Postnatal anxiety and when to turn to ADs?

[SweetieTime]

I gave birth the twins 6 weeks ago, I had a really good pregnancy and had a planned section at 38 weeks. I think I had pre-eclampsia as I had very high blood pressure and fluid levels towards the end. I was discharged from hospital only to have to go back in a few days later with disturbed vision. I still have blurred vision and am seeing an eye specialist about this but no answers so far.

So I have had quite a lot going on as well as caring for new born twins. I have felt very anxious but not really about anything specific. I think I hadn't been prepared for the overwhelming nature of parenthood and what the next year will hold. I have always been a very organised and in control person and feel this has now gone.

I am not depressed or tearful but I have totally lost my appetite and have this feeling of anxiety in the pit of my stomach for a lot of the time. I have been trying to manage this using diazepam (Valium) as needed but the GP has suggested going on ADs as a longer term solution as he doesn't want me to continue doing this due to the addictive nature of diazepam.

I am reluctant to go on ADs because of the side effects of getting on and off them and while on them. He had prescribed me citalopram but I haven't taken them as I have heard about the side effects. About 10 years ago I used paroxetine (Seroxat) but I know this has had a lot of bad press since I was on it.

I am not sure if to try to continue as I am, try to get some talking therapy or get on the ADs sooner rather than later. I know this is really a decision I need to make but would like to know if anyone else has had this and had a positive outcome.

Becoming a parent is really overwhelming, I can't imagine what it is like with twins. Once they get a bit older you can feel a bit more in control but it will always be a bit all over the place depending when they decide to fill a nappy, get ill etc!

I had a lot of anxiety after ds was born, turned out I had post traumatic stress disorder. I had a de-brief with the hospital to go through my notes from my labour. Then I had a specialist therapy for ptsd, which worked amazingly well, a lot of the anxiety just fell away. Have also had general counselling, which has helped to have someone I can be honest with and not worry about their feelings about my ds.

I was also not keen on taking meds as I didn't want my appetite/sleep to be more disturbed than it was. Also in my past there are clear reasons why I felt worried about my ds (bereavement etc) that I needed to deal with. My reluctance to go on meds may also have been to do with being in control though.

I have sorted out a lot of crap in my life and am probably the most happy and mentally healthy I have been in my entire life. It's not been quick and it's not been easy but there is support out there.

I go to a parents support group and it really helps to have other people who aren't having (or pretending to have) an easy time of it to talk to. Also would recommend the book What Mothers Do..., it's quite hippyish in parts but it helped me articulate just what is so hard and overwhelming about looking after a baby.

Thanks Kits. I have a GP appointment on Tuesday so will ask if there are any parent support group in my area. I would prefer to try talking therapy rather than longer term meds. I will have a look at that book too. I have read a couple of good articles and blogs recently so don't think I am alone but it is hard to remember this at 4am when at my lowest.

The twins are awesome BTW and I feel so blessed to have them and hate to be feeling like this when I have so many positives.

I had bad PND (was quite suicidal at the worst) but couldn't take ADs because of a previous severe adverse reaction, so I had to do the best I could with therapy + lifestyle stuff (trying to prioritise sleep, some exercise etc). I think it was harder work and took longer than a successful choice of AD would have done, but I also feel that I had the time and space to address, at least in part, the roots of my reaction which was a big help and perhaps more helpful long term. I saw a mother and baby therapist (which I think is the 'gold standard' if you can afford one or are lucky enough to have an NHS provision - we live literally five mins from the Anna Freud clinic so was v. lucky to get this on the NHS) and also a psychologist at the local children's centre. (The psychologist was just for me, though I went with DS to start with while he was very small and I was still on maternity leave.) I also did a lot of reading about attachment and attachment difficulties and about the relationship between a traumatic pregnancy (which I'd had) and difficulties bonding. My GP was very supportive and saw me weekly in the initial difficult phase while I was waiting for referrals to come through to other services. She stressed the importance of addressing the sleep and exercise issues.

DS is now nearly 14 months. I never felt good after the birth - i.e. the PND set in pretty much immediately - and I'd say I am 90% recovered now and have been for three or four months. I first sought help in, I think, February last year, and started seeing people other than my GP about 4-6 weeks later. I saw the mother and baby therapist until October, and had my last appointment with the psychologist in November. Coincidentally, I was started on steroids for an unrelated condition (rheumatoid arthritis) in June and they definitely helped my mood as well. I am now coming off them but having to do so very slowly. It was a slow process but I remember the worst bit as being, roughly, February-April, with gradual improvement after that, and feeling consistently more like myself (with some blips) from about July.

I think if I was advising someone in the same situation who didn't have the medical issues with ADs, I would suggest combining a low dose of a fairly innocuous AD (like citalopram) - which you could discontinue if you don't get on with it - with whatever therapy you can be referred to/can afford, with mother/infant therapy - infants in your case! - the priority if you can access it.

Hope that gives you some sense of what it's like to tackle this stuff without meds, feel free to PM me if you want.

Thanks for sharing your story too. I know it will be tough and not a quick solution but I want meds to be a last resort for me. I will look into the therapy you suggest in my local area too. I am going to discuss all the options with my GP but I might come back to you after that. Thank you so much for the offer as it is so nice to know I am not alone.

Kalidasa following an appointment with the GP yesterday I have started taking sertraline. I took my first dose yesterday afternoon and this morning my anxiety is really bad and I was restless in the night. I will see how I get on today as the GP said my symptoms and the side effects might take a week to go. I hope they lessen very soon, I don't suppose you have any idea how long this will take?

Hi sweetie. I'm afraid I'm not sure. I do know that ADs can take a while to work, and that you can feel worse (or at least, odd in a different way) before you feel better. I am not the best person to ask as the reason I can't take ADs is that I had a very extreme (and very unusual!) reaction to a tiny dose - it immediately triggered a manic episode. But this is v. v. unusual - and to be honest it was also completely obvious as I felt quite mad. Maybe try posting on mental health where loads of people will have experience with sertraline - how long it takes to work and how to handle the side effects.

Was your GP able to refer you for any counseling/therapy as well? Or are you able to afford some for yourself?

I am not sure these type of AD meds agree with me either. I had a terrible reaction (deep depression and crippling anxiety) to half a tablet I took so I haven't taken any since. I will go back to see the GP but earliest appointment I can get with the same Dr is next Thursday. I will speak to the health visitor who is coming tomorrow to see what she thinks as I think she can refer me to NHS talking therapy.

In the meantime I have been recommended a private counsellor, by my reflexologist, who specialises in natal support. I have spoken to her over the phone as an initial consultation. I am waiting for her to come back to me with dates for an appointment. I feel much more confident that this is the way for me to tackle the anxiety rather than resort to meds.