Not really sure what I want to say

[ummingandahhing]

So this may be a bit long-winded.

I think I may be depressed. It's something I've been thinking about for quite a long time now but I just feel this state of inertia about doing anything about it.

In a nutshell, DD is now 2, really not a nice birth, induced, back-to-back, DD was born with abnormal leg which has self-rectified. I also went into urinary retention which was just awful and had to be bagged for two weeks.

I now also have a diastasis recti which is about 3 fingers width and my stomach area just looks awful, as though it fell down in the front. I think I do have body issues now as I am really not the shyest of people but will not let DH look at me when I am having a bath.

DH and I have had pretty much next to no help from anyone. His parents are Up North and mine are abroad. DSis has helped a tiny bit and DBro who lives near has done pretty much nothing.

First seven months were pretty hellish with DD as I just felt like I'd made a terrible mistake. But my feelings kicked in and things are pretty good now though her being a Daddy's Girl sometimes makes me feel odd. I had a few scary thoughts about wanting to hurt her in the very early, hard days but nothing since then. I do wonder if I had PND and also is it possible to still have it now?

I don't sleep very well but recently I have been falling asleep on the sofa and sometimes spend the whole night there. DH leaves me there as he knows I need the rest.

DH is loving and supportive but we are a bit frayed around the edges due to financial pressures, a recent forced move due to landlord selling our flat and now extortionate rent.

I just feel flat a lot of the time, I don't seem to have a sense of direction which is the oddest feeling as I used to be the most full of purpose person you could meet. I also have the feeling that many of my friends don't really know how down I am as I am very good at hiding it.

So I guess I need to see my GP about it but again, what's stopping me?

[AndIFeedEmGunpowder]

You poor thing. It sounds like you have had a really tough time of it. I think PND was/is definitely a possibility, and yes it is possible to still have it now. I'm so sorry that, apart from your DH, you haven't had more support

I think you would be doing yourself and your family a huge service by seeing your GP. They can help. Do you think you could call and make an appointment?

[Koalagone]

The way you describe the first 7 months with your DD resonated with me, that's how I'd describe my time with DS. I agree with AndIFeedEm, it sounds like PND could be a possibility.

I found it really difficult to go to my GP at first, the first time I went I struggled to get across what I meant to them, and what helped me was writing down before how I felt, I actually used a post I'd written on here as a template, then showing my GP that. I think it was helpful because I was so used to trying to hide how I felt that it was hard to let the mask down even with my GP.

[ummingandahhing]

Thank you for your replies.

I just can't seem to find the motivation to do anything or as DH puts it: you've had no sense of humour for about two years.

I KNOW that I was running around doing all sorts when pregnant and now the idea just kind of exhausts me. I also used to exercise quite often and now can't seem to find time to do it.

And it's not like I don't have the time though. I have one of those magical sleeping babies so it all feels quite puzzling. Sometimes I lie there in bed and can hear DD and DH happily sleeping and just being resentful that I'm still awake. Then I don't get enough sleep and am tired the next day.

I just feel as though I've let everyone down including myself. Why did I not see earlier that this is not right? Why did I not do something earlier? Why am I still dithering about it now?

I think I have become confused about how yes, when you become a mother, your world order shifts a bit but it shouldn't mean that you don't matter anymore. I have become used to putting myself last ALL THE TIME. DH has been despairing of this as he's constantly telling me to put myself first a bit more, he's not one of those bastard husbands you sometimes read about on here. He's lovely and I feel as though I'm also letting him down by not being ME anymore.

Sorry. Having a bit of a cry now.

[SnowyMouse]

(((( ummingandahhing )))) it sounds like a visit to your GP might help.

[Mignonette]

Hello Umming

I don't often post on MH but your post caught my eye. I am an RMN and solely from what you have written can confirm that you sound like you have PND and/or Depression (they can be tandem or one segues into another).

Roughly speaking we look for evidence of depression in these areas-

1. What we would call Biological signs of depression (lack of sleep/oversleep, slowed down body movements or psychomotor agitation, constipation etc)
   
   
2. Affective signs of Depression- how you feel-(flat, tired, useless, helpless, anxious, irritable)
   
   
3. Cognitive Signs of Depression -what you think and how your brain works (slowed up thoughts, confusion, feelings of mental sluggishness, forgetfulness or distraction)
   
   Lack of Volition/Motivation are classic indicators of mental health illnesses and you have clearly described that in your post.
   
   Can you break down the steps to getting to the Doctor a little by focusing upon making the appointment? Could you tell your Husband to make it for you and help you get there? This is not being disempowered or helpless but making it easier for you to push through that fog to get the help you need.
   
   Make the appointment for the best time of your day (many people find their mood lifts towards the early afternoon. (This is known as Diurnal Variation and a classic sign of it is early morning waking.)
   
