To ignore my GP and TTC

[NeroliNeroliLifeIsBut]

Hope someone can offer an opinion, really don't know what to do. By the way I've had to name change as its sensitive.

I was diagnosed with depression after losing my fit healthy mother suddenly on Xmas eve. However I was never convinced of the diagnosis, just feel the loss hit me very badly and I struggled to pick myself up. I stopped working and wasn't able to continue. I cried for hours most days, couldn't go outside, went to a&e with panic attacks. Never suicidal but told GP I wished I could just drop dead, which I think was a concern for him.

Now i am ok ish. I am applying for voluntary work, eating again (went from size 14 to a 8 but not in a good way) and feel content for a little while each day, but yes still horribly sad at times. Still wonder what the point of life is (as in wtf does any of it mean!) but just trying to focus on DP and my dad.

The issue is this: I was prescribed citalopram three months ago at a reasonable dose. It took the edge off my grief, possibly (I really don't know how much was placebo effect).

Last month I cut down to the lowest dose, and now I don't even take it daily. Dr doesn't know this and I suspect would not be happy, as he wanted me on it for longer. I feel the same, maybe a bit better. I think that is just time doing its work with the grief. And some good talking therapy.

I cut down as I am 37 and want to try for my first baby with DP. I don't feel time is really on our side and it may take a while as I have pcos and we had been trying for quite a few months before mum died, with no success. Ideally I'd quit ad's properly soon and then start ttc ASAP. I think if I can't conceive, having left it too late, then I will be in an even worse mental state. GP is all 'we need to get YOU sorted first' but don't think he understands this. I asked to see his female colleague to discuss this a while ago, but she agreed with him

I know no one can advise over the Internet, but how does this sound to you? I am worried my dr will be annoyed as he said I should be on citalo for at least 9 months. That would mean waitindb another 6 months :(

Note - I can't take the ads AND TTC as it would make me too anxious, even though I know it is possible and many have done it

That sounds sensible to me. Having a baby will, undoubtedly, make you miss your mum more. It has made me miss mine immensely. I missed her when I was in hospital having DS, missed being able to ask her when I'd first walked or talked (my dad doesn't remember), missed her support in the early days. I know we would have argued about some things, but everyone else had a mum to turn to and I didn't. We managed fine of course, and mumsnet was a godsend - a place to ask all those questions that seem silly and you'd naturally ask your mum. It too bad though. There are things that make you cry, but the overwhelming love for that tiny bundle of joy anchors you and gives you purpose, new life to look forward to and to build.

Hiya,
I am a psychiatrist.
I would do a few things / some ideas to add:

• firstly update your gp about what you are taking. They won't be annoyed as it is up to you. They can't properly assess your mental state unless they are in the know.

• i have had loads of patietnts on ssris (including citalopram) during pregnancy with no problems for mum or baby.
• are you at least bmi 19-20 : ttc will be a harder longer more stressful business if you are not physically healthy. You will also need specialist care in pregnancy which is not ideal just on weight grounds if avoidable.
• are you wanting to ttc as a distraction from your grief/mood? If so you should work on that first and try for a baby later when you really want it.
• babies are hard work physically and mentally. For me ds has been the biggest challenge ever. That will be so difficult if you are not 100%.
• ladies prone to depression often relapse through pregnancy and postnatally -'continuing citalopram will reduce this risk.

Hope that is helpful!

Thank you, portly that's so helpful, really appreciate it

Do you mind me asking if, in your opinion, any antidepressants are better than others for pregnancy?

portlypenguin speaks sense.

however, I will add:

that said, there's no such thing as the perfect time to have a baby, even for a non-depressive.

As a depressive, I actually found myself coping with mood swings in pregnancy and PND better than some: I knew what to expect, had already had the "it's not me, it's the chemicals" mantra composed... In short, it was no big surprise.

Op, just bear in mind what others have said about whether grief is affecting this process, then, if you're clear enough for you, do what you feel is best.

But always - ALWAYS - be prepared for shitty-mindset stuff, and have stock mindset replies ready.

Example:

"waahh! DC will never know DM!"

answer:
"yeah, well, that's life. DC will know ME. who will love hir. And I will pass on wisdom [from DM or elsewhere], etc..."

Best of luck. PM if you like.

Bronya, I feel the same mumsnet filled the void where my mother should have been. I asked my dad when i first cut a tooth, or rolled over, walked etc... he doesn't have a clue.

I agree that for me having children healed something.

I take long-term antidepressants and have conceived, carried and breastfed three children whilst taking them. I've done a lot of reading and research into this, as well as advice from two different psychiatrists - and it seems from all of that, that tricyclic antidepressants (older drugs) are safer in pregnancy than ssri's. Some tricyclics do affect the serotonin system and those with less effect on reuptake of serotonin are safest.

However, many women have taken ssri's in pregnancy with no ill-effects. I have chosen to take a tricyclic during my fourth pregnancy.

Sertraline is known to be the safest for breastfeeding. That is an ssri. Imipramine is the safest tricyclic. However, I have breastfed two babies on dothiepin, with no ill effects.

Medication can be tapered down before birth and then increased again afterwards, to minimise the risk of problems with the babies withdrawing from the medication. None of my babies have had any problems after birth.

I think for me it is a balance between staying healthy and minimising medication taken during pregnancy. Obviously nobody wants to take unecessary medication whilst pregnant - but staying well is in everyone's interests, baby included. Good luck.

I agree with OMGtwins.

I'm still on citalopram - went through icsi on it, full term (easy) pregnancy and 7 months bf.

Consultant obstetrician and head of psychiatry discussed it and reckoned the risks of coming off it outweighed the benefits.

All is fine.

Agree with pp re counselling.

Neroli 10 mg every other day isn't a therapeutic amount.

Min 20 per day.

So, you're pretty much off them - and it's no wonder you don't feel different!

Should add, not a doc!

So definitely advise seeing yours.

My best friend is a GP in what can be described as a "very challenging" area.

She says that part of being a good doctor is accepting that patients don't always (or when she is having a bad day - ever!) do what she would like them to do but that she is to help them as best she can given the realities of the situation. I don't know the details but I suspect that the realities are far far more extreme than a 37 year old who wants children TTC.

So please do go back to your GP.

I'm so sorry you lost your mum. Mine died two months ago, she was previously fit and healthy too, it was all very sudden and it's been very hard to process so I understand the feelings of shock and anger.

I think you should ttc as soon as you want to. I think that delaying would cause you MORE stress and anxiety. My sister and her husband were discussing ttc when mum died and have decided to go ahead now - I think she feels that if she conceives, the baby would be a gift from my mum, in a way. It will be hard to go through your pregnancy milestones wishing you could share them with your mum, but that will be true at any time, now or in 5 years.

I hope your ttc journey is smooth, and that you are lucky soon. I'm sorry you have to do it without your beloved mum.

Thank you and I'm sorry for everyone's sad losses too, it feels unbearable at times.

I hope we will conceive when the time is right. Am prepared for it to take longer still, so maybe it will all come together at the right moment