Living with postnatal anxiety

This is a guest post by Tina from Adventures of Mummy and Me. Please check out her blog and follow her on Twitter, Instagram, Facebook and/or Pinterest.

It’s 4am, and I’m laying in bed, staring at the ceiling. I’m physically exhausted, my head hurts, and my eyes sting – but I can’t sleep. I haven’t actually been to sleep yet tonight. Or is it this morning now? I don’t even know what day it is anymore.

I’ve just got up for possibly the 4th time in the last hour to check on Chase. Each time I’ve got up, it’s taken me around 6 minutes to walk the three steps back into bed. And now I’m back in bed, I’m worrying again.

Why might you ask? Because I suffer from postnatal depression and anxiety (PND/PNA).

These invisible illnesses make doing even the simplest things, such as checking on my 18-month-old son only a few feet away from me – seem as difficult as climbing Mount Everest.

I want to start out by saying that this has been a really tough post to write. Generally speaking, when I’m writing, the words just flow out of me. But this one post has taken over a month of writing, editing, erasing; then back again full circle. Namely because, if I’m honest, it’s a subject I don’t like to talk about out loud. I guess I have this naive conception that if nobody knows, then it can’t be true. I wish that were the case. When in reality, it’s a fear of perception and acceptance that stops me speaking. So I’ve decided it’s time to open up, and to share my story with you today.

Meeting the midwife

Scroll back to two years ago, and I’m sitting at my dining room table meeting my midwife for the first time.  She’s just finished completing my 16-week pregnancy health assessment, and is giving me “the talk” after the results flag me as high risk for postnatal depression and anxiety.

At the time, I remember thinking to myself: perfect. Once again, another healthcare professional looking at my history of depression and anxiety, and immediately thinking I’m unstable. My “history” spans out over 15 years, and generally speaking, I self-manage my mental health pretty well. But on the few occasions I’ve needed extra help, I’ve asked for it.

Although any new mother can develop postnatal anxiety, it’s been found that those with a personal or family history of either depression or obsessive-compulsive disorder (OCD) are particularly vulnerable. Which is why those with a history, like myself, are flagged up during the pregnancy health assessments as someone to keep an eye on during pregnancy and initial postnatal care.

Giving birth & going back to work 

Following quite a traumatic birth experience, I was surprised to find that I didn’t have any issues bonding with Chase. If anything, the only problem was my lack of mobility due to having an emergency c-section. After about four months, when I was fully mobile again, I started to feel a bit alienated being at home all day alone with my baby. I’ve never been girly, or one to have a lot of female friends, so I found the mum groups I attended overly feminine and cliquey. I realised I was struggling when some of my depression tendencies starting rearing their ugly heads. This prompted a long discussion with my husband, which resulted in me returning to work sooner than planned at six months post-birth.

At first, this all went really well, but after a few months in the office I started to struggle again. Whilst I was on maternity leave, there were some significant changes made within my company. Changes which, in the end, affected both my job role and the way I had been accustomed to working for the past few years. I trudged through for a long time, believing that it was just an adjustment period because I’d been away for so long. What I didn’t realise was that by compartmentalising the stress and anxiety I had at work, I was actually increasing my anxiety levels in other areas of my life. The main one being in relation to Chase.

Noticing a problem 

It was around five months after I went back to work that I realised I wasn’t getting better. If anything, I was getting worse. Chase was coming up to a year old, and I would constantly worry about him at night – getting up multiple times to check on him to ensure he was still breathing. My usual hobbies such as reading and watching films just bored me, and the closest I came to exercise was walking downstairs to the coffee machine and back again. I sought advice from my GP, who referred me to a local counselling service.

Despite numerous prompts from my husband, I had no intention of moving Chase from our bedroom. Everyone I spoke to told me I was being silly – a typical first-time parent overthinking it. But I genuinely felt terrified about his wellbeing if he wasn’t in the same room as me. During the day, when I was occupied with work, and he was with my husband (he’s a SAHP), I was completely fine. However as soon as nighttime came, and it was time for me to relax and sleep, the silence would kill me.

By the time I eventually saw a counsellor, I was on the verge of a nervous breakdown.

