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On ADs for PND for 2+ years. When will I feel better?

(35 Posts)
beakysmum Wed 17-Oct-12 20:14:42

I've had PND pretty much ever since the birth of DS1 nearly 8 years ago. I was never depressed before children, so it has been a shock to the system. I've been on citalopram on and off most of that time, and constantly since 2.5 years ago when I was pregnant with child 3. I am on 40mg at present.

Child 3 (DS2) has just had his second birthday and I still feel constantly under par. Tiredness is the main thing; I sleep for an hour or more every afternoon when I am not working and sleep 9 - 10 hours every night. I have frequent headaches and migraines. I don't feel particularly negative, just utterly washed out.

Doctors ask whether I am going out with DH / friends / doing things for myself and the answer is "no". Not because I am too low to want to, but because I know my limits and I have to use the energy I have on doing the essentials for 3 children and working 2 days per week in a demanding job. Pre children I used to go to the gym and run loads. Now if I go to the gym of an evening, it wipes me out the next day.

I just want to know when I will get better?! This seems to be going on just too long.....

beakysmum Wed 17-Oct-12 21:04:58

bump

narmada Wed 17-Oct-12 21:27:12

oh you poor thing.

what do the docs say about your lack of response to meds? do they have anything more helpful than 'get out more' to offer?!!?

Have you been tested for a) anemia and b) hypothyroid recently?

The thing i can't get my head around is that your mood appears normal, and tiredness seems to be the major problem for you. Maybe it is something other than depression causing tiredness?

narmada Wed 17-Oct-12 21:29:24

or maybe vit d deficiency? clutching at straws here but if you have had 3 kids in 7 years it us a possibility...

Do you have a supportive partner?

beakysmum Wed 17-Oct-12 21:40:41

Thank you N.

I have had several blood tests including for thyroid and anaemia and they all come back normal.
I take a vitamin tablet every day and have just checked.... it has 10% RDA vit D.

Partner is OK, not brilliant. He has money worries as is self employed. He has become more helpful as the years go by, due to "encouragement" (!)

anchovies Thu 18-Oct-12 16:54:18

Very similar situation here except I was ok after ds1 , it was after ds2 six years ago my anxiety/depression started. Had lots of CBT then started citalopram just over a year ago. Took 40mg and felt good in the middle but 3 months or so ago it all started to slip.

I saw a psychiatrist last week and he was very positive that I just needed to try some different medication. Have now switched to venlaflaxine which apparently is a second line option if SSRIs dont work on their own (it is a SNRI). Feeling pretty horrendous at the moment but am hopeful that once I get through the initial side effects there will be an amazing turnaround! I am similar in that I don't feel particularly depressed just seriously lacking in energy/drive/enthusiasm.

If you have had thyroid/anemia tests I would go back to the docs and ask for a referral or something different to try smile

beakysmum Thu 18-Oct-12 21:20:42

Today I've had a migraine with the tiredness.

I just can't go on like this.

Will go to Gp tomorrow and ask for re-referral to consultant. Good to hear I'm not alone, Anchovies. Do you sleep loads too and it affects your lifestyle?

AlreadyScone Thu 18-Oct-12 21:25:54

Beakysmum, I'm sorry that you've struggled for so long, and that you're feeling particularly tired at the moment.

Have you been referred for any sort of behavioural therapy or counselling, or has your GP gone straight to ADs every time you've seen them?

anchovies Fri 19-Oct-12 09:10:16

Good luck today beaky. Yes my depression manifests as extreme tiredness and lack of energy. I am guessing you have done one of the gps depression tests and come out with a high score? This always surprises me because I still feel like my depression "symptoms" are so physical rather than mental.

The Dr I saw said this is very common if you're a busy mum because you put a brave face on everything and the tiredness is the only thing that can't be overcome.

Hope you get something positive to take away from today's appointment. I feel really hopeful that I can get back to normal life asap!

bacon Wed 24-Oct-12 11:03:52

I surprised that doc has continually perscribed ADs for 2.5 yrs with no other help and as you said its not working so really they arent any benefit. I would def go for refural or pay for private counseling. The trouble is GPs are happy to run off prescriptions without considering what would benefit you more its hopeless and do you really want to go on taking ADs?

