getting help

[arcadia96]

i have a young baby and am struggling particularly with anxiety and insomnia now leading into depression. I have tried to seek help but have trouble really saying how bad I'm feeling as don't want to alarm or upset people (friends/family), or be sectioned (GP/health Visitor). I really feel like each day is getting harder. Anyone been in a similar situation - how to really make it known that you need more help?

Trust me, you won't be sectioned. I was hospitalised for 3 months with my PND, and I still wasn't sectioned.
You should definitely seek help.
Write down exactly how you are feeling and the problems it is causing you e.g. insomnia and take it with you to the appointment.
That way you will have something to refer to if you go blank (which I normally do in front of a doctor!).
Please get help you don't have to suffer this way. You will probably not even be referred, most GPs can treat depression within their remit these days. Try and make sure it is a GP you like and trust though, there are some that are less sympathetic, although they should all be trained in mental health issues.
Hope you get the help you need.
x

Oh dear girl do you know how hard it is to be sectioned? It's hard to do and by law reserved for those who have no insight in their condition and are a danger to themselves and/or others. Please tell your GP and a good friend or two what is going on. Let them advise and support you. It's ok to do that.

Imagine your best friend struggling like this and not telling you - how would you feel. (My therapist used this one on me in a slightly different context)

I saw my GP this morning and she just gave me different anti-depressants but I'm worried they'll affect my sleep. She said they wouldn't but I've seen on the internet that it can (citalopram). I can't keep going back to the GP.

Oh no no no no. You made the cardinal error of looking up your medication on the internet! You will find absolute horror stories on just about any medication you care to mention on the internet. I admit it is tempting but I avoid "googling" my medication these days as it really screwed me up and made me so so anxious.
Citalopram should be fine with regards to sleep. Even if it's not (unlikely) they can give you another one which will help you sleep (mirtazapine).
Take it tonight and try not to worry. x

I already knew from having been on here, and was on sertraline before which is very similar, so I knew already! I wish I'd asked for mirtazpine this am but I just go all passive when I'm with a doctor. Out of interest, GDYWF, how did you end up in the hospital before? From your previous postings it sounds like a similar situation to me. I keep thinking I will end up in a mother and baby unit. TBH it doesn't feel like the worst thing that could happen right now.

Hi there

I think the mother & baby unit is a last resort, as they really don?t like hospitalising people, but you?re right it isn?t necessarily a bad thing because if you do get hospitalised you get loads of support ? nurses there 24/7 to see to you, give your baby all the night feeds, look after them during the day etc. (although you are encouraged to do as much as you can for your baby). People do generally start getting better in hospital. However, a downside is that the door to the unit is locked and you aren?t allowed out unless pre-arranged. It can feel a bit like a prison, especially if you are in a very bad way and everything seems 10x worse than it really is. You can?t see your DH all the time. The food is really rubbish (was in mine anyway) and when you have no appetite as it is? well, basically I hardly ate anything while I was in. I had nurses standing over me saying you MUST eat something, and I remember gagging over a piece of pasta, just not able to swallow it ? food was so disgusting to me.
You have access to medication all the time which you wouldn?t have at home e.g. if you can?t sleep there is someone there to give you a pill to help you.
The ward rounds are quite intimidating, sometimes there were 10 health professionals in the room and ?me. A psychiatrist, health visitor, social worker (sometimes), CPN, ward nurses, occupational therapist, student therapist, minute-taker etc. I found these very scary, but I think that was because I was so ill, now that I?m well I don?t think they were nearly as intimidating as they seemed at the time.

So how did I end up there? I started at the GP who gave me citalopram and zopiclone, but I just kept on getting worse and worse. My sleep was really bad I went 5 days and nights without sleeping at all. I went to GP again and I was so bad that I actually fell on the floor of his office and said that I wanted to die . I can?t believe I did that because normally I am such a reserved person! He sent me straight to A&E. Waited ages in A&E to see the emergency psychiatrist. She referred me to the crisis team who then visited me at home for several days. Kept getting worse, no sleep, etc. Eventually the crisis team got me to see the mother & baby specialist. It was she that got me admitted to the mother & baby unit, the same day. I do think they resist it though, because it?s obviously much cheaper for them to treat you at home. Sometimes you really need it though.