Anxiety overdrive 

Every time I get into bed, I have flashes of Chase becoming ill or involved in an accident of some sort. I know now that these thoughts are common concerns that parents have. The only difference being that most parents have these thoughts as a fleeting moment. An errant thought, gone before it can be fully processed. But my over-anxious brain doesn’t work that way. It overcompensates, analyses, and looks for ways to make sense of the flashes. Even when they are, in reality, highly unlikely situations.

It’s then, when my brain can’t put the pieces together of “How?” and “Why”, that it overthinks the situation. And that’s when the thoughts of “Did I put him into that compromising position?” come to play.

Which is crazy. I would NEVER do anything to put my son into harm’s way.

But that’s not how the brain of someone with PND/PNA works.

It actively LOOKS for ways to make sense of the thoughts, and therefore puts the only “logical” response into your head. That you must have done something to cause it. And this feeling opens up a whole can of worms for me. Most notably, I have obsessive-compulsive (OCD) tendencies. Meaning that I have to do specific things, in a specific order – with the fear that if I don’t, something bad will happen.

All time low

That nervous breakdown I mentioned? Yea it happened. But in a way, it was a good thing. It made me realise that in order to get better, I needed to take action, and focus on me and my family.

My GP signed me off work with immediate effect, and my intention was to do my counselling sessions, and spend more time doing everyday things with my family – like going for a walk, playing in the garden, or building bricks in the playroom. This was actually a lot harder than I thought it would be. The colder and wetter weather didn’t help, but the main issue was my sleep. I had insomnia due to the anxiety, and would often have panic attacks in the middle of the night because of the OCD. My GP prescribed sleeping tablets, but unfortunately they didn’t help in sending me to sleep any earlier – they just made me sleep until midday the following day, and then sit on the sofa in a dazed state for the rest of the afternoon.

It took a few weeks being at home to start getting a balance back in my life. To become more involved in day-to-day activities, and to actually WANT to participate in them. After five weeks at home, I opted for a phased return to work. Being honest, I wasn’t completely ready. But with only one income, and minimal savings, that decision was unfortunately taken away from me.

Fighting back 

Now, two weeks into my phased return, I’m starting to feel better. I have good days and bad days. Bad days are still tipping the balance, but nowhere near as much as they were before. I’ve started doing housework again – forcing myself actually. I’ve found this can help manage the OCD better than just ignoring it. Think of it as refocusing the thoughts elsewhere – it does help.

The anxiety is still there. Very much so. But I’m not naive to think that it will disappear as quickly as it came. And I think that’s the difference now. I understand my illness better, and know that it is an illness, and not a fault.

I’m still not sleeping great, but on the upside, I’m not checking on Chase half as much as I did before. And I’m even thinking about the idea of moving him into his own room. Maybe. I have however, cleared his room out so that the idea COULD become reality when I’m ready.

I have a few sessions left with my counsellor, which I’m hoping will help me through the first few weeks of the New Year back at work. Then I guess I’m on my own. Well, not really. I have my happy, loving son and my devoted husband at home to help me through this. And at the end of the day, that’s all that matters.

The Pramshed
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PND and believing you deserve to get help

Recognising the problem

I’ve been procrastinating over writing this post for a while. I’m hoping to publish a series of guest posts on parental mental health, which I’m kicking off with my own contributions. I’ve published my story of anxiety after having my first child, and a guest post on new mums and mental health generally.

But this post – the story of the PND I experienced after my second child – is the most difficult. World Mental Health day is on 10 October and it’s given me a kick up the rear end to share this story. I’m not sharing it to get sympathy, but because of the fact that I doubted myself. I doubted that I was sick enough to get help. I thought I ought to just get over it.

There is a huge problem in our society in which mental illness is not taken as seriously as other types of physical illness, including within the National Health Service. It is well known that there is not enough help for mental illness on the NHS. It is not clear what help is available and much of the help that is available sits at the top of a long waiting list.

On top of this, many still feel that admitting to struggling with mental illness carries a stigma. This is particularly a problem for women suffering with postnatal depression.

“What if they think I’m a bad mother?”

“What if they want to take my baby away?”

