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Advice needed re seeing GP for possible PND

(15 Posts)
pinkelephants Fri 07-Jan-11 11:56:59

Sorry this will be long. Before DS was born I have never personally experienced feeling depressed or felt like my feelings were out of control. However 2 close family members are/have been depressed so I have lived with other people suffering from depression and I know how hard that can be. I think my problems started when DS was between two and three months old (he is 7 months now.) I was often tearful, often woke in the night and couldn't get back to sleep, I worried constantly that something would happen to DS or DH and i used to imagine in detail what might happen to them and worry constantly about whether or not I would be able to help them. I felt "flat" a lot of the time and didn't want to do anything. I also have issues surrounding DS' birth. I had an elective CS due to previous surgery I have had (was advised by DRs that it was the safest thing.) However I feel incredibly guilty about it, I feel I let my son down and didn't do the best for him. I am angry at my self for agreeing to it too easily, I hate my body for being such a failure and not being able to do what it was supposed to do and I hate myself for not questioning the doctors more.

I don't know if the depression type symptoms are because of the issues I have around the CS or if I am thinking irrationally about the CS because I am depressed. (In my more "normal" moments I do realise that it is not rational or helpful to feel as I do about the CS.)

I have had lots of ups and downs and for a while really thought I was getting better and felt more like "myself" again. I had a birth debrief appointment in November and was able to go through my notes and understand better why the CS was necessary and also understand what happened in surgery (there were some complications which contributed to how I feel.) This helped enormously and I thought I was getting better. I have also seen my obstetric consultant again recently which also helped. So I have had a lot of help to process this and have probably used up far more than my fair share of NHS time.

However I seem to have "slipped" again now. I no longer feel "flat" and hopeless and I have stopped worrying about bad things happening to Ds or Dh. However I am back to crying most days, feeling panicy for no good reason much of the time and waking in the night in a panic and not being able to get back to sleep. I also can't stop hating myself and my body. This is not who I am. I have never been like this before and I am tired of feeling like this.

Yesterday I made an appointment with the GP. However I really don't know whether or not to keep it. As I say I have had a lot of help and my feelings are not rational and maybe I need to stop thinking like this and just get over it? Also I don't like my GP so have made the appointment with a different Dr at the practice who I don't know and I don't know how they will respond. I am worried that if they are dismissive it will make me feel far worse. The health visitors round here do a home visit at 3 months to do the postnatal depression questionnaire. When I had this visit I considered lying but in the end was honest and apparently my score indicated depression. However the health visitor felt I had too much awareness of my feelings to be depressed. I don't know what to make of this, maybe she is right and I am just over thinking everything. After she said that I was much worse and I couldn't talk to anyone else (dh, my mum etc) about how I felt in case I was making it up. I am scared that if the GP thinks something similar I will really struggle. Is she right? I am aware that the way I am thinking is not normal and I have tried really hard to change it but I just can't seem to do it long term and I can't see how being aware of my feelings makes them ok?

I really don't know whether to keep the appointment. I have good and bad days (today is a good day) and if I am having a good day on Monday (when the appointment is) will the GP believe me? On the other hand on bad days I am often not really able to talk about the darker feelings I have. It is only when I am feeling a bit better that I am able to be honest about how bad I have felt at times.

I am so sorry to have gone on for so long, I am just really torn. The 2 family members with depression have never sought medical help for their condition and their lives and those around them have been badly affected by it for many many years. I don't want to be like that. I don't want my son to grow up with a depressed mother. On the other hand I am scared to be labelled as depressed. I am scared I will always struggle with this and giving it a label will make it real.

madmouse Fri 07-Jan-11 12:12:08

Hmm my DH has a lot of awareness of his feelings but he's still depressed, ditto for me and PTSD - what an odd thing to say from your Health Visitor hmm - lack of insight can bea sign of mental ill health but it doesn't work the other way around and certainly not in depression.

Please keep your appointment and print out your post to take with you as it is very clear.

