I am sorry to hear about your very serious concerns.
Antenatal depression (AND) occurs in about 12% of pregnancies so is nearly as common as PND (approx 1 in 7) and is becoming better understood. For this reason we now call it Perinatal Depression to cover both antenatal and postnatal depression.
Antenatal depression increases your risk of PND. Your past PND puts you at risk of AND and another episode of PND. Additionally your past episode was severe so you are right to be concerned and need specialist help.
There are some low to no cost help available but it does depend upon where you live.
1. PANDA - they have a national directory of perintatal services and service providers and a national telephone PANDA National Helpline Mon to Fri, 10am - 5pm AEDT 1300 726 306
2. If you are in WA, Vic or NSW and in the right location St John of God Healthcare has perinatal services called Raphael Services even if you are not in their area, call them as they may be able to suggest other low cost services
3. Again depending upon where you live many public maternity hospitals or maternity units have mental health support linked to their antenatal clinics.
4. Community Health Centres and NGOs (eg Connections, Anglicare in Victoria) often have low or no cost counsellling but may not have perinatal specific training.
It is important that your GP excluded physical illnesses that can cause depression including thyroid disorders, autoimmune disorders and vitamin defiencies eg B12, Folate vit D
There are lifestyle strategies that you may already be attending to but include: A healthy diet, regular exercise, mind-body modalities yoga or tai chi (safe in pregnancy), mindfulness meditaiton (Mind The Bump is a terrific perinatal mindfulness App and free), fish oil.
Since CBT did not work it (it does not work for everyone) would be good for your to see someone who may offer other forms of therapy. There are other forms of therapy available which may be better suited to your needs. It does depend upon what are the reasons for your PND/AND but including - Interpersonal Therapy, Acceptance Committment Therapy, Dialectical Behavioural Therapy, Schema Therapy or Mentalisation Based Therapy and Psychodynamic Psychotherapy.
If you can get the right help during your pregnancy you may not need to go to hospital and you and your baby can be kept safe. However, sometimes hospital is the right option. I would suggest a Parent Infant Unit (previously called mother baby units) they have specific perinatal mental health expertise, your baby can be admitted with you so that you can maintain/work on bonding.
Finally often perinatal mental illness effects husband/partners and other famly members. PANDA and beyondblue have good resources as too COPMI.
I sincerely hope that this has been helpful.
All the best.
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