Pregnancy and depression...anyone been through this?

[mrsS]

I'm so sorry, the last message was from me - I've got 2 usernames on this forum and mrsS is my sort of anonymous one!

[mrsS]

I think the psychiatrist I saw on Friday evening was quite inexperience, or I might be wrong but she seemed very unsure about the whole thing. She asked me a couple of questions but did not give me a questionnaire, I know what questionnaire you mean though, have filled out several of them in the past.

I have not spoken to my midwife during the weekend but I will call her tomorrow. She said that I will hopefully get an appointment with the perinatal team at the end of next week.

This might sound odd but I'm not sure that I would want CBT or any other therapy at this point without taking medication. I just feel too raw at the moment. The last time I had CBT was at the Maudsley's for post traumatic stress disorder (caused by having been in a domestic abusive relationship in my early 20s) and I experienced the therapist as quite pushy as I was asked to relive some of my most traumatic memories. At that point CBT was not the right thing for me, and to be honest it did scare me off!

Agin...thank you so much for all your support, to all of you who have written on this forum and sent me messages. You have no idea how much you have helped me, it does make me feel a little bit more hopeful.

[mrsS]

Wrote that in a bit of a rush, apologies for all the spelling mistakes :/

[mrsS]

Saffron, if I had the money I'd definitely pay ?500 to see a psychiatrist privately.

I still have not got any appointment confirmed with the perinatal team, I spoke to my midwife again today and she said that she would get back to me when she had more information.

My husband wants me to go back to my gp tomorrow and ask for sertaline (a drug that is apparently quite often prescribed to pregnant women). Not sure what to do though, I got the impression that she wouldn't prescribe anything without talking to the perinatal team first.

I am aware that I need to be patient, but it's easier said than done.

[Pugwash]

You maight find it helpful to contact an organisation like MIND or SANE to see if there are any self help groups locally which you can get some peer support. Hubby has bi polar and CBT never really worked for him. I had depression after my first child - but it was not diagnosed until 4 or 5 years later- I carried on working etc but never really felt 100% mentally. Was very aware of my tendancy for depression ( was under maudsley following a relationship break up for 6 months as I refused to take anti depressants) when had daughter no 2. But this time I had a very supportive partner who wanted to be very involved as a parent and had 5 months off work rather than the 6 weeks with first child.

[Belle]

mrs S - sertraline is the drug I have taken, in my experience (and that of several people I know) it's very good and works pretty quickly too.

As great as the Brierley are, it doesn't sound like they're going to be able to sort this maybe as quickly as you'd like? I agree with your husband and/or Saffron re going back to GP or failing that A&E for a referral and pretty much requesting drugs if you feel the need. It's a bit outrageous that someone in your situation is not being seen more quickly in my opinion.

If it's helpful - maybe take your husband with you to the GP appointment to help you make your case more strongly? I did this a couple of times and found it helpful and it kind of made me stick to my guns more.

I think in situations like this you need to be really definite about what you are feeling, and what you need. because it all about budgets (in my experience), and the professionals having to work out who really 'needs' help, I have found myself almost playing down my situation in the past because I felt that's what they wanted to hear. Don't do that.

[mrsS]

Pugwash - good idea, will look into that.

Belle - thank you. I think I'll try to get an appointment for tomorrow and bring my husband along.

I will do my best to be strong and not give in. Its hard though when they are the experts, specially when both my go and the psychiatrist I saw seemed so unsure about medication and pregnancy.

[WorkingMummy]

You are expert on you. They are just there to help.