I could throw you something else to consider - Chronic fatigue syndrome - if you are continually exhausted, headaches and feel yuk then I would def read about this especially if all tests have come back negative. There are links between CFS and depression.

Mine is mild now but I am suseptible to anxeity and drepression. With help and plenty of self help I've managed to improve my life loads.

NanaNina Wed 24-Oct-12 17:10:16

Hi BM it seems fairly obvious to me why you are so tired - you have had depression and whilst you say you are not particularly negative, this horrid illness does make you feel tired and unenthusiastic. I have it too, intermittent but when it comes (like now) it can last for days on end and I spend most of my time crying and lying in bed. You see i am a 68 year old grandmother so don't have small children to care for, like you do.

Honestly my heart goes out to you young mums who have to cope with depression and look after small children - I don't know how you do it - but then you have no option do you. My sister told me the other day I was brave, but I'm not I have no option.

You don't need me to tell you that bringing up children is one of the hardest things in the world and the most tiring especially in their younger years. You are doing amazingly well and you work part time too.

Re the migraines - I too suffered for years from weekly migraines. The GPs assured me there was nothing but "over the counter" stuff, paracetomol etc which didn't touch it. Then a friend told me about the "triptans" - naratriptam, sumatriptan (brand name Imigram) and how well they worked. So I asked my GP if I could try one of them and he sighed and said "I suppose so" and they changed my life. They are not pain killers, but they reduce the swelling in the blood vessels around the brain which causes the pain of migraine. I can be pain free in 2 hours with naratriptam. GPs don't like prescribing them because they are expensive - around £5 a tab I think. You can buy Imigram over the counter - £7.50 I think for 2 tabs. If you haven't tried them I would definitely ask your GP for them.

Your children will grow up and there will be brighter times ahead - hard to believe now I know.

NanaNina Wed 24-Oct-12 17:13:10

Oh bacon I think "looking up" CFS is not going to help the OP at all tbh. I thought I had that a few years ago when I was struggling to get better after a bout of food poisoning and the websites scared me stiff and I didn't have it after all. Why wouldn't a women with 3 young children a part time job and depression feel worn out and tired.

Don't go looking on that site BM

beakysmum Fri 26-Oct-12 21:39:29

Thanks everyone for posting.

To answer some questions, I have had several lot of counselling over the years from GP surgery. First counsellor said she was really a relationship counsellor, but that she would see me. Abut 4 weeks in, she said, "Oh, I think you have PND. I thought you were here because of anxiety". Great :-(

Several counsellors have said, "You need more support". No shit. I know that, but what am I supposed to do about it? I can't magic family / friends out of the air. MIL has categorically said she never wants to be left alone with the children, and she lives 4+ hours away anyway. My Mum lives 2 hours away. She has issues of her own. Just last week I asked her to come down for 3 days to look after children while I work and childminder has operation. Mum hasn't been down since Easter, but she asked if I could find someone else to do it as she was "busy". I think actually that was one of the reasons I was feeling so bad last week.

The latest counsellor asked me if I was avioiding anything because I was depressed, then she was gradually going to get me active again. I said I don't avoid anything, but sometimes I do miss out on going out in evening / seeing friends etc because I am so tired. She said it sounds like I am managing as best I can and there was nothing she can offer.
I used to think counselling was good, now I think it's a waste of time. If I am going to all the effort of sorting baby sitters etc then I would rather use the time as "me" time and go shopping or something!

ADs do help me, they reduce my anxiety and tearfulness and help me feel calmer. I tried reducing the dose over the summer but soon noticed I wasn't as calm. I am wondering about redusing them again tho as I know tiredness migth be a side effect of the citalopram and not the depression.

Bacon I have wondered whether I have CFS, but I don't have any pains?? Is this possible?

Ninanana THank you so much, it IS really hard working and having 3 small children and depression. The worst is that I never had depression before I got pregnant, so I totally wasn't expecting this. I just want it to go away.... hence thread title grin

narmada Fri 26-Oct-12 22:41:49

I am not surprised you are feeling depressed. No family support plus working plus having 3 children.....well.

You poor thing. I really feel for you.

If the counselling isn't working/ hasn't worked for you, ditch it. YOu might get more joy from CBT which could help you change how you react to life stressors.

