Pregnancy and depression...anyone been through this?

[mrsS]

Hi,

I'm pregnant with my first child after a long time of trying. I'm very grateful and have been feeling quite alright throughout the pregnancy, and am now in week 23 and everything seems fine.

But for some reason I am very depressed. I had quite a few dark thoughts in the first weeks of pregnancy but then managed to calm down. However, in the last week I've seen to have been dragged down in to depression. I've been through it before and have had periods of being on anti-depressive medication. I know that I'm quite sensitive to hormones and always struggle with quite severe PMT. I'm with the Brierley's midwifes which is great, and I should probably contact them and see if I can get some support.

I'm doing as much as I can to fight this, I try to think positivt thoughts, which is bloody hard as the depression is taking over 99% of the time, I try to focus on the here and now and keep myself vaguely occupied.

But I can't help feeling that everything is meaningless. Life is extremely painful and I don't know why, and I feel quite ashamed to say so - because I don't have a real reason. I know it will pass, it always does - but I guess I'd like someone to tell me that it will.

[mollie]

Hi mrsS, it will pass, but it is now that can be difficult. I think finding support at the moment would be a good thing, and antenatal depression although not often talked about, can affect both men and women, so approaching the Brierley sounds like a good starting point.I work with women and their partners both antenatally and postnatally, and over the years can see how those people who recognise their symptoms of depression and contact their health professionals really do benefit from their support.

Pregnancy is a rollercoaster for many people but I think you are so right to recognise how you are coping and look for support.

APNI: the Association for Postnatal Illness have a good website in case that is of interest.

All the best, and do keep us posted.

[mrsS]

Thank you Mollie, if I wasn't pregnant I'd start taking medication again but not sure what the best thing to do now.

[reren]

I assume you know that the brierly have a particular specialism with women who have mental health issues / depression? Definitely talk to your midwife - it isn't something I have personal experience of but i was with the brierly with my son and they were wonderful. I am very confident that you will be met with some real expertise in helping you cope with this. It's scary being pregnant and overwhelming - and your hormones are doing all sorts of strange things - not surprising that it might throw things out of kilter.

[mrsS]

Yes thank you I do know that they specialise in mental health. I'm gonna call them tomorrow and see if there is anything that can be done, I feel that this is definitely more than 'mood swings' or feeling a bit 'blue'. Worried that it's going to get worse and that I'll need medication to get out of it.

[Belle]

what I found with the brierley is that they tend to refer you to the perinatal unit at Kings for stuff like this or suggest you contact your GP if it's urgent. I can PM you more details if you're interested. I do know that medication during pregnancy is an option - it's all about weighing everything up basically. I think antenatal depression is less known about than postnatal depression but can be just as debilitating. I'd suggest contacting your named midwife or GP asap, this isn't something you should just have to endure - there may be ways of alleviating it for you. Do PM if you want to talk.

[midivydale]

MrsS, medication during pregnancy is an option, like Belle says it is a matter of weighing it up. Please speak to your midwife and GP asap- there is help at hand. Belle is right, you shouldnt just have to endure it.

[Mathilda]

Hi MrsS, I had this in the first trimester, it was awful. Hormones play a big part. It will pass, but do find support as others have said. As a pregnant woman I think you can be fast tracked by the GP for counselling etc if you need it. I also found things like yoga, medititation, keeping a diary helped. PM me if you want to talk.

[mrsS]

Thank you all for your support. I've been to my GP this morning who is referring me to the perinatal psychiatrist at Kings. She seemed quite reluctant to prescribe any medication which I guess is understandable but it still left me feeling a bit hopeless.

I've called Brierley's, my midwife is on annual leave but someone else will call me back later today.

[intexasatthe moment]

How hard for you .

There are therapies that don't involve medication .

If you could get on one there are group therapy sessions on NHS which can teach you techniques to relax and to focus on good thoughts ,also "mindful" ones ( that I know nothing about ) but I think teach you to live in the moment .

And there are on line courses like this https://moodgym.anu.edu.au/welcome and I'm sure others supported by local NHS .

Well done for seeing GP ,don't be afraid to persue things if they seem to be taking a long time .

Good luck x

[mrsS]

Thank you...

I am willing to try most things - I just hope this depression is not going to get to that stage where I feel that I need medication to do all the other things that might help if you know what I mean? It's very hard to think positive thoughts sometimes as the depressive and negative ones take over with full force. But I am doing my best to fight this.

