counseling is what i have done. no meds yet. So far, counseling alone has helped a lot!!!!! if you are worried about how you will be perceived, go photocopy the symptom list for PPD from Our Bodies, Ourselves, take it to your doc and say, "wow - I just saw this and it describes me really well - I need some help". My onset was actually during pregnancy, which is why I didn't recognize it as POST-partum. If you can manage it with counseling alone and no meds, do it, but I know meds have helped some people tremendously so I wouldn't totally rule that out, either. I would just be inclined to try the counseling first, unless I was having suicidal thoughts, etc..
anyway, I am feeling better - and responding to my kids a lot better now after only 1 counseling session (though I'm sure going to more!).