PND: drugs or counselling?

[CatIsSleepy]

I think I have PND
I have some good days then a run of bad days. Feeling bad right now.
dh really wants me to do something about it and god knows I do too- our home life is crap right now and some days all i want to do is cry. My Hv contacted my local MIND and I think I am on some kind of waiting list but I don't know how long.

The only alternative seems to be ADs-but I've never taken them before and I'm scared of them-side-effects, maybe feeling worse, being unable to come off them.
And I don't have much faith in my GP!

anyone got any advice, or can just offer their own experience to help me make up my mind what to do?

[wingandprayer]

Sorry to hear you've been having a such a hard time. Personally I would bypass HV and just go and see your GP as soon as possible and discuss your options.PND needs treatment not bloody waiting lists. When I had it I found correct solution for me was pills and counselling as the pills restored the chemical balance and counselling gave me coping mechanisms. I felt more able to cope within a few weeks was on medication for about 9 months very minor side effecyd and had no problems coming off. Not everyone is so lucky but there is lots of possible medication and if one doesn't work for you then speak to your GP and get it changed.

Go and see the doctor ASAP and good luck x

[wingandprayer]

Why no faith in your GP? Is there another doctor at practise you could go and see? It is important to talk to a doctor you have confidence in.

[CatIsSleepy]

thanks for replying wing
have to feed baby but will post again when done

[CatIsSleepy]

gp is old and not a very sympathetic or empathic character. She is not someone I can easily talk to about how I feel or what I may need. It's a small practice, there's another doctor too I think but he's not much better.

I saw the nurse a little while ago for dd2 -was having a bad day and she spoke to me about PND and asked me to come back the next day to talk to the doc. So I went along and saw the nurse again, then she called the doctor in briefly-she just stood there with her hands on her hips and said there were three alternatives, drugs, counselling, or being monitored by the surgery, what did I think I wanted.

Tbh I didn't really know what to say-at that point I didn't know what I wanted, I just wanted some help, or to feel better, or something...how do I know what would be best for me? it was laughable really.

i dont know...I think I just want to have a good talk over the alternatives with someone I trust. But at the moment I don't quite know who to turn to.

[wingandprayer]

That is tricky.

I'm not a doctor and can only go on my personal experience here and I always hate just blindly recommending drugs when I don't know about someone's specific circumstances. However, I know that life is too short to be bloody miserable the majority of the time.
Which would be easier for you - signing up to new GP practice where you might get more understanding or going to see current old bat GP, getting the tablets, and letting them take affect for a month before deciding what to do next? Can your DH, a friend or your Mum come with you to doctors and help make sure GP doesn't ride roughshod over you while you're feeling vunerable?

The lack of faith/confidence in your own decision making is perfectly normal when you have PND so you need someone to view things clearly while you're not able to. And while couselling is brilliant, if there's a months long waiting list then clearly it's no use here when you need to take more immediate action.

So what do you think? Could you get someone to go with you to doctors or is there an alternative practice nearby?

And what's the waiting list for couselling where you are? If it's more than a couple of weeks would suggest you consider med

[wingandprayer]

Sorry didn't mean to include that last sentence!

[pooter]

hiya, catissleepy
Sorry you are having such a hard time. Although i didnt have PND, i have had depression on and off for 15or so years. IME you need to fight for right to help (unfortunately just at the time when you are least able to do so . Antidepressants are nothing to be scared of - i have been on lots of different types, and i truly believe they have saved my life. they dont make you anything different than your normal self, but just make it possible for you to get through the day without crying or wanting to hurt yourself. (IME).

There are lots of ADs you can take which are ok if you are breastfeeding, so no worries about that - if you want - if its relevant to you i can tell you more about each one and it's affect on the nursing child - i have a book by the Association of Breastfeeding Mothers.

I reckon the best approach is to hit it with all you have got - ADs as a short to medium term solution to help get through the day, and counselling for a longer term solution. Friends and family need to know what they can to do help. Do you need company around certain times of the day? Help with housework? A bit of time for yourself away from baby? There is an online Cognitive Behavioural Therapy course called 'beating the blues' which your GP can refer you to - its a hell of a lot cheaper for them than a real life counsellor!- while you are on the waiting list to see a real person. It was quite useful for me.

Why not talk to your DH and tell him you cant carry on like this and need his help to put some coping mechanisms in place. He could ring up the GP/Mind/sort out beating the blues/tell friends and family what you need etc. You need a team behind you. (and of course, mumsnet - anytime of the day, someone will be here to listen (just never post on AIBU!)

Best wishes It gets better.

[pooter]

ps, just seen that you like Belle and Sebastian - what good taste you have! I havent ever come across anyone else who likes them! Right - back to In the Night Garden

[CatIsSleepy]

pooter and wingandprayer, thank you
(and LOL @ old bat GP)

have tried to take some action today-called MIND but the relevant person was not around, so I still don't know about the waiting list situation. But hopefully i will find out tomorrow.

