CPN - any experiences?

[anon4this]

Hi
Have posted previously about PND but changed my name for this. Briefly, I have a 7 month old, but have never really felt like he is mine. I don’t have negative feelings about him in the slightest but if someone turned round and said that a mistake was made at the hospital I would believe them. I’ve totally felt unmotivated to do anything apart from sit around all day. There are also a few health concerns about him which are worrying me. My HV has been visiting weekly but really recommended I saw my GP. I bit the bullet and went last week. My GP (who I had not seen before) is writing a referral to the mental health team, and he said that depending on what they decide I will either be seen by a CPN or a psychiatrist. I feel it’s all a bit heavy and am now worried that I am on a road I can’t get off. Does anyone have any knowledge of what exactly will happen. He said if it was a CPN that they would come to my house?

I feel like it's all got out of proportion but guess I may not be able to judge things rationally at the moment.

Hi anon4this. Sorry to hear you are feeling so low atm. I've never seen a CPN but was referred to a psychiatrist when PG (OCD/Depression). As I understand it, CPNs come to see you and review your symptoms/medication and talk things through with you and support you - sometimes they may be able to do counselling or even cognitive behaviour therapy with you. Are you on any meds at the moment? I know that it does feel a bit scary being referred to a psychiatrist but it is good to be dealt with by an expert in the mental health field, rather than just fobbed off with tablets. If you are seen by a psychiatrist then a lot of the first appointment will be going over your history and symptoms in detail, with a diagnosis and recommendation for medication and/or psychotherapy at the end. Further appointments review your medication/symptoms etc. I probably shouldn't be recommending another website, but there is a very good Babycentre bulletin board on PND where people have been referred to CPNs, psychs etc and so know what it is like and people would definitely be able to answer your questions about CPNs. If you want to msn me, please feel free to contact me via contact another talker.

Hi. I am a medical writer who specialises in mental health. CPN's (community psychiatric nurses) are nurses so they won't be able to prescribe any medicines but they will talk to you and can offer counselling as Mummytosteven says. They should be able to refer you to psychiatrist if needed. It is best to get everything sorted out sooner rather than later. I know it's scary but you will soon be feeling better with the right help. Stay in touch.

When I was ill with PND (baby at about the same age as yours) my HV refered me to the Peri-Natal Outreach team in my area. A CPN and an Occupational Therapist came to interview me at home. I asked my dh to take the day off work and be present to make sure that I spoke truly and did not try to dismiss my problems. They then had a case-meeting with a psychiatrist, who recommended that I go on Prozac. I did not want to take any drugs, and was afraid that they would therefore refuse to help me. That was not the case at all. The OT came to visit me at home once a week for several weeks, then once a fortnight, then once every 3 weeks and so on. They also refered me for psychotherapy, and the OT stopped visiting at a time when I felt happy not to be visisted any more, a few months before the psychotherapy started. When the OT visited, she would listen to me, encourage me to talk, help me develop coping strategies, suggest mental exercises for me. We would be at home, or several times I asked her to come out for a walk with me. I know that if I had felt the need, she would even have gone shopping with me.

When I was pg with my second child, I was very concerned that I would develop PND again. Part of my preparationw as to get back in touch with the Peri-Natal Outreach team again. This time a CPN came to visit me once a month for 2/3m before my due date, and continued for several months after dd was born. Again, the frequency of the visits was very much under my control, and the CPN would go with me anywhere I wanted. She, too, helped me with coping, thinking etc. I did not develop PND that time, partly I'm sure due to the care I was given, but nonetheless the visits were not terminated and I was not discharged from the P-NO team's care until I felt happy about it.

I cannot fault the care I had from the OT or the CPN at all. I never felt under any pressure to take drugs if I chose not to (though I was informed that they were available to me). I never felt obliged to continue under their care. Most importantly, I never felt that I was now labeled as a 'looney' (one of my great fears about PND).

In admitting to PND and asking for help, you have taken a big step forward. I don't know whether your experience with the CPNs etc will be anything like mine, but I do recommend going through with it. One of the worst things I found about PND is that I couldn't be honest about my feelings and behaviours among the people who mattered to me. With the O-T and especially with the CPN I felt able to be completely honest and not shamed by my tears.

