To start a thread here instead of Mental Health because I know it will get a response (PND related)?

[purplepeople]

Sorry if this is the wrong place to post but I've been a lurker for a while (have NCd for this post) and I've noticed that AIBU gets far more response than other forums, and I NEED a response.

I was diagnosed with PND in August, DC is now 6 months old. I have been under my local CMHT and have regular meetings with a HV, doctor and CPN.

I also take Citalopram 20mg every day. I THOUGHT I was getting better but over the last 2-3 days, I have had an increasingly overwhelming urge to kill myself.
I feel pretty calm about it, in my mind it's something on the 'to do' list, and it's started coming as easily to me as thinking I must go and get a pint of milk.

Even typing this doesn't particularly scare me, it feels like I am writing a shopping list right now.

I have a plan of how I would do it(which I won't detail for trigger reasons) and even where I would or wouldn't go. Ironically it involves leaving the house so when I am on my own with the kids, like now, I a, safest because I would never leave them on their own. I'm probably least safe on my own.

I am 99.9% convinced that I wouldn't have the guts to do it, but what's scaring me is how easily it's coming to mind and how I don't seem to be able to realise what a ridiculous thought process it is.

When it first started,my dark thoughts were aimed at the baby, but now they appear to have deflected onto me.

I can't think of anything that has specifically triggered these thoughts - Christmas was fine, although pretty low key due to family illnesses and OH working.

My house is an absolute bomb site (as in actually has bits falling off, it's not just a mess) and there are no funds to fix it and my OH has no concept of tidying or cleaning so whether it's that and additional Christmas clutter getting tome, I don't know. I intended to do Christmas with all the trimmings this year but never got round to it, we had a tree up with some lights and decs and that's it, none of the lovely candles and other things got put out, they are still waiting patiently in a box in the dining room.

I also have a 6 yr old and OH works shifts so am pretty knackered as well, so can't face sorting everything out.

I have an appt with the doc on Tuesday but don't want to tell her because it's obvious things aren't working and the next step is admission to the MHU, which I DEFINITELY don't want.

I've told OH about these thoughts, he is very understanding but doesn't know what to suggest and he has a lot of stress at the mo with work and both parents being very ill so I feel guilty putting on him too much.

I just don't really know what to do - is this actually a sign of improvement in any way or doI need different help???

Feel free to delete if not allowed. Thank you for listening.

It could be a side effect of the Mrs you are on, but don't try stopping it on your own. Go to a walk in centre or a and e and tell them, and see if you can try a different med before thinking about admitting you to mhu.

Mrs? Meds!

Please get help.

You need to go to your GP, I'm sure the next step won't be in patient care, you are on a very low dose of citalopram, they can increase it, or change your medication. If these thoughts are feeling stronger today, ring the OOH, don't leave it.

I really hope you'll get some help, this will stop one day.

MHUs can help lots of women and their babies.
But that is not an inevitable course of action for you now. Your GP or CMHT can see you today. It is likely they would change your meds and this could make a huge difference very quickly.
Thank you for sharing.

I agree, on 20mg citalopram i would be very surprised that admission would be the next course of action. Much more likely a change of prescription and additional support.

Have you been on citalopram for long? It can cause suicidal feelings when you begin taking it. Please contact a doctor. There are other meds that you might try before being admitted. Please stay safe. You don't want to die. There is a way through this

You should be able to contact a mh crisis team linked to your cmht.
Nhs 111 can direct you if you don't have their number.

You need to speak to your mental health professional. Ironically one of the side effects of citilopram can be feelings of suicide.

Either way you need some additional care now because you are obviously feeling pretty bad.

(I understand the calm feeling rather than the sobbing, it's all terrible, I'm going to kill myself as the only option feeling)

Call 111 they can help x

Suicidal thoughts are unfortunately a known side effect of the medication you are on.

You will prob need to take another antidepressant as this one obviously does not agree with you.

Please contact someone ASAP.

I recognise these feelings, the calm, the shift of focus from baby to you, the ability to plan like you're making a shopping list. I felt this with my first. I went on to 20mg of citalopram and for a while it helped but then the bad feelings started to intensify and I had to see my GP and increase the dose. I don't know why the dose suddenly wasn't enough but the higher dose made a difference again. At no point was my GP thinking about admitting me and I had told her everything (similar to what you mention).

My advice would be to see your GP as soon as possible. If you think you are a threat to yourself tell someone in real life. I knew I was safest when in company so went to every group I could and walked the streets in between. You can take yourself to a&e if you need to.

This will pass and you will get better. I did and I know lots of other mums who have too. Pm me if you want to talk x

Second the other who say call your emergency support helpline if there is one (you mention being under the CMHT, they have on call staff)

There are many different meds you can take or combinations of, we all react differently so it may be just a matter of fine tuning them.

Please talk to someone in RL, but keep talking to us too.

It's crap but it does get better honestly, I had it with both mine & although they're 18 & 20 soon (eek when did that happen?!) the memories of how bad I felt are still clear.

Not MN I know but biggest of hugs.

You know you need to tell someone and you need to do it today. You could be on the wrong dose of medication or need a completely different medication. Please please do this. You can get better and the feelings you describe the professionals will have heard a hundred times. What you are experiencing is not unusual so they will not be shocked and will know what to do.

Of live, I've been there too. That awful calm planning. This is cruising part of your illness.

Please keep talking - call your out of hours service or NHS 24 (or ararat the equivalent is) and explain how you are feeling.

