Author Archives: fostress

Veganism and eating problems – I think I’m finally ready to go back to veganism for the ‘right’ reasons

Our non-carbon footprints!

In 2015 I did Veganuary. Controlling my food intake and restricting or cutting out certain foods contributed to a return of disordered eating problems. Food and eating – or not eating – took over my thoughts. Despite moving away from a completely vegan diet, I continued to restrict my food and purge through exercise.

I lost too much weight, my periods stopped and it was only a long and increasingly desperate attempt to conceive that forced me to look those gremlins full in the face and take steps towards recovery. A recovery that involved eating cheese without panicking or purging for the first time in two years.

We finally got a positive pregnancy test in January 2017. Pregnancy with residual eating problems wasn’t easy but I’ve found that, since Oaklan was born last October, my relationship with my body has changed. It’s hard to pin down exactly why. I think it’s felt more powerful and more important. It’s helping me do one of the hardest jobs I’ve ever done and perhaps getting through the sleepless nights and challenging days has given me a different kind of confidence. A belief in myself that’s not linked to weight, appearance or my ability to control. And sometimes there’s just been no energy or headspace for anything but survival.

The ‘right’ reason to go vegan?

I’ve also found it harder to justify a non-vegan diet for myself. It feels weird to drink the milk of another species. From a mother whose baby was taken away so I could have that milk instead. That’s a very personal reason of course and is definitely linked to how much I’ve loved breastfeeding.

I have flirted with veganism over the past few months – but I was scared that I was doing it for the wrong reasons. Veganism can be a cover for disordered eating. It’s had that effect on me in the past. Was my motivation purely an ethical one? Or was it an excuse to restrict certain foods and a way of helping me control my calorie intake? Perhaps it’s indulgent to worry about my motivation anyway? Alex didn’t like the idea; he remembered how long it took me to recover last time.

But, since the latest IPCC report, I can’t justify a non-vegan diet for myself any more. I’m scared for my little boy’s future and, although it’s a drop in the ocean, I want to do everything I can to try and reduce my carbon footprint. Although there are environmental issues with any diet, the consensus seems to be that a vegan diet, particularly a thoughtful one, will massively reduce my carbon footprint.

So I’m planning to eat vegan for a month, keep a close eye on my eating and mental health, and see how I go. I’m confident that I’m doing it for the right reasons and I hope I have the mental strength to keep it that way.

Postnatal depression and anxiety after 10 months – a bit of honesty on World Mental Health Day

A few weeks ago I saved an article about Instagram from the Guardian’s website – Instagram is supposed to be friendly. So why is it making people so miserable?

It struck a chord because I was feeling uncomfortably aware of the disconnect between how my life looked on my Instagram account and how it really felt. I do live with my husband in a house I love, in the gorgeous Chew Valley. We have a healthly and happy one-year-old boy Oaklan and an energetic collie Dr Watson. That much is true.

I’m very aware of how lucky that makes me. Something the article misses out is how a collection of your favourite pictures, shared with people you love, can sometimes help create that sense of perspective during darker times.

An honest picture

But things haven’t been easy recently and I wanted to write something honest about that. After Oaklan was born I thought I had managed to avoid any serious postnatal mental health problems. I even wrote about how parenting a newborn had helped my mental health. But 10 months and very little sleep later, things felt quite different.

He has never been a good sleeper and three hours unbroken sleep was a rare gift. Until six months he wouldn’t nap in a cot at all and until eight months I couldn’t leave him while he slept. He hated being put down or sitting still and needed constant attention and interaction. All of which was manageable until his sleep deteriorated to the extent we’d have regular nights when he would wake every 45 minutes or so.  I was surviving on the nap I would get when Al took him for a couple of hours in the morning. Four hours of broken sleep felt like a good night. My own insomnia started to get worse.  Al went away for work for eight days and everything broke soon after he got back.

I couldn’t sleep even when I had the opportunity. Bedtime and naptime made me panic. I went to bed with a dry mouth and my heart racing. I felt I had nothing left to give and spent a lot of the day in tears while feeling guilty that my stress and sadness was affecting Oaklan.

