GP's PND advice.

[SickAndTiredAgain]

I had a call with my GP today to discuss my PND. For context, DD2 is 4 weeks old, and I'm suicidal - he was aware of this. I also have a toddler DD1.

Am I wrong in my expectations, or is this advice batshit?

Him - what time does DD1 wake up?
Me - 6:30
Him - ok, so that's when you all need to wake up, you, your husband, DD1 and the baby. Then just work backwards from that to get feeds every 3 hours, so feed DD2 at 3:30, and right before you go to bed at 00:30. That way, you're in charge, she's not, and you only have to wake up once in the night which is better.

Only have to wake up once in the night? She's 4 weeks old. I'm not sure I can get her onboard with the new schedule. This would also mean me getting less sleep, because currently I go to bed much earlier than half past midnight. He suggested half past midnight to allow quality time with DH, as he currently takes DD in the evening and lets me get some sleep.

Is this really the advice for suicidal mothers? Or is he on to something and I need to enforce this? I feel really low that I reached out and this is what I got. He is the most senior GP at the practice.

Situational and hormonal depression are different, pnd can be either or (generally) both.

If (big if) it's only situational - forcing yourself into a routine (not necessarily that one), having more control, having time to yourself (not necessarily with dh) - that could help.

Tag team parenting works for lots of people, it also doesn't work for lots and can be really isolating. Suggesting spending time with dh isn't necessarily an unreasonable suggestion.

His specific routine or way of doing that is unecessary. Some people need to be told 'you must do this' so they don't feel guilty about putting themselves first because it's not their choice. But tbh not a drs place to make that decision and they shouldn't, but it may be why he did.

Actually rereading - that's all he came up with?
That's not okay. I would want some sort of plan: this is who you can contact for support, if these changes don't help come back on x date, these are options available, if it gets worse call this number.
It's absolutely not just this will fix it, as part of a package of options it might be okay.

Oh and being a senior gp just means you've stuck it out, not that you know more. See someone else.

Fair enough, a routine might help, and I know more time with DH would help but he does wfh so we have lunch together - it just seemed very "it's easy, just do this and then you only have to get up once in the night". And (and I know I'm not in the most rational place right now) it's just something else for me to do badly/not be able to manage. Like she should be in a routine and then I'd be ok.

Yes, that was all he suggested. I'm meant to call back if it doesn't help.

It's okay to take that advice and decide it's not going to work for you, you know you and you know your baby. If you're unconvinced by this then you need either support to follow through or (probably) different advice. Trying and knowing/thinking it will fail obviously isn't going to help if you're already struggling with feelings of not coping.

It's okay to go back and say: I've thought about it, I can see how elements of this routine might help long term, but right now my thoughts are spiralling because I can't see how to get there, and I don't think that right now I can handle this being one more thing I can't do, that I can't even do the one thing that I've been advised. And give practical and emotional reasons you don't think the suggestion will work. See where that goes.

It's okay to go back and ask for a second opinion. If it's too hard to do that outright, just say it's a mental health matter and you're only prepared to speak to a female practitioner (to get someone else without actually having to say it).

It's okay to contact your health visitor and ask if there are mental health services you can access outside the GP.

I know it's really hard to ask for help, and even harder to ask a second time. BUt that's one thing you've managed and should be proud of taking that first step.

(I'm not saying you can't do anything by the way. That's frankly irrelevant and dependent on the baby. But it's how you feel and that's important.)

If you genuinely think a routine might help and might be achievable, And only you really know that, you might consider a separate post on here about that, there are people who will help you work out something you think is managable starting from where you currently are. But that's unlikely to be a quick fix to pnd, not that anything is.

Has he referred you to HV or anyone? Your hospital may (should) have a post natal mental health team that you can be referred to up to 6 months after giving birth.

Perhaps he isn't well versed in PND. Perhaps that advice works for some mums. But if it isn't helpful for you, and if you are at the stage of feeling suicidal, then you need more help. It's so hard to ask for it in the first place. The first GP I saw gave me some leaflets to call a couple of charities for advice. I mean, I had literally no chance to make these calls but never mind!!

If you've not been referred on, could you try your HV? I found second time round that there is less contact and support as people think well you've done it before so you are fine.

Please reach out for more support. You're doing amazing job, even if you don't feel like it right now.