“What if the medication means I can’t breastfeed?”

My story

For me, I was not worried about the stigma, nor intimidated by the difficulties of getting help. It was taking myself seriously that was the problem. I didn’t even realise that I needed help.

I was over the moon at the birth of my second son. I had a natural birth – the thing that I’d wished for and had eluded me with my first. I was also happy that with the second child, I felt that my family was complete. I did not enjoy pregnancy and was incredibly happy to know it was finished and I never needed to do it again. And of course, my son was beautiful, as babies always are.

It’s hard to say if there were any number of factors that contributed to my PND. My baby spent time in special care for feeding problems. Some other things happened to friends and family that upset me, and then we had a house guest that came for a week and stayed for a month. My son was born in November, but by the time February rolled around – that darkest month of the year – I was in a dark place.

I spent every day on my sofa crying. I wasn’t even sure what I was crying about. I felt insecure. I didn’t want to leave the house. Also, I felt so incredibly angry. My older son, who was about 3 years old at the time, was having some difficulties getting used to having a baby brother and that was affecting his behaviour. So he was a little more challenging than usual and I was less equipped to deal with it. I used to bite my bottom lip so hard to stop myself from shouting and exploding with anger. It seemed like my bottom lip was permanently stuck under my teeth. I felt guilty for being angry with my son.

It took me a long time to take my feelings seriously. I blamed myself and my own lack of self-control for the feelings of anger. I called myself lazy and weak for not wanting to leave the house. I felt foolish for feeling sad so much of the time. I had everything I wanted, so what excuse did I have to be sad?

I didn’t think there was anything a doctor could do for me. I thought I just needed to grow up and deal with it. Having a baby and a young child is hard work. I thought it was par for the course. And I kept suffering.

And then one day a leaflet dropped through my door. It was for Ieso Digital Health, an NHS service that offers Cognitive Behavioural Therapy (CBT) via secure instant messaging on a computer, smartphone or table. It said that you could refer yourself to the service, and it didn’t matter if your symptoms were mild, moderate or severe.

The penny dropped. I realised I desperately wanted to talk to someone about how I was feeling.

So I took the leaflet to my doctor and asked her to refer me to the service. It turns out that was the wrong thing to do, and I could have just signed up online without even going to the doctor. In the end, she referred me to a different service that involved talking on the phone instead of online.

I found CBT difficult in a lot of ways, especially over the phone. I think I would have preferred hiding behind my laptop screen. The idea of CBT is that it helps you examine your patterns of thinking so that you can see how they’re being unhelpful to you, and this can empower you to change them.

In some ways I didn’t like it because I felt like I was being blamed for how I feel. But I made an effort to engage with the therapy, and it did help me channel some of my angry feelings when my son was winding me up. The therapy helped me remember logically that he wasn’t doing it on purpose – he was only a young child – and that I had the power to choose how I reacted to it.

The sad and insecure feelings were more stubborn. They hung around until I ran out of birth control pills and forgot to refill the prescription. Within a week of stopping the pill, I started to feel better. I decided to stop taking them altogether and I’ve felt better ever since. It may have been a coincidence, but recent research is showing that depression can be an adverse effect of hormonal contraceptives.

What I’ve learned

My story exemplifies a number of challenges we have around mental health, and maternal mental health specifically. These include:

  • Helping women to take their feelings seriously – to not to be ashamed or afraid to talk about how they’re feeling and to ask for help.
  • Taking mental health as seriously as physical health.
  • Raising awareness of the symptoms of PND and other maternal mental health problems so that people will be equipped to recognise when there is something wrong – not just in themselves but in their friends and family.
  • Increasing the availability of appropriate mental health services on the NHS.
  • Increasing awareness of how to get help on the NHS, and the range of services that are already available.

The leaflet that popped through my door saved me. It came at the right moment. But we shouldn’t have to rely on chance for people to receive the help they need.

If you are feeling down, angry or anxious, please speak to someone. The Mental Health Foundation has a useful list of some of your options for getting help. And if you see a friend or relative struggling, please don’t look the other way.