I called the HV and she is going to visit tomorrow.
Hopefully we'll be able to discuss all the options although am not sure how much in depth knowledge of ADs she'll have. But it may be a start.
pooter, anything you can tell me would be helpful. i am absolutely ignorant about ADs, and like I said, rather nervous. But I haven't ruled them out.

I don't know about changing GP-didn't even realise it was an option. I know tht when I moved here and realised the local surgery was so small I was a bit worried and tried to find out if I could register with a different one but at the time it didn't seem to be an option.

i guess part of the problem is I feel a bit lonely and isolated on a day-to-day basis...I don't have enough friends that are close by to see every day. And the way I feel at the moment is not conducive to being sociable and making new friends! bit of a catch 22. But I know that company generally does help, so I need to do something about that too.

thanks again, i appreciate you taking the time to post for me

[pooter]

No probs Cat,
just a thought - have you joined a mumsnet local group? I have made some really nice friends through it.

Well done on ringing MIND and the HV - very impressed!!

Are you breastfeeding? oh, hang on - your DD is 2 isnt she? so probably not (my DS is two as well and he is still BF but i know that we are in a minority ) The info i have is all about ADs and BF, but from personal experience i have been on seroxat, fluoxetine (prozac) and citalopram. All have worked in the same way, but after a while (we are talking YEARS here btw) became less effective. The side effects i have had have been loss of libido - i'm not bothered by this at all, but DH is! I would avoid the AD's that are difficult to come off if i were you - the SSRIs (selective serotonin reuptake inhibitors) are not meant to be addictive, but i found it very hard to come off paroxetine (seroxat) as i had horrible withdrawal symptoms. GP will know best (hope you change to a nice one!) Why not join your local MN board and ask for a recommendation? You could find a lovely GP that way.

anyway - let us know how you get on.

[CatIsSleepy]

my profile is v out of date- i had a baby 3 months ago (so yes I am breast-feeding her) and my older daughter is 3 now. Right now am being a rubbish mum to both of them!

have looked at mumsnet local but there doesn't seem to be much going on round here in terms of meet-ups etc. but am also looking at netmums...

[pooter]

well i wont tell anyone!

will just get my bf info out....

[pooter]

ok,
i think it would be easier if i gave you this link info
they also have a drugline you can call to get advice about BF and any drugs at all - 08444124665 and leave a message.

It appears that Sertraline is the drug of choice for BF mothers. If the HV or gp says that you cant BF and be on ADs they are WRONG!! Honestly - they are not given much if any training on it, and just go with the back of the packet, which is all about covering the backs of the pharmaceutical companies than proper advice iyswim.

I often feel like im being a rubbish mum, but when i am thinking straight, i can see that im just being ridiculously hard on myself, and wouldnt think that of somebody else.

Hope yr HV is helpful tommorrow.

[wingandprayer]

Great info from Pooter. I was on Sertraline and like I said before I had no problem coming off it. I do think though that you have to pick your moment and make sure your counselling coping mechanisms in place. Don't be afraid of AD's, they are after all only restoring a chemical balance. But you are right to demand a medical professional talks you through things first, specific to your situation.

Ask your HV about changing doctors too, as round here they tend to work for several surgeries and might be able to point you towards one that's more helpful.

[CatIsSleepy]

thanks

[wingandprayer]

Hi Cat

How you doing?

How did you get on with HV? Was she able to answer your questions?

[CatIsSleepy]

hi wandp
didn't see HV in the end-she was meant to come at 2.30 but rang to say she would be late, probably about an hour. At nearly 5 she still hadn't come and I was fed up of being stuck in the house and took dd2 out for a walk...sure enough she called while I was out...

still haven't found out how long I will have to wait for counselling either, the right person is never there when I call MIND. Although someone did call me back as I was in tears and I had a bit of a chat. And she said that they could refer me to the primary care trust for some kind of counselling more quickly if I needed it. We are about to go away for a couple of weeks so I will maybe do that when I get back.

i am so fed up of feeling like this of crying every day of feeling lonely and depressed i just don't know what to do with myself

and i'm bloody sick of feeling sorry for myself, am mired in self-pity and uselessness

[wingandprayer]

Do you know what? I've typed this response three times now and each has fallen prey to gremlins and been deleted/crashed. So apols for spelling but going to bat it out now in case it happens again!!!!

Sweetheart, you are mired in PND - it's so, so hard but you need to keep focused on the fact that the feelings of shitness are the illness, not accurate reflection of you. The lonliness, despair, self pity all the illness.Which is why you need to do something about it right now because it's not true. If you had physical symptoms making you feel as ill as you do now you would be stright to the doctors.

So go to the doctors tomorrow. I know she's crap but you need help now, not after another few weeks or months of crying all day. The chances of you getting side effects from AD's worse than what you going through at the moment very slim. MIND being useless and if they only going to refer you to PCT then cut out middleman and ask GP for referral instead.

