Can I keep BFing if I start taking meds for PND?

[squintytiger]

I was diagnosed with severe PND 3 months after my 1st DD was born. At the time, my GP advised stopping BFing to go onto anti-depressants. I said no to the meds and said that I would go down the talking therapies route, not wanting to give up BFing.

Six months on and I find myself sat here in tears. I feel so stupid and ungrateful... After a horrendous childhood, I am so unbelievably lucky right now - I have the most wonderful, precious daughter and a husband who loves me (for some unknown reason!) BUT there is this dark cloud hanging over me. Some days I am fine and other days I doubt that I will make it to the end of the year. On one hand, I am petrified of losing everyone I care for and on the other, I think they'd be better off without me... I suspect that depression was always lurking in the background, but I always laughed things off and had the energy to deal with anything life through at me... not anymore!

I had an assessment with the local CBT lot in Dec 2008, who said they couldn't really help and that full-on counselling would be my best bet, along with meds. I know I have to sort out the counselling thing but I feel that if I ever find the time to start sessions, everything will come to the surface and the floodgates will open... I am so scared. Only my DH and mum know about the diagnosis. I can't talk to my friends about it, they would be horrified to see me like this. I seem to be avoiding most friends and feel as if I can't even talk with people properly now - it's like I'm wading through thick treacle, IYKWIM?

I'm posting here to ask - is possible to be on anti-depressants AND keep BFing? If so, which ones? I desperately want to keep going with the BFing, at least until a year - so a few more months.

I feel like if I have to give that I up, I really will be a complete failure. After a pregnancy and birth that were as far removed from what we wanted as possible, I just don't want to lose the one thing that gives me (and possibly DD!) the most happiness... DH is v.supportive but I know that he wants me to keep BFing, too. He's seen how bad I can get and says he will support me whatever I do, but I would feel so disappointed for all three of us if I have to give up...

TIA for any advice x (sweet Jesus, how long could one post be?! sorry...!)

[squintytiger]

PND and now appear to have lost the ability to spell... what life "THREW" at me...

[MadameDefarge]

squinty. Did your GP not tell you it was fine to take ADs and breastfeed?

Someone will be along to give you more specific info, but really really take advantage of them. They are very useful in, well what it says on the tin. I had PND and struggled for two years before caving in and going to the doctor. Part of my depression was a refusal to admit I had it, because it would have been a bit like having to give up breastfeeding for me, isyswim.

All I can say is that antidepressants made me think that there might be a god after all. The light went on. The smells came back, the world shone, music was pleasurable and I no longer felt that the misery I was enduring was my punishment for nameless crimes in the past.

I also had a short session of counselling (am surprise CBT people thought you were not a candidate for it, as it does tend to be a good fix it to at least tide you over, and give practical tools for changing negative thought patterns). Longer term therapy can be a challenge, but not all immediately and all at once. I found you tend to bring up stuff you can cope with.

Take it all in baby steps. You will get there. And give yourself a break too. Atm you feel that bf is the only positive thing you are giving your dd. It's not. Its one thing, and not the most vital, so even if you did have to stop bf (which you do not on ad) you would still be a fabulous mum.

You are at the beginning of a wonderful journey with your child. You are not letting her down in any way.

Okay?

[MadameDefarge]

Just reread. Your GP is a total twat. Totally out of touch with current practice, tell the practice manager he needs a AD refresher cause pdq, as he has caused you months of needless suffering....

God it makes me angry. Grrhhh.

[SOLOisMeredithGrey]

I took them during my pg with Ds and afterwards when bfing him. It was 10/11 years ago and at the time they put me on the old fashioned type of Ad, not the SSRI's or the like of today.

Talk to your GP, tell him how much you want to continue and ask about suitable meds that you can take safely whilst you continue breast feeding. It is definitely possible to do both at the same time.