Good luck - this is the beginning of the way up again for you .

Thanks for all this.

I think in the back of my mind I had this view that they only would come and see people with a view to sectioning them. I "know" that's not the case, but I just feel it's a bit scary. I just have this worry it's a bit like childbirth - one intervention leads to another. I just think that maybe I've made myself sound worse than I am, as I know I am feeling very inarticulate at the moment.

I had been offered ADs but turned them down as I am still b/f and the GP was supportive of that.

I suppose I am scared that once they come I'll have to let them keep coming, i.e. that since I'm "mentally unsound" enough to need them to come and look at me, I won't be considered sane enough to say I don't want them to come. Sorry clumsily put but hopefully you get the idea.

The thing is I had thought I felt better than I did a few months ago, but my dh and a couple of close friends don't agree - so I'm not sure whether I've got used to sitting round doing nothing and consider it normal. If I have something I have to do I will do it, but I still won't proactively do anything.

mummytosteven thanks for the offer of msm - unfortunately I have absolutely no idea what it is/how to do it, although I keep seeing mentioned in posts and really should set my task for tomorrow to understand it.

Anon - you sound anxious and depressed

I don't personally have experience of CPN but my FIL recently had a period of severe mental illness and MIL found the CPN team very helpful. Please be reassured that they're not there to cart you off against your will, they will be able to help you find a way back to your old self.

Just wanted to touch on another thing you've said about your concerns re your ds's health. If you have a child that's sick it can affect the way you bond with them - a tendency to keep them at arms length - to protect your own sanity as much as anything else. Its as natural as pulling them closer. It doesn't make you a bad mum or a candidate for the funny farm (no offence mean't)-its a coping mechanism.

Hope you get some support.

luckymum, thanks for your kind words. The problem is, the way I look at it my son has to be able to rely on me to be there for him. However bad I feel I should be able to support him and put him first as it was my choice to have him - he had no say in the matter.A good parent would instinctively be there all the time for their child. When my son was in SCBU I felt I let him be looked after by strangers and I was not there enough. Howevermuch people say I was in shock about it all it doesn't defend the fact (to me) I abandoned him. Now it is possible there may be some longer term health problems with him I feel even worse.
So many people have problems conceiving, or lose babies and I don't appreciate what I have got. I just feel I am letting him down.
I know'm not being rational but I feel I can't judge how serious things are, whether he's having tests purely as a precaution or what.

Hi Anon4this. I know it's scary when you have extra people visiting - I feel a bit like this coz the HV has been visiting weekly until quite recently to keep an eye on me and ds - when you feel a bit better you can suggest having less frequent visits. TBH as it is your house I don't think that they can force you to have a CPN visityou anyway. About the ADs - would you ever consider taking them. I have found ADs extremely helpful (Prozac) but realise that not everyone likes the idea. I was told that it was OK to take Prozac and bf, and understand the position is similar to the other SSRIs.

Do you have a chance to get enough sleep/a break from you lo - something as fundamnental as a good night's sleep/a night out could be very helpful (though not wishing to sound like I am belittling your problem by suggesting that all you need is to get smashed one night!).

MSN - if you download Windows Messenger and get a hotmail account, it is fairly easy/self-explanatory - you add people to your contacts list by getting their hotmail address, and can then chat online to them by sending them Instant Messages

anon4this - firstly I just wondered if there were issues surrounding DS birth that you need to talk thru, as it sounds like a very traumatic situation. Also it is very, very difficult to have a baby in Special Care. When you are just recovering from labour, with all the hormones flooding through you, in conjunction with the physical exhaustion, you are not going to be yourself at all - it's not a valid assessment of your true nature - in what other situation would anyone go through such a physical ordeal and then be expected to deal with another very vulnerable person's needs without any real chance for a rest.

I had a relatively difficult labour and time in hospital with DS jaundiced and in an incubator under the lights and attempting to establish bfing- obviously nothing by comparison to what you have gone thru and are still going thru - and I certainly don't feel proud of things that I did during that time. Not because I was consciously being selfish/a bad mother, just because I was stressed out and zombified by lack of sleep and not thinking at all logically.