Maybe if I?d had mirtazapine straight away I wouldn?t have got admitted, who knows. It did certainly help with my sleep. But on the other hand I was very ill. I think if you can bear it you should go back to your GP and ask for mirtazapine, if you feel you would cope better if you could sleep better, because it may help you with that. You could also ask the GP about specialist mother & baby psychiatrists in your area because you could get a referral if things don?t start improving soon.

I really hope you start getting better soon, post again if you want to ask anything.xxx

Thanks GDYWF, thanks for telling me about that. Reassuring to know they prefer to have you at home for treatment if possible. I have made docs appt for Fri to go with DP (if he can get off work to come with me) to ask about mirtazapine because I feel that citalopram is going to make the sleeping worse and am now too scared to take it being in quite a delicate state at the moment. I honestly think sleep is the key; nights I have slept well, I have actually felt fine and cheerful the following day.
I have actually been obsessed with the idea that I will get so bad through lack of sleep and it seems to be a self-fulfilling prophecy.
Did you get counselling in the unit, as well as medication?

Arcadia you and me still in the same boat. I'm totally happy when I've had enough sleep, feel awful when I haven't. Is this PND?? Surely someone with PND is down all the time, sleep or not sleep. That's what I keep asking myself - do I have PND or a sleep problem? If I have had sleep I enjoy life, see my friends, get out and about (last week I took a homeopathic remedy and got enough sleep and was so happy). If I haven't had enough I drag myself through the day and think doom and gloom thoughts all night. I don't understand it at all. I can't understand why I can't sleep - it's like my body is too alert. It's pants, isn't it? Is this PND? Do you have more than just a sleep problem? You mention anxiety. Is that about the sleep or about other things too?

BBL I know we are similar, I hoped that you were better! I was sleeping a bit better again last week and then I had ONE bad night (which DP did too - he had been out and had a few drinks so disturbed us both!) and that panicked me so I had three bad nights in a row. Am now getting off to sleep OK but wake in the night and then worry I'm awake and... you know the rest! Sometimes I can get back off to sleep in the morning but this week building work going on next door so feel everything is against me! Took temazepam last night and hate having to but slept around 8 hours. But it has become an obsession and that is the problem. When I say anxiety, that was following a difficult birth and a longish and stressful hospital stay with health worries, which triggered anxiety in me, which has now focused on my sleep and being convinced I will have a breakdown. TBH you sound like a more 'balanced' person than me and you have had two kids before so at least you know it is not an issue with mothering, whereas I have also been having the worries that I'm not cut out for being a mum etc. because of this. Not to say that it is easier for you ... just to try and reassure you!

Arcadia the strange thing is that I found looking after DS1 when he was a baby far harder than this with three of them. The doctor thinks I had mild PND with him but didn't do anything about it. I think looking back I came close to getting insomnia with him but somehow nipped it in the bud by telling myself that if I didn't sleep the world wouldn't end so I slept better. This time, not sure what has happened with the sleep thing, but I know what you mean by one bad night causing your confidence to plumit. I had a bad night on Sunday and took a zopliclone (sleeping pill) on Monday so felt awful for doign that! Although Tuesday was a great day because I'd had enough sleep! So last night 3 hours and feel crap again. I didn't have a traumatic birth like you did, and I really feel for you going through that. I worry about having a breakdown too and dread having to take ADs as there are threads here about how hellish it is to come off them! Are they worth it? I don't know.

arcadia96 and BeckyBendyLegs
I was so like you. Feeling I could cope fine if only I had had a good night's sleep. Sleep became my obsession, I just craved it so badly.
I would even look at passers by and people on the street and wonder how much sleep they had last night .

I kept telling EVERYONE including the drs. etc that if ONLY I could sleep well I would be fine again.

Something one of the nurses said stuck with me. At the time it made me want to slap her, but she was right

"what you've got to ask yourself is WHY are you not sleeping? Insomnia is not NORMAL".

