Need advice on antidepressants

[babypinkelephant]

So I'm not if they're what I need but I keep on being told I'm depressed.

After having my child two years ago I have not slept properly since. I don't mean waking once or twice but continuously throughout the night no matter what I do or try. My husband can't help (won't go into it and too outing).

She is now going through medical tests to see why she's not sleeping but it's not helping me. She's on sleeping medication which is just a making things worse.

I've put on 3 st since having her because I'm in survival mode of reaching or sugar and catching sleep where I can.

My husband says I'm a different person now, I'm always exhausted, I'm low in mood, I find everything a challenge and difficult.

My worry is I have heard some medication you can't breastfeed on, they make you put on weight, they can make your mental health worse.

I need something to lift my mood so I can face the day and be happier and healthier for my family. I try and put in a brave face for my daughter but I'm not sure it's working any more.

Could someone advise me on what course I should be going towards. Doctors just want to stick you on a generic medication and never listen.

Oh and I lost my mum at the start of the year and have no family to help with my daughter.

Life is tough

The doctor will be able to advise on what can and can't be taken while breast feeding. As for your other questions, I've been on Prozac, citalopram and escitalopram and they don't make you gain weight - but people sometimes gain weight because anxiety or depression was causing them not to eat properly or have no appetite, so their appetite can increase after they take antidepressants. And then weight is gained as you are eating normally again.

The side effects can make you feel worse for the first week or so, but it gets better after they've subsided. I had side effects with Prozac and citalopram and Setraline (which I stopped because I couldn't deal with it) but not with escitalopram. It's worth sticking with it though, as you will feel better.

Thank you for your reply

I'm just curious how do the doctors know which in to put you on.

My eating habits is that I tend to go for sugar and quick bad carbs but I'm trying to change that. I want to loose weight, not put it on.

I don't feel like I'm typically depressed either I'm just so exhausted I can't physically or mentally go on so I'm worried they won't work.

Take what they suggest. They normally start with either Sertraline or Citalopram as they are the two most widely tolerated, with least side effects and best likelihood of improvement. Of course you will get a lot of people who don't get on with them and switch to something else but the majority of people will tolerate them.

They're the go to drugs of choice for good reason.

You do get a lot of people advising you to try Mirtazepine, Venlafaxine etc but they do tend to have a higher risk of side effects.

I take Amitriptyline which is quite an old fashioned antidepressant that isn't much prescribed anymore. You have to go to a psychiatrist to get it prescribed over a certain dose. The reason for this is that it has a LOT of potential side effects, many severe, some heart related which means a yearly ECG for me as I have a high dose, and it just wasn't well tolerated for most people in general.

It is also absolutely lethal in overdose. I think this is true of all tricyclic antidepressants though, not just Amitriptyline. But if you have treatment resistant depression, it will work. It will work in much the same way as a sledgehammer will crack a nut but it'll work. So its very good but shouldn't be the first port of call.

I was put on Sertraline for postnatal depression and was able to breastfeed on it. I think the stance is taken that breastfeeding is great and should be encouraged if the mother wants to take that feeding route, and having a medicated functioning mother is better than one on no medication who is potentially a risk to herself or the child (not speaking about you, just generically here.)
I have found it really helpful and have been on it for two years now. I'm happier than I can ever remember being and can function with daily stresses a lot better than before. It almost feels like I have a bit of an emotional buffer around me which prevents me from being constantly on edge and teary.

I was also very concerned regarding weight gain. I have a past history of anorexia which to some extent reared it's ugly head in pregnancy. However, I have found that no longer being depressed means that I don't comfort eat and I am now a healthy weight at 58kg for 5"6 which I have found easy to maintain alongside my usual exercise.

@nothingcanhurtmewithmyeyesshut

Take what they suggest. They normally start with either Sertraline or Citalopram as they are the two most widely tolerated, with least side effects and best likelihood of improvement. Of course you will get a lot of people who don't get on with them and switch to something else but the majority of people will tolerate them.

They're the go to drugs of choice for good reason.

You do get a lot of people advising you to try Mirtazepine, Venlafaxine etc but they do tend to have a higher risk of side effects.

I take Amitriptyline which is quite an old fashioned antidepressant that isn't much prescribed anymore. You have to go to a psychiatrist to get it prescribed over a certain dose. The reason for this is that it has a LOT of potential side effects, many severe, some heart related which means a yearly ECG for me as I have a high dose, and it just wasn't well tolerated for most people in general.

It is also absolutely lethal in overdose. I think this is true of all tricyclic antidepressants though, not just Amitriptyline. But if you have treatment resistant depression, it will work. It will work in much the same way as a sledgehammer will crack a nut but it'll work. So its very good but shouldn't be the first port of call.

I did amatriptyline (sorry so) a few years ago for pain relief and to get me off to sleep because of the pain but had to come off of them in the end as they made me really groggy as I kept having to take a higher dose.

Thank you for your reply, I'm just worried about being labelled a flake and just being "tired" but being exhausted every hour of the day is affecting my marriage, my friendships, my job and my personal life

You won't get labeled a flake. Tiredness is a common symptom of depression especially when you carry the entire mental load of the household. Being depressed and anxious is exhausting.

Hi OP, that all sounds really relentless.

As one of your problems is not being able to sleep through, mirtazapine might be a good AD to try, as it has a sedative effect (you take it at night) I'm prescribed that and venlafaxine together. I didn't gain weight, but did have to be kind of strict with myself not to crack open the carbs at any opportunity. Negligable side effects with mirtz (just feeling a tad weak for a few days) but the venla produced some quite unpleasant ones (mostly like I'd been mainlining espresso) but these subsided within a week or 2. Glad I stuck with it, because life has improved.

