PND

[Helpneeded]

Does anyone have any recommendations for counsellors etc to help with pnd? I am still bfing and desperate to avoid medicating. Please pm me and thanks so much x

[Ruth_Baldock]

You can safely medicate whilst bf: i have bf both mine, still feeding my 5mo old pretty constantly but i am on sertraline, which i find really effective.

I hope you get the support you need asap, well done for seeking help xxxx

[Belle]

I'd ask you rGP in the first instance, women with issues such as PND and a child under 12 mths are prioritised for psychological assistance under NICE guidelines. Southwark Psychological Services provide CBT (cognitive behavioural therapy) which is excellent for PND and anxiety issues. Also though, depending on your needs, some surgeries have a counsellor available (I know Dulwich Medical Centre does). This is the 'talking' kind, ie you just sit and talk through your feelings with the counsellor - I think it really depends on what your needs are, again the GP shd be able to advise in first instance. Therapy combined with medication is thought to be the best approach, like Ruth I've found sertraline v effective. And you can def use it when bf. Sorry just saw you said PM so will do - but leaving this public in case useful for others.

[Otta]

As Ruth says, Sertraline fine for breastfeedingfeeding.

[Helpneeded]

Thanks so much to everyone, both on this page and those who pm'd me (I will try and reply individually if and when I can but forgive me if not). The only reason I said pm me was just in case you didn't want to share your experiences that's all, it's great to have it in the public domain so thanks for all. All the messages have been extremely helpful and I have more of an idea of what to do. I have been to my GP but will go back with more of an idea about what I want to happen, so will hopefully get somewhere.

Much love and HNY x x x

[hpsaucey]

You can get yourself referred/or refer yourself to the Maudesley. I saw a wonderful therapist there for CBT Clare Kenyon, although you can't ask for particular people. As 'Belle' as said they were keen to make sure that those who were pregnant/with young children got the help they needed. Also, CBT doesn't suit everyone, but I think they offer a much wider 'personalised' range of therapies/avenues these days - including computer programmes to do on your own etc. for example.

I didn't use the drugs as I, personally, very strongly felt I didn't want to take the Prozac I'd been proscribed. I was also thinking about planning a future pregnancy at the hazy future. However, as you've probably encountered from various responses people can feel very differently. I remember a friend of mine at the time very forthrightly saying I should absolutely definatley take the medication as she had found it so useful herself during her own depression. I just knew it wasn't right for me personally. Each to their own.

Good luck - I feel for you.

[Belle]

yes - sorry if my post sounded like drugs wd be necessary for everyone, of course it's all down to the individual. I guess what I meant is that the professional advice is usually to go for a combination, but I think that's perhaps more to say that drugs on their own won't be as effective without some kind of therapy. Speculating here though, am not a professional, just a recipient! I found after both births the difference sertraline made was very obvious, so guess am a bit evangelical - but I really think the priority for any recovery is seeking help, whatever that help may look like, and talking to people close to you. As you say, you do need to consider future pregnancies etc too if you go down the medication path. Usually you are not advised to come off them too suddenly so it's not like planning another baby cd be a spur of the moment thing.

The southwark pysch team i mentioned are based at the Maudsley, I suspect the same team you refer to HP. There is something v proactive about CBT which I find appealing, and my understanding is that it may help with issues outwith the immediate post partum related stuff. Life in general, basically.

[Saffron]

For mild to moderate depression, medication or therapy are equally effective, although therapy will take longer to become so in most cases. For moderate to severe depression, a combined approach is often suggested but not necessarily required. It really depends on what is causing the depression and on the individual's point of view regarding expectations of treatment. If you try one type of treatment and it doesn't work, be open to trying something else.

For me personally, I was told by a GP (in Southwark!) that there was a 14 week wait for therapy. She also told me (wrongly!!) that there are no safe drugs to treat postpartum depression while b/fing. In fact she wouldn't even diagnose my postpartum depression, despite the fact that I have a history of anxiety and depression. She acted like I was just a whiny first-time mum with baby blues and fobbed me off to the HVs who were rubbish. Thanks. Thanks a lot. Tell the suicidal woman with a 3week old baby that there's no available treament. Very professional and upstanding. You should be applauded for your stupidity.

I ended up having to see a private psychiatrist (Dr Jeremy Pfeffer 020 7935 3878) b/c I was so upset by the shoddy treatment I received through the NHS postpartum. It was very expensive, but I can say wholeheartedly that it was worth it to be treated like a human being.

Sertraline was the treatment I chose, and I found it very effective. But as others have said, it really is a case of to each their own. The main thing is that you're proactive and open-minded about treatment options. There are as many types of recovery as there are forms of depression.

I've also found acupuncture treatment to be helpful as an addition to medication. By using acupuncture I was able to take less medication and to come off of it sooner. Giles Davies (15a Barry Road, 07739 414 210) is an exellent acupuncturist and a very caring person. He and his wife have grown children of their own, so he understands postpartum issues from personal experience too. If your baby is very small, he can treat you while you wear your baby in a sling (most of the treatment points will be legs/hands), so you and your little one don't have to be separated.

I've listened to Denise Welch speak very passionately about postpartum care for women. She herself suffered severe postpartum depression. She made the point that postpartum depression should really reclassified as postpartum illnesss b/c of the way it can affect every part of your body. No truer words were ever spoken!