Insomnia is a symptom of depression. Unfortunately I think one can lead to another but if you have one, you will likely have the other sooner of later. Sorry, I found that very hard to hear, so I guess you will too. But you are getting treatment so you are on the way to getting better.

xxx

But aren't you now trying to come off the ADs? I saw the other thread about lack of support and how hard it is to come off ADs (other people's comments). That's what troubles me. Also everyone keeps telling me 'you are not depressed'. I don't feel depressed. I feel generally really well and happy (until bedtime that is and in the middle of the night). I realise that insomnia isn't normal but why, why, why? I don't know. DH keeps saying 'but you aren't depressed'. I'm not. I don't think I am. I don't feel it. I go to a 'transition into motherhood' group with other PND suffers and some of them there are really struggling with other issues and not wanting to get dressed, not wanting to leave the house, not wanting to look after their babies, etc. I don't have any of that. I just can't **ing sleep!

Yes I am trying to get off medication now. Because I feel now I am fully better and don't need them anymore. But dr.s would rather keep you on stuff for an easy life which I don't agree with.
But even I admit that I needed them at the time. I did get myself into a very bad state through resisting medication.
In the early stages I didn't feel depressed either. If I managed to get some sleep I could get on with my day, see friends etc.
It was only as the illness developed that the depression aspects started coming out.
TBH I think the lack of sleep in itself started to make me very very miserable.
I admit it's hard to know for sure though... Just only have my own experience to go by.

I think it's hard to say what comes first. For me, I've always been a bit anxious but my anxiety has always been focused on external things which came and went, if you know what I mean, until I had my baby and then it kind of turned 'inwards', as I no longer had work stress etc. Coupled with disruption to hormones and sleep patterns after the birth and particularly the hospital experience, and various things that were said to me that panicked me (e.g. if I didn't sleep I would go mad, by the first GP I saw!), it HAS become an obsession now. I think if I had become obsessed with something else I wouldn't have so much trouble sleeping and the vicious cycle wouldn't have begun as it has.
Everyone has trouble sleeping from time to time but once it becomes an issue and you are conscious of it and worried about it, then it really does affect you. It's a total PITA. I'm just trying to tell myself in the long run I will be stronger from the experience somehow, as I've found with other things in life.

You are totally right, depression and insomnia are like chicken and egg, it's really difficult to tell which comes first.

Like you I had a very traumatic birth and long hospital stay and probably some background anxiety issues which having a baby brought to the fore. These things alone would give someone a sleep problem. Then with a young baby waking up randomly too, it's a recipe for insomnia really. I will say though YOU WILL COME OUT OF THE OTHER SIDE!!!!! I really didn't believe this of myself and told them all that "I would never get better, ever". At times I felt like I would never sleep properly again. But I do, and I promise you will too.

Please please can I urge you to invest £6 in this:

Overcoming Insomnia & Sleep Problems

It helped me no end. It really helped me get out of the negative cycle of obsessing about sleep, thinking about sleep all the time etc. Buy it! NoW!

GetDown I see what you are saying and your experience is valuable and helpful. I think I am just scared that this will get worse and turn into depression like you say. I've had the odd bowt of insomnia before but not like this, and managed to get over it with positive thinking and a few changes to environment, routine, etc. I'm confused this time because sometimes I can just lie awake without feeling worried or anxious about anything particular, I'm just awake! Who knows what will happen. I just keep looking to the summer and thinking 'I'll be better by then'. I want to take all my boys on holiday in the summer. I hope so. I really hope so.

I know Becky, I know. The first night it happened I wasn't anxious or worried. Just wide awake. The dr. couldn't understand it - "but what were you worrying about, were your thoughts racing, did you want to check your baby all the time" - NO!!! I was just wide awake! It was so frustrating not being able to make myself understood. Everyone seemed to want me to have some reason for my insomnia, but it was completely inexplicable as far as I could see.
I then started to get anxious about the sleep - the sleep in itself. Not about my baby, not about anything else, but the sleep. That's when it got really engrained.

I do recommend that book to you too Becky, as it really helped me. I hope it will help you too.

You WILL come through this. You WILL sleep again, I promise. xxx

It's on my wish list

DH thinks I am getting better. The homeopathic remedy really helped last week (I have to have a week 'off' this week) and Paul McKenna is helping too, he helps me relax and fall asleep in the first place.

I have to force myself not to be anxious about the sleep. Some nights it just overcomes me though and then I know I've blown it. But other nights I manage to overcome the anxiety but still frustrated at how awake I can be when before I slept 9 hours a night like a dream.

PS Sorry Arcadia, I've done it again! I've hijacked your thread and ended up going on about my problems.

