Ruth – dealing with severe PND and getting an excellent well rounded care plan in action

Ruth has been beautifully brave in sharing her story with us. Ruth discusses how she had a history of chronic major depression and generalised anxiety disorder. Ruth was nervous about how pregnancy, birth and motherhood was going to affect her. She tells her story about how pregnancy was a joyful time and that she learnt that she could reach out for professional help and secure an excellent support team who have helped her move forwards into motherhood.

Hi Antonia,

I am writing this as if it is a letter to you so that I don’t think too much about other people reading it – that way I might share more…

You asked for stories about how people have overcome postnatal depression to provide a resource for women finding themselves at risk of or in the midst of similar things, so here we go.

I was diagnosed with chronic major depression and generalised anxiety disorder around a year after leaving university and had struggled with it, for many years. After my diagnosis, alongside 6 x sessions of NHS CBT, I took antidepressants which helped lessen my panic attacks and intrusive thoughts with little to no side effects. At one of my review meetings with my GP, he said in passing, “you’re coming up to childbearing age now, so you’ll want to think about coming off of your tablets”. I was 24, and had always wanted children and worried that I would pass on my sadness to them if I didn’t “fix” it before I got pregnant. I sincerely hope I have never said anything so damaging, so flippantly as this doctor said that to me. It felt like he was saying, ‘you should really be sorting yourself out now, and you can’t have children if you’re depressed’. To me, it meant that I had to make sure I was able to cope (i.e. be happy) without medication (and essentially further support of the NHS).

I knew that pregnancy would bring on a lot of new potential stressful situations, hormones and generally would not be a great time for me to test coming off of medication that I had been taking for 4 years in differing doses.

Fast forward three years; I had around five months of private counselling. I had come off my medication very slowly (with the support of Dr Google…), and I was struggling to keep my mood balanced or function without feeling very anxious and low – however, I was feeling better than I had in a long while.

We came to the conclusion that now was the right time for children. It took a few months, but nothing stressful, we were very lucky and very happy.

My booking appointment at the hospital was the start of something utterly wonderful, it’s making me well up thinking about it now. The midwife I spoke to at my booking appointment listened to me. Really listened.

She asked the questions about mood, the ones designed to catch people who are struggling. The ones that probably seem really odd if you are fine and not nearly enough if you are not.

I wanted to answer truthfully, but I didn’t want to make a fuss, and she was able to ask the right questions to get me to open up a bit more. I told her what the GP had said and could tell she was angry on my behalf. She ended up getting me a prescription signed within thirty minutes of our appointment ending and referring me to a consultant for further monitoring and support.

When you are in that place it is the hardest time to ask for help, to tell someone that you are not OK.

I worried that they would tell me I was unfit to be a mother, advise me to have an abortion, put me on a watch list for social services in case they needed to take my child away. I know full well that those things are not going to happen,

but a depressed mind rarely listens to rational argument.

That positive reinforcement of telling someone and getting support, feeling normal, feeling like it might be ok, helped me reach out at all the next stages of my pregnancy and parenthood.

I have had fantastic care, but I have been really vocal about my fears and current struggles.

During pregnancy, I took an antidepressant. The midwives and consultants reassured me on how many patients that had taken the drug worldwide, and how they weighed up the lack of any (there is none) anecdotal or researched evidence of harm to the baby, with the preventative help to the mother.


I felt really confident and honestly, pregnancy was the happiest and calmest I have ever been.

Ruth and her boy

My community midwife put me down for extended care after birth.

After the highs of pregnancy, I did have a real dip after my gorgeous son was born. The birth was not calm, intimate and joyous as planned. I found the change in identity and lack of control incredibly hard to deal with. I think maybe the hardest thing was the intensity and constancy of the responsibility; I had always imagined that if someone looked after the baby for a little bit you would feel relieved. I didn’t. I felt pressure all the time, it was almost like a superstitious; if I wasn’t watching him, was he still breathing? Waking up after 11 minutes sleep in a cold panic, checking his breath. And I was in pain, pain from surgery, sciatica reignited by lifting at odd angles, sleeping weirdly and not moving my limbs freely.

My health visitor was completely incredible; kind, non-judgemental and persistent in making sure I got the care I needed. She arranged to come weekly for about three weeks for listening visits where we made a management plan for how I could get more support from the people around me. We discussed me going to the GP to ask for a change in dosage and any other support they could offer.

The GP wrote a referral to our areas Mother and Infant Mental Health team and agreed that I could take a bit more of my medication. The referral was denied; I received a copy of the letter sent to the GP which advised: “other measures are tried first, for example increasing the dose of the antidepressant and referral to CBT”. I thought – fair enough, I’m only imagining falling down the stairs and dying, or tripping over in the kitchen with a knife and stabbing the baby, or driving off a bridge because it feels like I have to. I don’t want to do those things, I don’t make plans. I just need to stop being so scared of my own head, because it can’t make me do things, can it?

When I next spoke to my health visitor she said she believed the application may not have had all of the necessary information and that she would reapply. I got accepted for an assessment that time round.

After my assessment with the amazing mental health nurse, I was accepted onto their books and, although it took me a month or so to trust that they were actually going to go through with what they said, I felt so contained. I saw a psychiatrist for medication, a mental health nurse at home for more practical life stuff and a psychologist for proper, excellent talking therapy.

The people caring for me knew what they were doing, they had a plan, but it was a plan made about me, not a plan that I fitted into.

I felt for the first time that there was a chance I could feel better one day.

I can’t properly explain what it means to me; the belief that I am not a write-off, that I am worth working on and that what I was feeling wasn’t something I have to put up with.

These beliefs allow me to do a bit of (ever-so-trendy) self-care. Self-care for me is; washing my face, brushing my teeth, taking my medicine, walking the dog, eating vegetables, reading a book. Stuff that makes me feel normal and keeps me healthy.

I’m not fixed. I’m a fucking human.

However, I now believe that I’m wonderful, and there is a place for my voice in this world. And 6 months ago, I had NEVER believed that in my life.

Not only can you recover, even from your scariest days where you don’t even know who YOU are anymore, you can feel easy and happy and light again.

Things I do now I didn’t know if be able to – have family & friends round for dinner, it felt so overwhelming before and I was scared my house, my cleaning and my food wasn’t good enough. Now they come round and we laugh and it’s lovely.

I have also made so many friends! I was convinced no one would want to talk to me before, but when I got a bit happier I started opening myself up to new relationships.

Ruth has an instagram account where she shares lots of insights about her life and her work as a birth and post natal doula. Click here to find it.

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