PND, therapy and medication

[captaincake]

I've had pnd since DS was about 2 months (now 9m). I actually think it's reactive depression from long term lack of sleep, long term stress and DS being very difficult and in pain and discomfort a lot. My GP was horrible and I've recently changed so don't know the new one well - have only seen her once. I've been under perinatal and they haven't been able to help. A 2 night stay in a mother and baby unit was a disaster and I came out feeling worse. My CPN was lovely but couldn't help it seemed like all she did was come round, remind me my life is shit then left again leaving me very distressed after each visit, so she doesn't visit or call anymore. I have tried sertraline and paroxetine. The paroxetine was a disaster I had an instant really bad reaction so only took the one. The sertraline gave me not very nice but bearable side effects but did nothing to lift my mood or anxiety or very sudden uncontrollable lows.

I have just found a private therapist and have an appointment in 2 weeks. I have the option of trying another mother and baby unit but I'm very concerned the same will happen as last time. I can also take venlafaxine. The venlafaxine I did take a low dose for 2 days but I started with the same side effects as the sertraline and started to feel even lower again and unable to cope alone with the suicidal plans and thinking that it would go the same way with not helping but making me feel bad so stopped that. My concerns with taking them are that and not being able to get hold of them once I'm on them. My last gp practice consistently got prescriptions wrong. I know that I'm at a new one now but I'm paranoid. DH is very supportive but is too at a loss at what we can do to help me.

I suppose this is a little bit of a WWYD? I know you can't answer for me but was wondering if anyone has been though anything similar and might have some advice?

The bad memory is such a problem...I so hated feeling dumb and pathetic.

I have been on it a month now and have noticed improvements in the following: anxiety (which still needs some further improvement in the mornings), depression (feel minimal depression now), insomnia (the greatest improvement, and associated energy), memory, concentration, appetite, motivation to exercise, ability to finish a task, less procrastination / less hovering about getting nothing done, far less brain fog, colours outside seem brighter and more in focus, rediscovered ability to make eye contact with strangers, now able to smile at someone without thinking how fake and insincere I am, renewed interest in how I look and what I wear, far less crying, and huge reduction in all those awful words like guilt, dread and paranoia.

Is that a good start? It was NOT overnight...it has been gradual.

Oh, and playing with my baby with genuine joy and excitement, rather than smiling and laughing with him while thinking 'I'm such a fake, please don't be damaged by your unhappy mother, please don't'.

I really hope it has the same effect for me. I'm feeling about the same only finding it harder to motivate myself to do almost anything. Even have any facial expressions. I'm going to bed as soon as DS does and it's still hell getting up in the morning. I let DS watch tv for 10 mins twice today just so I could sit on the floor and do nothing. That's what I'm thinking when I play with him too . I don't think he has any idea. I hope not. He's such an amazing and wonderful little dude.

Captain you have done 4 days! That is fantastic!! Well done you. That is more than half the first week.

I would say in the next 4 - 6 days you are going to feel something....it might be brief, but there will be a glimmer of something different. And after that you will reach two weeks, and it will be steady improvement from then.

Please please stick with it. And your son got watch TV twice today for 10 minutes? My son gets about double that and I feel pretty normal!!

Well done again.

I've done 8 days now and remembered every day. Over half way to 2 weeks. So at that point it should start feeling gradually slightly better? Still no real side effects I don't think. Perinatal have been back out to see me now too. I had an awful few days and used quite a lot of diazepam but from Sunday started to feel calmer. I'm going to see the gp tomorrow about increasing to 20mg of escitalopram and talk about it all - I want to find a way of not needing diazepam. It's not the tv time more the reason why I just put him in front of it because I couldn't distract him with playing just to sit there feeling awful. It hasn't happened again. DS has been amazingly well behaved recently which is really helping.

How are you? Are you finding it's helping more with your anxiety now?

You have done so well Captain! You are definitely over the initial start up hurdle.

Your anxious few days were probably side effects that have now passed. If you increase to 20mg that could happen again briefly but then you will be done!

Your tone already sounds better. You even sound optimistic. Compared to your very early posts you really sound different...take a look back at them.

And yes, by the weekend you will be agree that you are feeling better. I think 20 mg is a good idea so you give it the best chance. When they say 4-6 weeks to reach maximum effect, that is actually true. So you have lots and lots of great progress coming your way but you do need to be patient after each dose increase. Which is no problem for you as you aren't feeling bad with side effects.

My anxiety is getting better all the time...the stomach grinding has nearly gone, mornings much calmer, and sleep still getting better. I am very very happy with escitalopram. Recovering from long term insomnia is quite slow...I am finally sleeping 6-7 hours a night but still feeling totally exhausted at times. I think I need a few more weeks of good sleep to start to get truly refreshed again.

Please keep in touch!