Is there anyone you can talk to at the hospital to get a better explanation of the tests that they are running?

anon - you're not letting him down, just finding it all hard to cope with. My dd spent loads of time in ICU - on the day she was diagnosed (she was 4months) I walked out of the hospital and drove home. She was with my dh, but I still left her IYSWIM. I regret it every day because I should have been there for her but I walked away - something just flicked in my head. I know now it was a way of coping - it is for you too, and I've forgiven myself. You did your best for him and are still doing, under very difficult circumstances.... they are still doing tests - and you have that hanging over you too. Don't be too hard on yourself.

Hi mummytosteven

The HV has agreed to not come for a while unless I ring her, so that's good.

The trouble is I don't know if it was really traumatic, if that makes sense, or I am making too much of it. He was born, after getting stuck, with the cord round his neck. So by the time he came out he was not breathing and so they intubated him and took him straight to SCBU where he stayed for a few days. I've got copies of the notes, and he is seeing the paed as a precautionary measure every couple of months. Hopefully this test will come back ok too.

I just keep reading things on the internet and worrying myself, e.g. the cord cutting thread elsewhere on MN.

I should be able to get a good night's sleep as he does 7-7 most nights, 7-5 on a bad night. We've been out once and it was not a sucess. We got there and I just felt so awful I just wanted to walk out - don't know to go where or what.

I just feel I am being sorry for myself and I should be able to get myself motivated. Lots of people on MN have far more serious worries than me so I should stop wallowing in it.

Luckymum I feel I just did not think about staying with him. I'd just pop down and see him and then go back to my room and watch TV (that's what it felt like anyway). They had to ask me twice to express milk for him, I hadn't even considered that I needed to feed him

Sorry for rambling on again, and thanks for the words of support.

anon4this, you're not 'mentally unsound', you are ill, just as if you had the flu. That was exactly what I worried about at the time, and please please please believe me when I tell you that that was not the way in which I was treated by the health professionals.

Could your dh stay at home with you on the day the mental health team come to visit for the first time? My dh believed that I was ill and persuaded me to go for help, at a time when I denied that there was anything wrong. Like you, I felt that things were overwhelming me, but denied that I could possibly have PND.

It's very difficult to keep things in perspective when you have PND, and all sorts of feelings and thoughts take over...like feeling as if you abandoned your child, when you didn't do so at all. Eventually you do begin to consider it normal. It was only when I started getting better that I ever admitted that I had been ill, and eventually I could see just how ill I had been and accept that it had happened.

Keep your courage up, remember that you are a good mother under very difficult circumstances. You are the centre of your son's universe. Your bonding with him will increase - it's a fallacy that all mothers love and bond with their babies immediately.

Oh dear, how bad you must have felt about the feeding . Of course it was traumatic! Poor you, how were you to know to go and express? After all, it was a totally new experience to you, and no doubt you were all over the place with fatigue, aching, hormones and all the rest.

You're not wallowing, and you don't need to feel guilty about it. It's very difficult to deal with PND on your own. Modern motherhood is isolating enough as it is, but PND increases the isolation.

Could I suggest that you stop looking at things on the Internet that may distress you? Right now you need happy thoughts to buoy you up a bit, not stressful research about what may or may not happen.

Keep posting!

Hi anon4this - it does sound like DS's birth was a very scary experience - and would have been for anyone. Maybe it would help if you could talk through your memories of the birth with the CPN. Mine was less bad - DS also had the cord round his head, so had to be ventoused out, and have his airways cleared - so I know what you mean about that cord cutting thread. Things like that are what I consider a "counsel of perfection" - i.e. in a perfect world that would happen, but they are not vital. The worst thing you can do is read internet info on things like that - some of the info is not always good quality anyway and the more you read the more you scare yourself silly about it.

What you did when you were in hospital sounds pretty normal to me - other girls on my ward had babies on SCBU - sometimes they would go and visit, other times they would come back up and chat with people. I.e. you are not at all at fault, or in anyway abnormal for not being a permanent fixture by your los cot in SCBU. If you have a baby in SCBU/in an incubator you do feel as if the nursing/medical staff are in control not you - so I can completely understand why you would expect them to take over feeding as well! Also bear in mind that you would not have been thinking at all logically after what you had been through.

