Feeling judged by GP

[AnxiousCarer]

I care for my DH who suffers episodes of psychosis since getting 'into the system' 3 years ago he has had fantastic support from his MH team and been very stable. We both felt that his condition was well managed and had started to try for a baby. Unfortunately recently after changes to his medication and stress at work he had a relapse, which he is currently recovering from.

This obviously made me ask myself a lot of questions about our future and having children. I discussed this with the CPN within his team who supports me who was very positive that DHs condition could be well managed long term and was supportive of us having children (we have both always wanted to have them), he didn't feel that we needed to stop trying for now unless we wanted to. DH wants to keep trying and feels that by the time a baby arrives his condition will be stable again. I want to wait till thinks are more stable and then start trying again.

Anyway since DH had this relapse I've been feeling very anxious and this is starting to be more of a problem and as its not resolving I decided to take steps to prevent me becoming unwell as I've suffered from depression before, booking appointments with CPN, occupational health and my GP. I visited my GP this morning to discuss anti deppressants which I have used to help me through tough times before. Knowing from the past that to be effective I would need to be on them at least 8 months I asked her if they would be safe to take if I became pregnant. She looked absolutely horrified and told me no that I must not get pregnant on them, she then told me to seriously consider the morals of bringing a child into our life and if it was fair to the child. She said I needed to ask myself some very difficult questions and then asked if I was married to DH.

I was really upset by her manner she also snapped at me when I asked to go back on the pill for a while that it wasnt something you could just start and stop when you wanted. I had no idea that you couldnt! She did then explain the health risks of restarting the pill so soon after stopping it which was fair enough, and just gave me a prescription for the anti depressant, not the pill.

The thing that upset me most is that I felt really judged for considering having children with DH. I felt like she thought I was selfish. Its not like I've not considered this carefully and I've already asked myself some very difficult questions in the past about our future, including children. We've both discussed it with the CPNs who know us and understand DHs condition who are in support of us having kids. My GP doesn't know DH at all and certainly not our lives and relationship in the way the CPNs do. I can understand her concerns but part of me thinks that there was a degree of predjudice about DH and his condition coming through too. I know that he might have furthur relapses in the future which could be tough, but would she tell someone whos patner had MS or another long term physical condition that they shouldn't have kids? I know some excellant parents who have serious mental health condition that they manage.

Its also given me some other things to consider. Do I start on the antidepressants knowing it will be another 8-9months before we can try for a baby? I am already in my mid 30s and scared of leaving it too late. I'm not yet in a really bad place, not depressed just very anxious, but was trying to pre-empt things, do I try the councelling etc first and see if thats enough to get me back on track? I do know I will need to be in the best place possible mentally and physically before getting pregnant as I'm under no illusions that having a small baby will be easy, and I need to be well enough to deal with the stree and sleep deprivation and to support DH if he needs it.

Having come across vast amounts of very judgemental drs, none of this surprises me. Still sorry that you have to put up with it. I would not see that dr again, definitely.

there are some anti-ds that are safe to take when ttc and when breast feeding etc. I would actually make an appt to see a nicer dr, hopefully there is one, and perhaps even mention to the practice manager that you felt this dr behaved in an inappropriate way.

I wouldn't put your mental health on hold while trying for a baby is also on hold and you have lots of responsibilities. I would give myself the best possible chance of strength. Good luck.

anxiouscarer your GP was COMPLETELY out of order.

Some doctors get 'hardened' by the work they do. They have to, otherwise they would go mad. They say things that are completely morally wrong without thinking through the implications. Yes, she probably would tell someone with MS not to have kids (this happened to someone I know. She was a great mother).

The thing is, your DH may, or may not have further relapses. Just as any random stranger who has never had a MH problem might get one in the future. Also, just because someone is completely mentally ok doesn't mean that they are going to be a better parent than one with a MH issue

TBH I'd see a different GP. They say it's best not to be on AD's when trying to conceive but there are ones that are less risky than others. And the thing about the pill- I thought you could just stop and start!

I was taking anti-ds when I got pregnant with DS1 (prozac) and the GP just said simply, we'd better stop it. However there are others which are safer, for example I was prescribed sertraline while breastfeeding.

I wou;don't take what the GP said to heart, focus on what the CPN said as she knows the illness better. Maybe the GP was worried about prescribing the wrong thing, or stressed, but they shouldn't have been dismissing with you. I have seen one who is a bit like this as well.

Maybe there is another GP you can see in future, who might be a bit better. Our GPs has this rule we have to make different appointments for each issue, or a double, so it might be easier to discuss the two things (pill and anti-ds) and different appointments.

Thanks guys, you've made me feel much better, I cried myself to work this morning when I left the GPs. I've been reading up on Flouxitine (prozac) which is what she prescribed me as it's what Ive had before. Apparently it's the most studdied antidepressant in relation to pregnancy. There is no evidence that it causes problems when ttc, or miscarriage and the risk of birth defects is very very low, theres no evidence of long term health problems, the only real risks seem to be if taking it in the 3rd trimester when there is risk of breathing difficulties and withdrawal at birth. Its made me really cross as she was adamant that I must not fall pregnant whilst taking it.

As for the pill she said that the risk of having a stroke is highest in the first 6 month after starting or stopping it therefore it was not advisable to do both in the same 6 month period.

I think based on the studdies I've looked at I will take it and not worry too much. We are currently not ttc but not preventing so if I become pregnant then I will go and see a different GP and discuss things again. I need to get myself in a good place and look after myself before I can look after anyone else.

And I'll discuss with the CPN too sure they know more about it than the GP will.

There are anti depressants that are safe in pregnancy so you could go see a different doctor and ask for one of those. You could also request a psychiatric review to get an expert opinion on which AD would be best for you right now.

You and your DH have good support from the mental health team and are clearly self-aware and willing to ask for help. That's a great starting point.

Also your GP was rather foolish imho to give you an AD you shouldn't get pregnant on and not to give you the pill or an alternative contraceptive at the same time. Time for a second opinion?!

Roo

Thanks Roo,

Having done a literature search theres no evidence that the one shes started me on causes any problems unless used in the last trimester. Even the NHS website states that while they recommend to avoid in pregnancy there is no evidence its harmful! I'm not under a psychiatrist my CPN is attatched to DHs team in a carer support role. I doubt I'd meet the criteria for a referal. I also couldn't belive she would tell me I must not get pregnant, then not prescibe contraceptives! She booked me a review appointment forthe end of the month but I'm condidering asking to swap it to someone else.