In the news - is support for PND chanigng?

[bealos]

I can't stop thinking about the incredibly tragic case that's been in the news today. A mother killed her two, small children when suffering from post natal depression. And then also tried to kill herself. She's been admitted to phychiatric facility.

The reason it's bothering me so much is because there's so little support and care for mothers beyond a few weeks after the birth (and, I found, little more than a 'are you feeling sad?" questionnaire.)

I suffered from (self diagnosed) PND with my 1st child and am now (7 years later) expecting my 2nd child. It does make me worry.

Do you feel that support for mums with PND is changing? Are we able to access better resources? Or are you experiences none too good?

www.bbc.co.uk/news/uk-england-london-20136443

yes same here, it is hard but i am fine now as well, but that first year of ds4's life is just a blur, i really dont remember it as well, with support mums will get better, but it is hard.

i cannot imagine how that poor mum is feeling :( i actually dont know how you could live after what she has/is going through :( poor woman :(

pilgit I think the case was horrendously tragic. Clearly the woman was seriously ill and deluded. I feel so sorry for those little children, the father and ofcourse the woman herself who has lost her children.

I am not sure what can be done to prevent such a tragety. I think that partners need education in how to spot signs. They need to know who to contact if they believe their wife/partner needs help.

Extreme postnatal depression/ anxiety/ postnatal pychosis is very rare. In my experience my health visitor was totally out of her depth. I think it would better to employ a community mental health nurse to work with women than a health visitor.

I would like more to be done to embrace positive pychology by the NHS in general. I think that massive care needs to be taken to prevent women becoming overly dependent on health professionals and developing into revolving door mental health patients.

Agreed care is patchy, and healthcare people need to know a)that PND doesn't just mean you are staying at home all day crying, and b) that practically all drugs are in fact OK for nursing and pregnant women.

I mostly managed PND by getting out and about, but actually got it triggered by a baby group this time, run by a HV who said she had had PND 'so I know all about it' (hint: no-one does, and you sure don't), who was patronising as hell and would tell us off for not paying for the baby group and other things, having never actually said that one had to pay, how to pay, or mentioning the other rules. The baby group then got cancelled thanks to various politics between local PCT and SureStart, but the amount of lying to mothers and at one point telling us "you can't come to this group any more - you've been coming too much and other women deserve it more" - while the room was far from full - made at least a dozen women with PND or near to it, feel terrible and totally unsupported. The phrase 'talk to your health visitor' keeps getting used, which is incredibly annoying as in most oversubscribed areas you don't get one - apparently mine is officially the one who turned up after dd was born, but I have no idea what her name was as she refused to look at me or write anything down!

Not sure what the best support is, as suspect like other depression it;s a very individual thing, but encouraging mothers to lower standards and to get outside for any reason are probably both useful. My GP asked if she should get my HV to visit. I said I'd be happy to chat to X who I'd met at the Children's Centre, but wouldnt let the others in my house as they're all bonkers and/or ignorant (GP totally agreed!) X has visited a few times which is nice, but if you are feeling the weight of every minute, half an hour is only a tiny fraction of a day, and I felt it didn't help with that. Much more useful has been one of the local Children's Centres, where even if you turn up and there isn't a session you're allowed in at the time, or it's full, they will encourage you to sit in the lobby, have a quick word, play with your baby, and generally treat you like a human being rather than an over-entitled person getting in the way of their services. Letting my older child in to play while I chat to people has been a total godsend - but I only found I could do that by luck! Other Children's Centres have been much less welcoming - very 'here's a list of sessions, yes there's about one a week you qualify for, now go away for H&S reasons'. Baby groups where you don't have to be 'educated' (which all CC ones have to do now) or get religion, would be very much appreciated.

I suspect it's a paranoid culture - I had routine SAD while pregnant, and as advised by previous medics, started taking my ADs. Fine until I went to get a new scrip and new nervous GP said No. I told him I was already taking them, as advised previously, etc. He told me, 6 months pregnant, "You are putting your baby at risk. You are damaging your baby." Luckily another GP wrote the scrip but then I needed to get the head of perinatal psych at the hospital to write on my notes that this was not a problem (or as the MW who phoned him relayed, 'would everyone chill the hell out already'!)

