considering mum and baby unit - please help

[narmada]

hi everyone, am hoping for some advice.

i have a new son aged 7 weeks, and a daughter aged 2.5. my son has reflux which means he has been unsettled and cried a lot since birth. he needs to be held for all daytime naps and/ or paced around the house to prevent screaming. he is on meds and we are awaiting paed appointment.

i have been feeling totally unable to cope and just want to run away. currently my partner is doing every night shift with the baby, my 70 year old (but fit and active) mum sleeps in with my DD and is basically caring for her. i have been staying at a local hotel on the advice of local mental health team, who are heavily involved with us. they presented this as an alternative to going into acute care because i felt totally unable to stay at home and was saying i needed to get away and couldn't cope at home, the idea being to give me some space for a few days and chance to rest.

i am on citalopram but having horible anxiety and panic symptoms,which i know are normal on this med,am on zopiclone at night to help me sleep but averaging about 5 hours before waking up totally unable to get back to sleep in a state of sheer panic.

by going to the hotel i feel i am becoming less and less involved with my kids each day - i can't wait to escape in the evening, but in the morning i semi-dread coming home and am feeling less able to cope as the days go by.

last week i was pleading for inpatient treatment of some kind but don't want to go into local psych ward as nightmarish mixed sex place and my kids won't be allowed to visit and i fear i would never come out. i would just spiral lower and lower and how would it help me feel i copuld cope with the kids? in any case they wouldn't admit me as say i am basically not ill enough as not suicidal or psychotic. there are no local nhs mum and baby units - the local one has closed. and again they say they will not refer out of area because am not ill enough.

i keep thinking it is for the best to go to a private mum and baby unit and pay. it would wipe out all our savings, meant for a house, but i feel the alternative is our family falling completely apart. my mum and partner cannot look after the two kids forever on their own and i am worried they will both collapse from sheer exhaustion and then where would we be? i am also puttying myself under real pressure to get better quickly because they are dealing with the burden of everything at home.

does anyone have similar experience or any thoughts? please?

sorry if this is a bit rambly and long but unsurprisingly finding it hard to concentrate at the mo.

i should also say i had PND after my DD, but it was nowhere near as bad, not even close.

That sounds awful for you narmada, how scary. When my DD (now just 1) was about the age your DS is I thought I wanted to go to a mother and baby unit and was convinced I would end up there or worse, in a normal psychiatric ward. I had really bad anxiety after she was born. However, within a few weeks things settled down. Remember that your hormones will be all over the place and it is a massive adjustment even with all the help you have in place.

Have you started the citalopram recently? I've heard it's very good for anxiety. If you have just started it then it may take a week or two for the initial side effects (which can include increased anxiety) to die down and for it to start working.

I'm sure someone will come along soon who can help you more, but try not to panic and take one day at a time.

Also narmada try not to worry too much about your DP and your DM and how they will cope. I was exactly the same, worrying about everyone around me getting exhausted, but I was distorting it in my mind and actually they will cope with it if they have to, and you need them at the moment.

thanks arcadia- yes started citalopram 20 mg about 11 days ago. . they sure are making the anxiety worse in the short term, i knew to expect this as have been on SSRIs before. just never ever been this bad. even when well i cannot see how i can cope with such a high need baby and demanding toddler....it is scaring me to death. i know he will get better and older and it's my pnd/anxiety that's making it seem even worse than it is but........

You really do have my sympathy. My DS2 had dreadful reflux and the constant screaming and pacing around the house drove me to despair and by 6 months I was on medication for PND. I too checked in to a hotel and spent a couple of nights at a friends just to get away. How long ago did you start the meds? I found after a few weeks I really started to feel I could begin to cope again. I don't have any specific advice but wanted you to know I really understand what you are going through. The reflux issue really tipped me over the edge so don't underestimate the effect that has on you on top of the hormones. Accept all the help you can and try not to worry about those who are helping you

emlim, thanks, that really helps to know about your experience. it is the reflux hat has tipped me over the edge too i think. glad you came out the other side and astounded you made it to 6 months before going on meds....