Feeling anxious when you go out is part of the PND - once you treat that, that should improve. Do you manage to get out all - whether by yourself, with DH/DS?
Like prettycandles said, this is an illness it is not a sign of personal weakness. Just because it is a mind issue, you feel like you should be able to control it. If you had diabetes, you would not feel guilty for having it - it should be the same with depression - which IMHO is essentially a seretonin deficiency. Some people will have far better lives than you on MN. Some people will have far worse. But what is important is YOU. If you can't express yourself freely on an anonymous web forum, where else can you???

Take care
X

I know I shouldn't look at stuff on the internet, you've no idea if its been peer-reviewed, or sample size or anything but I am desperate to really understand what happened, how common it is, how often it has implications. GP/Paed/HV all say he's doing fine, but fine compared with babies who did not have his inital problems, or fine considering his poor start, and possible subsequent problems? I just worry that they assume I realise that he will have a problem, and so are saying fine, taking that into consideration.

prettycandles I did perserve with b/f although there were 2 weeks of hell, and he got to 6+ months with no formula or solids. i'm sure i only did it because I felt guilty about the start, and then once I got the hang of it I just couldn't stop! not sure if it helped with bonding though,

The trouble is I'm not sure I have got PND. Some days I really feel fine, usually when I am doing something with husband/friends, and I think I am making a fuss about nothing. But when I am on my own, I just can't get the momentum to do anything, and I now consider it normal to sit on the floor with him all day.

I guess I am scared that by having a CPN it steps things up a gear, and I just wondered how common it is. I know that I can function at the moment, and I'm not sitting round in floods of tears all the time anymore. I can do stuff if I have to and I can enjoy things. I just feel that I'm going to be wasting everyone's time, and I'm going to get a black mark on my medical records for needing a CPN.

I know I've always avoided the medical profession totally until I had my son, I always feel worse when I come into contact with them, and I worry that this makes them think I am worse than I am. I just wish I'd never gone to the GPs in the first place. I wish that they'd told me that it would gradually get better and I would have just plodded along.

However, I suppose I owe it to my son to be as happy as possible for his sake and not let him down again.

anon4this - how are you feeling today? You have done so well with the b/f - you've done it for all the right reasons not guilt.
Why has your HV stopped visiting? Do you get on well with her? I would take all the support you need right now. Seeing the cpn could be the start of getting back on track.
I don't think you would know if you have PND. I assume that the HV did that questionnaire with you?
Keep coming to MN for support.

hi Strawberry,

thanks for asking. My HV is going on holiday for a couple of weeks, and then we may go away, so that takes out most of August.

I think I am worried that the CPN will "play mind games" with me, and I'll be guarded in what I say in case I say something that I worry will be interpreted incorrectly and then they will jump to wrong conclusions.

yes I did the Edinburgh at 6weeks, she hasn#t bothered doing it with me again as she knows I know how to score it and will be conservative. However, I've done other depression tests on line and come out poorly.

The stupid thing is that I feel worse now. I felt I had had a few days that were ok in terms of functioning but now I feel I've opened a can of worms. When I am busy I don't feel too bad, it's when I've got time that I feel low. Trouble is that get's to be a vicious circle.

Sorry rambled on again

Not rambling at all. The cpn won't play mind games with you. I recently had a miscarriage and I understand about keeping busy - I think we all do this to cope. But facing up to stuff is important too and talking things through. Do you meet up with other mums in your area? There will almost certainly be other MN'ers in your area if you're interested.

What you're saying makes a lot of sense to me, a4t, and TBH it does sound to me that you are suffering from PND. Even if you are not, you could still benefit from the support a CPN could give you - just like I did after dd was born, when I didn't have PND.

Well done for the breastfeeding! You did better than I did . That is something you can look back on and for which you should reward yourself. It's harder to establish bf when your baby is in SCBU.