However, you have a lot of life stressors. You can't magic family friends out of thin air but you could use your babysitter to eke out a bit of you time. Sod the counselling: do something nice for yourself.

Do you have a partner?

narmada Fri 26-Oct-12 22:43:07

Sorry you already said you had a partner. Duh.

mercibucket Fri 26-Oct-12 22:50:47

Well, I'd double check the blood test results for a start. And would look into a thorough health check. You need to make sure for thyroid, your tsh is well under 2 and your t4 is well in range. If t4 was not tested, ask for a test. Ferritin should be well beyond the minimum, preferably over 90. Vitamin d deficiency is very common anyway and that level of supplement wouldn't achieve anything.
It is very easy to get written off with a mental health problem when you have a physical problem. No harm checking it out. Just ask for a print out of results plus reference ranges

beakysmum Fri 26-Oct-12 22:59:48

Sorry - should have been 100% RDA of vit D, not 10% - doh!

Yes, I will get a print out of blood test results, I think. I've had several over the years, from different GPs in the practise but they all come back fine hmm

I do have a lot of life stressors - DH is self employed and money has been a big stress over last 5 years and he has depression on and off most of his life. My job is stressful and I have just changed base in September to one nearer home, so long term that should be good but short term I don't feel I have the energy to learn all the new bits I have to learn.

So.... are we saying that any woman with 3 children under 7, working, depressed Dh etc etc would be exhausted / fatigued / depressed?

I just don't know... a lot of women seem to cope better than I do. Plenty of women have 4 or more children???

mercibucket Fri 26-Oct-12 23:21:45

What worries me more, in general, is how easy it is for physical problems to get ignored when you're a mum of young kids, busy life, stresses. Thyroid, anaemia, b12 problems are very often missed, either by not even doing bloods, or not flagging up borderline results.
Always worth double-checking yourself

narmada Sat 27-Oct-12 10:14:01

Yes i agree with mercibucket . Thyroid results are v open to interpretation and many results reported as normal in UK would trigger treatment elsewhere.

Holland and barrett do vita d supps at 1000 and 2000 IUS but may be better to have proper test for deficiency first.

Its true not everyone is tired with 3 kids but all Im saying is don't be tempted to white off your circumstances as a contributing factor. Women often end up doing the lion's share of stuff with home/ kids and to ease things for you maybe you need some form of outside support if your DP cannot help more. You could ask HV about homestart. There is no shame in it and it could give you headspace to get yourself back on an even keel.

I do thinking sounds like either the depression is causing issues tho, or there is something else physical with you going on too- eg thyroid. Difficult patches are often caused by a combination of factors is what I am trying to say, prob not very well!

beakysmum Tue 06-Nov-12 19:57:56

Well, I've got my copy of my blood test results and they ARE all completely normal, and they are very wide ranging!

I checked them with a family member who is a doctor and they confimed they are all well within the normal range.

So now what?

anchovies Wed 07-Nov-12 17:12:58

What did the GP say in terms of suggestions on what to do next? Do they not think it would be worth trying a different AD?

mercibucket Wed 07-Nov-12 17:47:53

Just fyi with the blood tests, altho 'normal' a lot of women need b12 above 500 to feel well, ditto ferritin (well over 50 minimum, better over 90), and vit d (over 90). How do your results compare?
I'd go back and speak to the GP again. Maybe a different ad would be helpful?

mercibucket Wed 07-Nov-12 17:47:53

Just fyi with the blood tests, altho 'normal' a lot of women need b12 above 500 to feel well, ditto ferritin (well over 50 minimum, better over 90), and vit d (over 90). How do your results compare?
I'd go back and speak to the GP again. Maybe a different ad would be helpful?

beakysmum Wed 07-Nov-12 18:12:13

Thanks -

my B12 = 335
my ferritin = 47 (?? range given as 12 - 250 ug/L)
interestingly, vit D not tested

I'll carry on taking the vitamins!
What foods are good for B12 / ferritin / vit D?

I have asked to be re-referred to the mental health consultant as I was discharged in Jan this year as part of their latest round of NHS re-organisation. Marvellous [sceptical]. I am hoping to ask about trying another AD.
I also think long term sleep deprivation is a lot behind how I feel. Not terrible sleep deprivation, but always being woken rather than waking naturally, being woken 6 am when I really would be better til 7am, often woken briefly in night by one of the three dc for one reason or another.....

mercibucket Wed 07-Nov-12 21:24:14

Sleep deprivation is so horrible long term!

