In the news - is support for PND chanigng?

[bealos]

I can't stop thinking about the incredibly tragic case that's been in the news today. A mother killed her two, small children when suffering from post natal depression. And then also tried to kill herself. She's been admitted to phychiatric facility.

The reason it's bothering me so much is because there's so little support and care for mothers beyond a few weeks after the birth (and, I found, little more than a 'are you feeling sad?" questionnaire.)

I suffered from (self diagnosed) PND with my 1st child and am now (7 years later) expecting my 2nd child. It does make me worry.

Do you feel that support for mums with PND is changing? Are we able to access better resources? Or are you experiences none too good?

www.bbc.co.uk/news/uk-england-london-20136443

[bansku]

I think there is too much support for a thing that do not exist. I had to tell HV's to go away couple of times when they came for a "spying visit".

[Marcheline]

banksu are you serious?

Just because you were lucky and didn't suffer from PND, doesn't mean that no ones does.

OP, I had PND with my forst and am now pg with number two - it's something that I worry about quite a lot, but DH and I have been talking about it a lot recently and have sort of made some plans to try to avoid the depths that I sank to last time (should I get PND this time, but I understand that the hormones can vary massively and I may not suffer this time).
I don't really know what supposrt there is at the moment, but I assume it could vary quite a lot depending on where you live. Last time we were in central london and care was really excellent.

Could you speak to your GP / midwife about your concerns and ask what is offered in your area?

[Marcheline]

Sorry for all the typos, my computer is playing up at the moment and I can't see what I'm typing!

[bansku]

Very serious. If they have resources to visit people who are healthy, the funds should at least be halved and the money given for people who have cancer, for example.

[MavisG]

People die of depression (through suicide/infanticide) as well as of cancer, Banksu.

[ReallyTired]

bansku I think you have real issues. ARE YOU ALRIGHT?

I have two children who are seven years apart and the way that mental is supported in mothers is different rather than worse. I had very bad depression with my first child.

Having lots of listening visits is not a long term solution. I found that I become very emotionally dependent on my health visitor. My first health visitor gave lots and lots of well meaning advice that under mined my confidence to think for MYSELF. I believe that person centred councelling can make depression worse as I found that I tended to about things that made me miserable or angry. Talking about my feelings made me feel worse. For me it was a vicous circle.

I went to a postnatal depression group which was hell. If I didn't feel depressed at the start of the meeting I certainly did at the end. I am relieved that my present health visitor tells that this group has been scrapped. There were women who attended this group for years.

In our area the local mind network run courses for women to improve their mental health. In particular teaching assertiveness to improve relationships, protective behaviours, work life balance, activity and nutrician and thinking styles. I believe that the approach of teaching women strageries works better than group coucelling because it teaches people skills for life.

The children's centres offer support to the healthy mothers so they do not get develop depression in the first place. It facilitates women mixing in the community and has made a real difference in our area.

[Marcheline]

People with depression are not healthy and funds should not be halved. HV's weren't trying to 'spy' on you, they wanted to make sure that you were OK, as many women are not.

You are being quite offensive, to be honest.

[5madthings]

there should be more support, i ended up with post natal psychosis after ds4, my hv didnt even do the edinburgh test on me, and i went to the gp repeatedly and was told that as he was my fourth i knew what i was doing! i broke down i the end, dp came with me to the gp, saw a different one who got mh team in andthey had me in hospital within hours! i had a hellish year but was lucky to get a great cpn and also a homestart volunteer but it was soo hard.
i went on to have dd who is 22mths and was monitered carefully in my preg but some consultants were useless, i took a low dose 10mg citalopram through my preg and when bfeeding as okayed by mh team, midwife and a consultant and yet a registrar that i saw was horrified that i was taking it, wouldnt discharge me and dd after her birth asi was bfeeding taking it and threatened to call social services! utter madness!

thankfully my midwife and hv were great and i had support and they kept an eye on me after dd, i also still saw my cpn for a bit, but i was fine and had no problems.

there could def be better support.

so sorry for the poor mum in the news, i hope she gets the help she need but i cant imagine how she will ever live with hersefl :( poor poor woman :(

[Marcheline]

ReallyTired I agree re: the listening visits, it doesn't sound healthy and HVs aren't qualified to treat PND, just well placed to spot the signs and encourage a mother to get appropriate help. I was only seen once by a HV (who made me cry by being incredibly agressive about the way i was attempting to BF, but that's a whole other thread) so I suppose I have a different experience but, while I'm sure your HV was well meaning, it sounds odd. A does the PND support group, to be honest!