CPNs don't play 'mind-games'. It's not in their interests to find the worst in you. Please don't be afraid of the system. I was terrified of being labelled a loony. I was afraid to be honest about my feelings of detachment from my baby and of disgust in myself, in case 'they' decided that I incapable of looking after him or was a danger to him. But it was fine. They hear all sorts of things adn are very very experienced at putting these things into context.

I used to be ahsamed of the fact that I had suffered PND, and that I had psychiatric treatment. Then I discovered Mumsnet... First I accepted that PND had happened, then gradually I became open about it. Over the last few days, talking to you has made me realise that I'm actually quite proud of myself for having survived a horrible experience.

Please don't sweep your distress under the carpet. Yes, some days you cope, but sometimes you don't. There are still issues that disturb you and that you need to deal with. Getting help will not diminish you in any way. It will get even better, promise!

BTW, if yo want to find out more about any repercussions to your son's birth-experience, Mumsnet is a very good place to start! Have you tried starting a thread explaining what had happened and what you are worried may happen as a result, and asking if anyone has any similar experiences?

thanks prettycandles. Glad we've helped each other as it were.

I'm sure that they won't play mind games. It's just I really have no idea what they will do, and I hate being at a disadvantage. I suppose I am worried that they'll say something, e.g. "you MUST have ADs you're that bad", and I won't have the knowledge at hand to be able to challenge them.

Did you always feel detached from your ds, and how long did it take you to get over it if you don't mind me asking.

It's not I resent my son at all, it's just every time I see him I am slightly surprised and I don' feel like he is mine

Sorry, did not include the last bit of my message.

I don't feel like he's mine and I feel like I am taking liberties when I do anything with him, e.g. look in his mouth to see if he's teething. I keep thinking someone is going to tell me off.

I think I worried I was not maternal before I had him, and don't know if I am using his poor start as an "excuse" for how I feel. I just don't feel it is fair on him. I don't know but I assume the CPN will be able to go back before the birth in any discussions.

I'm reluctant to put something up about his birth on MN, as I think at the moment I am trying to tell myself that I am worrying about nothing, as all the medics have told me that he is developing fine. If I put something up and someone tells me that they had a similar experience and they have had problems I'll worry more. I know that's not rational as I'm surfing the net looking for stuff but ..

Re-reading this thread I do sound paranoid. I just hate doing things where I am not in control or someone knows better than me, although I'll admit there's loads of things I know nothing about!

anon4this - you are not using the difficulties around the birth as an "excuse" - having a difficult birth is definitely one of the risk factors for developing PND. I'm sure that the CPN will want to discuss your past history/experiences as these will have an impact on how you are feeling now. You don't sound paranoid - I have certainly had thoughts from time to time about how DS was distressed at points during the labour/was born with the cord round his neck and thought - what if there is something wrong with him because of this - the issue isn't that you have these worries, but that you are not able to "discard" these until something comes up to prove that there is nothing to worry about. I would second prettycandles that mental health staff are not there to play mindgames, but to help you get better. I've never had a CPN but the psychs I have seen have always been very pleasant and treated me with respect - tho telling them what meds I wanted to take, and not having significant side effects does I imagine make the "working relationship" somewhat easier.... The CPN/psych will be there for YOU ,l rather than the baby in a way that other professionals, such as the HV and midwifes aren't, in my experience.

Your feelings about DS not quite belonging to you sound like PND - but don't worry about putting a label on how you are feeling - just concentrate on getting the treatment you need to get better. In many ways people are more keen to look at methods other than ADs to treat PND than many other sorts of menthal health problems, so if you really don't think ADs are for you, there are other things you can do to help you.

Would it be helpful to know that lots of us have had really quite acute "he isn't really mine" feelings, so that in themselves those feelings are not at all abnormal?

When I look back on how I got to know ds (he's now 5), I don't think I felt a real bond till he was about 10 months - and it noticeably started in his absence - ie I suddenly found myself lying in bed at night thinking happy thoughts about "my" little chap.

I don't mean to say that you shouldn't have outside help if it is needed - I just wanted to let you know you shouldn't beat yourself up about the feelings of distance per se. It is so difficult when all of the literature says how you will melt with tenderness, think your child the most beautiful on the ward, etc. Sometimes it just is a longer process.