I hope you feel better soon

[Jacksmama]

I took sertraline (here it's marketed as Zoloft) for godawful bloody horrible PND and PTSD after Jackbaby's birth. It's absolutely safe. I started taking them when he was 6 months old and stopped last month when he was 14 1/2 months, and he was almost exclusively breastfed until 12 months. My GP told me that sertraline and escitalopram/citalopram were the best ADs while breastfeeding. I agree with whomever said it was as if the lights went back on. You need to feel good to be the best mummy you can be. You deserve to be happy and your baby deserves to have a happy mummy. PND is like a paralyzing fog that sucks the life, colour, happiness and hope out of everything - pretty much like Harry Potter's Dementors.

Do this for yourself and your DD and your DH. You all deserve for you to feel better and all of MN will support you even if your GP is a complete arsewipe.

You might also want to see if any psychologists in your area do One-Eye Integration. OEI. It helps with resolving trauma and can speed up talk therapy results. I can tell you more about it (and getting over PND etc) if you want, but go and get those meds, sweetie - and don't worry - they will not affect breastfeeding.

[hairtwiddler]

I took prozax (fluoxetine) and continued to breastfeed dd for seven months afterwards. GP was extremely understanding and said benefits far outweighed any risks. I remember the fear of taking them though - absolute indecision and panic (that's part and parcel of the depression). I just wanted someone to take the decision for me.
Eventually I had a particularly bad day and decided it made sense to go onto a low dose. Was told only effect might be slightly sleepier baby but didn't notice any difference in her.

The antidepressants really helped me feel in control of myself again.
Has your local area got a specialist peri-natal team?
Unfortunately I think there are no really exhaustive studies on breastfeeding with medication, as difficult to get any ethical approval.

All the best, and I promise it WILL get better.

[squintytiger]

Ladies, ladies, ladies.... Thank you SO much for your messages!!! Yes, useless twunt of a GP told me that BFing was out if ADs were in. I know I should have probably checked for myself and am now kicking myself (when I should presumably be kicking him!)

Will make an appointment this week and go and get sorted. Just didn't want DD to miss out (that's not me judging non-BFers, in any way btw) or get side-effects of drugs but she really does deserve to have a proper happy mummy. When I look at myself I can hardly recognise what I've become - so self-defeatist and about an 1/8th the woman I used to be! In mental terms, obvs. Not physical terms - I look like I've eaten about 12 of my former self!

Jacksmama - OEI sounds v.interesting. Tell me more if you get a mo, please. My DH is amazed that I've never gone for counselling before and always dealt with stuff on my own. I guess that's another reason why I haven't pulled my finger out and sorted this nonsense out. Silly, stubborn tiger...!

Thanks again. I think you MNers may have just saved me... Off to kick that GP xxx

[hairtwiddler]

Glad to hear it. Wish I'd known about mumsnet then!
Good luck and let us know how you get on.
Do ask if there is a specialist peri-natal team in your area. I saw a cpn for cbt as well as taking the prozac. Really helped too.

[Jacksmama]

Mumsnet has saved my sanity on a few occasions. Glad to be able to pay it forward!

OEI is at its most basic a form of trauma therapy but it can be used to affect just about any undesirable emotional state. Warning: it sounds terribly, terribly kooky!
However, it's based on neuropsychiatry - meaning, a science that integrates the brain's anatomy, physiology and chemistry (in other words, how the brain functions) with psychiatry (the study and treatment of emotional disorders). Which makes it sound a little more cool.

(Further explanation - I have experienced OEI from both sides. As a patient, so I can personally vouch for its effects. And in my professional life I do some co-treatment with several colleagues who are psychologists, in which we address the mind-body connection. So we work on people who have both physical and emotional "scars", so to speak, or people who have been so traumatized that their emotional problems express themselves as physical problems.)

What OEI is based on is that traumatic memories are stored in the brain's visual cortex. So when we remember a trauma, we see it again. And it's been shown that the eye movements of a trauma patient are extremely erratic and the eye tends to "glitch" or "get stuck" in a specific spot in the line of sight where the brain "sees" the trauma. This is mostly only figuratively speaking, in most cases, but not all, vision is not affected. However, there have been cases of patients who are so severely traumatized that their vision disappears in a specific eye position (presumably the one where the brain sees the most severe trauma).