I hope you're feeling better soon - you shouldn't have to struggle through life.

Mirtazapine made me eat and eat.

If you weren’t breastfeeding, I’d say Agomelatine. Makes you sleep and sleep but no cravings.

Or Trazadone

Thank you all, my problem with sleep is that my daughter doesn't sleep. I'd sleep for a week but she is under investigation for a medical condition for why she doesn't sleep.

I saw a programme once on childhood sleep disorders. Is she very tired during the day? Is she in your bed?

@ArseInTheCoOpWindow

I saw a programme once on childhood sleep disorders. Is she very tired during the day? Is she in your bed?

No she's in her own room and has been for a year (she's 2) she has a nap for an hour at lunch which she needs otherwise she's a devil. She goes to bed around 7/7:30

She has always been a terrible sleeper, never joined her sleep patterns, always woken up up to ten times a night (better now but can still be 4 times and needs reassurance to get back off to sleep, or she is up for hours and hours)

What happens if she sleeps with you?”

@ArseInTheCoOpWindow

What happens if she sleeps with you?”

She wants the boob all the time lol

@ArseInTheCoOpWindow

What happens if she sleeps with you?”

Even though she is night weaned it's too much of a temptation

It sounds as if you need an activating one.

Sertraline
Fluoxetine
Or imipramine

I am currently taking Sertraline because it is apparently a good one to take if you are planning to get pregnant/ breast feed. Sertraline is often the first line one that they will put people on, so you might think "generic"... but that's because it's incredibly safe! There is usually a reason for the first thing that doctors recommend.

I do recommend trying antidepressants (having had experience of several different types). There is really nothing to worry about if you are taking a low dose SSRI, which is what the GP would start you on. Just give it a try and see if it helps, and if it doesn't you can just come off them. It's not a big deal. Good luck x

You’ll probably find a Gp is a bit cautious about anti-depressants when you’re breastfeeding. The reason is most of them haven’t been tested on pregnant/BF women. Setraline appears to be safe from what has been observed which is why it’s often offered. I think it might help just to get you through this. Must be so tough with the bereavement on top of the broken sleep

Our DD was a poor sleeper. It’s better now but it was tough for ages. Probably the main thing DH and I argued about! Now she’s sleeping better and DH is taking melatonin gummies so he’s sleeping better, our home is a much happier place! I really hope you get to the bottom of things soon. Do you want suggestions to help with her sleep? Don’t want to patronise you if you’re already stressed and I imagine you’ve tried a lot...but I can share what’s helped us if you think it could help.

@ThePontiacBandit

You’ll probably find a Gp is a bit cautious about anti-depressants when you’re breastfeeding. The reason is most of them haven’t been tested on pregnant/BF women. Setraline appears to be safe from what has been observed which is why it’s often offered. I think it might help just to get you through this. Must be so tough with the bereavement on top of the broken sleep

Our DD was a poor sleeper. It’s better now but it was tough for ages. Probably the main thing DH and I argued about! Now she’s sleeping better and DH is taking melatonin gummies so he’s sleeping better, our home is a much happier place! I really hope you get to the bottom of things soon. Do you want suggestions to help with her sleep? Don’t want to patronise you if you’re already stressed and I imagine you’ve tried a lot...but I can share what’s helped us if you think it could help.

Any more sleep ideas would be great, I feel like I've done everything bar cry it out (which I did last night and she catapulted herself out her cot bed and face planted from four feet high)

Thank you everyone for your replies xxx

It's incredibly hard

What’s her bedtime routine like now?

Tea between 5-6, after 6 no tv just calming music and a pudding either banana/yogurt/porridge, every other night bath time at 6:30, we go up to bed at 7, she brushes her teeth, gets in her jammies/sleeping bag, her red night light is put on and sound machine, she had her two toys and her drink, she has 10 mins of breast feeding (she is night weaned and not fed to sleep), then she get put in her cot, I sit in the room nearby until she falls asleep in about 20 mins.

It's not so much the falling asleep it's keeping her asleep.

I get that she wakes and feels that I'm not in the room with her but she has never linked her sleep cycles and from about 1am she wakes frequently and then up awake at 5-6am

She has epilepsy induced by how tired she is, even with medication to help her sleep she is still waking up.

I've tried different sound machines, essential oils, Lush sleepy balm and massage, the feber method, stroking hair/holding hand, shushing, husband rocked her in the chair until she fell asleep, she was fed to sleep until 18 months as HV said that was the right thing to do and she would just stop one night, I've brought sheep skin cot bed mattress covers to keep her warm/cool, gentle classical music the list goes on abs on

Could you wean her off the boob and co sleep with her?

Or sleep on a mattress in her room.

Oh gosh, just wanted to give you a hand hold. No sleep IS depressing. It affects everything.

It does sound to me that there is an underlying issue causing her sleep problems because they are severe (it's hard to see what is more 'normal' when you're in the middle of it and you only have one child).

Keep pushing the investigations and definitely push for medication for you.

You're stuck in a horrible cycle and assistance with one element with start to change everything else.

Best of luck to you both.

And I imagine you are a different person but don't let that burden you, you are dealing with huge challenges plus losing your mum am so sorry for you loss

You mustn't feel guilty for the change in you, it's the circumstances - EVERYONE would be the same. You have to think of yourself first.