Feeling awful - any advice?

[limpinglimpet]

Reposting from Antenatal/postnatal depression as this forum gets more traffic.

Have NC'ed for this thread, please don't out me if you recognise my history. Sorry it's long...

Am 10+6 weeks pregnant with first DC. Planned pregnancy, stable relationship with supportive DH, no financial worries. However I have ongoing moderate-severe depression which has been unresolved for the last 3 years - in my view, the GPs haven't taken it sufficiently seriously, insisting I stay on citalopram when it obviously wasn't working fully, referred me for CBT which did absolutely nothing.

Psychiatrist I saw this time last year said I needed to increase the dose (though it had been higher in the past and symptoms not improved). I then asked about planning pregnancy, he said 'well you need to come off it for that, after all you don't want to damage your baby'. I honestly thought with my history there would be more of a discussion about the pro's and con's of stopping medication, but no.

I came off meds in March and conceived 3 months later. Since getting pregnant I have gone rapidly downhill - ongoing distressing symptoms of complete lack of enthusiasm and excitement have now spiralled and I'm almost unable to function, taking a lot of time off work, feeling suicidal.

Feel zero excitement about this pregnancy despite the fact I've always wanted DC and it was entirely planned.

Went back to GP last week to ask what my options were. In the long run, I am pretty sure I need to be on a different AD or combination of ADs - probably something that boosts noradrenaline too. GP basically said well what do you want me to do? She is trying to speed up my referral to perinatal MH team, but I guess this may still take several weeks. In the meantime I am going rapidly downhill - almost considering terminating the pregnancy so I can get back on meds.

I don't know where to go from here. I'm exhausted from feeling terrible for 3 years and feeling that no-one is listening to me or helping. I've been going round in circles with fluff/handholding/vague promises that things will get better - why can't I get an intelligent opinion on my diagnosis and what the best treatment strategy might be both immediately and long-term?

I don't know what I'm asking for here exactly. Does anyone have any advice/suggestions what I should be asking for? I feel it must all be my fault for not managing to get the right help.

Hi limpet sorry to hear you're feeling so bad at the moment. I don't really have any experience in pre/postnatal depression but wanted to offer a hand to hold.

Did your GP say how long your referral may take? Maybe worth asking so you're a bit clearer about how long you need to last out for - and then you can plan for that in a ticking off the days way.

I'm sure I've read other posters on here who have taken some ADs whilst pregnant so I would have thought that would be an option - just depends which ones I guess.

Do you work fulltime? I found it exhausting working and being pregnant, especially the first trimester (was asleep on sofa by 8.30 each night) so do try and be kind to yourself and take things as easy as you can.

Take care.

Thanks for the hand Colouring. The midwife I saw at my booking in appointment said 'a few months' but I wasn't feeling so bad then, I guess I could phone back and ask where I am on the priority list now the GP has flagged me up.

I can't take sertraline which is the one most people are prescribed in pregnancy as I reacted very badly to it in the past. I could go back on citalopram after 12 weeks I guess, which might improve things a bit.

Nominally I work fulltime though it's pretty flexible (am an academic). I was totally exhausted in weeks 7-8, have been feeling better (exhaustion wise) the last couple of weeks. But am hardly getting any work done at all, brain is foggy and I have the attention span of a gnat.

You are clearly very intelligent and am i right in thinking you know a little bit about the medications and how they work? are you a biologist at all? The reason i ask is you are very factual in your OP and I can't help but wonder if you were matter of fact with your Dr and possibly came across as more well than how you feel? Could you try another doctor? CBT totally didn't work for me, it was like, yeah, i know all this, its not rocket science its common sense, but it didn't change the way i FEEL! I find that straight-forward talking therapy works better for me.

I think you will find you will physically less wiped out as the pregnancy progresses though.

Did you make your Dr aware of you feeling suicidal? How does this present? Do you make plans? visualise?