Ok, with those vitamin results, while not terrible, I would definitely look at increasing them, I use spatone, it's a natural water, or there's floradix, both good for boosting iron. And for b12, which could be causing some of the tiredness as well, maybe a sublingual spray? Our UK 'normal' for b12 is pretty low really and it can cause a lot of tired type symptoms. For vit d, buy d3 at least 1000 iu daily, I would take 2000 personally. It has to be d3 not d2, which is in a lot of vit supplements.

mercibucket Wed 07-Nov-12 21:24:14

Sleep deprivation is so horrible long term!

Ok, with those vitamin results, while not terrible, I would definitely look at increasing them, I use spatone, it's a natural water, or there's floradix, both good for boosting iron. And for b12, which could be causing some of the tiredness as well, maybe a sublingual spray? Our UK 'normal' for b12 is pretty low really and it can cause a lot of tired type symptoms. For vit d, buy d3 at least 1000 iu daily, I would take 2000 personally. It has to be d3 not d2, which is in a lot of vit supplements.

mercibucket Sat 10-Nov-12 16:37:27

Interesting bbc programme about b12 on bbc if you google 'dr chandy and b12'

What was your tsh and t4 btw?

beakysmum Sun 11-Nov-12 20:56:59

Thank you so much, I will find the bbc programme. x
Have had a really bad day today, but then am due on...

My TSH is 1.29 (range = 0.35 - 5.0)

T4 is 9.9 (range = 7.0 - 20.0)

So both on the low side?

mercibucket Sun 11-Nov-12 21:07:16

The tsh looks great but the t4 is low. I don't know much about it when it's that way round but it's worth looking into, maybe another thread on here specifically about that, or try thyroid uk's forum on health unlocked

narmada Sun 11-Nov-12 23:58:17

T4 is low but within range. I would get it rechecked but that may well be sign of problem I reckon. DP has just within range T4 and is sloth-like smile but DR sent him away ....

narmada Mon 12-Nov-12 00:04:08

Strange q but did you bleed very heavily when having last baby and/ or have problems with inadequate milk supply/ milk not comibg in?

beakysmum Mon 12-Nov-12 22:08:49

Narmada - I lost 1.8l blood post partum haemorrage with first child, and I honestly think I've never fet right since then! Was not given a blood transfusion. I don't think I lost much after other 2 babies.

Milk supply has never been a problem, but I did have thrush with third baby from a few days after he was born. I took him back to hospital when he was 6 days old as he vomited blood, but it had all come from me! (Not pink tinged milk vomit as everyone seemed to think, I mean bright red blood.) Proud of myself that I managed to continue feeding him at all after that!!!

Does that help? What were you wondering about?

Off to look at health unlocked......

narmada Wed 14-Nov-12 22:18:00

Hiya beakysmum, sorry for delay in replying.

You lost 1.8 l of blood and didn't have a transfusion - is that normal shock??

THere is something called Sheehan's syndrome that you can acquire after a PPH which can muck up your body but I think given you had two further children this would be unlikely (or maybe even impossible, I am not a doc).

narmada Wed 14-Nov-12 22:25:33

Nope, further reading - not very possible at all. Just clutching at straws for you.

HOpe you find something that works soon.

beakysmum Thu 15-Nov-12 20:53:05

Hi Narmada, thanks for all your support.

Bloomin' Norah, reading about Sheehan's syndrome; I had no idea about that!!! Fortunately as you say, I don't think I have it.

I know; 1.8l blood loss and no transfusion sad. This was in 2004 and i've been told since that that time ws the height of the "do not transfuse" guidelines. Since then the pendulum has begun to swing back again.
It makes me very sad that the extent of my blood loss was not explained to me or my family at the time, with the result that I was left home alone with a new baby when he ws 10 days old and I felt like crap. I would never ever want to do that time again. It was only when the midwife came back at 6 weeks to talk through the traumatic birth that some of this came to light sad sad

Anyway, off to psychiatrist tomorrow following re-referral to her at my request. Not sure what I am going to say, beyond that I still feel so tired and that I know I struggle to cope, though I know I do cope somehow.

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