   In the meantime try to practice good sleep habits- try to avoid sleeping on the sofa, make yourself go to bed at a reasonable time, avoid stimulants in the evening (and stimulating TV/books/talks) and have a warm bath.
   
   But make that appointment! Good luck.

[ummingandahhing]

Hello Mignonette, what is an RMN?

Ok so:

1. Lack of sleep yes. Though over Christmas I have been oversleeping. I have also been gaining weight.
   
   
2. I feel all of these things. The irritation is driving DH mad. Understandably so.
   
   
3. I now find long magazine articles too long to read. Odd seeing as I usually LOVE long books etc. I'm not forgetful though as I have a very good memory.
   
   It's fine. I'm doing it. I WILL make that appointment. I'm just trying to jot down her all the other things I feel.
   
   I personally suspect that I have PND and have done from the start but just was never diagnosed or treated. I did fall through the HV net in my area as I never received two follow up appointments. But to be honest, I am a bit suspicious of my HV as the first one I did see upon discharge advised me to not eat beans as I was BFing and she said that beans would give DD wind.
   
   My concerns are also that if I am giving antidepressants which I think might be a good idea, what would be the impact on foetal development should we try for another baby? NB. I felt absolutely fine whilst pregnant.

[ummingandahhing]

Aha, RMN = Registered Mental Health Nurse?

[Mignonette]

Gosh, sorry I missed your reply. Yes it is a registered mental (health) nurse.

You need to get your thyroid checked too. The weight gain could be down to less activity but it might not. Thyroid issues can cause woolly headedness and low mood.

It is very important that your physical health is checked so general bloods (iron levels etc) and DEFINITELY Thyroid Hormone.

Re medication in pregnancy, that isn't something I feel I should comment upon and that your GP, a Pharmacist and/or Psychiatrist is the best source of current advice. I have treated plenty of pregnant women who have to stay on medication but it is dependent upon the necessity of it and the stage of pregnancy. If you are fine whilst pregnant then you may not need them anyway.

Please don't forget the Thyroid levels - write it all down before you go to the GPs.

[Mignonette]

And how many times did I remind you about Thyroid levels .

Bit forgetful myself- It's been a long week!

[ummingandahhing]

Thyroid question duly noted!

I have got an appointment booked for Thursday.

Koala, what happened after your appointment?

[AndIFeedEmGunpowder]

Good luck umming. Hope Thursday goes well.

[Mignonette]

Good luck Umming

Hope it goes well.

[ummingandahhing]

Thank you.

Odd though. I hardly got any sleep last night and today I was in a fairly good mood for most of the day. Apart from one point when I had to go to the loo to have a few quiet tears. This still isn't normal is it?

[Koalagone]

Hi Umming, well done for making your appointment! Good luck and hope Thursday goes well.

After the appointment where I actually managed to tell my GP how bad I was feeling he offered a lot of help, he recontacted the HV group to ask about baby groups and support that way (my baby is younger, but I'm sure there is the same/equivalent service for toddlers), he prescribed anti-depressents and offered to make a referral for counselling. I actually felt a lot better in myself just knowing I'd acknowledged that I was feeling how I was and that I wanted help, especially because I felt like I have to try and hide it from friends so they didn't realise. It was really a relief to not have to hide it for once.

[working9while5]

The only important q imo is whether a diagnosis of PND is going to be helpful or not. In the end, it's just a handy label for maternal distress in the period after having a child... you can call it depression or feeling down or having a tough time and those things don't necessarily change things 'on the ground' so to speak.

Are you the kind of person who will find relief or stigma in a diagnosis, or maybe even birth? I think this is very dependent on the meanings you have learned to attach to PND over your life course, within your peer group and family Tec.

Would you feel medication would be something you'd like to try? The evidence for mild to moderate depression isn't strong and there's evidence that without therapeutic intervention symptoms may recur when you come off ADs but many find great relief. How would you feel about long term AD's or committing to therapy right now, etc? Maybe there are support groups in your area you could access?

The Health system places a great deal of emphasis on diagnosis but isn't always great depending on area in terms of intervention. I got a diagnosis of antenatal depression and OCD in pregnancy from a specialist perinatal h team but had no advice or intervention while pregnant and after the birth the groups on offer were inaccessible due to childcare needs for my older son or not really right for me e.g. one was all about how to care for your baby and first aid etc which I was quite confident with and I found it sort of demoralizing to be referred to that group as though I couldn't care for my baby (though I know it was really to support women with low confidence these areas).

It varies hugely from area to area and a friend had a very different experience with music and art therapy etc.

Diagnosis is only a tiny part of the journey, because PND is not like the common cold and it won't usually easily pass without some form of engagement from you. I used to work in autism diagnosis and it can be intensely frustrating to get a diagnosis and take a very long time... after which families frequently received little to no intervention. The name itself is just so irrelevant and even though it enables you to access information on a condition, there's so much variety from person to person in how it presents that sometimes just reading can be unhelpful and bring up more issues than it resolves.