Luckily, my family came down to help for a week. While we were away in Cornwall (see the gorgeous beach photos) I had another three or four sleepless nights and panicky days. I spoke to the doctor and upped my medication to 100mg/day (the highest it’s ever been).

Over the next few weeks, our sleep was up and down. The insomnia and bedtime fear was still there. After a bad night I would feel very panicky that the awful sleep times were returning. Although my anxiety slowly reduced I started to feel very low with lots of intrusive suicidal images. I found it hard to feel connected to Oaklan and could only go through the motions of parenthood. At night, I could feel my heart beating hard in my chest as I struggled to sleep.

These feelings are slowly fading now. But it takes time to climb out of the hole. For a while I was coping on a daily basis but my resilience was really low. I struggled to manage when Oaklan was difficult or if something else made the day harder. Then I felt really guilty for relying on other people and pretty useless as a mother.

But nights have got easier to manage. His sleep is improving and Alex can settle him now. My sleep is mending and I’m feeling brighter and calmer. I hope I’m rebuilding that resilience too. Returning to work has also helped. I enjoy the balance of three days writing and four days with Oaklan.

Postnatal mental health support

So that’s the honest story behind some of those lovely pictures. Postnatal mental health problems can affect you much later than you might expect (I think technically the definition is up to a year after birth). It has been really really hard. But I’m incredibly thankful for wonderful friends, supportive family and, of course, Alex. Not everyone has those kinds of brilliant and nourishing relationships to help keep them safe and well. And it’s probably worth adding that a lot of people find supportive communities and friendships on Instagram too. This post by Holly Bourne is a lovely example.

 

Understanding mental health problems – booklet launch

Last week Oaklan and I went on an adventure to London for the launch of the latest version of Mind’s flagship booklet ‘Understanding mental health problems’.

I wrote this when I was pregnant and it was great to see it finally published. It’s the first title to be published in the new full colour format – complete with pictures. It looks great and I’m really proud of my involvement.

‘Understanding mental health problems’ is one of the titles that Mind publishes as a booklet. You can find it in local Minds as well as workplaces, charity shops, universities and GP surgeries. You can also read it here. You can see the other titles I have written for Mind here.

Is that a cake or a book? Either way I want to eat it please!

 

 

Oaklan enjoyed himself too. He got a free apple in Pret after stealing it from the box and charming the staff, visited our old house in Mile End, had a picnic in Victoria Park, played on the swings and in the sand, met a London baby, slept on a walk through the Olympic Park, mashed strawberries into Mind’s carpet, came with us to the pub for a quick drink, looked out of the window of the DLR at Canary Wharf and threw spaghetti about in my brother’s kitchen.

Thoughts on mental health and parenting a newborn

Oaklan came on the 5th October. He’s almost eleven weeks now and things are slowly starting to feel a little easier. I’m still pretty tired – and I’m writing this with him feeding on my lap – so please excuse any typos, half-formed ideas or clumsy phrasing.

I wanted to get down some thoughts about early parenthood and mental health. It’s something I was pretty worried about. I was concerned about the lack of sleep and relentlessness of it, plus not being able to exercise enough and dealing with a very different shaped body.

I was on 50mg of Sertraline throughout my pregnancy (a decision that was definitely the right one for me) and I chose to increase this to 75mg in the first difficult weeks. I think that’s helped. But, despite everything, early parenthood has also highlighted some healthier thinking patterns and approaches.

The achievement of labour and birth

I’d hoped that pregnancy would change my muddled relationship with my body. I’ve heard women say that it helps them see their bodies in a new light and recover from long-term eating problems. This didn’t happen for me. The whole nine months was an uncomfortable struggle with my changing body. I felt trapped and out of control. By 41 weeks I was desperate not to be pregnant. But labour and birth were more empowering. After seven hours of contractions, he came so fast I delivered him myself at home. An hour ago the midwife on the phone had told us I was still in early labour. We were lucky but it’s still an experience I’m proud of. I finally managed to see my body as something special and cut it a bit of slack (at least for the first six weeks or so).
Continue reading

BMA Patient Information Awards for Mind and Miscarriage Association work

I’m really chuffed to be able to share that both Mind and the Miscarriage Association received awards at the British Medical Association Patient Information Awards 2017 for information and that I researched and wrote.