[Lochie]

Hi mrss,

I would recommend seeing GP and insisting on a referral to the community mental health team. I did this (or rather my husband did this as I was too depressed to do anything really) when my first child was 6 weeks old and I had terrible PND. We did this in tandem with the health visitor too who supported us. Once the referral had gone through I was seen I think within about 3 or 4 days. At that time I also asked for a referral to the perinatal psych team and also CBT at Maudsley (I was desperate and we trying to get treated as quickly as possible). The perinatal team took 6 weeks to respond. The Maudsley CBT took about 3 weeks. unfortunately I don't know how tied together these 3 sources were, they all acted in silo when arranging appts with me. By the time I was called by perinatal psych I felt better so didn't need them. I took up the CBT at the Maudsley as it was the best form of ongoing treatment and was recommended btpy the community mental health team. I also took sertraline. Like you said before, you can be at a point in depression where talking therapies are ineffective until the anti depressants kick in...that theory was supported by the psychiatrist and they made sure I didn't start the CBT until I was out of that very black stage.

I have had another baby since and used the brierley. They were fantastic, but I didn't need to really use them beyond midwifery support as the problem didn't occur to the point I needed help from perinatal psychiatry. It was mentioned that I could start taking sertraline in the last trimester if I felt depressed in order to prevent PND again. But I did t need to.

I believe there are NICE guidelines that state a mother with child under one year or a pregnant woman are top of the list re: mental health support. Ask your GP about this.

The key to recovery for me was consistent treatment from the amazing services offered up here, linked into kings and the Maudsley. When my son was born and I was living in Sussex and it is beyond words how appalling their mental health services were ( I was told of a 6 month wait list for therapy despite having a 4 week old baby and being diagnosed with probable post traumatic stress by my GP).

Good luck, and take an advocate to as many appointments as you can, as belle said, like your husband. You will start to feel better I am sure once you have a treatment plan in place. The uncertainty is often the worst thing

X

[Saffron]

Print this out and take it with you to your GP or the A&E: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1488905/

Demand to be seen or immediately referred to someone who actually is familiar with the guidelines for treating major clinical depression during pregnancy. Untreated depression itself poses a risk to the foetus. You need to be seen immediately by someone competent.

(In fact, print out this whole thread and take it with you to the drs!)

[mrsS]

Working mummy: You are absolutely right about that. I will remember that.

Lochie: Thank you, I've tried to get an appointment at my GP today but they are closed for staff training. I'm also trying to get hold of my midwife again but they must be busy as no one is getting back to me. I'd feel much calmer if I knew when I'm likely to see someone from the perinatal team.

Saffron: Thank you I will do that. I think it's a bit strange that it takes so long to get help with depression in pregnancy. I understand that is's not that simple, but last time I was depressed all I needed was an appointment with my GP who was so understanding and lovely. I've not been able to see her this time as she is on leave. The GP I saw last week was nice but it really did feel like she did not want to deal with the issue.

The feeling of impending doom is over me all the time and it's absolutely awful.

[Saffron]

Would it help to phone NHS direct? You can ask for advice not only about treatment itself, but also about how to work the system. For example whom to contact, and exactly what to say to get seen as soon as possible.

NHS direct: 0845 46 47.

xx

[mrsS]

Thank you Saffron. I've now heard back from the midwife and I've got an appointment with the perinatal team 21st March. Too long for me to wait so my husband and I have decided to go back to my GP tomorrow or A&E (if GP refuses to prescribe) and demand medication.

[Saffron]

That sounds like a good plan. xx

[hellosailor]

Good luck at your appointment Mrs.S, hold your ground and don't leave without the medication you leave, you're doing brilliantly sorting this stuff out when you currently feel so grim, it's going to get better when you have the help and medication you need, glad you're taking your husband tomorrow.

[Yak]

MrsS, I just wanted to say sounds like you're doing all the right things and doing amazingly well. Please keep posting and letting us know how you are gettting on. Fingers crossed your GP is able to see you tomorrow. Good GPs are worth their weight in gold at times like this (and I know it shouldn't be that way, but that seems to be the way it is, and certainly has been in my experience!). Keep on going, we're all rooting for you.

[mrsS]

Last week I saw a doctor that I'd never met before, as the doctor that I normally see was on leave. I hope she will be there tomorrow because she is fantastic and so supportive. She even found online support-groups for me when I was struggling with PTSD. Fingers crossed that she'll be there tomorrow.