Hi there, sorry to hear you are having such a difficult time. The reflux sounds awful and it's no wonder you are struggling when your newborn is so demanding.

I would echo what arcadia said re. your mum and your DP. When you are ill all your anxieties are exaggerated and you tend to catastrophise everything. When I was really ill with PND I was convinced my grandfather would die because my mum was spending so much time looking after me. Also that my DH would leave me etc. etc. They were out of proportion worries and were caused by the illness.

I spent some time in a mother and baby unit. I did get better there, but it was quite scary to be taken into hospital. I think if you can possibly manage to stay at home that would be better, but of course if you really can't then mother and baby units are good. They do night feeds for you and give you lots of support re caring for your baby. Don't know what to advise re private ones and the cost though. Is there a private one near you, that you could visit maybe? That's really bad they closed the local one

there is a private unit in eastbourne which is 2 hours drive away. i think it costs a truly eyewatering amount - we are talking tens of thousands of pounds.

i know what everyone is saying is true e.g. catastrophising, worrying about everyone else, but so hard to think myself out of it. my mum is getting on a bit and is herself on treatment for depression ( altho currently well), and our DD altho gorgeous is not the easiest child.

Don't worry about anyone but yourself right now. They can look after themselves, honestly, and probably are just glad to be in a position to be able to help you right now.

Are you sure you couldn't get into an NHS MABU? I know in our one (hertfordshire) they took people from as far away as scotland sometimes.

Tens of thousands of pounds is an absolute fortune (although of course worth it, if it gets you well).

I think sometimes when you are in the midst of feeling dreadful (or in my case anyway) you feel much worse than the professionals have assesed you to be. I had AND with DS1 and was so sure I would be hospitalised and have him taken away from me. Although I felt the worst ever they did not think I was bad enough to be admitted, what I am trying to say is to trust the professionals as they have so much experience and will admit you to a M and B unit somewhere should they feel it comes to that. Taking time out at night in a hotel sounds like the way to go for now, each day at a time and all that.

I had never heard of reflux before so it came as really quite a shock as I must admit the jump from one child to two was much harder than I ever imagined, dealing with one difficult baby is one thing and then with a demanding toddler aswell combined with utter exhaustion is so, so tough. I probably should have gone on meds sooner to be honest, my marraige nearly didn't survive that patch (baby was affectionately refered to by my DH as the marraige wrecker),it was a dreadful time BUT we did all get through it and you will too. x

Thanks emlim for your support. Even though I don't know you it means so much to hear that someone has been through similiar and survived, and that you've taken the time to post. Reflux is a terrible thing, agreed. It makes what should be a happy event - a new baby - into an extreme endurance event of the highest order. It is so not just a bit of regurgitation.

My toddler is doing lots of attention seeking, naturally, because of the new sib and also because he is so demanding of attention - e.g., toddler is now refusing to eat most things she previously enjoyed, waking early herself, either from hunger or general unsettledness I can't tell. Honestly, it feels like everything that can go wrong is going wrong but I know I would cope better under normal circumstances.

Get down, there is apparently a M and B at Bethlehem hospital in kent, which is the nearest. Used to be known as Bedlam...

Narmada - me too feeling so sorry but it was a long time ago when I had babies and I don't know very much about PND, BUT I have had 2 severe episodes of depression and both times have been hospitalised for 3 months. I am still struggling to get better but your situation is just so difficult and I do know about reflux because my friend's daughter has a 5 week son with it and 2 more under 5s and they are in chaos.

Can you not emphasise again to mental health team that you think you need a mother and baby unit - have they referred you to a psychiatrist who would normally make the decision to admit. As someone else has said, they would find you a place somewhere if they felt it necessary. I was admitted to a psychiatric ward and was not suicidal (but with suicidal thoughts which is a common symptom of depression)nor psychotic.

Can you tell them you are worried about the bonding with you new baby - it would be so much better if you and the baby were being cared for in these excellent mother and baby units. Then you DH and DM could probably manage your little girl. Naturally she is going to be unsettled, but please please bear in mind that however awful it seems now this is a temporary situation and you must not scare yourself into thinking that you would "spiral down" in hospital and "never come out" - that does not happen these days. Depression is a truly horrid illness but it does get better over time, and you have to try to believe that.