You are being very impatient with yourself and definitely need to give yourself much more time to process what was for you a very difficult experience. It sounds like you would benefit from some counselling. Whether you would need meds I'm not in a position to suggest.

It feels as if you need to talk about what happened and how you feel a lot more than you have and I think you need to give yourself permission to do so.

I know that is hard - I was talking to a friend about my difficulties last night, the same friend who has been listening and supporting for nearly two years now and I got angry with myself for still not 'having a grip'. But you deserve to have more time to heal and more space to talk.

socialhandgrenade Fri 07-Jan-11 12:54:00

Hiya, I am recovering from PND, and also have a family history (my dad and paternal grandmother) of depression. I think what the HV said was very strange, I can only think she meant that your level of insight would mean that you would know if you needed more help. Please see your GP, I didn't go early enough and have ended up in a bit of a mess. My PND didn't really kick in until I returned to work when DS was 9 months, so I chose to ignore my thoughts and feelings for 4 months, because the rational part of me could see that they were disproportionate, and I thought it couldnt be PND because you only got it straight after birth. WRONG! The result was that the feelings and thoughts didn't disappear, they just got bigger over the following 10 months until I couldn't function and now I have been off work for 8 months sad. Unfortunately, although the GP was good and referred me for a community mental health assessment, until I became too ill to work, I wasn't taken very seriously. The start of feeling better was a proper medication review in my case and eventually getting some CBT. I agree with madmouse, your post is very clear and it would probably help to take it along to your GP so they can understand what you are experiencing. I really hope your GP will prove a useful source of support. If you don't click with this one, see another. I don't see my normal GP for PND, I see another one because she seems to really understand. I really hope you start to feel better soon. I would like to know how you are after Monday's appointment, so if you feel up to updating your thread, I will look out for you. But if its all too much, don't worry about updating. Take care.

pinkelephants Fri 07-Jan-11 14:26:42

Thank you both for your replies. So sorry that you are both suffering with your own issues. Socialhandgrenade what you say about ignoring your feelings because the rational part of you can see that they are disproportionate sounds exactly like me. I know that most of my feelings and partiularly my anger at myself is completely disproportionate to the situation. Madmouse you are probably right that I need to talk about it more, but as you say it is hard. I am sick of the sound of my own voice on the subject! I want to just "get a grip" and move on but I think just writing everything down has made me realise that it probably isn't something I am going to achieve by myself.

To be fair to my health visitor, I very much dislike getting upset or loosing control of myself in front of people so if I feel I am going to get upset (as I did when speaking to her) I tend to speak in a very calm and controlled manner and be very matter of fact. Possibly she felt that I had already worked through my feelings and that is what she meant by having "too much awareness."

My mum and brother suffer from depression (although my mum is well at the moment and has been for quite a long time smile. So as a family we were all affected, and living with their illness has been hard at times. I think this makes me more fearful of publicly saying I may be depressed (I was so certain I didn't have the "depressive gene" if such a thing exists.) My brother has been crippled my depression for many years but doesn't admit there is anything wrong with him sad. He says he is not depressed just stupid and worthless. It is so sad to hear him say this and frustrates me no end as he is a wonderful funny person with loads of potential he just can't see it. Part of me feels guilty seeking help when he is so much worse off than me and part of me knows that I must seek help before I reach his position. I guess finally experiencing a small part of what they have gone through for so many years has brought up its own issues for me and also makes me feel guilty for not understanding them for so long. (sorry I'm digressing here!)

I will do my very best to keep the appointment and I think you are right I should print out my post and show it to the doctor, that way I will have told her everything that I am feeling. Otherwise I think I will probably gloss over bits. I will update this on Monday - thank you for wanting to know how it goes.

Socialhandgrenade if you are able to (and please don't worry if you would rather not) I would be interested to know what your feelings were and what prompted you to seek help. I've never spoken to anyone else with PND and it would be nice to hear someone else experience - but as I say please don't worry if you would rather not.

