Mental Health / Pregnancy / Consultant tomorrow but think its a waste of time

[Funkycherry]

I'm 34wks.
At my booking appointment all those weeks ago, the question of mental health obviously came up. I suffer from depression and have done for some time. So MW ticks her little box and I'm sent to see consultant.
I spend about 5mins with him where I tell him that my GP is going to help me come off my anti-depressants as I don't want baby to suffer withdrawal when its born. He says looks like I've researched it well, they'll see me again at 32wks.
So 32wks comes and I remind MW this is what he said and ask whats the point in going? She says its just that as depression has been identified, they just need to keep an eye on me.

Why? There's nothing they can do! I suffer from depression - nothing they can do or say will change that. If they could, they would have done it by now, rather than me taking AD's for 8 years.
I've had councelling and phychotherapy.
I manage it as best I can. I function well enough to hold down a full time job and most people would never guess just how much of my time I spend hating myself and daydreaming about being dead.
I also don't feel the need to lie when health professionals ask me questions about it. e.g. do you feel hopeless? - yes, Do you feel sad most of the time? - yes, Do you derive little pleasure from things you used to enjoy? - yes.
I just feel like after the birth I'm going to get labelled as having PND due to my responses, whereas actually feeling like this is a normal state of mind for me.

Ooops. Turned into more of a rant than a question. Sorry.

I experienced this in my last pregnancy. My anti anxiety meds were swapped at 12 weeks because the original ones werent good in pregnancy.

A side effect of the withdrawal was anxiety.
A side effect from commencing the new meds was also anxiety.
Hormones in pregnancy also cause anxiety.

I felt so ill, and told everyone that I needed help. I was assessed by a psychiatrist. I was told they would keep an eye on me. But I received no help.

The GP came to our house when the baby was bornto meet him and asked if everything was OK. My family were all there but |i wasnt bothered, and I said " I am extremely anxious, I really need help with this2 he looked all embarassed and said " This isn`t really the time, come and see me on Monday in surgery!" Useless. The only way to get help is be seen as athreat to yourself or the baby and I wasnt.

9 weeks after the birth when I was staring to feel better due to hormone levels dropping I saw a CBT bloke. Pointless, I needed help at 12 weeks.

I am 26 weeks pregnant now and am waiting for treatment again. I have had meds changed again and am suffering anxiety again.

Sorry to hear you're having a tough time

I've been really lucky, that coming off my meds hasn't made me feel any worse. The mood swings take me by suprise a little more, but the thoughts themselves are no 'darker' than usual.
I'm actually hoping that having a different focus in my life (first sprog!) may actually change my thought processes a little and improve my mental health.

Like you say though, pregnancy just compounds anxiety. I really feel for you.

Not had CBT (apparently wouldn't help with my issues!?!) Did you find it any good? Would it have helped if it had gone on longer or if you'd started it sooner?

Actually, I would count yourself lucky! I have sffered depression and anxiety before, as has my Mum and she has been more seriously ill than me. told the midwife all this, explained I was concerned about PND. she ticked the 'no previous history' box! I know it's a pain to go through the motions, but it is good they are keeping an eye on you.

I have had CBT - it was ok, but it is all about retraining your brain to think differently when anxious and I kind of felt like if it was as simple as that, I'd have no problems! It would have been good if I had no understanding of the physical causes of depression and anxiety (brain chemicals, hyperventilation, adrenaline etc etc), but if you have read lots about them and generaly kept yourself informed, i'm not sure how ueful they are.

There is an online course you can do - google living life to the full and it will come up.

consultant will want to see for himself how you are doing, I guess with a view to talking through whether coming off ADs in the run up to birth is a good thing - if you were in a bad way then it might be a less clear cut decision in weighing up risks to you of coming off ADs against risk of withdrawal. is this a psych consultant or obs/gyn consultant out of interest?

funkycherry, they are just being responsible in monitoring you, and I think in general, if you have depression or any mental health issue, it is better for HCP's to be aware of it than not.

You are right in that a single appt, whatever kind of consultant it is with, is not going to change the fact you have been/are currently depressed. That's not what they are for. They may want to reassure themselves that you are being looked after elsewhere (e.g if your GP is aware and you are in touch with them). They may want to find out if your depression has got worse/better with pregnancy - some women do suffer more, and I don't think it is as well identified or recognised as PND. As TotalChaos says, what seemed like a sensible course of action some weeks ago may not be the case now if things have changed for you.

Unfortunately, it is also true that some kinds of depression (not all!) make new mothers more likely to suffer from PND. This absolutely doesn't mean that you, or anyone else with depression, WILL suffer from it - and I recently had a conversation with a peri-natal psychiatrist where she mentioned that it's often women who get PND but who have never suffered any previous depression who are harder to identify and treat. They don't ask for help because they don't realise they are depressed, and just blame themselves for not coping, etc. If the consultant is reassured that you cope well with your depression, that you have established ways of managing it and a strong existing support network, then it's fairly unlikely they'll take any action themselves.

So the appt absolutely won't be about 'fixing' your depression. They are just being responsible and making sure that there is a 'support system' in place for you if you need it. The alternative is abandoning ill and vulnerable women to cope on their own, and that's not a good idea.

Haggis - It sounds like your MW was as bad at listening as the ones I've seen! You're right, at least she picked up on it with me. Think she got a bit freaked when she asked if I thought about killing myself and I said "only a few times a month these days"

T'Chaos - Its an Obs/gyn consultant again, but a different one from before. The last one agreed that my depression meds were something best discussed with my GP.

I guess I was just a bit peeved about the fact that it feels more like an 'arse covering' exercise than genuine care. Particularly in these times when I'm sure the NHS have much better things to spend their money on than ticking boxes for me.

Damn, I sound ungrateful!

barkfox You're right - I was just ranting.

I've had a really rubbish time physically with being pregnant and when I mention my concerns I'm either ignored or fobbed off. Yet the minute you mention mental health everyone flaps around fussing.
I could cope with the mental stuff (like you say, existing stratergies and support etc.) much better if the physical bits weren't so shitty.

Guess I'm just one of those ungrateful people that's never happy. Feel guilty now, because all your kind responses make perfect sense.

funkycherry, you've nothing to feel guilty about, don't worry - and I'm sorry you've had a rough time physically being pregnant. That's not going to help anyone's mental state, and more so if you've not been taken seriously. I hope you feel a lot better once your baby is here.

Fringe - fingers crossed I get someone like that.

barkfox thanks

This thread has helped me look at another point of view, so I'll be going to todays appointment with a much more open mind.

The guy I saw today was brilliant.
Asked questions and he actually listened to my answers. Explained things well. Made me feel more empowered about options open to me if I start to struggle.

Thanks for your support everyone.