You WILL come through this but no-one can give you a timetable for when that will happen. And please please don't blame yourself (which is another symptom of depression) it's such a deceitful illness.

I really would think twice about spending the kind of money that a private unit would cost.

Hi Narmada
Sorry things are so difficult at the moment, and that you are struggling to cope .

My opinion, which may or may not be helpful, is that you may have some magical thinking about the M&B unit. It is unlikely to solve some of the issues that you have, and you may find that the financial impact of being admitted actually increases your stress.

You may also find that the other mothers have different types of illnesses and that in itself can be quite stressful. Eastbourne takes a lot of NHS referrals from areas that have no NHS M&B units, and therefore will have some seriously ill women who have been deemed "unsafe" to be at home, either through psycotic symptoms or severe suicidality.

It will give you some time and space away from home, but is unlikely to provide any quick solutions or special therapy that you could not access nearer to home as an outpatient (much cheaper) or via NHS (but may have waiting list).

I can really see the attraction of an admission at the moment, but worry that you do not have a realistic view of what it will achieve, and may be left feeling even more hopeless and finacially worse off to boot.

On a more positive note you sound like you have great insight and a supportive family, and have started some treatment and are having support from a crisis team. I wonder if delaying the decision for another week would feel like a reasonable option at the moment?
Best of luck, keep posting and getting the support on here too.

been to GP again this am who has prescribed lorazepam - another bloody drug - to get me over what everyone is telling me is an anxitey 'hump' induced by citalopram. some hump.

this morning when i woke in hotel i was sick 3 times and honestly wanted the anxitey , racing thoughts and panic to stop so badly that I wanted to be hit over the head with a hammer or something. i was hiding under the duvet to try and escape which of course didn't work. I truly hate this. it is the worst experience i have ever had in my life.

grumpy and nana, thanks for your posts by the way - they both made sense even tho saying opposing things :)

Hope the lorazepam brings a bit of relief, sounds really awful for you at the moment. Sounds really intense.
Have you made any decisions about treatment or are you just getting by day to day at the moment?
How are the rest of the family bearing up?

narmada, you will get through this you, really will....this might sound odd but I remember with the chaos that the reflux issue brings I thought I would rather be 'mad' so I could somehow opt out of life rather than have to deal with the non stop screaming, the sleeping sitting up with baby on my chest as upright was the only way he could manage to sleep, the 4 loads plus of washing a day, the endless trail of vomit and the never ending worry about DS not gaining weight well. When I finally admitted defeat I took the meds, took sleeping tablets so don't worry about taking another drug, it wont be forever and may make all the difference between just about coping and not. How are you managing during the day?

I don't know how bad your babies reflux is but it is likely to take some time to resolve so whether you go to a MABU or not you still need to find some practical ways of managing a difficult and time consuming baby. You sound like you have some good support around you. My MIL who has had 4 of her own and 10 grandchildren said she had never come accross one quite like mine and the pain they suffer with acid reflux causes a cry quite unlike anything else, so take it from me , you have very good reason to be feeling the way you do. How long do you have to wait for a Paed appointment? Are the meds baby is having helping atall?

Hope you have had a better day and thinking of you.

Narmada - sounds like a really rotten morning for you and I so know that feeling of hiding under the duvet and never wanting to come out of it to face another shite day. It's imposible to explain to anyone who hasn't experienced it isn't it.

I can see where grump is coming from and she is making good points and obviously has more info about Eastbourne NHS. I live inthe Midlands and I just know that a friend of mine some years ago suffered a post birth pyschosis (very scary as she lost touch with reality) and she went to a really good NHS M & B Unit, so I suppose a lot depends on where you are in the country and what facilities are available.