PhishFoodAddiction Fri 07-Jan-11 17:34:25

Hi, I just wanted to say that I felt exactly the same about going for help- and was wanting to back out of the appointment, and I ended up in tears as soon as I started talking to the doctor. It is worth pushing through the anxiety about going, it really is. (I'm now in situation where I have to go back to the doctors as I came off my medication too soon, and agan I'm terrified about going but know it's something I have to do).

Another thing I would say is that it's very sad about your brother- but he's the only one who can sort his life out.You're not taking away from him or anyone else by getting help.

I understand what you mean about knowing that your thoughts aren't rational- that is actually a good sign. It doesn't mean you can 'cure' yourself though.

Maybe some counselling would help? I felt really awkward about going at first, but talking can really help. Maybe you could ask your GP about this when you go.

I have chronic depression (ie had it for years on and off) but had a bad bout after having DD1-mainly because I felt like a failure and a terrible mum, and it was hideous. I found being a mum brought up a lot of issues from my childhood too. Counselling really helped with these issues.

Good luck with your GP appointment.

socialhandgrenade Fri 07-Jan-11 21:31:00

pinkelephants, I am happy to share my story if it helps. I don't want to go on about me, me, me though! After initially being elated after my DS's birth, I then began to feel numb and robotic. I was meticulous in how I looked after DS, but I just didn't feel any pleasure. I couldn't relate to how much my mum and DH obviously loved being with him. I ignored those feelings as I had read it takes time to bond and thought that going back to work might give me some breathing space from DS. Within a couple of weeks of returning to work I was feeling very panicky and unable to think clearly. I went to my GP who prescribed AD. The feelings didn't go so she upped the ADs and referred me to the Community Mental Health Team (CMHT)for an assessment. They felt I was 'functioning well' as I was at work and meeting my childcare responsibilities and sent me on my way. The panicky feelings kept on, I returned to my GP who upped the ADs. This happened a few times until I was on max dose. I went back because I still felt awful and she changed my medication to another type of AD more suited to treating anxiety and took me off the original medication. Unfortunately I then had a major dip, I became convinced that my panic and anxiety were clouding my professional judgment and that I had already made poor decisions which had affected patients adversely. (I am a health professional). I felt suicidal and took myself and my DS to my mothers. I planned to sneak off in the night to kill myself, luckily I think my mum guessed and everytime I got out of bed she would appear. She helped me phone the GP and I explained about being suicidal. The GP signed me off work and referred me to the CMHT again. I had to wait for a week to be seen, I could have had the Home Treatment Team the same day if I had been at home and not at mum's but as it was I had to wait and just be with the suicidal thoughts. I saw the CMHT and they reviewed my medication and changed it again. I thought I would be hospitalised but as I promised not to act on my suicidal thoughts they were happy to leave me to it. This time the medication worked, within 2 weeks I felt much better. I started to actually enjoy hanging out with my son and finally felt that rush of love. When I saw the CMHT again I was better enough for them to refer me for CBT. I had to wait but I have started it now, and it is helping. I am hoping to go back to work next month, I am scared of the stigma more than anything but will have to tough it out I guess.
Pinkelephants I don't know if my story helps at all but I hope it shows that it's possible to feel really really bad and make a recovery. Will look out for you, you can PM me if you want too.

socialhandgrenade Mon 10-Jan-11 11:09:49

Hi pinkelephants, hope you are ok today?

natsyloo Mon 10-Jan-11 12:56:45

Hi there pinkelephants - I totally understand how you feel re the diagnosis issue. As you will see I've posted quite a bit re PND as I still don't think a lot of new mums get the support they need from HVs in recognising the issue.

My HV assumed I didn't have it as I was 'acting' v lucid, positive and upbeat but I was masking my feelings and like you unsure of how I actually felt. It was only when I was honest with myself and contiually cried and tormented myself with negative thoughts that I sought help.

Please go to your GP - it will help you to recognise your situation is extremely normal and speed up your recovery. I have been lucky enough to get CBT (cognitive behavioural therapy) which is working really well for me (my DS is now 22 weeks).