I would like to publish as many stories about maternal mental health as I can to spread awareness. If you would like to write a guest post with your own story or perspective, please email me: themumreviews (at) gmail.com.

Petite Pudding
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New mums and mental health

A guest post by Sally Hogg

I remember when my son was born, people kept asking ‘are you enjoying being a mum?’ The answer in the very early days, was probably ‘no’. It got better, but it wasn’t fun at first. Yes, he was absolutely amazing and wonderful. But I hurt. I kept crying for no reason. I was so very, very tired. I worried whether I was doing things right, and – to be honest – I missed my old life. This was a momentous time, but it wasn’t enjoyable at first.

But I never said ‘no’ to that question. It was loaded with expectation. Asked by grannies, aunts and older mums who look back at motherhood through rose-tinted glasses.

Are you enjoying being a mum? New mums & mental health

There are many reasons why it’s hard to admit that you’re not having a great time as a new mum. It seems as if everyone else is doing fine and having a magical time. It seems like everyone expects you to be on top of the world, and it feels like failing – and perhaps a betrayal of your baby – to say that you are struggling.

Yet most, if not all, mums will struggle at some time. And for a significant proportion, this struggle may not simply be the normal rollercoaster of new parenthood, but something more serious. Between 10 and 20% of new mums (and around 5-10% of new dads) experience a mental health problem during pregnancy or the first year after their baby is born. To put this in perspective, it means that in any typical antenatal class or baby group, there is likely to be at least one person in the room who has a mental health problem.

Whilst postnatal depression is well-known, mental health problems for new parents are not just postnatal. In fact, experts now suggest that depression is more common in pregnancy than postnatally. Problems go wider than depression too. They can include, for example, anxiety, OCD, PTSD, psychosis, and eating disorders. Some of these problems will occur for the first time when someone becomes a parent, others may be the recurrence of an existing problem – perhaps one that has been well-managed for many years. Some people with pre-existing conditions are particularly at risk: any woman who has ever experienced bipolar disorder, for example, has a 50% chance of mental illness in the weeks after birth, although this can be very effectively managed with specialist help in pregnancy. The severity of mental health problems varies too. Thankfully, most will be relatively mild, but this is not always the case: suicide is actually one of the leading causes of maternal death in the UK.

Mental health problems can be very effectively prevented or treated with the right help, which is why it is so important to speak out early if we think something is wrong in ourselves, our friends or partners. If you feel you or someone you know has a mental health problem, trust your instincts and talk about it. It may be that they are just having a few bad days, but they will still benefit from a supportive conversation and, if they are ill, the sooner they can receive help, the better.

There are a range of options available to prevent, reduce or treat mental health problems. These include support groups, counselling or other forms of psychological therapy, or medication. The best option will depend on the nature and severity of a mum’s illness and her own personality and preferences. Midwives, health visitors and GPs should ask all expectant and new mums regularly about their mental health, and should be able to signpost mums to different sources of support.

There are also things that we can do ourselves to improve our mental health. These may be enough to overcome mild mental health problems, but won’t be sufficient in themselves for women who are more seriously ill. Activities associated with reducing depression and anxiety include socialising, exercising, getting more sleep, and active relaxation (things like mindful mediation or having a massage). These can feel very hard to do when you have low mood and a new baby, which is why it’s good to talk to family and friends so that they can help you to take care of yourself.

Sadly, there are gaps in services in the UK, and some professionals don’t have the skills and knowledge they need to detect mental health problems and give women the support they need. You may need to be persistent and assertive in order to get help.

Things are improving though: the Maternal Mental Health Alliance (a coalition of over 80 charities and professional bodies) is doing a lot to raise awareness and improve services, and earlier this year, the Government announced over £350 million to fund new services.

Parenting is a rollercoaster, and it’s not one that we’ll always enjoy. For most new mums, the highs of this rollercoaster should far outnumber the lows, but a significant minority will be less fortunate. If you feel the balance isn’t right, don’t suffer in silence. You aren’t alone and things can get better.

Sally Hogg is chair of the Oxted & Caterham NCT branch. She also runs the Mums and Babies in Mind project for the Maternal Mental Health Alliance.  They offer some useful self-help guides about recognising and facing maternal mental health issues.

