depression in pregnancy

[knackered76]

I would be grateful for any advice I can get regarding a friend. She is expecting her second at the end of Jan and is suffering from depression. She was on ante-depressants but came off these when she found out she was pregnant as she had a really stressful first 4 months with pregnancy problems and didn't want to take anything. From things she had said and messages she's sent her depression is getting worse and I'm getting increasingly concerned. I have advised her to go to her gp to talk about how she's feeling and get back on ante-depressants.

I just wanted to get some advice from people about anything I can do practically to help or from anyone who has been in the same boat as my friend about steps she can take herself. Her home situation is complicated, making it worse, so has limited support.

Thank you for any suggestions.

going back on anti depressants is a big decision in pregnancy, there are potential complications in the third trimerster so she more than likely needs to be referred on to a psychiatrist rather than a GP to discuss this properly- Im not saying that she should or shouldnt just that this needs to be an informed decision helped by someone who works in this area

In terms of alternatives, counselling is very useful, and if part of the problem is anxiety (im guessing here but complications and lack of support often mean the two co-exist) then counselling will be very effective - and as a pregnant lady your friend would be sent to the top of the waiting list

another option is for her to appropach her midwife as often the midwives in my area handle these referrals for people to save on the stress of trying to get seen

This is a fabulous resource www.ntw.nhs.uk/pic/leaflet.php?s=selfhelp I am a mental health nurse myself (and I suffer with OCD and depression so I recon I cover most angles ) and we highly recomend these at work, for people needing information in how to self help and for families, they are pretty basic but a good starting point for you both - In terms of your help all I can suggest is that you be there for her, having someone that you can off load your biggest fears and worries too is a big start, and sometimes a little extra encouragement with getting out and keeping busy is a huge help

Hope she gets sorted :)

Firstly you are a good friend and just being there for her to call when she needs to is a big help. I was on anti-depressants but came off them when we started ttc. I wasnt ready & felt myself slipping back but was determined not to go back on them so i tried hypnosis (privately, not thru nhs) and it was £60 a session & i only needed 3 sessions, after the 2nd one i walked out feeling like a massive weight had been lifted that i didnt even know i had. Perhaps this could be an option for her to try. Its not for everyone & you may need to suggest it in a way that it could help her with the birth as a lot of it is about relaxation. For me it was the best money i have ever spent.

I would also say that its good to try to get her out of the house, phone her up and offer to take her for a coffee, sometimes a change of scenery can really help and just be your normal self, no need to walk on eggshells around her or bring up the subject of depression, obviously ask how she is & just listen.

she can call Tommy's charity and get comfidential help. I had mental health issues with first pregnancy brought on by shocck and they were fantastic. On the end of the phone whenever i needed them

Am currently pregnant and have history of depression, although never been on anti depressants. There are some physical lifestyle things you can do to ease the symmtoms. She can:
Exercise outdoors in natural light.
Eat regularly.
5 portions of fruit and veg a day.
Ask Dr to check and eliminate all other physical possible causes like anaemia, thyroid gland.

You can ring regularly and ask: how are you doing? Is there anything I can do? Perhaps suggest something you could do together like a walk in the park. Something gentle that isnt too full on. That way she has space to talk if she needs to and has enough distraction and stimulation if that's what she needs.

You sound like a wonderful friend.

Everything you have said in your OP applies to me (down to the due date) and I just wanted to say that I wish I had someone like you. The worst thing is feeling alone and as though you don't want to burden other people with your feelings. I was at a wedding yesterday and had to take myself off for a cry so as not to worry anyone. My DP just keeps saying 'ah - you'll be fine' and ignores the problem. He just doesn't get that I can't help feeling like this, so I try and keep it from him too. I would love someone I could talk to and you will be a great help to your friend.

Encourage her to talk to her mw if she is lucky enough to have a good one. I plucked up the courage and it really helped with the support I got through out the rest of my pregnancy. Whilst they will also tell her to see her gp it's good for them to know and give that extra bit of support. Especially if it is her second cause you do have fewer Appts, my ms made a point if booking mr in for extra ones to check I was ok.

Re the ad, it is a big decision. Did she speak to her go when she came off of them? She really does need to go back and discuss it fully with them.

You are a great friend.

Due to my history of depression my midwife referred me to the MAPPIM team at my hospital when I got pregnant with dc2, I know not every hospital offers it but I'd second that talking to the midwife is a head start. Mine had booked monthly appt with me this time just to keep an eye and encouraged me to ask my doctor to refer me for cbt therapy saying she'd also have a word. My doctor had also received letters from MAPPIM so was clear that I needed some sort of help but didn't want ad's. Due to being pregnant I went to the top if the NHS list immediately and now have cbt weekly.

It's not for everyone but is worth trying and also puts your friend on the system so she is kept an eye on, because of course her risk of pnd will increase.

In the meantime. Just being there is more help than you can imagine. Everyone's different but knowing I had someone to talk to if I needed to was better than the ad's which only numbed me. Offer to look after dc1 so she can have time for herself, organise another friend to have dc1 so you can both have an afternoon together. Don't put pressure on her to talk about her problems, just bring some normality and cheer into her life.

You're a wonderful friend

I would strongly recommend she talks to her GP. Mine got a lot of advice before we started ttc and I was told to stay on my anti depressants for pregnancy and breastfeeding.

There aren't any clinical trials about ad and pregnancy (might not be too ethical) but it's important that she feels she'd made the decision to stop taking them from a fully informed point of view.
there is a thread on here about citraloplan and pregnancy (it's long mind!) where LOTS of women are taking AD during pregnancy... you both might want to read it to see if actually the AD would be the way to go?

(not meaning to sound like I'm pushing drugs here.. just that I know my depression wasn't fixed with counselling or cbt or the million other things that I've tried.. mine is simply a chemical imbalance that goes when I take AD and comes back when I don't!)

if she gone this far without them she should carry on its only 9 months and then she can go back on them some hospitals even have units she can stay in if the depression gets really bad as it can do especially week after giving birth but I wouldnt risk having anti depressents if anything was ever wrong with the baby she would always wonder. Thats just my opinion mind.