Antenatal depression

[AwkwardPaws27]

Wasn't sure whether to put this here or under mental health. I'm 33 weeks pregnant and my mental health has gone to shit. I'm autistic (although late diagnosed) and have been on antidepressants on and off since my teens. They take the edge of but have never been the wonderful cure others seem to experience. I stopped them in early pregnancy.

I really don't want want to go back on medication as they said baby would have to stay in for additional monitoring after birth and I really wanted us to be able to go straight home afterwards like I did last time (which was the whole point of stopping citalopram in the first bloody place!).

I feel like such a failure but I'm not coping. Talking Therapy is useless - after over a year of waiting I've just started a 6 week course of CBT but its basically a woman talking me through a self help manual with no accommodations for the fact that I'm pregnant and actually physically doing stuff is getting hard so going for a nice walk is painful rather than relaxing.

I had a breakdown at a consultant appointment on Tuesday, begged for MH referral, was told someone would call me yesterday but nothing. Midwife helpline is rarely answered, I've tried a few times and left a voicemail.

I'm just yelling into the void at this point. I feel like I keep saying how awful I feel but nothing changes. I'm just going to have to take medication, aren't , as there's no therapies available except the most basic CBT. I'm dreading Christmas as I just can't keep masking long enough to be around people all day.

I’m a midwife and wanted to reply to you. Antenatal depression is recognised more and more these days so I am sorry you are feeling this way and sorry you are not getting the help you are asking for. Prescribing anti-depressants in pregnancy is a risk-versus-benefits exercise - if your mental health is deteriorating, it is probably worth taking them and possibly staying in hospital for a bit longer rather than let your mental health deteriorate further. Lots and lots of women take medication for their mental health in pregnancy because it is better than not taking it. The last thing anyone wants is for you to deteriorate further especially as childbirth and the early neonatal days can cause even more mental stress from tiredness/lack of sleep/hormones. Has your hospital got a perinatal midwife or team? If so, reach out to them. And try the charity Mind - they have a subsection called Mindful Mums where women support each other. Keep pushing untol you get the support you need. You can even change hospitals if you need. Good luck

@Holdonforsummer it feels like everyone says "its your choice" but there is no choice really as medication is all there is.

They say there will be support but actually its just assessment after assessment with nothing in between. Fill out this questionnaire etc.

I'll have to go to perinatal mh directly. Was under them last time, just fortnightly assessments but again no actual treatment except medication. No talking therapy at all on offer.

If I'm on medication we have to stay in and a postnatal ward sounds like hell. Everyone says its loud, people playing music on their phones etc, no chance of rest or sleep, hence wanting to go home where I might actually get some quiet.

I've done the Mums Matter course before with Mind. Doesn't actually fix my stupid stupid brain though unfortunately. I'm just broken and should never have decided to have this baby.

How much support have you got around you from partner/family etc? Unfortunately there is no magic wand - but you already know that.

I've been on antidepressants while pregnant and had to stay in postnatal ward after the birth for 48 hrs. I shared a room with only 1 other person both times and it wasn't too bad. There is a lot going on on postnatal wards and can be a bit of a sensory overload with all the people and activity. Perhaps mention your autism diagnosis to your midwife and see if you can put you in a quieter room with fewer beds.

One of the plus sides of staying in hospital is you have your meals made for you so you don't have to think about that at least. Perhaps bring some home comforts, like your own pillow.

If an extended stay on postnatal ward is your only concern about taking the medication in pregnancy, I really wouldn't let it put you off. 2 days will pass so quickly and the medication could give you back so many more days than this where you feel better. Its really hard being pregnant, please know that you are not failing in any way, pregnancy can be such a huge stress for anyone.

I just want the magic wand now. I've had 20+ years of this bastard illness and it always comes back. I just want it to be gone.

I know that's not a reasonable or realistic request, I really do, but I am struggling to face this cyclical shitstorm being the rest of my life.

MIL is having DS (3yo) overnight tomorrow; its also my last day at work for two weeks. We do rope grandparents into babysitting for a night every couple of months so I know I should be grateful we have some help.

DH is going to want to go out and do something to make the most of childfree time though and I just want to hide. Seeing people might help though.

@Starsea thank you. Everything I've read on here about postnatal wards or heard from friends has been that they are awful.

I've been given some paperwork to complete about autism and preferences but need to work out what to say. I'm usually quite high masking so actually admitting how vulnerable I feel about being an inpatient is quite hard. I've never stayed in hospital before.

I also feel so guilty that I might cause her harm that necessitates staying in, when the meds might not even help that much.

Have you tried any of the other SSRIs? Citalopram did nothing for me, but fluoxetine made a massive difference. And it’s safe to use in pregnancy.

I've tried Fluoxetine, Sertraline, Citalopram, Lofepramine & Venlafaxine.
Venlafaxine was most effective but not an option for pregnancy & breastfeeding.

Just wanted to send you a hand hold. Also autistic, also suffered ante natal depression for both my pregnancies that went to term. For me, the depression resolved as soon as babes were born (I know that doesn't always happen but birth certainly creates a change in the whole storm the hormone piece cannot be underestimated). I also just wanted to let you know that a stay in hospital might not be that bad: I had Pre-e for second pregnancy and the babes had a spell in ICU and I was really ill and needed to be in for about a week (both before and after birth). I was in a ward with one other person (who also had pre-e and a babe in ICU) and once the babes were out of ICU we were put in a private room. It wasn't awful and I had quiet everywhere I was (sub optimal bed and hideous food, but it was quiet). Please tell them you are autistic and, as others have said, if the meds have an outside chance of helping you please don't let the being on the ward thing be what holds you back. I often also wish there was a magic wand for various things so sending solidarity and love. xx

Please take the meds. Having you unwell in pregnancy has an impact on your baby's development too. If you really don't want to stay for neonatal observations for low blood sugar (the main risk of SSRI medication) you dont have to, you can always self-discharge, and keep making sure baby is fed very regularly and not showing any symptoms of low BP

I got the medication last night, starting on 10mg citalopram and increasing to 20mg next week. Had to go via GP as perinatal team have a 4+ week waiting list but the nurse I saw after my last pregnancy (due to PND) called me and we talked it through and she had contacted GP in advance to basically say yes please prescribe. Hoping it will kick in quickly.