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.

Well, I had a pretty good night's sleep - at least 6 hours. DD woke me with coughing and I think I woke her with my snoring but we both got back off which has been unheard of of late. DH did the nightshift with DS. Again. Although since he has started doing it my son has apparently started sleeping through from 11-7 . I think I have to do the nightshift with DS tonight - a really scary prospect but I think the longer I put it off the harder it will become.

I have been telling everyone how much I appreciate their support - and I so do. I realise I am fantastically lucky to have such support. DH and DD are off to the in-laws for a week or so for some respite, and poor old mum gets to stay here and babysit me and DS.

I used to be of the brave face disposition, but not any more. There's no hiding it this time.

Mental health team who came this morning have suggested changing my main anti-d meds to Mirtazapine (sp?), apparently citalopram is always prescribed because of NICE cost/ benefit calculations and Mirtazapine is expensive . It also has some strange side effects like weight gain but to be honest I really could't care less. Would rather be large and happy.

leonie, that is really interesting - thanks, giving the citalopram till mon for anxiety symptoms to start diminishing. even then tho am wondering if mirtazapine might be a better fit for me as the night time sedation would help my insomnia - have had it on and off for years but chronic at the mo. not helpful with new baby....

narmada mirtazapine is definitely meant to be really good for sleep. Basically that one and amitriptyline and dotheipin (which are tricyclics) are all sedating and much better for sleep than the SSRIs. The GPs keep on pushing the SSRIs though, as they are the modern thing. They don't seem to get the sleep issue.

Getdownyouwillfall who is a regular on our insomnia board swears by mirtazapine - she's just managed to get off it but was on it for at least a year. It completely sorted her sleep out!

well i doubt 10 hours are on the cards - god, that sounds like heaven - but just being able to sleep when my baby does would be a big mprovement for me

thanks arcadia, too.

How about going to a private Paed (instead of waiting for an NHS one? A couple of appointments are not going to cost anything like a M ad B unit. Maybe a few hundred pounds at the most.

He/she might have some good advice for your baby.

Pippop, thanks for the idea. We have a fairly quick NHS appt. - it's under 2 weeks and we are trying to get a cancellation.

I did the nightshift wiht DS last night for the first time in ages; for my DH my son has apparently been sleeping through fro 11 till 7. No such luck for me - he was down at 11, after being held and jiggled all evening, then spent the next 4 hours grunting and writhing although staying asleep, and then was up at 4 ish properly awake. I fed him, then he grunted and writhed and I had to walk around with him for nearly 3 hours. Even when I did get him down eventually for another half an hour, he was being so noisy with the grunting and writhing.

My mum is going to do tonight. See if she has better luck.

Sounds like a rough night narmada. Well done for getting through it though. I think you sound a bit less anxious than you did before, is that right?

A bad one here too - DD coughing most of the night until 3am by which time I was wide awake and couldn't get back to sleep til 6am when i got about an hour an a half.

Even though it was a terrible night (and now DP is in bed really ill too) and I'm really worried about DD's cough, somehow when you're in the thick of it and just have to get in with it you just do. That is why I was a bit about the hotel idea - though I understand it as you have a small house (we have the same problem). But sometimes you are only confident you will cope when you have to, with support of course.

Hope you are feeling a bit better though. You certainly sound pretty sane to me !

sorry you had a rotten night too. and your DP is ill - really tough.

with the reflux the thing that freaks me out is it could go on for months and months - the paed may not have all the solutions cos that is the nature of the beast. sure i can cope with one night after several at a hotel, getting medicated sleep. but day and night after night?? it is physically and mentally un-doable, it seems to me. sorry if that sounds defeatist :(

Thanks, at least I have managed to get out of the house and do the tesco and pharmacy run. Now both my babies are asleep! (the big one - DP - and the little one!).

narmada you are doing the classic thing that us worriers do - projecting into the future. And you're scaring yourself by thinking 'ok I've coped now but how will I cope in the future?'. This is actually an improvement from a few days ago, when you didn't feel that you could cope with that day. So in fact you have improved enough to start worrying about the future. We can all think 'what if?' but you just have to deal with the concrete, the here and now. You may find that your baby starts to sleep much better, or you find the right medication for him, or as you recover from the birth you manage to sleep better, so when you find yourself thinking 'what if I can't do this?' try and think 'but I am doing it'.