You will hear it from a lot of people and it won't really feel real to you at the moment (I've been there) but you will feel better and you're already taking positive steps.

Take care and good luck with everything.

pinkelephants Mon 10-Jan-11 13:03:45

Hi socialhandgrenade and everyone else who posted. Thanks for checking in.

Thank you for posting your stories, it helps to read about other peoples experiences. socialhandgrenade it sounds like you have had a really tough time and I'm so glad you are finally feeling better. Good luck with going back to work, I think I can understand a little of how daunting that must feel (i'm also a health professional.) Hopefully there wont be any stigma attached to what you went through and your colleagues will be supportive.

PhishFoodAddiction you are right that I can't fix my brother no matter how much I might want to and my getting help does not take away from him. You are also right that it is worth pushing through the anxiety and going to the doctor.

The GP was lovely. I had written everything down for her to read as I really didn't want to go through it all. She read what I had written and asked question. She asked what I wanted to happen. I said I would prefer not to take medication at this point but that I didn't know what other treatment was available. She has referred me to a local counselling service (listening service is how she described it I think) for women with PND. Apparently they have a variety of services they can offer and they will contact me quite quickly to discuss what would be appropriate for me. She has also referred my to the hospital to see a doctor who deals with women with PND and/or issues around their babys' birth. I have to go back and see the GP in 3 week although I can go sooner if I need to.

I'm glad I went, she was very kind and I didn't feel like I was wasting her time. I feel better for having admitted it "officially" if you know what I mean and I am happy with what she said.

madmouse Mon 10-Jan-11 13:06:57

Pinkelephant well done and glad you got such a good response from your GP - being listened to is so important.

pinkelephants Mon 10-Jan-11 13:12:08

Hi nastyloo Sorry x posts.

The GP was very hmm at what the health visitor had said. She has advised me not to see her for a while. There are 2 health visitors in our area so I think if they do need to see me again I will ask to see the other one.

I'm glad the CBT is helping you. I'm not sure exactly what treatment I will be offered (I think the services I've been referred to will do their own assessments to decide what is most appropriate) but hopefully they will be helpful. I certainly feel more hopeful today than I have in a long time just to know that there is treatment.

natsyloo Mon 10-Jan-11 13:41:59

That's excellent news pinkelephants - some HVs are really good but others are less tuned in to issues like this, which is worrying but true.

You've already taken the most important steps and it's a slow process for many (and can be challenging) but it's also a really interesting learning curve. The loveliest thing I read from othe mums with PND is that it can genuinely make you a more empathetic and kinder person and the bond that grows with your DC is even more precious as a result of all you've been through.

Take care and keep posting/direct messaging as MN is a fab outlet for when you have dips.

PhishFoodAddiction Mon 10-Jan-11 14:11:08

So glad it went well with your GP, it's such a relief when you've finally told someone who can help.

You've just got over one of (what I feel) the biggest hurdles, it will get easier from here.

socialhandgrenade Mon 10-Jan-11 16:40:22

Thanks for updating, I'm so glad you had a helpful GP, I'm very relieved for you. The Listening Service sounds a good option. Medication has its place, and for me it ended up as essential, but being able talk things through with someone else is so important. Good luck with everything, and well done for getting help early.

pinkelephants Mon 10-Jan-11 18:17:35

Thanks everyone for the support. socialhandgrenade you are right medication definitely has is place and I haven't ruled out taking it - I would just prefer to try other things first. I'm breast feeding and to me that seems like the only thing I have got right. I was rubbish at being pregnant and failed to give birth properly so the fact that I managed to breast feed without any problems is really important to me. Even if I was prescribed medication that was safe when feeding I think I would still feel guilty that I was exposing Ds to drugs he didn't need and I think its possible that the guilt would negate any benefits I would get from the meds. The GP has already said that if I don't see any improvement with the counselling then I should consider medication, and if she advised that it was the best treatment I think I would take her advice. But I think it is important for my own peace of mind to feel that I have tried other options first.

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