[esme]

Definitely nothing to feel ashamed about, really feel for you esp as they say avoid medication in pregnancy... have you tried gentle exercise such as pilates, swimming, yoga? you would find you'll make friends as well as hopefully lifting your spirits. Also worth altering your diet to include more B vitamins and minerals / vits that help with energy levels. Oh and good news is chicken, cheese and chocolate(yay) are "happiness" foods according to the Food Hospital (channel 4 series also has a website).

Talking therapies can definitely help with a variety of issues, so agree worth a go. If no use through GP try a private counsellor, lots of good ones around East Dulwich.

Hope you feel happier very very soon xx

[mrsS]

I have just got back from the GP, not the same doctor as I saw the last time as she is not there. She refused to prescribe and did not ask one single question. Said that I needed to go back to the gp that I saw last week as she 'obviously thought' that I did not need it. I told her that I could not cope and she just looked at me, said nothing and looked very bored.

I find it strange, having worked in mental health myself that she did not ask any questions. I told her that I could not cope and she seemed to not want to know about it.

Anyway...one a more positive note, I did manage to get an appointment for tomorrow morning with the doctor that I normally see. She is so lovely and empathic so I am hoping that she will help me, she always has in the past.

[bjm]

I am so sorry to hear this has happened. I hope you finally get the support you deserve tomorrow. If not please pm me.

[mrsS]

bjm - thank you I will do!

[midivydale]

I am furious! MrsS is a very dear friend of mine so my comments here are more general as we chat daily. I just want to publicly applaud you for finding the strength to continue the battle of finding the help that you need.

MrsS does not only have previous personal experience of depression (by her own account above) but is also an acclaimed therapist with a degree in psychology.

It is gut wrenching that a woman that has a dedicated most of her career to the mental wellbeing of some of the most vulnurable peolpe in our society is met with this barbaric attitude by health professionals!

I am outraged. She has cared for, fighted for and been haunted by her patients mental health issues for years, spending sleepless nights wondering how she can best help them.

Now she needs the system- and it is letting her down. How many times is she supposed

to see a doctor? How ill does she need to be?

On a positive note (we talked about this today) once again the solidarity and sisterhood of the women here are breathtaking. The compassion and help and kindness you show make me well up.

Keep it comming- she needs it.

X

[Belle]

That is unbelievably lax of the GP you saw. As I think Lochie pointed out aren't pregnant women (certainly mothers with a child up to 1 yr old so surely should include pregnant women) supposed to be prioritised for mental health treatment under NICE guidelines?? I find it actually terrifying that a doctor would be so unworried by the situation - thankfully you clearly have enough knowledge from your professional life plus supportive husband and friends (and good midwives) that you are not alone in this but she had no way of knowing that! And what you clearly have said is that this isn't enough and you feel the need for medical support. Fair enough - and something to be taken very very seriously I'd have thought, and hoped. When you feel stronger it would really be worth considering a letter to the practise and maybe your MP about this. In the meantime, I think someone suggested contacting Mind or a similar charity? Might help to get ideas about how to get help? But very glad for you that you have an appt with a more sympathetic doctor tomorrow - fingers crossed for you.

[hellosailor]

Shocked to hear of how you were treated today but relieved to hear you're seeing a doctor you trust tomorrow, please keep posting MrsS, we're all rooting for you x

[mrsS]

midivydale - touched by your kind words! You being angry helps me!

Belle - I know. I think of all the women who might have very little experience of this sort of thing or very little support. How far does it need to go until you get the right help? My sister suffered post partum psychosis and was sectioned and hospitalised for a month after the birth of her second child so I definitely know how bad it can get...

The fact that the GP today did not ask me a single question is scary. I might complain when I have the energy. And I might give MIND a call tomorrow.

hellosailor - so am I, I asked her if there is a policy stopping GP's from prescribing/taking action and she said there wasn't but that she wouldn't do it anyway because of the lack of continuity...