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.

About how the birth affected you, I had a vaguely similar experience in that I was very upset by various aspects of ds's birth and the physical after-effects I suffered. By anyone's standards it was a normal birth, with the desired outcomes: healthy mother and healthy child. But it affected me, and I didn't realise just how much until I was pg for the second time and at the hospital's pre-natal class. The anger that was bubbling up in me - and it took me quite by surprise - was clearly obvious to the midwife taking the class, and afterwards she invited me to come and talk to her in private about ds's birth. It took me some weeks to make up my mind to do so, but in the end I went. I am so glad I did! We talked through every aspect of ds's birth, she had my notes ready and explained everything, and we discussed how I could prevent certain things happening again. It made such an enormous difference to me. My anger and distress at my previous experiences were completely washed away. Not pushed aside, but acknowledged and accepted, and then they went away. I was able to go forward to my next birthing with confidence and joy.

Why am I telling you this? Because I want to emphasise that the trauma you experienced is real and valid to you, and causes you real and important emotions. It is damaging you, and you need to accept the way you feel about it, be given permission to grieve or rage, and then let it go. I'm sorry that I don't know how to express this without it sounding like psychobabble!

Also, we have been brought up to be in control of our lives. Then we become mothers, and don't we remember our mothers as being in control, especially when we were little? But your introduction to motherhood is an experience over which you have very little control: giving birth. Particularly when your baby is then taken out of your arms and put in SCBU. And then as an actual mother you find that you don't have much control in any case. You may be in control of this little individual's life, but you're really at his beck and call. You're determined to do your best by him, but you can't control his future. It's all essentially unpredictable, and the best you can do is to be prepared.

I imagine that researching your ds's issues is a way of trying to be prepared. But I don't think that you are prioritising correctly. Yes, by all means find out what the future may hold, but first look after yourself. Right now this research is causing you greater distress rather than giving you confidence, so you need to put it aside for a while until you have regained your inner strength.

Prettycandles - the second part of your post is just so true, well put. I found the lack of control so difficult.

And sobernow.... 'if she's going to die, take her now before I get to know her' that's just how I felt. Almost holding her away from me, just in case.

A4T, prettycandles is right. Your birth experience was traumatic, and that's not a strong enough word - others may or may not have had worse but it doesn't make your experience any less valid. It has had a marked effect on you and to admit it to yourself and to others isn't a failing. It wasn't until an aquaintance of mine went through a similar experience to me and I thought 'God how awful for her' that I let myself believe that it had been awful for me too. The effort I was putting in to push it aside was actually what was preventing me from coming to terms with it........ Don't know if that actually makes sense, but I'm rubbish at finding the right words.

Keep talking.

Binkie - that is helpful to know. This is partly what I am tussling with in my head. Everyone "says" that as soon as they see their baby it is the most wonderful feeling in the world and that they can never imagine life without them etc.... I know I don't (at the moment) feel that. I feel like I have been entrusted to look after him, but not that there is any connection really. He makes me laugh and I make him laugh but I can do that with lots of babies. I did wonder whether other people felt the same, and so if so seeing a CPN about it is a bit extreme. I don't know whether if I had seen him straight away when he was born rather than him being pointed out to me in SCBU would have made a difference or whether I would have felt like this had everything been totally straightforward.

Good - I expect if you started a thread called something like "how long did it take you to 'bond'"? you would get some very relieving answers. One little extra suggestion, sorry if this is too obvious, but is he constantly with you so that you never get any (waking) time away? If so, could you leave him with his dad for an afternoon or so and just see how much you "miss" him? That sort of thing helped me.

However however I really don't want to put you off talking to someone, CPN or HV or other sort of counsellor, if there is more than the distant feelings going on - it does sound as if there is some unfinished business around your birth experience, and as if something is sapping your energy generally. Please don't think that I'm suggesting a kind of "snap out of it" line - I'm not at all.

TBH Blinkie I think I want someone to tell me to snap out of it. I still think I should be able to get myself together. I have left him for part of a day a few times, and I don't really think of him at all, only in the abstract, e.g. buying a pushchair for him. My task is to buy a pushchair, I don't really think of its purpose.

However, this non bonding is only part of the problem, because I do feel very miserable a lot of the time, especially when I think of my situation and I just want to cry. hence if I could keep busy I would not have time to think... Trouble is I feel so lethargic. On more than one occasion I've washed clothes and left them in the washing machine for so long that I've had to re-wash them even though the tumble drier is a few feet away.

I also feel very distant from my husband (although he is supportive of my difficulties). I feel it unfair to love him if I don't feel I love my son (even though I may do and not realise it).

So I think I do need to do something although I'm still unsure whether a CPN is the correct path. But I sometimes think that while I appear to be exploring different options I'm too frightened to take them forward, in case I don't like what I find.

Well, as they say, if you had a broken arm nobody would expect you to snap out of it (and more to the point, nobody would expect you to decide all by yourself whether the break was serious or not).