I would like to publish as many stories about maternal mental health as I can to spread awareness. If you would like to write a guest post with your own story or perspective, please email me: themumreviews (at) gmail.com.

Petite Pudding
Tammymum
Diary of an imperfect mum

Birthing babies is a messy business – my postnatal anxiety

I’ve mentioned before in my breastfeeding post about the traumatic birth I had with my first son. Without going into too much detail here, I was induced, I had an emergency c-section and he was in special care with pneumonia for 10 days after he was born.

This all threw me for a massive loop. I had planned a natural water birth with only gas and air in a midwife-led birthing centre. I’d been doing pregnancy yoga and was convinced my body was a childbearing temple and I could have the birth I wanted if only I thought positively about it.

What a load of bull!

I had a drip and was strapped to a foetal monitor which kept bleeping in alarming ways that made me think my baby was dying. I had an epidural after being pricked in the spine countless times, and finally was rushed to theatre (after 20 hours of labour). I was so scared and addled during the surgery that I sang all the songs from The Sound of Music to my anaesthetist. Apparently, that was a first for him – but he was quite young.

And I hadn’t even considered, nor had anyone mentioned to me, the possibility of my son going to special care and being in one of those plastic oxygen boxes. I thought that only happened if your baby was premature. Turns out, special care happens to loads of mums for all sorts of reasons. But nobody warns you ahead of time.

Birth trauma and its effects

By the time I finally brought my son home from hospital, I was seriously messed up. I was convinced he was going to spontaneously die. We couldn’t fit his cot in our bedroom, so I slept in the nursery with him (away from my husband). I lost so much sleep, staying awake listening to make sure he was still breathing.

I remember that every night I would go to sleep repeating to myself, “Please God let him be okay. Please God let him outlive me. Please let him grow to be an old man.” My anxiety about his survival was all consuming.

And other times, when he had colic and wouldn’t stop crying, I wanted to throw him out of the bloody window. And as soon as that thought crossed my mind, I would be overtaken with guilt.

When I think of myself back in those days, I see a woman walking around in a sleep-deprived haze of constant anxiety around my baby’s well-being. Who couldn’t go on a buggy walk without me stopping to check on him every couple of minutes. I hated his rear-facing car seat because I couldn’t see him – we had to buy a mirror.

When well-meaning people would try to hold him or feed him a bottle, I was liable to hover and even yell at them, criticising their techniques – even though these were people who had children of their own and knew what they were doing.

I wore the same clothes day and night – a nursing top and baggy elasticated-waistband trousers. They were inevitably covered in baby sick and the crumbs from my attempts to eat toast without putting the baby down.

I was lonely but I couldn’t maintain a conversation. The days and nights ran into one another. Each day it seemed like I’d be stuck forever in my dark living room, curtains drawn, trying to soothe my screaming baby. Each night was spent begging forgiveness to the universe for being such an ungrateful and unworthy mother.

When I look back at the woman I was in those early days of first-time motherhood, I almost don’t recognise her.

Getting better

I never sought any help for my condition. I didn’t realise it was a problem. I thought it must be normal. In retrospect, I know it wasn’t normal.

As time passed, the trauma of my birth and my son’s illness faded.  Eventually, my son started crawling. Seeing him be independent and robust relieved some of my anxiety. By the time he was 1, I was feeling more like myself.

I was lucky that I got better in my own time. But it would have been much better if I’d realised what a state I was in and that there was help out there for me.

That is why this is the first post in what I’m hoping will become a series on maternal mental health. My next post will deal with the PND I had after my second son. And then I’m hoping to commission guest posts on the topic. Not just on diagnosed PND or anxiety, but about any mental health challenges you might have faced as a new mum. These could be shared on my blog anonymously if you like, or you can put your name to it.

If you would like to contribute a post on maternal mental health, please email me at themumreviews (at) gmail.com.

If you are feeling down, anxious, lonely or depressed after having a baby, you are not alone.

You can find support and information on http://www.pandasfoundation.org.uk/. Please also consider speaking to your GP or health visitor, and seeking support from family and friends.

My Petit Canard
Tammymum
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