One thing I did find difficult to deal with was those questionnaires which only ask whether you might hurt or kill yourself (and this is often the only answer staff seem to look at). They don't ask whether you fear you might harm your children, even from neglect or desperately needing sleep. I'm an articulate professional with huge experience of fighting for treatment I need from the NHS, but this omission made me feel either that this fear was so rare that no-one could help me with it, or it simply meant I was such a terrible person that no-one would consider helping me with it.

Luckily, as I was walking out of the house leaving my two children for their own safety, looking up train times, I saw an Active Convos thread about Cerazette causing PND. I stopped taking it. I was back to full sanity within a week. None of the HVs, childcare workers, GPs or the consultants had mentioned that might be an issue.

I don't think you can say that a fear of AD's damaging a baby is a delusion.
I haven't heard any doctor to say AD's are 100% safe when breastfeeding or pregnant. And this leads to problems we know. Some people start taking them but stop, because of the fear them damaging the baby. They do not want to tell doctor (or anyone else) in fear the baby is taken away if they do not comply. Then there are people with pre-existing illnesses, which need medications that cannot be used in any case while breastfeeding. This kind of people won't go to GP's when they start to get symptoms, because they fear the baby is taken away if they do not take the meds, too.

I would suggest that depressed women on AD's who breastfeed should be checked out more often, because they might stop treatment more abruptly than bottlefeeders.

But bansku, how can you say all that? You said unthread that pnd "don't exist"?

My GP and HV encouraged me to bf on antidepressants, in fact I fed dd2 for 23 months.

But bansku, how can you say all that? You said unthread that pnd "don't exist"?

Because I think so today.

Such a desperately sad case. Ive found it very upsetting to read about it.

I agree with strawberry - think the fact that the mum had stopped takng the ads abruptly very significant.

I have personal experience of the terrible terrible mind distortions that this can cause.

Im not against ad's - but for a long time have strongly felt that patients (not just those with PND) should be much more closely monitored when they go on and come off them.

I had a traumatic birth then two weeks later was left fighting for my life through an unconnected issue. My recovery was slow after surgery to fix me up and prior to my 6week chk I told my MIL something didn't feel right - more than just the blues. She came with me to my 6-week check up for support but the GP there made me feel small and she said "every woman feels like you once they have a baby." I felt stupid and upon leaving swore I would never mention it again. That was in the October. The following February I had a complete breakdown in the GP surgery after going there with the intention of getting antibiotics for a chest infection. I had completely lost the plot. This was after weeks of crying, rocking, feelings of worthlessness, thoughts of suicide, speaking to myself, the feeling of going mad and constantly wanting to pull my head open because 'it' just wouldn't leave me alone and being too scared to go outside. I was scared people would find out and take my baby away, brand me an unfit mother and my life would completely fall apart. This was my third baby and I had never experienced PND before. It was triggered - they say - by a traumatic birth followed by a bout of serious illness.

I would not wish that condition upon my worst enemy and after spending 2 years on Citalopram I have been off meds for 2 years now but it all still feels very recent and my mental health has been left with a scar - as I call it. My confidence is all gone and I am still slightly reclusive but I don't need the meds anymore and if I notice any feelings of sadness that remind me of how I used to feel I get straight on the phone to a friend for support. I am not the same woman I was before I had my daughter (and I miss that ballsy woman) but I have managed to get through it and still hang onto my sanity without anyone getting hurt.

Others are not so lucky and for those women and their families I feel so sorry.

SparkleSoiree thanks for sharing. It sounds like you've been through an awful lot.

Ruby Wax has been speaking recently about how when you have a disease somewhere in the body, then everyone is sympathetic, but when it's a disease of the mind, less so. I think a huge culture change needs to happen around this. Mental illness is not invisible and won't go away.

PND is well known and well documented. Yet, I don't feel like doctors are taking this on board. Often a cry for help, a doctor's appointment is often the culmination of weeks, months of depression or sadness. The phrase 'baby blues' just makes me so angry.

Bealos I had to write a paper recently - from a completely novice angle - on mental health illness and human rights. One thing that stood out from my research into the issues was the fact that some treatments are not 100% effective or that a huge amount of experimentation still goes on without much success. Who wants to offer themselves up for research into mental illness - really?

I also think it depends on your GP whether or not you receive good support. Some GPS are very interested in the subject, others are not at all and fob you off as in my case initially. I have no idea what could be the way forward with so many people even doubting the condition exists ..

