyone around them is happy.

Understanding and care from the family are crucial to help lift the blues and prevent or relieve depression, according to experts. Psychological and medical treatment is recommended for depression.

"Most women will suffer emotional problems after delivering a baby due to both sudden and major physical and psychological changes," says Dr Gao Xiaoling, associate chief physician of Shanghai First Maternity and Infant Health Hospital. She has been working in women's psychological counseling for 16 years.

About 50-70 percent of Chinese mothers suffer postpartum melancholia with symptoms such as sadness, anxiety, guilt, irritability, fatigue, weeping and insomnia, according to Dr Gao. This corresponds with international estimates.

After the great anticipation during pregnancy, giving birth and the aftermath may be anti-climactic. It's definitely exhausting. Mothers may well be disappointed the demanding baby isn't a bundle of joy - and they may feel guilty about their feelings and jealous of attentions showered on the baby.

The abrupt and dramatic drop in hormones is the physical trigger. During pregnancy these hormones (estrogen, progestrone, hCH and others) increase around 10 times above regular levels. When the placenta is expelled, frequently around the third day after delivery, the levels plummet.

In addition, many young women are sheltered and the sudden change of social role from a daughter/wife to a mother with responsibility can be stressful and anxiety-producing.

Many mothers worry whether they can become a good mother, and whether they can rear a healthy successful child in a demanding and competitive world. As soon as babies are born, families start saving for their education and other expenses, a major family burden.

Comfort and support from the family, especially the husband, help the mother adjust more quickly and most recovery naturally in several two weeks.

About 10 percent of Chinese mothers develop more serious postpartum depression, says Dr Gao. The symptoms are intensified, with profound sadness, feelings of guilt, anger, isolation, mood swings and sometimes unwillingness to bond with the baby.

Both medication (anti-depressants) and psychological counseling are recommended.

Only around 0.1 percent of Chinese women suffer postpartum psychosis, involving self hate, hatred of the baby, possible attempts to commit suicide or kill the baby.

"The occurrence rate of postpartum depression has increased quickly along with the growing pressure on young people," says Dr Gao.

Research in 1994 showed that only 25 percent women suffered postpartum melancholia or depression. That was probably low since figures are based on reported cases, and many people would not report.

Postpartum depression more often affects young mothers as they are usually less prepared emotionally for role changes. Single mothers and women with bad relations with their husbands have higher rates of depression. History of depression or premenstrual tension can be factors. Women who are very sensitive or introverted are especially vulnerable, says Dr Gao.

The possibility of depression is greatly reduced by informing pregnant women about what's happening in their bodies during pregnancy and what to expect physically and emotionally after giving birth.

"The mother also needs love and care," says Dr Gao. "Some family members shower all their attention on the baby and neglect the mother. This will aggravate the mothers' already low mood, and possibly lead to postpartum depression. Mothers may feel they are treated like tools that provide all-important babies."

Criticizing a mother for her low mood and telling her to "snap out of it" is even more dangerous and likely to make the situation worse, says Dr Gao.

Comforting talk, caring and encouragement can help the mother feel valued, she says.

Meanwhile, the mother should also take care of herself rather than devote all energy to her baby. Finding pleasurable pastimes, indulging herself and attending to her own appearance can help improve her mood.

Many mothers observe a traditional one-month period of yue zi (sit the month) after childbirth, when they are said to be especially vulnerable to "invasive cold and wind." They are supposed to stay strictly indoors, stay out of drafts and eat certain nutritious food, lest they endanger their health for the rest of their lives.

This is the period when people who care should be especially alert to mothers' sadness, anxiety and other symptoms. After a month, sunshine and activity is helpful.

Seeking medical and psychological help is important for depression.

"Don't neglect the mother," says Dr Gao. " healthy and happy mother can usually contribute to a healthy and happy baby."

Jellyfish

Joyce Zhang

JellyFISH salad, with vinegar, ginger, sugar and soy sauce, is a favorite cold dish in China.

Jellyfish is also nutritious, rich in protein and micro-elements, such as selenium that has anti-cancer benefits. It's also high in salt, so it's not for everyone.

Each 100g of jellyfish contains more than 12g protein, 4g sugar, 182mg calcium, 132mg iodine and 4g carbohydrate. Fat content is negligible.

According to traditional Chinese medicine, jellyfish is a neutral energy food that helps dispel pathogenic heat, eliminate phlegm, relieve high blood pressure, indigestion and edema.

It is recommended as dietary therapy for people with tracheitis, asthma, high blood pressure, indigestion, constipation and stomach ulcer.

Jellyfish can help relieve "hangover" thirst caused by drinking too much alcohol.

It should not be eaten raw as it contains toxins. The preferable form is dried or pickled jellyfish withe salt and alum. It should be soaked and carefully washed to remove the salt, alum, sand and grit. It should be dipped briefly in boiling water.



Cold jellyfish salad

Ingredients: Jellyfish (400g), soy sauce, vinegar, ginger, sugar and sesame oil

Preparation:

1. Soak jellyfish in water for 4-8 hours. Wash with boiled water.

2. Chop into fine slices.

3. Place briefly in boiling water.

4. Add seasonings.

Benefit: Helps relieve high blood pressure and resolve phlegm; laxative.



Jellyfish and chufa

Ingredients: jellyfish (60g), chufa (100g)

Preparation:

1. Soak jellyfish in water for 4-8 hours. Wash with boiled water. Chop into fine slices.

2. Wash, peel and chop chufa.

3. Make soup.

Benefits: Helps relieve high blood pressure and resolve phlegm; relieves indigestion.