LEM I am 'glad' to hear that CBT didn't work for you either -well not glad, but it does seem to be offered as the answer to everything at the moment and it's very frustrating to go through all that and not improve! I can see exactly how it would work for me on regular anxieties/issues if I were feeling well enough, but I'm a long way from that point at the moment.

Yes a biologist :) I spend a lot of time reading up about medication options on the internet and research papers, I want to discuss options preferably with a psychiatrist but there don't seem to be any options as such, they just work through their flowchart agenda.

Suicidal thoughts - it's mostly a feeling that I just can't face going on, and on, like this with nothing ever getting better, and being scared of sharp objects. It hasn't ever got beyond that. I did tell the GP this, also that I have days when I am just curled up on the sofa crying and barely able to move. I have seen several GPs in the practice and this is the one I find the most helpful.

You're right I maybe come across as more well than I am, partly because my emotions have shut down so badly I can't even 'shout louder'. I feel a bit like a baby that's given up crying because it's learnt that no one ever attends to it - it doesn't mean it's OK.

I took venlaflaxine in early stages of pregnancy. Not ideal but I needed it and osychiatrist say they weigh up risk of mother and out mum first. Will your gp give you nothing as there are ad's gp's do prescribe in pregnancy.

I'm a biologist too :) well, i was in a previous life :) I know what you mean about the fear of sharp objects, i don't get this, my fear is trains, im ok with it now but that was my vision and i would worry that i would just be taken over by something and just walk in front of a train. Thankfully i am not in that place now. Citalopram seems to work for me but when i was discussing which meds to go on with my GP (who thankfully does listen to me!) she mentioned the escitalopram is often a better option but isn't a first option as it is more expensive - i don't know if it is safe in pregnancy though. I have never got as far as seeing a psych but they did move pretty fast when i told them i was feeling suicidal to get me sorted for some counselling - still had to wait a while though. I do hope you manage to get something sorted out though - and you don't feel so wiped out with being pregnant - do try to remember that pregnancy is pretty shattering, especially at the begining - tis all those miracles happening inside :)

These fears are odd aren't they? I don't want to hurt myself but I am scared I will lose my grip on reality and do something to myself that is the illness rather than 'me' doing it. Glad you are not suffering with your train fears now though (I can loosely relate to those too).

HoopHopes had you been on venlafaxine before you got pregnant? Can I ask what dose you were on? I do wonder if I should ask to try this one, but have read a lot of bad things about it which scare me. I also tend to become very agitated and much more suicidal in early stages of SSRI treatment, it's OK if I can cover with a short course of diazepam but I suspect this would be a total no in pregnancy.

I was hoping at 10 weeks the GP might say we could start exploring medication options for the 2nd trimester... in fact she said 'well that's still very early' which made me feel totally crushed. By 10 weeks you know you're thinking you've done well to be over the worst of the danger zone! (not just from ADs but early pg risks in general).

Yes was on it before pregnancy and in pregnancy took 75mg until about week 10. I have used sertraline, citalopram as well.

Hi limpet hope you're doing OK today. Do post if its helpful. Take care.

I'm not doing too well, sitting here crying and feeling pretty desperate. There are too many stories on the internet about people with this sort of emotionless-ness induced by SSRIs who never recovered despite trying loads of other ADs. I think that's going to be me. In any case I can't see how I'm ever going to find out since I can't even find anyone who's willing to try prescribing anything else (pregnancy or not).

Oh (((((hugs)))) limpet, please switch off Dr Google. I know its hard. I did exactly the same thing when I started on ADs (and scared myself) as I thought I would never be well or nearly well again. But I am now loads better than I was back in Feb.

Are there any other Docs in your practice you could speak to? I guess you've also had other general health tests done to check there aren't any other health issues underlying which would contribute to your depression (thyroid, b12, vit D, hormones) if not, maybe worth a thought.

Have you ever rung the Samaritans - I found them very helpful 08457 90 90 90.

Take care x