I'm being a bit tough with you and I'm a worrier myself so know you can't help it but try and find a mantra such as 'where there is life there is hope' - that seriously helped to get me through the worst time of my life (the first 8 months after DD was born). In my head everything was completely bleak but I told myself that and eventually, slowly, things did improve and it will for you too. x

Leonie and arcadia, you're both right of course. Just hard to remember in the thick of things.

I know narmada. Telling an anxious person not to worry is like telling a dog not to bark or a fish not to swim!

Too right. I wish they could take the 'worry' part of my brain away.

I have decided on some coping strategies - partner and I are going to do one night on, one night off, with DS otherwise it will take me an age to get better from the PND. I truly believe it was caused by the sheer relentlessness of sleep deprivation, pacing around all day and the screaming. Also, we will look into having a night nanny once a week to give ourselves a break. That means me and/ or my husband sharing room with daughter on a regular basis but hey ho.

I know the PND/ anxiety is the main problem at the mo but as some other sensible person said on this thread, I also need to address some of issues that brought things to a head - e.g., my son's reflux and the extra work it entails.

leonie, yes, was feeling ok last night. not so great this am, been to GP again for review, not keen to switch me to mirtazapine.

mum looked after DS last night. he slept 1130-345 and then she had to pace around with him till 530, then he and she slept till 730. she is bloody brilliant. i slept in spare room medicated but still wide awake from 5 am, puking with anxiety from 7 am. my DP and DD are away at the in-laws for a break.

i really wish i had been on the mirtazapine from the start. now on this citalopram/ zopiclone rollercoaster, coupled with the underlying depression/anxiety i can't even get back to sleep if and when my son does after the middle-of-the night pacing sessions.

still feel trapped.

Hi narmada sorry you are still struggling. As arcadia mentioned earlier, I have found mirtazapine great for me. It really helped my sleep so much.

I didn't get on too well with citalopram or zopiclone either. Citalopram sent my anxiety through the roof and I had terrible nausea and vomiting on it.

Glad that your mum is there to support you.

My mum did the same, but I found I still couldn't sleep even if I wasn't "on duty". Felt it was still my responsibility and felt awfully guilty that my mum was up in the night

I hope you get the mirtazapine, as I say, it really helped me and suited me so much better than citalopram. I never gained any weight on it either, despite all the warnings and horror stories they give you.

getdown, i am seeing the consultant psych tomorrow and think i will ask for it from her. i really don't care about the weight gain or lethargy or any of that. with a reflux baby whose sleep is even more erratic than a normal newborn i really do need to be able to sleep when he does.

did you change straight from cit/ zop to mirtazapine and if so how long had you been on the former before changing? my only concern is if there's a risk i could go backward for a few weeks....and/ or suffer withdrawals from cit/ zopiclone.

he thought i should stick it out on the ctialopram/ zopiclone leonie, said risk of me going backward but i can't keep taking the zopiclone indefinitely and it doesn't even work that well!

GPs don't generally give out mirtazapine as it's not a "first line" anti depressant - whatever that means. It's good you are seeing the psychiatrist as they are much more knowledgeable about all the diff ADs and their side effects and will be much more likely to give you mirtazapine than the GP.

I only took citalopram for 3 days as the side effects were so horrendous, so don't think long enough to get any withdrawal. However they put me on a different AD after that which also didn't suit me (lofepramine) and I was on that for quite a few months before finally switching to mirtazapine. I didn't have any particular problems with the switch over.

My main problem had been with the sleep and mirtazapine sorted that out overnight (literally).

I wouldn't take zopiclone every night if I were you, it can be quite addictive. I take them very sparingly. I was also given temazepam - have you tried that? It's also addictive though so you need to be careful how often you take it.

You WILL get through this. Feels pretty hopeless at the moment, but it will get better.