You will NOT be put in an MHU, you will get extra help and support. It may be you need to change your ADs.

Please could you pop in later, k when you feel up to it, to let us know how you are being on?

Good luck for today

Yes definitely your medication I would agree. Go back and tell your doctor and in the meantime keep talking and please tell someone IRL.

Sorry, bloody autocorrect, hopefully you got the gist (and maybe had a bit of a giggle too).

So sorry OP...
PLEASE contact the crisis team or your GP if they're open today. Read the instructions on the mess and you'll see that these feelings are horribly predicted. Either a higher dose or diff AD could change things. I tried two different ones and have ended up on 225mg venlafaxine. It HAS taken a long time and still in the woods but nowhere near the despair you feel; you do have other options than suicide- or before you need to consider it so closely. That sounds awful but suicide can feel like a logical almost comforting option. No one can or should tell you that what you feel is wrong, just try the other paths..? With kindest thoughts x

Err meds, not mess. Soz

Contact someone now or ask your OH to do it. Print off what you have wrote here and show it to someone who can help. Don't wait until Tuesday. Your OH need you as do your gorgeous children. Even out of hours doctor to start getting your citalopram increased

Hi Purple. I know what you're going through. My PND took a similar course.

My thoughts are that 20mg Citalopram is probably too low to do anything. It's the starting dose if you see what I mean. Mine was increased to 30 and very shortly afterwards to 40. Then it started working.

What you have is suicidal ideation, thinking about suicide all the time, plans etc. Tell the GP this. It will trigger the next lot of help. Unfortunately or fortunately (depending on your viewpoint) it is very unlikely they will suggest hospital for you at this stage. They are more likely to refer you to a psychiatrist. This sounds more scary than it is in reality. They are just doctors who know more about these types of drugs.

Suicidal ideation is very distressing and exhausting to live with and can obviously tip over into becoming more actively suicidal. You need to turn your thoughts away from it. I know much more easy to say than do. I looked at suicide prevention sites online. They really did help and it made me see again how ridiculous and serious it all was instead of, as you say, coming very easily as a response to everything.

So a trip back to the gp for an increase in dose and trying to manage the thoughts. You are an intelligent woman and it's time to turn the power of your intelligence and determination and get the better of this thing. Your family love you and you them and you will have many happy years once this illness is over. You just need to stay alive now.

Talk to your DH and get him on board re the tidying. Stress how important it is and how it will make you feel hell of a lot better. Get him to blitz it for 15 minutes and you join in if you're able (i remember i could do very little). Your DH can do that much even with his other commitments. Everyday and it will make a differnce soon. The house repairs I sympathise with. We are in a similar position. But if there's no money, there's no money. It'll just have to look after itself. You have bigger fish to fry at the moment. Put it in a box and sort it later.

All the best. Take care of yourself, you'll be very glad in years to come that you did xx

Hi guys, just checking in to say thank you all very much for your kind words and advice.
I didn't know that some ADs can make you suicidal -that sounds like a sick joke I ever I heard one!
Thought I would update people. I didn't go to the OOH service yesterday as I didn't feel the need - while the thought was still in the back of my mind, I made the decision to keep busy and took the kids to their gps where we stayed till OH got home from work. I feel like as long as I don't have the opportunity I will be fine, and ATM, it's only one specific method that I have thought of - for example, I have plenty of other things right here that could be seen as means but have absolutely no intention of trying them. So I am avoiding giving myself any opportunity.
My 6yo is noticing things aren't right and is getting ultra clingy so I am determined to stay strong today, then go back the GP tomorrow when school's back.
I PROMISE I am not in denial or anything, I am just trying to manage the situation as much as I can, take back control etc, but if I feel even slightly worse I will seek help sooner.

Thanks for listening.

OP, I could have written this eight years ago after my first baby. I too had made a plan and was just working up the balls to do it.

I was told that when I felt so strongly about it I should go to A&E and they will help. Im not sure what ringing NHS direct will do...you need immediate help. Please don't get so far into it that nothing means anything, I suspect your well on your way. Clearly their is some part of you that knows that you need help. Trust me when I say your husbands job is way down the list compared to his wife killing herself leaving two young children. Please talk to him. I know that this is hard but once its out there, knowing that he knows where your at does relieve some sort of tention for you. You are ill and CAN be helped but you need to allow yourself to be helped, this is one of the things I mean by so far into it- don't switch off.

Im sorry if im not making any sense, but I suspect you know what I mean.

Having been here myself I want to cry reading your post it brings it all back. Huge huge hugs, trust me it does get better but you must seek help.

I want to pick you up and give you a big hug, if only that would help!

Your dose of citalopram is way too low.

I suffered horrendous pnd after the birth of my first child 12 years ago. It took a dose of 60mg a day to start to see an improvement. I don't think they are even able to prescribe that dose anymore now - I think 40 mg is the limit - but sometimes they will make allowances if they feel the risks outweigh the benefits or they can try you on something else.

I also found the post natal illness association a big help. They have a great forum and I started a diary and used to write about my feelings.

It did take me a while to recover - about 2 years but as dd got older and more independent things improved as well. I went on to have my second child 2 years ago after thinking I would never want to have another child because of the pnd and I haven't suffered with it once. I haven't taken any medication for depression for about 9 years now.

Good luck... Please do seek more help. I have been suicidal and on the edge of my sanity and still hospitalisation was never ever mentioned as an option for me so please don't feel scared.