Ok, enough explanations. Here's the nitty-gritty:

The most basic tool of OEI is "switching". Try this:
cover one eye, and observe how the world (or a specific person), or your current emotional state, feels to you. Then uncover the first eye, and cover the other one. How does the other side feel different to you? There is usually a difference in emotional intensity, especially when you feel fear, anger, sadness, inadequacy, whatever, very intensely on one side. So the switching procedure goes like this: cover one eye. If your "intense" eye is uncovered, you'l feel intense emotion hit you. Switch. The intensity should recede. When you feel better (usually 10-ish seconds, sometimes more, sometimes less), switch again and allow the intensity to rise. Switch quickly, so it doesn't overwhelm you. Switch back and forth several times. Over several switches, you should notice that the intensity of emotion decreases significantly, until you feel calm (or relatively calm, at least in comparison to before) while covering either eye.

I know - it sounds koooooooooooky!!! But what this is doing is integrating the visual cortices on both sides of the brain's hemispheres.

There is more to it than that, but this is at least something you can do yourself when you feel overwhelmed by sadness, anger, fear, inadequacy, memories of a trauma etc.

It does get more involved but for the rest, you need an OEI therapist.

Good luck!! Remember we're all here for you. If you find talk therapy isn't all you want it to be, venting on here is quite cathartic. Plus, most therapists won't make you laugh... and MN sure will!

[squintytiger]

Okay, have been to see different (lady!) GP. She seemed equally unimpressed with 1st GP's lack of knowledge and said "Oh dear. Naughty Dr. Arsewipe. I'll be having a word".

She was really helpful but did fill me with dread about actually starting to take these. I've been given a prescription for Sertraline and about a week's worth of valium... She said that for the first few days, the darker thoughts might be brought to the surface, so I should have someone on hand to talk me through this phase and the valium on hand, just in case.

Does anyone have any tips on getting through the first few days? I'm really hoping it's not a hard and fast rule that things have to get worse before they get better... I'm not going to take the valium unless things are utterly horrendous and I can see something bad happening.

DH will be on the phone and then home for the weekend, so that will help if needs be. I thought I'd mention starting them to my (usually wonderful) mum - hoping that she could maybe help me through any problem days. Oh dear, BIG mistake. I got a general barrage of "I went through hell and I coped" (we all went through it and yes, she did somehow cope but we are all still a mess), "you'll get addicted to them and won't be able to come off them for years" and the corker of "pull yourself together"... I don't know. I've been desperately trying to do just that for 9 months and it ain't happening. I guess I just need someone to tell me that I will get through those first few days and then those lights will come on. I can't wait - sunglasses at the ready! I'm also fretting about how long I will be on the Sertraline for... (I know I'm being useless and need a kick up the arse - I'm just being a scaredy cat)

Jacksmama - thanks for the info on OEI. Does sound a little kooky but I can see (no pun intended) the thinking behind it. Wondering how easy it is to find a OEI therapist though...? I'm going to start counselling, as recommended by CBT lot but need to get some funds sorted first and do a preliminary assessment. Really want to get my life back, so I can be a proper mummy!!!

ST x

[sparklycheerymummy]

I wish I had known you could take ads and breasfeed... i gave up bf to go on ads. Feel a bit gutted now. Was also worrying about this as i am 14 weeks pregnant and I think i may be needing support again this time...... I have had counselling, a break down and CBT since my dd. Sounds stupid but deep breathing really helped me.... do it seriously for a few minutes, it works to just bring the anxiety down. Hang in there, it does ease. My dd1 is now 7 and is a delightful rounded and happy girl.... there is light at the end of the tunnel!!!!

[claireinthecommunity]

Squintytiger, I'm pleased you've seen a different Dr and been given more helpful advice for your situation.

I've started a similar thread about advice given to me by my GP and conflicting information that I've read here, that seem to indicate contradictory advice from medical practitioners.

Hope things settle for you soon, congratulations on your DD .