But if you are thinking that a CPN route sounds drastic to you now (although from the posts below it doesn't seem as if it is really) and as usual with apologies for suggesting things that might sound trivial (or you've already thought of), there might be some different options to explore as well:

• non-bonding (as yet): don't focus on this for the moment. Let yourself notice how happy he is (you mentioned him laughing) and that can be enough for now;

• lethargy: have you thought at all about a thyroid problem? Or iron deficiency? Or just creeping general slow-down that might respond to some fresh air, nice food and exercise? (Do I sound like your mum?)

• sadness: do you have friends who make you laugh still? Have you tried a MNer meetup, they are lovely? Have you got a copy of Libby Purves's How Not to be a Perfect Mother? (All of this is about whether there are still things you enjoy - because if there aren't (at all), that does need looking into.)

And for other ideas there are various books mentioned on the reads-for-new-parents thread, lots of which sounded promising.

Good point, binkie, about the lethargy. After ds's birth I took no supplements - after all I was quite well, wasn't I! But after dd's birht I continued taking iron, multivitamins and mineral.

Technically I was never anaemic, but I knew from my previous pregnancy that it didn't take much reduction in my blood iron for me to feel ill and exhausted. I thought the drs would poo-poo this, but no, they took it very seriously, did extra blood-tests and encouraged me to take extra iron despite what would normally be considered a perfectly acceptable level of iron in my blood. So you see, another instance of me worrying about what a dr would think of my opinions, and being quite wrong!

Anyway, back to the point. Which is that despite having two being more exhausting than having one, I didn't get PND with no2, and was not as exhausted as I expected to be. It seems very reasonable to me to put some of that down to taking the various supplements. It's never too late for that, so why not try it?

a4t, seeing the CPN commits you to nothing. You will be in control of the relationship. After I had stopped seeing the CPN, the team wanted to discharge me but I asked not to be discharged - even if I wasn't getting 'treatment' at that time. They were fine abut it. No pressure whatsoever. Eventually my discharge was agreed mutually.

May I ask what sort of pain-relief you had during labour? You don't really need to answer that - I just want to point out that virtually all of us on Mumsnet have gone through a very similar experience: giving birth (there it is again! ). Yet some of us 'coped' without any pain-relief at all, some of us with a little, some of us with everything going. Some of us feel bad for having had pain-relief, some of us delighted, some couldn't care less.

Your distress is like that. The help or treatment that was fine for one person may be excessive for another or totally inadequate for a third person. Don't feel bad that you need outside help...you can't do everything from inside.

Sobernow, yes it is possible to talk to a midwife like that. My hospital had a 'Liaison Midwife', which was the person I spoke to. As a healing experience I cannot recommend it highly enough.

sorry if this sounds a bit garbled, I feel at the moment like I am wading through mud all the time. In conversations I hear what people are saying, but don't feel like I am making the right response. So if someone said they'd broken their leg, I'd probably say "oh right", while thinking - usually much later at night when I replay the day's conversations- I should offer to do something to help.

I'm not sure what I have said in total and am too tired to wade through the thread, but it's more a case I'm always surprised when I see him as if I have to remember who he is, and this is why I feel I may not have bonded with him. It's as if I keep forgetting about him - which when I think about it distresses me.

Finding it very difficult to keep up with friends. not many pre-pregnancy friends live near, although I force myself to meet up with my ante-natal class for coffee every couple of weeks or so. usually ok when I go but sensitive to any comments about son. been meaning to catch up with good friend for several months, finally did but only after making myself not cancel at last minute. other friends who can't have children (for different reasons) I can't really face anyway.

I keep having good intentions but not following them through when it comes to food and exercise. I bought a pedometer, and have worn it twice. Decided to go organic and bought a load of food from supermarket, but then when it came to making dinner each night, my proposed menu just seemed to complicated and so that didn't last. I feel like I know what I should be doing but can't be bothered/not able to do it.

I did wonder if it was thyroid/low iron but don't really think it is (or not just that) but I suppose I could mention it to the GP when I go back.

Think in a way I would rather go down private counselling route, but it just seems too much effort unless I know it would work.

Thanks very much for everyone's constructive comments. I feel bad now that I've wasted your time.

anon4this - you've not wasted our time at all - that is the beauty of an internet forum - if someone doesn't want to look/read they just won't bother. I think that you do need to do something because you do sound really unhappy = whether that is CPN, private counsellor, or ADs is whatever you feel comfortable with - or even exercise/meditation. Re:bonding. For many of us (me included) it does take time to get used to having responsibility for a vulnerable little being; its not a love at first sight on the labour ward thing. I think that many of us are taken in by the rosy picture in the PG books/mags for our first baby - it was only because I was depressed during PG, and looked at the more "pessimistic" side of things, that I knew that it was pretty common not to bond straight away.

another thought - you can get iron supplements off prescription AFAIK - so worth trying these or a suitable multivitamin anyway

Very quick before bedtime, but - PLEASE do not feel you have wasted anyone's time - sharing experiences and support is what we are here for (and speaking personally get a lot out of too).

Please keep posting whenever you feel up to it.

thanks for all this. I think the trouble is I'm not convinced I am depressed! And I think that because sometimes I feel fine I should be able to all the time. I just feel I'm being lazy, self indulgent and feeling sorry for myself, and then when people obviously take the trouble to give long considered replies I feel bad - although the advice is useful and appreciated.