[mollie]

Dear mrsS, People do care about you and I know how hard it can be to motivate yourself to do anything when the 'black dog' rears its head. Going to the GP and contacting the brierley were good steps, well done. Do PM people who have offered this if you want to and can I suggest that you let people around you know how you are feeling? Sometimes we try to hold it all together for others, but in fact they could be a help even on a practical level when things get very difficult.

There is a link through the NCT's website for people who want to be put in touch with others who have been through the same experience as them. It's called the Shared Experiences Register. The main website is nct.org.uk, I'll have a look now and let you know the link.

Keep in touch.

[mollie]

The NCT Shared Experience Helpline is 0300 330 0700 and operates from 9am-7pm and has an answering service outside of those hours. They can put you in touch with people who have gone through the same experience.

HTH

[canela]

it sounds as if you are worried about what might happen further down the line if you get worse. it's important to get your support set up now so that you know what you can do about things if that does happen - so really good that you are asking for help.

i think pregnancy can be completely overwhelming - and more so if you have high levels of depression. i don't know what mine would be classified as I muddled through alone - but I do know that the first 3 months of both pregnancies were the worst time of my entire life. which is weird as i was also very happy to be pregnant. with first I was so afraid i could hardly leave the house, and with second everything was just black. what kept me going was just trust that it would pass, and it did, and just doing my regular routine without really questioning it. keeping a diary and getting out for a walk in the open air were also good.

you don't mention the kind of support you have around you, but i hope you are able to reach out to people. be gentle on yourself.

[mrsS]

Thank you Mollie, I might try the helpline today and I will also look on the NCT website.

Canela, I was very emotional in the first three months of pregnancy and then managed to calm down. I'm in the middle of the second trimester now, when things are supposed to be better? Of course I feel better physically but mentally it's absolutely awful. Everything feels black and meaningless.

I've got my husband who is absolutely amazing and lots of friends so I am not alone, although I feel very alone with it all.

[mollie]

Dear mrsS, did the midwives get back to you? I know you mentioned your midwife was on annual leave, if not do follow this up and make sure they are aware of how you are feeling at the moment. Thinking of you.

[rgracieg]

Dear mrs s

Apologies if this Hals already been said but I would see your gp and ask to be referred to the iapt service which offers talking therapy and as you are prepnant you should be prioritised. There are groups on here for pregnant women spring/summer babies clubs where you can meet up with other mums being isolated will make depression worse. Good luck x

[Mathilda]

Hi, people react to pregnancy hormones differently so whilst some have problems in the first trimester, for others it can happen later. If you do a search on mumsnet you will find many others going through similar. Well done for contacting your GP & Brierly.

[mrsS]

Mollie - yes, or I called them back and they have now referred me to perinatal psychiatry at King's. She said that it will be seen earliest late next week but suggested strongly that I go to A&E tonight or tomorrow and then I will be able to meet them sooner.

The midwife also said that I can go back to medication and that the psychiatrists at King's will help me with that.

Regarding medication, has anyone of you taken antidepressants in pregnancy? PM me if you want to stay anonymous of course! I am SO grateful for this forum and the support I get.

[mollie]

Dear mrsS

glad to hear you are getting a good response from health professionals, A&E suggestion is good to know of. EDF is a great way of getting answers! Hope this weekend goes well for you and DH.

[Belle]

I didn't because I don't think I was actually depressed during pregnancy, just a bit stressed - so it didn't warrant it - but I would have done, and would have pushed to if I felt it did warrant it. And actually, if I were ever to have a 3rd (which I won't!) I would definitely request pre-emptive Anti-Depressants in the final weeks, which can be done, because I've had PND twice now and I would want to avoid it if I could (chances of recurrence would be very high). I did some research into this at the time and it is done in some cases.

Sadly the NHS is so overburdened that e.g. CBT just wasn't available as I wasn't classed a severe enough case during pregnancy (not being technically depressed, as I said), but I believe that if I'd had it during pregnancy I could have helped prevent depression after the birth. So do push push push for whatever you can get. And if you have any kind of private medical insurance, use that.

[mrsS]

Thank you all,

I followed my midwife's advice yesterday and went to A&E in the evening. Met a psychiatrist who could not do much for me, she agreed that I probably need medication but would not prescribe any as I'd not be able to see her again (I guess she was a locum) and that would be bad practice. She also seemed quite unsure how to deal with medication in pregnancy so she did not fill me with confidence. She urged me to wait until I see someone from the perinatal team and they will be able to give better advice so I will have to wait for that.