I think you'll get through this too, whatever happens. We have to have faith that it will get better

One of the things I found really hard was all the "helpful" comments from friends / family etc.

"Oh, have you tried lavender oil"
"You need to listen to soft music"
"Use nytol / Kalms / Night Nurse / valerian"
"have a hot bath"
"have a milky drink"
"count sheep" - yes people told me that!!
"Oh if you get tired enough, you'll sleep in the end" - err, no, the tireder I got, the worse it got!

All well meaning, but intensely irritating to an insomniac who knows only too well all the sleep hygiene advice and has been there done that and all over again and back again, all to no avail.

I did go to a homeopath too, and I found that helpful. To be honest she was such a lovely lovely person, just talking to her, pouring my heart out about everything that happened surrounding the birth etc. really helped me. I don't know if the remedies helped all that much, but it was certainly worth doing.

I also did reflexology. And CBT. But it all got too expensive in the end.

I can so relate to both of you! The lying awake - I'm not even worrying about anything, other than (eventually) the fact that I am still awake!
Also the 'have you tried' thing, but worst of all telling you what a great nights sleep THEY had last night, or how easily they get to sleep.
I bought that book at the weekend (the Colin Espie book). My trouble is that I'm too tired to read it and take it all in! Also it is hard to put into practice the behavioural stuff when you have a small baby (I want him to write a book specifically for me, basically!) because of the lack of control you inevitably have over your sleeping environment. I'm also scared that initially it could make me worse e.g. by keeping a sleep diary (see how bad I've got?!). Did you find that? I think in any case I will need to combine with medication.
GDYWF, it does sound so similar to your experiences. Did you try the homeopathy etc after the hospital or before?
It IS expensive, I feel guilty the money I spend on this that I should be saving up for the baby!

The homeopathy etc. was after the hospital, when I was in the "recovering" phase.

When I was really bad a friend of mine told me "oh yes insomnia is awful. It took me half an hour to fall asleep last night! Normally I'm asleep by the time my head hits the pillow". I'm not joking when I tell you I was so upset with her I wanted to shake her. It is truly amazing how insensitive people can be.

I agree, it's very difficult to concentrate on anything when you are so so so tired, and you have a small baby. The book is also quite dense so hard to get into.

The thing I found most helpful was the "positive sleep thoughts" PSTs. Forcing myself to think up, and WRITE DOWN psts in my notebook which I kept by my bed. Here is my list of psts:

I have survived insomnia before, I will do so again

I'm probably getting more sleep than I think

The worst that will happen to me is that I will feel bad tomorrow

If thoughts contribute to my insomnia, then thoughts can also be part of the cure

I have a lot of support and I don't have to cope on my own

I'm more likely to sleep following a bad night the previous night

It's normal to initially feel alert if I wake in the night, drowsiness will soon follow

there's no evidence that insomnia causes health problems

my daytime malfunctioning is partly due to my negative sleep thoughts

My sleep will be improving as I learn these behavioural techniques

Other people have recovered from insomnia and so will I

I can sleep without sleeping pills

I am confident my sleep will improve

Sleep is enjoyable, and relaxing

Every bout of insomnia is another opportunity to learn how to overcome it

I can be fully relaxed in bed

I sleep better after I have used my PSTs

There is help out there

I feel better when I think more positively

Even if I don't get to sleep straight away, I usually get enough sleep in the end

I encourage you to make your own list and use these regularly, replacing negative sleep thoughts such as "I will never get to sleep" "I'm never going to cope tomorrow" etc. etc

Thanks, both of you, you have been so helpful. some of those statements are spot on, GDYWF, and I can see that they will really help. I have read a bit more of the book this evening, will just take it in small chunks. Also really nice to hear from someone who has been through it all, sounds so similar to me. I feel more relaxed already! Let's hope we all have a good night.
xxx

Hiya! I hope you slept well last night Arcadia. I slept really well - woke every hour but about eight hours sleep in total. I've had a lovely morning with coffee with friends and DS3.

GetDown I love your list. Very, very helpful and all so true.

PS arcadia spending money on getting better IS spending money on your baby as you will be a happier mummy and that benefits her. That's how I see it anyway. I want to get better for the good of my family and my lovely children who need me.