I also feel in a way that my HV was proactivelly looking for PND from the first week she came, and so I feel it's acceptable for me to feel miserable (if that makes any sense). Another HV may have told me to pull myself together and I may have got on with things more. I just don't know.

Nevertheless I am worried about the fact I'm constantly surprised to see my son, and forget about him when he's not in sight (although I;m not worried I'll leave him anywhere!). And I have to admit that I have some of the signs of depression, worrying, not sleeping, no motivation etc

I think I just keep going round in circles and then tell myself I feel normal, when I've just probably got used to feeling like this and so I do need an objective person to look at the whole picture

I suppose I could let the CPN come once and they could advise what sort of counselling would be best, maybe even recommend someone. Then I would feel I would have some control over the process if I was paying for it. I'll see when I get an appt for the CPN and if it is not for ages I will probably go and book a therapist anyway. Well I say that now but..

thank you

PS I do know how to spell proactively, honest

a4t, some of the things you have said, especially in your last few posts, made me feel as if I was reading my own diary. It was exactly exactly what I was feeling when I had PND. And, when I was on my way up from the bottom, I found it difficult to believe that I had been that way, and that it had felt so normal at the time.

Can I suggest something that the CPN asked me to do? Every day or two write down something that made you feel good about yourself. For example (I've got the notebook that I used here) some things that I wrote were: 'I read both children a story together' 'I watered the plants' 'Went to Brent Cross in the morning - all 3 of us breakfasted, washed and dressed'.

You are so definitely not wasting anybody's time, not even your own, by posting here.

No, not 'normal', more that it had seemed acceptable to feel that way.

bad afternoon - feel worse than for ages. So if I don't hear from the CPN about an appt soon I shall take pot luck in yellow pages. From what my GP said it could take a while, and I don't expect the referral letter would say I was especially urgent, so I am guessing weeks??

Please look at this I had a CPN for a while during my 2 pregnancies. Hope it helps you!

hi anon4this - here's some info I have posted before on finding a therapist sorry it rambles on a lot:-

"I had Ante-natal depression and OCD whilst pregnant. My GP referred me to the practice counsellor (a few weeks waiting list) who I found worse than useless. He specialised in inner child therapy (which is no use for OCD - you need some form of behavioural therapy). I then found a Cognitive Behavioural Therapist via
The British Association for Behavioural and
Cognitive Psychotherapies (BABCP) www.babcp.com. What happened was I phoned up the first local woman on the list - who was busy doing a PhD thesis, so couldn't see me, but recommended someone else on the list to me, who I was able to see. I had about 10 sessions with him whilst pg, and have started seeing him again afterwards. and have found him very good.

Basically I agree with Cookie Monster that your first port of call should be your GP - she may know someone good who you could be referred to for free on the NHS. For behaviour therapy on the NHS there tends to be a waiting list as long as your arm. You could ask your GP if they know of anyone good you could see privately.

I think that cognitive therapy tends to quite effective for depression. I'm not too sure whether behaviour therapy would be appropriate - I think that is more appropriate for compulsive rituals, such as handwashing, checking etc. I can't really comment on psychodynamic therapy - not quite sure if that is the same as inner child therapy.

If you are looking for somebody to do CBT by yourself, I would suggest that you start off on The British Association for Behavioural and
Cognitive Psychotherapies (BABCP) web site, and for preference go with people who are NHS clinical psychologists (that way you know they are properly qualified). I would also speak to a few different ones, and ask what sort of experience they have in treating people with PND, and go for someone who sounds like they do it pretty regularly. I am not sure how best to advise you on finding a good counsellor other than personal recommendation - and people don't necessarily wish to advertise the fact that they are seeing a counsellor. Cost wise - the GP practice counsellor charged £35/hour for private sessions, and my psychotherapist charged £50/hour for private sessions, which I think is pretty reasonable.

The combination of counselling/therapy and ADs tends to work better than just counselling/therapy. Do you want to talk about why you don't want to take ADs, or is your mind firmly made up?

Hope something in this long rambling rant is of use to you!"

thank you both very much. I'm going to give it a week and then if I've not heard anything I'll book something privately

Anon4this, whereabouts are you? I know of very good, caring, psychotherapy collective practices in central London and Edinburgh. I have used the London one (for bereavement not PND counselling) and it was very helpful. I was referred there by work, so my "mad" label was out in the open and I fully understand your worries of escalation and being unable to opt out. But I really hope your CPN referral comes through soon.
You've had such good, caring advice on this thread. As others have said, don't EVER feel you are wasting anyone's time.
My dd spent two days in SCBU just after birth (she was breathing on arrival but collapsed five minutes later) and just like you, I "froze". Sent dh down to see her (although admittedly I was post c-section for the first 24 hours), completely failed to take the initiative on expressing, so she had formula during that time, and was not really all that pleased to have her back. I think it's a very normal reaction to having a baby in SCBU! And I think it's also normal to find it hard to "regain authority" over your baby after he/she has been through SCBU. I had to ask a m/w if it was OK to change her nappy on our first home visit...