Mind are excellent and my DH just ran a half marathon and chose to raise money for them as a thank you for the support I had. (Bansku we also know people who have suffered from cancer, heart disease and stroke, and my DH chose to direct his resources to a charity helping with depression. Think about that.)

[5madthings]

banksu what do you mean a thing that doesnt exist?! it most certainly DOES exist and is awful, just awful for those that suffer. you may have been lucky enough not to and i was the first three times and also after no 5 but when i got ill after having ds4 it was the worst experience of my life, i wouldnt wish it on my worst enemy!

[Marcheline]

5madthings that sounds awful. I think part of the problem is that it depends on a woman having a good GP, HV or midwife.

I was really lucky last time that my GP knew what she was seeing and referred me to a mental health team straight away, as well as prescribing citalopram immediately, but I can well imagine that I could have had problems with another GP.

[ReallyTired]

With mental illness quality care is far better than quanity care. The health visitor I had was well meaning, but she got completely out of her depth. She was not nasty, but just lacked the necessary training.

Every person is different and there is no magic wand. I feel that its important to track whether a particular intervention is improving someone's health or not. No one should spend years languishing on anti depressants that aren't working. The primary care team should recongise when the time has come for them to give up.

I think that online CBT is a brilliant step forward. There is a huge difference between needing help and being completely helpless. There are ways you can improve your resilence and manage depression better. Although postnatal depression is caused by a chemical imbalance there are ways of managing the feelings and reducing the chances of a relapse. In particular keeping the brain active, exercise and diet.

For example your body needs certain protiens to create the sertatoin needed to keep the brain healthy. If you eat turkey or oily fish then it will give the materials needed for the body to make sertatoin. Sometimes anti depressant medication fail because of a poor diet.

I believe that health visitors are foccussed than in the past.

[DoubleYew]

5madthings They just said on the news this woman had stopped taking her meds as she was worried it would harm her newborn that she was breastfeeding. Seems this is a really key point that hcp need educating on so they can support women.

La Leche reckon that hardly any drug is dangerous while bf, perhaps only some chemo drugs but how many posts do you see on mn from people saying they can't take or are worried about ads as they are pregnant / bf?

And I still get told by gp/hv that they can't prescribe as I am bf a toddler. Not that I want them. I agree, help to manage my life is much more useful.

There are signs that you may get pnd - history of depression and if there is pnd in your family, which suggests that it could be some way of thinking / believing / living that contributes to it developing (eg setting too high standards for yourself etc.)

[strawberry17]

DoubleYew I think you hit the nail on the head, the key thing is she stopped her AD's, stopping them cold turkey can cause horrible horrible withdrawals and disturb the balance of your thinking. I had PND and I stopped them cold turkey myself.I don't think people are anywhere near aware of how important it is not to just stop these drugs dead. I wish there was much much more support for women with PND, it's such a hellish and isolating illness

[bealos]

Thanks Marcheline ReallyTired 5madthingsGood to hear about your experiences...

I think you're right that different women need different things and a selection of ways to get help. I remember feeling that I "didn't really have depression as I could go out" but after the fog had lifted a year later, I could see it for what it was.

I feel that people too often want to give advice and tell you things to make it better, rather than simply listening and being compassionate. This is particularly true to health visitors who each seem to have very different personal opinions about how things should be done and a check list to fill in.

[is banksu trolling?!]

[Marcheline]

I agree bealos. I also think that women need to be made aware of the 'selection' of resources available, but again that does depend on good GP / HV / MW.

I think that CBT is excellent, but it really does take effort (IME) - so for me, I needed meds in order to get me to want to try to improve my mental state and then CBT to help me to properly recover.

I didn't realise that there were online resources and will check them out.

