Perinatal Mental Health: Its time to break down the stigma.

Disclaimer: Please be aware that there may be triggers in this post for those experiencing anxiety. If you are worried about that skip forward to the blog written about Perinatal mental health by mental health nurse, Sammi Carson.

38_baby_wilfredMental Health is very important to me. If you know me you will be aware that I am passionate about talking openly about my own personal experience. I have come to the conclusion that if I, a midwife, feel unable to raise the issue, then how can I expect mothers to do so. So here it is in black and white, I am one of the 1 in 4 who will experience a mental health problem in their lifetime and I am also one of the 1 in 10 who have experienced a perinatal mental health problem (antenatal/postnatal). I hope that by sharing my story I will reach women and even men who may have otherwise brushed it off as normal and spent their days living a torturous existence.

Let me tell you about what happened to me….

In the summer of 2015 my husband and I found out that we were expecting our third baby. The first 5 months were plain sailing. Yes, I had horrible morning sickness and was waking up every hour of the night to have a pee in the first trimester but by the second trimester (12-28 weeks) I actually felt really well, with a good level of energy.

However, around 22 weeks something changed. I started to find myself worrying, a lot and about quite irrational things. Now I should tell you I have suffered in recent years from low level anxiety linked to my fathers death and have had some amazing therapy for it. I had lost my wonderful dad to cancer 6 years prior to this pregnancy and once again I found myself thinking about him at the end of his life more often. That in itself is not odd,  many people tell me that they think more about death when they become parents. There is something about our fragile existence and our innate desire to protect our babies from harm that seems to have us thinking more about the unthinkable.

It started with a really bizarre and strange thought. I was putting up some pictures in my house last December and as I banged the nail into the wall with a hammer I had a frightening and strange thought about someone breaking into my house and attacking me and my children with a hammer. Now a normal mind would think this and then think, what a strange thought, and put it to the back of their mind and forget about it. I couldn’t. I freaked out. My anxiety rocketed and I found myself checking all the windows and doors obsessively and truly starting to believe that this thought was quite realistically going to happen. It consumed my mind and the harder I tried not to think about it the more it crossed my mind. This anxiety would produce an adrenaline rush that would make me shake from head to toe and I would not be able to carry on doing the simple day to day things in my mummy life.

After a few days this thought started to fade, but in its place another one would grow, always based around harm coming to my family. Thoughts arose of Dan, my husband, being knocked down as he cycled to work. I made him promise he would call me when he arrived at work, and if he forgot and I could not get hold of him I would be in bits with worry. Thoughts of the kids getting seriously ill. Thoughts of myself getting cancer like my dad and not seeing my kids grow up overwhelmed me and I became consumed by it. I started to believe I must be experiencing psychosis. I could not listen to the radio, or read the paper or watch the television because stories I would hear would trigger upsetting anxiety. I felt like I was actually going crazy and did not even know how to start telling Dan, my mum, my sister, my midwife or my friends how I was feeling.

I felt completely on my own.  I was hardly sleeping, it felt uncomfortable just to be in my own skin, I flitted between agonising fear and vacant emptiness. If anyone mentioned my growing bump or pregnancy to me I wanted to burst into tears. The school run was agonising. Now as you know I am a midwife, how the hell did I not know what was happening to me. If this was how a perinatal mental health problem could feel, how had I so casually asked women ‘have you ever experienced a mental health problem?’ ‘how are you coping with your newborn?’. I simply did not get it, until I got it and it was like living in a horrendous nightmare. What if this was my life now and I would never get back to the happy and enthusiastic me that I’d always been?

That’s when I reached out to an amazing friend who had experienced the most hideous and debilitating post natal depression (PND). I very slowly and cautiously started to tell her how I was feeling and how tortuous my life had become. She was incredibly kind and we started messaging each other every day. I would send her long rambling messages about the overwhelming thoughts and all the feelings, oh the feelings! I found this so helpful but through speaking to her I realised I also needed professional help to help me climb out of this pit of despair.

I reached out to my midwife, unfortunately as it was Christmas time it was very hard to get hold of someone. Eventually I did get hold of my own midwife, I did not feel comfortable telling someone I did not know, which is a shame but that is to do with the stigma. My lovely midwife listened to me and referred me to the mental health team at my local hospital. I would hear from them within a couple of weeks. I could not wait anymore, I had got to the point where I refused to let Dan go to work, something had to change.  I had to get help.

As well as the NHS support which was helpful but very limited, I was really fortunate, and through Dan’s work I was able to find support using their medical insurance policy.  We contacted them and I got referred very quickly to see a psychotherapist.  I wish to the bottom of my heart that everyone could access this care and help. I begrudgingly told the Doctor how and what I had been feeling and thinking. He was just brilliant and diagnosed me with antenatal depression and anxiety. He talked me through medication options, which I was not comfortable with at first, he did not push me in any way and let me find my own way to the care I received.

I was encouraged to join their anxiety and depression CBT (cognitive behaviour therapy) course to learn to control my thoughts and behaviours. I was so worried about sharing my thoughts and feeling with strangers but it ended up being one of the most liberating things I have ever done.  Everyone there had their own personal experiences of anxiety and depression, not all perinatal related, and I ended up getting to know some of the kindest most genuine folk I have ever met. I was not longer alone in my suffering and I started to truly believe I was going to get better.

A couple of weeks into my CBT course and I had been contacted by the mental health team at my local NHS trust. I was in the system and they were going to help as much as they could especially after my baby was born to reduce the chances of developing PND (postnatal depression). They were wonderful but NHS perinatal mental health services are financially stretched and waiting lists are very very long.

After much personal research and asking some highly trusted professionals I decided to start taking a low dose of  medication to help lower my extreme anxiety levels and work as a buffer while my mind learnt and processed my new CBT skills. Although I was sceptical at first I began to understand that the illness was caused by some sort of chemical/ hormonal imbalance and it was treatable. There is SO much stigma around taking these sorts of medications but on a personal level it worked for me. After a couple of weeks an incredible thing happened, my debilitating intrusive thoughts just started to fade away. I was returning to being me.

As the weeks continued I began to start living again and enjoying my life. On my due date labour started and I had the most empowering and calm birth. I started getting some contractions once my older two children had gone to bed at 7.45pm and by 10.45 pm Wilfred was born in the water birthing pool at my local hospital. I was immediately aware of the love I felt for my baby. I was discharged home after 6 hours and my older children woke in the morning to find me tucked up in bed with their new baby brother.

In the following days I had extra support at home from visiting midwives as you are more likely to experience  PND if you have suffered with a mental health problem during pregnancy. I was so lucky though and felt well mentally and physically. I found the first 6 months of Wilfred’s life to be a joyous time.

Since I started talking about my experience with antenatal anxiety and depression, it has amazed me how many people have spoken to me and contacted me about ante/postnatal depression and anxiety and have said ‘me too!’.

I hope that hearing me speak out empowers those who are suffering to acknowledge that they are not well and that there absolutely is help out there but you need to flag it up and ask for support. Easier said then done I know, but If someone reads this and decides to access help from a partner, friend, midwife or GP then just maybe my experience was not completely in vain.