Having been an inpatient on a pyschiatric ward twice (once in April to July of this year) I have to say that even though it was an acute ward I did not see anything scarey in terms of other people's illnesses although some were psychotic but controlled b drugs. In fact I felt I was the worse person on the ward as I couldn't stop crying while evryone else seemed better than me! I think the thing is about inpatient admission is that you are feeling so terrible yourself,, what others are doing around you is of little significance.

I know what grump means about "magic thinking" - there is a feeling that because you are in hospital, you are going to get better and this can well be the case, but you don't need to be in hospital to get better. The nurses and assistants on the psychiaric wards I have been on don't really talk to you about how you are feeling. Even if they do they tend to have stock phrases "it's early days yet" and "maybe tomorrow will be a better day" - they make sure you have the meds and for me it helped that I was giving my partner and friends a break from having me around, crying and panicking at every verse end.

You do have good support narmada and this time next year I'm sure you will look back on this as a distant memory. Sorry don't mean you are going to be ill for a year, but I'm just trying to say it WILL end but no-one knows quite when that will happen. When the drugs have kicked in, you will be more able to do things to help yourself but you are far too low for that at present.

Keep on trying very hard to believe that this will NOT last, this illness has a beginning, a middle and an END.

Anyway you do have good support and are involved with the

emlim, thanks again. Our DS's reflux is of the silent variety, so we don't have the endless washing to deal with like you do - an additional stressor I am sure, what a nightmare. There is enough already. My DD had silent reflux which became un-silent at around 4 months and then we had lots of washing......but hoping he won't go the same way.

You are right about the need for reflux coping strategies. At the moment, he is on max dose of ranitidine which seems to have reduced the squirming and screaming, and we have managed to get him to accept a dummy for the inconsolable wailing times. So he is actually a bit better than he was a week or so ago. Heaven knows what he would have been like if we hadn't gone early for treatment. Paed is in about 2 weeks. We have already tried omeprazole but couldn't manage to administer it effectively due to the formulation. I am really hoping the early intervention will head off any risk of developing food refusal, as my friend's baby has this and has FTT as a result.

Other coping strategies - well, it's horrible, but my DD is going to have to go to nursery 4 days per week from january as there is no way on earth I can cope with both at home even in the best of mental states. She goes 2 at the moment and told me last night she doesn't like going because there are too many children and too much crying :(. But it is a good nursery so we will just have to plug ahead with that one.

In the day I am just about managing, as long as surrounded by people helping practically and emotionally, but it is taking its toll on them all. I am a weeping wreck most of the time although I try not to do it around DD. My partner this morning said he couldn't go on like this for ever, and he has been totally brilliant. I can't blame him at all. But he seems to be OK now. And my mum is OK seemingly although I know her and she will be very very worried about me.

I took half a lorazepam and it seems to have taken the edge off the anxiety but they are only for short term use as highly addictive and cause rebound symptoms when you stop them .

Thanks everyone for your support.

Narmada, I don't have experience of your issues but one thought i had reading your post was that if you have some savings can you buy some more support with children? Could a nanny at home for a few weeks take the pressure off all of you, allowing you to focus on you, and one or other of the children knowing that the other one is well cared for?

crikey leonie, that sounds hard. Thanks for the post. And reassurance about meds.

am not atll concerned about dependency Leonie , i have been on and off SSRIs for years and they have helped immensely, generally. still a bit concerned tho about my seeming inability to sleep without the zopiclone. and the wierd super-extreme reaction (apparently) to citalopram which have never experienced before.

mercedes, good idea and one we have considered: altho DD is not at all keen on new people and i think most nannies would last about a day with lovely but super- challenging velcro DS, bless him.

i am at home tonight. think that i need to face the fear of being at home and give my mum a break from 7 am face-painting sessions with toddler DD...she has noved to the hotel ( we have a tiny tiny house, hence all this to-ing and fro-ing).

Hope it is OK at home tonight and you get some sleep at some point
Tell your DD, partner and mum how much you love them and appreciate their support, it will be hard for them too but they will be glad they are able to help.
You sound like a battler and I am sure that you will be able to come through this too. What a lovely strong family you have, and how nice that you can be honest with them without having to put on a brave face.
Keep your chin up Narmada and let us know how tonight goes.