[Pilgit]

Have to admit that this news story had me crying on the train last night (7 months pregnant with number 2 at the moment so, there but for the grace of god...). But then I got angy - where were the HV vistis? If she had been displaying signs of such severe depression these should not have stopped (as a chronic depressive myself before DD1 my post natal care was planned out and I didn't get signed off from having home HV visits till my baby was 14 weeks old and even after that she would ring from time to time - btw, am now diagnosed Bi-polar II). She had PND with her first and I would hope she would have told her medical team here and so similar care plan should have been put in place. When she was put on AD's the risks to the child from being on the drugs (don't know which ones she was on) and discontinuation syndrome should have been explained to her. Knowing that it was perfectly fine to bottle feed if necessary could have prevented the delusion that caused her to come of the ADs.
Care for those with PND is incredibly patchy (I know there are lots of people out there doing amazing things) but this poor woman slipped through the net and that is so incredibly sad. If this doesn't prompt better care going forward what will?
Because I have pre-history and am in the system I get excellent care - but this is at least in part because I go and get it. Had I not had the 12 years experience of both the illness and the system I would not know where to go or who to turn to and would not be in the mental state to go and get that support.

[5madthings]

pilgit it had me crying as well, this is a story i dont tell very often (for obvious reasons) but as i said earlier i was fobbed off by the first gp i saw on numerous occasions, in the end dp dragged me back to a different one, because i held a pillow over ds4's face,i dont think i wanted to kill him, i did want him to shut up, i just wanted to sleep and never wake up. i didnt hold the pillow hard, it muffled his cried but he could obviously still breathe as he was cryiing but dp came in and then i kind of snapped to my senses and it was a real WTF moment, i had no idea what i was doing, i just wanted him to stop crying and let me sleep. it was a horrible horrible moment, but i can so see how when you are in the depths of depression this can happen. i just feel so so sorry for that poor woman :(

anyway i saw a gp that day who got the mh team in who then hospitalised me, i was so tired i was hallucinating and i was just a mess. i was only an inpatient for a week but then had further treatment for well over a year and monitering for a further 2yrs when i was then preg and had dd, thankfully i was fine after dd :)

pnd and post natal psychosis are awful and yes care if patchy and tho on forums like this it is talked about in rl life it isnt much, tho i have made a point of talking about my experiences, awareness needs to be raised.

[5madthings]

lots of anti-d's are fine for bfeeding, drs need to ahve more info on this and women should be put in touch with bfeeding network etc and people that know about these issues and can support a mother to continue to feed if that is what she wants.

but yes bottle feeding is fine, after totallly bfeeding my first three i ended up bottle feeding ds4 due to my pnp/pnd and i beat myself up about that for a long time, he was and is fine, 4 years old a little sweetheart :)

[Mylittlepuds]

I had severe PND with first baby - who is 18 months - and I'm pregnant again, so it's a huge concern. Still not over first bout.

Could it be that what this lady did was brought about through coming off ADs rather than the initial problem? I never went on ADs as was petrified at the long list of side effects, one of which was suicide.

Just a thought. It's desperately, desperately sad - whatever the cause.

[5madthings]

yes coming off anit d's and in some cases going on them can make you suicidal which is another reason why this mum should have had support adn been closely monitered.

[Mylittlepuds]

Just read the piece in the Mail. Tragic beyond belief.

[weegiemum]

banksu that is one of the most offensive things I've ever read on MN, and I've been here since 2002!

PND is very, very real and if it hadn't been for a HV being worried about me I'd probably not be here now and my 3 dc would have no mother, as I attempted suicide when dc3 was 16 months old.

Keep your disgusting opinions about mental health to yourself! I hope no one important to you ever has any mh issues, because I'd pity them if they did.

[5madthings]

well said weegie and i am sorry you were so poorly, its a horrible horrible place to be, so dark and just undescribebly awful :(

and banksu comments like yours and that kind of view is what stops women getting the help they need, you should be ashamed of yourself.

[weegiemum]

Thanks 5

I'm fine now, in fact been medication free for 14 months (dd2 is now almost 9). It was a hard journey but I conquered it in the end (with the help of dh, excellent GP and superb clinical psychologist).