I think everyone at some point in their lives feels down or particularly sad and to them that may be their understanding of depression. So when someone else starts to voice similar symptoms the attitude of 'get a grip of yourself' or 'everyone feels like that' start to echo about when in actual fact depression in its varying degrees is not just feeling sad or a bit down. I think this is a distinction that society fails to comprehend.

Thank you for those great posts, sparklesoiree. Well done for getting through.

Much of what you said resonated with me, in particular the "scar". Certain experiences do change you, leave you more fearful, less resilient. It's hard to explain to the "what doesn't kill you makes you stronger" brigade. Sometimes it feels like it is killing you, just slowly.

I feel guilty for depression. I am having therapy at the moment and it isn't working. Part of me wonders if it is because I keep imagining my mother insisting I am fine and I feel like a big attention-seeking fraud. I sit there in the room with the therapist thinking "she should be seeing people with real problems, I am wasting her time". I think I am going to stop this. I fought hard to get it but I am no better.

In someways I can understand what bansku meant up thread.

I suspect that postnatal depression does get a bit over diagnosed (especially by those who "self diagnose") In certain circles having postnatal depression which cures itself within weeks without medication is fashionable.

Sometimes I think that health professionals are far too quick to diagnose depression when the person is simply unhappy for good reason.

It is possible for someone to go through emotional hell without actually being ill. Certainly someone going through a difficult time in their life may experience extreme sadness (ie. breavement, loss of a job, divorce, having a disabled child)

The type of treament such a person needs is very different to someone who is sad only because their brain chemistry is f*cked. In the past churches and communities took on the role of supporting people through difficult times.

Experiencing insanity is a truely humilating experience and I'm glad it's rare. I don't think I less relient for having a breakdown ten years ago, but it certainly knocked my confidence. What I experiened was an attack on the inner soul and what is fundermentally me. This type of post natal depression is not fashionable and carries a huge amount of shame.

I am impressed that bansku had the courage to admit that she was wrong. It make this thread worthwhile.

If they HV had come to do a "spying" visit on me she would have found a smiley mum, with a slightly messy house, 3 clean and happy DC.

But no one came.

I had a home birth, the midwife came back letter that day, then the next day, the HV at 10 days, and I had to phone up for the midwife to come back for the heel prick. I aced the "test" given out at the 6 week check, because I thought it was a test you had to past, and I could tell which answers were "correct". That was it for the first year.

I never went to have DD weighed.

They didn't know what was really going on.

reallytired I have no problem saying my PND was 'self diagnosed'. This does not make it any less real. I had an incredibly traumatic birth with regular flash backs for months.

I was seeing health care professionals at the time, including a counsellor, who failed to offer me the support I needed or identify I needed help beyond the weekly meeting they gave me.

I think mums who have been through this once are rightly thinking about how it might affect them a second time. It's good to talk through the options with your partner (if you have one) whilst you're pregnant. It's something I find quite hard to share though (different partner with soon-to-be dd1 than ds1).

meant to say earlier (got distracted by work - mumsnetting in lunch break) that my heart goes out to that poor family.

ADs and breastfeeding- I've done quite a bit of research into this as I take venlafaxine and mirtazapine daily (and am 7months with no2). The issue isn't necessarily about them being affected by it when breastfeeding continues as studies show on a lot of them that there are no discernible effects. The issue is more of discontinuation syndrome that occurs when you have to wean them off. DD1 went through this at birth from a much lower dose than I take now. It was horrid to watch but thankfully she will never remember the junkie jitters she had at 24 hours old. within 3 days she was fine and we bottle fed. As discontinuation syndrome can go on for differing times depending on the drugs it really is a circumstance based decision. However mothers on ADs should be made fully aware of the issues so that informed decisions can be made. For me, knowing how bad weaning off ADs can be (from personal experience of it) not breast feeding was the best option.

Help for PND isn't the only area where mental health care is deficient, alas.

Piglit you're not wrong there, there is no support or advice for people on how to come off AD's safely and properly.

Piglit I'm glad your daughter's fine now, & sorry you had to watch her go through that.

Some people find that breastfeeding helps, because the baby gets tiny amounts of the drug (some drugs) in the milk and that helps them come off more gradually, or that it makes no difference because the drug doesn't come through to the milk anyway.

I've a friend who went through similar and now know midwives who specialise in supporting women with MH issues through pregnancy & birth. I wish my friend had had one of these knowledgeable specialist MWs. I think having to 'explain herself' to each new & worried MW (about the drugs she was on, with of course full consultant support) was very stressful, and unnecessary.