So... What do you think (if you have any idea) of what you might need?

• antidepressants
• therapy on the NHS
• support groups locally
• support with practical tasks or respite that Homestart might provide
• information on PND
• to develop a better support network locally
• stress management skills
• childcare or parenting skills
• time off from childcare
• something to do that's not just focused on being a mum
• other therapies to lift your mood.. aromatherapy, massage etc to relax and distress
• time to just settle and not be so driven by the needs of others, to feel other than you are everything to everybody and nothing for yourself.
• long term therapy to deal with past trauma or childhood abuse (not always available at optimum level on NHS).
• time off work

Think about what you might want and to what extent you want out of a diagnosis and what you might need to arrange, what you will get from NHS Tec.

[ummingandahhing]

working that's quite a lot to take on and right now I don't think I'm ready to completely think about all that you've written. I have just about articulated that things are not right and ready to accept that things can't go on as they have done.

I actually talk about my feelings A LOT as it's what I naturally do but something is definitely not right.

I'm not sure if talking therapy would greatly help me. As for your list I will try to tackle it now.

Antidepressants - maybe, but it depends on what kind and for how long and what dosage.
Therapy - not sure if it would be right for me but always willing to give things a go.
Support groups - what kind?
Support with practical tasks - I think I'm ok here
Info on PND - I've already read about it
Support network - DH and I are working on it actively right now
Stress management - open to ideas
Childcare / parenting skills - we have a great CM and I don't have any worries about how either me or DH are parenting. DH really is a great father. One of my problems is my inability to put myself first over everyone else.
Time off from childcare - it's there if I want it but I can't seem to do it. It's all part of my inertia.
Something to do that's not to with being a mum - again, inertia.
Other therapies - already doing them
Time to settle - I have it, I just don't do it.
Time off work - not possible due to massively increased rent. Also I would just brood and I don't think that would help.

[AndIFeedEmGunpowder]

I think articulating something is not right and making an appointment to deal with it is a huge step.

[working9while5]

Only asking so you think about what you might want going to GP and get best treatment for you.

Generally because of 7 minute appointments the clearer you can be the faster things get moving eg I would like antidepressants right now but want to talk through the optionsI'm not interested in talking therapy at the moment, do you have any information on local support groups for women with PND etc

It is very different in terms of preference.. I would much prefer talking therapies and things like Mindfulness as a first intervention, sounds like it might be different for you.



IME with GPs they are often better with this approach vs 'I am feeling rubbish, tell me what to do'... even with physical illness and injury.

Many areas have support groups for women with PND and some people find these great.

[ummingandahhing]

I don't want to out myself but I am fully aware of the time constraints at play here as I have actually helped train doctors.

Also in my line of work, you need to get to the point about how you feel and what you want very quickly.

The thing is, I think you're asking too much of me here. I don't really entirely know what I want / need and that's part of the whole problem. For the first time ever, I don't feel qualified to say that my judgement is the best. I've been putting up with this for two years, so surely I may not be the best judge here?

[Mignonette]

Umm

The important thing is that you have that first appointment. Tackling long lists of possible treatments/approaches and considering labelling theory is perhaps something for when you have a bit more clarity of thought and you have had bloods done to ascertain if there is a physical cause.

Good luck!

[working9while5]

I'm not asking anything of you so I will step away from thread.

Just sharing my thoughts and experiences in ways that others shared with me that I found useful at points... remember I am just a service user so if you don't find it useful that's fine and you don't need to say anything to me, we don't know eachother and I certainly don't have any expectations or demands. Was just trying to chat.

[AndIFeedEmGunpowder]

Totally agree with Mignonette.

[working9while5]

As above I am just a service user.

I don't see it as labelling theory and I mentioned it because you Mignonette 'confirmed' OP had depression with a list of signs and symptoms.

That sort of stuff was not so useful for me when I was in OP's position but it may have been useful for her. I found things about biology and cognition frightening and overwhelming and wanted more practical experience-based tips and suggestions.

We are all different and find different things more or less helpful. Ummm isn't liking my posts so I will bow out but I don't like your suggestion I am having some sort of spurious academic chit chat about labels when this has been a crucial part of my experience from early on. It's not right for Umm so fair enough I'll shut up... I did post in a spirit of offering the type of support I found
useful though.

[Mignonette]

I said that I confirmed that it sounded like the Op had symptoms of Depression.

I also made it clear that there could be other physiological reasons behind this.

[Mignonette]

And I wasn't intending to have a pop at you working. I didn't discount what you said, just that it appeared to be a consideration for later on when the immediate 'crisis' has passed and a person is able to take on more.