HI HM,
I am so sorry this is your thread, but i think that talking about it is sucha good thing.
I think counselling helps because it gets you to rationalise some of the stuff that is going on. ADs help, counselling helps, sleep helps,money helps 
as I reckon pnd is a mulitfactorial thing really. Lack of slep really eacerbates it too.
I think i had pnd about 7 months after ds1.
I couldn't sleep and felt sort of GREY if that makes sense. I vividly remember sitting on our bed at 5am shaking all over and trying to decide if i should just run away and never be seen again, or (Sorry) whether it would be easier and less stress to do myslef in..
i was trying to decide the best way, it was truly truly horrid and i never want to go back there.
My GP was a "you're lucky your baby sleeps" type of person so no help there.
I got through it with meditation and anti-histamines (weirdly) and as soon as i was sleeping better the owrld did improve.
I know a big problem is your home and can totoally see how that would get you down. We have a lovely flat but are busting at the seams, we paly muscial beds for a good part of the evening... 
I am not sure if or how this may help you- but it is just to say then talking and counselling will help you. I was lucky enough to gtet over some of the stuff on my own anyway- i think the pnd was assoc with weaning for me.
I was really scared it would come back this time, but luckily so far it has been fine.
Anyway, email me ruth at serlin.co.uk if you like, I am jsut hanging around this week - but dh has booked a trailer holiday in gt yarmouth for easter {shock} so will be away then- not sure what to amek of that but will let you know 
be kind to yourself and don't feel a failure, we all have glitches 