Write out all questions for GP tonight so you can hand her piece of paper if you get upset. you need some people on your team for the time being. Take DH or family member who wont take any crap from her. You just need to get a little bit better then you can access better quality care and change surgeries or complain about her or whatever is required but right now, you just need to stop the misery getting worse and from what you say only one way to do that.

How do you feel about going away? Looking forward to it or source of more anxiety?

[CatIsSleepy]

HV came around yesterday in the end and asked me lots of questions re state of mind before and after baby. In the end she said she was going to refer me to the local mental health trust and I will get an assessment from a consultant psychiatrist.
So I guess that's progress!
Her own assessment was that what I was feeling was 'situational' rather than full-blown PND, I think maybe because i told her i have had periods of feeling low in the past (though not as bad or as prolonged as this). And to be honest I dont know, she may be right. I certainly feel extremely lonely at times as I was working before and don't have a big network of friends/family around me to support and distract me.

Any my gut feeling re ADs is still one of unease. I guess I will see what the proper assessment brings out. I htink I want to be sure of what's going on in my head first.

I think going away will be good if only for a change of scene and more company. And it might be useful to see how I feel in changed circumstances.

wandp you are lovely

[naturelover]

I had to reply to this thread. I really feel as if I understand how you are feeling.

I self-diagnosed with AND a few weeks ago but after more thought I think it's PND and has gone on for at least a year. But since being pregnant (am 6 months pg) and moving house and worrying about money in the last few months, I've felt totally unable to cope.

I'm a SAHM and most of my mummy friends work so I don't see them every day. It takes a lot of organisation to make sure I see people and do something every single day, but it does help when I do this.

We are social animals, not designed to raise children in isolation (am sure I read good chapter about this in Sheila Kitzinger's The Year After Childbirth). Alas my DH works long hours, my family is far away (see them a few times a year only) and as I said, my friends mainly work. SAHMs are actually quite rare where I live.

Anyway, to cut a long story short, I went to my GP a month ago and she prescribed prozac and although it went against all my instincts to take something while pregnant, I decided that things were getting desperate (marriage suffering, was bad tempered and crying a lot, had no patience with my adorable DD). I hadn't taken so much as a paracetamol since I got pregnant so it felt like a Big Deal to take something - it's the first time in my life I've taken ADs.

But you know, a month on, I feel tons better, and I had no side effects at all. I really feel that my mood has lifted enough for me to be proactive about doing the things that I know will give me pleasure. I was so caught up in my misery that I wasn't able to see the wood for the trees, and was filled with self-pity, which is of course a vicious cycle.

I've begun exercising again, have really addressed with DH the fact that I need a break from DD from time to time, have realised I need to make time for my previous interests and realise that although being a SAHM is all-consuming, I do need other things to talk about!

Taking prozac has just given me a bit of my old self back, to take control a bit and address the "situational" issues. Being a mum is the hardest thing ever and I often felt like I was alone to struggle.

My GP is great, I'd recommend trying to find a different GP if you can because it makes a world of difference.

I'm on a waiting list for counselling as well but god knows how long it will take.

All the best. Sorry for the essay!

[wingandprayer]

Hiya Cat

Really glad to hear that the HV was helpful and you've made some progress. Did she give you any inidication of how long you will have to wait for appointment?

Like you say, holiday will be great chance to see how you get on in other circumstances. I think my PND was situational for what it's worth, but of course you can't escape the sleepless and demanding situation that having a newborn puts you in so you are stuffed really!

Nature Lover - your post was really interesting and has some great tips. Especially the one about having something to do every day. I didn't have any mummy friends because of a useless antenatal group, but found planning to take the dry cleaning in used to require hours of planning and enough energy to keep me happily diverted some days! Getting out, getting some fresh air and a bit of exercise every day is essential.

I remeber my counsellor said try and find something to give you a bit of joy every day. Think about the things you enjoyed pre-baby Cat and see how you can make a a bit of space in your day to enjoy them now, even if it's only for five minutes per day to enjoy your favourite magazine and a bar of chocolate, or watch your favourite TV programme cuddled up with DD. It's good for the soul!

Onward and upward Cat - and thanks for the compliment . Stay in touch x

[CatIsSleepy]

naturelover-good to hear your story and am glad the ADs helped you. I think you are dead right about raising children in isolation - I know I wouldn't feel like this in the midst of a big extended family or with lots of friends and neighbours to help out. It's a very unnatural situation lots of mothers find themselves in and it's not good to spend so much time with just a baby for company (however lovely the baby). And having something to do to get out of the house every day definitely helps.

wandp...HV said 2-4 weeks for an appointment. She suggested exercise too. Am wondering if I could find a yoga class somewhere...Oh and have a sort of blind date with another local mum tomorrow (thanks to- Netmums). So I'll see what comes of that. Had a better day today, trying to be positive for once

[wingandprayer]

Yoga brilliant idea - I love it.

Have fun tomorrow despite defecting

[wingandprayer]

Yoga brilliant idea - I love it.

Have fun tomorrow despite defecting

[wingandprayer]

God sorry for repetition. Connection shonky again. Definately not down wine. Oh no.