She also mentioned CBT but that would also take a long time, and I've had CBT before at the Maudsley and actually thought it made things worse...

Anyway, thank you so much again for all your support, it has made these days a bit more bearable.

[WorkingMummy]

I am so sorry that A&E did not work for you! Have you updated your midwife? I am sure this is not the outcome she had in mind? She may be able to help you/suggest a way through. It sounds like she thinks you need emergency attention and you haven't got that yet.

Any idea when you will be seen by the perinatal team?

Also, I would just like to say, I am so full of admiration for you, that, in the blackest time which you are describing, you have reached out, to all the right places, for help, and that you are persistently pursuing those places until you get the help that you need. This is very courageous. Putting it mildly, depression is an energy-sapper. It is terrifying too. To people who have never had it, I always remind them that it was the experience of severe depression that brought J K Rowling the idea of the Dementors in her Harry Potter series: she had it about right, I think. It shows an enormous amount of strength and resilience that, from within your black thoughts and feelings, you have found the will to get out of bed, let alone exercise this degree of care for yourself and your unborn child. Beneath the blackness, you must have enormous reserves of love.

Obviously it won't feel like this to you right now, but it's the truth: you are going to make a wonderful mother.

Keep posting Mrs S.

[Saffron]

Hi MrsS, sorry to hear you're having a rough time. Major depression during or following preganacy should not be left untreated to just hope for the best. I think you should go back to the A&E and demand to see a different doctor.

I disagree that it would have been bad practice for the locum psychiatrist to prescribe you medication, citing "not seeing you again" as reason. As it stands, she's left you with a major medical condition (and make no mistake, depression is a medical condition) and no treatment. That's tantemount to negligence in my opinion. I think the psychiatrist has failed you in her duty to care. Despite the fact that she was not going to see you again, she would have been perfectly capable of making a written correspondence with your GP and midwife. That's very shoddy service, and she should be ashamed of herself. Did she even try to assess your depression? There is a straightforward self-assessment questionnaire she should have given you.

Something similar happened to me postpartum, and it makes me very angry that highly vulnerable individuals like pregnant and postpartum women with depression get the brush-off.

Do you have the means to see a psychiatrist privately? I can highly recommend Dr Jeremy Pfeffer, whom I have seen personally before my pregnancy and postpartum, office tel 020 7935 3878. He practices out of central and north London locations. Consultations are not cheap, probably in the region of ?500. However, in both instances that I sought his help, I was able to have a single consultation, followed by him writing a detailed letter to my NHS GP to recommend a course of action.

Also, don't feel pressured into CBT if you're at a point where you don't feel comfortable with it. CBT is very highly recommended because there has been a lot of research on it to say that it's a good and effective therapy. BUT, if it's not your bag right now, then pressuring you to try it could just end up being really off-putting. Plus, there are many other types of therapy available.

Finally, as a stopgap measure (or as additional support) would you be willing to try some acupuncture? Complementary therapies, like acupuncture, can also help you stay on the lowest dose of meds if you do end up needing them. I can personally recommend Giles Davies who practices out of consultation rooms in the ground floor of his home at 15a Barry Road: http://www.gilesdavies.com/contact.htm . Giles and his wife have grown children of their own, so he is very understanding about pregnancy and family issues, as well as being an excellent acupuncturist.

Please PM me if you want to talk or want any more info. xx

[astrid83]

I got the feeling that the psychiatrist at King's was quite inexperienced, or maybe I'm wrong here but she did not seem very unsure about what to do.

She asked me a couple of questions but she did not give me a questionnaire. I think I know what questionnaire you mean though, having done several in the past.

I have not spoken to my midwife again as I feel like there is not much more she can do, she said that I will hopefully get to see the perinatal team at the end of next week. I will call her tomorrow though.

This might sound odd but I don't think I 'd want to do any therapy or CBT without medication at this stage. I'm scared that the feelings will be too raw to handle, and especially with CBT as that can be very 'pushy' in my experience. The last CBT I had was at the Maudsley's for post traumatic stress disorder (caused by having been in a abusive relationship in my early 20s) and I do not agree that CBT should be used for things like that, it's just too traumatic.

One a positive note though...the dark thoughts are still there as well as the anxiety, but some of the things I'm doing seem to help. Thank you so much for all your support, you have no idea how much it is helping me at the moment.