Feeling awful - any advice?

[limpinglimpet]

Have NC'ed for this thread, please don't out me if you recognise my history. Sorry it's long...

Am 10+6 weeks pregnant with first DC. Planned pregnancy, stable relationship with supportive DH, no financial worries. However I have ongoing moderate-severe depression which has been unresolved for the last 3 years - in my view, the GPs haven't taken it sufficiently seriously, insisting I stay on citalopram when it obviously wasn't working fully, referred me for CBT which did absolutely nothing.

Psychiatrist I saw this time last year said I needed to increase the dose (though it had been higher in the past and symptoms not improved). I then asked about planning pregnancy, he said 'well you need to come off it for that, after all you don't want to damage your baby'. I honestly thought with my history there would be more of a discussion about the pro's and con's of stopping medication, but no.

I came off meds in March and conceived 3 months later. Since getting pregnant I have gone rapidly downhill - ongoing distressing symptoms of complete lack of enthusiasm and excitement have now spiralled and I'm almost unable to function, taking a lot of time off work, feeling suicidal.

Feel zero excitement about this pregnancy despite the fact I've always wanted DC and it was entirely planned.

Went back to GP last week to ask what my options were. In the long run, I am pretty sure I need to be on a different AD or combination of ADs - probably something that boosts noradrenaline too. GP basically said well what do you want me to do? She is trying to speed up my referral to perinatal MH team, but I guess this may still take several weeks. In the meantime I am going rapidly downhill - almost considering terminating the pregnancy so I can get back on meds.

I don't know where to go from here. I'm exhausted from feeling terrible for 3 years and feeling that no-one is listening to me or helping. I've been going round in circles with fluff/handholding/vague promises that things will get better - why can't I get an intelligent opinion on my diagnosis and what the best treatment strategy might be both immediately and long-term?

I don't know what I'm asking for here exactly. Does anyone have any advice/suggestions what I should be asking for? I feel it must all be my fault for not managing to get the right help.

[Cluffyflump]

Sorry you're having such a rough time of it.

I don't have any answers for you. I wish I did.
Could you get your Dh to call your mw and explain? She/he might well push for help for you.

Could you see another gp if your one isn't very understanding?

[lymeregis]

Could you afford to go private? If you can get a reco for a psych who can suggest the right AD for you. You will get better xx

[lymeregis]

How are you feeling today?

[limpinglimpet]

Thanks for asking lymeregis. I was feeling a bit better this morning - managed to go to work - but am feeling awful now, can't cope and have just come home and collapsed on DH sobbing that I don't want to go on.

I could pay to go private, but had a very bad experience with a private psych in the initial stages of my breakdown - he was very dismissive of how bad things were and just said CBT would sort it out. The resulting report to the GP seems to have really hindered things moving faster as the surgery can't override this.

I don't think my GP isn't understanding, and she's the one in the practice I have the most respect for - I just think they are absolutely wedded to not prescribing ADs in pregnancy. I understand they don't want to take risks but it seems they're happy to risk me just getting worse and worse. Also I'd much rather talk through medication options with a psychiatrist rather than the limited prescribing spectrum of the GPs.

I just don't understand why I can't ever feel happy?

[lymeregis]

I would see a consultant go private. Get some recommendations for who is good in your area. Do you have any contacts who are health professionals ? Or mumsnet can be good for getting an assortment of suggestions of people. Take one day at a time, be kind to yourself

[lymeregis]

Mindfulness is supposed to be good too. I've not done it but it is highly regarded and you can do an online course in conjunction with the mental health foundation for around £60.

[kalidasa]

Are you seeing a therapist of some sort? That's at least something you could arrange immediately, if you can afford it, it would give you some space and would take a bit of the weight off your husband too. I can't take ads so have had to manage both AND and a pretty severe bout of PND with talking therapies and lifestyle stuff. Hard going but it has worked.

[kalidasa]

And yes to mindfulness, extremely useful ,though really you need to get the hang of the method when you are not too unwell, it's hard I think to master any of these techniques if you are currently seriously depressed. Good prophylactic against future episodes though, once you are a bit better.

[lymeregis]

How are you limping?

[orangeandemons]

I understood that it was safe to take Prozac and amitriptiline when pregnant, and I thought see trailing had now been approved. I'm sure nortriptyline is safe too and that works on noradrenaline. In fact I know these are safe, as I saw a maternal psychiatrist and she told me. I was on amitriptiline all through pregnancy and dd now 7 was fine