The awards aim to ‘encourage excellence in the production and dissemination of accessible, well-designed and clinically balanced patient information’. They look for accessible information that is evidence-based and well researched. It’s also important that people with lived experience are involved in the production of the information. You can see all the award winners here.

Information for young people (for the Miscarriage Association)

The youth resources I researched and wrote for the Miscarriage Association were highly commended. They were also given a runner-up award in the special category for Young Adults. I was particularly pleased with this award as I managed the whole project, conducted the on and offline research with young people, developed recommendations and wrote the resources themselves. You can read more about the consultation process here.

It was reviewed by Dr. Hannah R Bridges of HB Health Comms Ltd who wrote:

Wow! This is a wonderful example how good consultation and understanding your audience can lead to great quality information! The Miscarriage Association has identified a need for materials to support young people, who have different experiences and support needs. The consultation, planning, and promotional plans show excellence in producing health information. This shows through in the end products – high quality and extremely well-tailored to the audience. The insight and thought that has gone into this is commendable. Take for example the ‘what happens when you call our helpline’ page – simple, highly visual, concise and reassuring information to encourage young people in need of support to dare to pick up the phone – the overall impression is one of kindness. Just wonderful.

Money and mental health (for Mind)

The information product Money and mental health I wrote for Mind was highly commended. It also received a runner-up award in the special category for Self-Care resources. This resource was one of the first to be written in a new ‘hub’ format. It involved research with Mind’s online community and social media audiences, working with bloggers with lived experience and researching common problems and support options.

Unfortunately, I couldn’t attend the awards with colleagues from either charity  – at 39 weeks pregnant it wasn’t worth the risk of going into labour on the train from Bristol, at the awards or in my brother’s shared house. But it’s a lovely way to leave work for a while.

Published in The Recovery Letters

Last year, James Withney of The Recovery Letters emailed to see if I would be interested in contributing a letter to the published anthology. The Recovery Letters are addressed to people experiencing depression. They share experiences and give friendship and hope for recovery.

I’ve always believed in letters and writing as a way through difficult times. In 2012 I wrote about the benefits of public and private writing, on and offline. In 2013 I wrote about creative letter writing for self-guidance and managing mental health and in my post ‘Understanding mental trickery, notes from depression island‘ I used islands as a metaphor for the concept of depression being such that it’s often hard to remember you’ve ever felt happy or imagine you’ll ever feel better. And when you’re not experiencing it, it’s hard to understand or even remember how it feels.  I introduced the idea of finding and making connections between a happier mind and a depressed one. These messages don’t always have to be words. But it’s this idea that forms the basis of my recovery letter.

The book is published next week. I got my copy yesterday. There are some wonderful messages from people prepared to open up and be vulnerable, to share their experience to help others.

And I’m also chuffed to report that mine is the very first letter in the book – and that is has been selected as one of 12 letters that will be on display at the 2017 Mental Wealth Festival.

Understanding eating problems – updated Mind resource

I don’t usually blog about individual Mind booklets and online resources I write or update (you can see the list here).

But my most recently completed product is pretty close to my heart. It’s called Understanding eating problems.

Changes and updates

I’ve tried to emphasise that you can find eating problems incredibly difficult to live with, without necessarily having a diagnosed eating disorder. I also wanted to make sure it was clear that you can have an eating problem or disorder without being noticeably over or underweight – and that you shouldn’t need a certain BMI or a particular diagnosis to access treatment. It was important to make sure the information was accessible and useful to everyone – including men and older women. These are both groups who are affected by eating problems but often less able to speak about their experiences and access treatment. I also tried to include blogs and quotes from lots of different people, about a range of experiences and problems.

It wanted to talk about the fact that even thinking about recovery can be scary. Eating problems can feel safe – and even exhilarating. Despite an eating problem making your life difficult, you may not feel ready to try and recover straight away. On top of this, I wanted to expand the information we provide on coping with recovery – dealing with food and eating every day in an on and offline world that can seem to spin around eating, food, weight, appearance and body image (you can read more about my own experience here). Sometimes you can look healthier physically, while mentally you’re actually feeling a lot worse. Recovery can take a long time and relapse is common.

The Information Standard

All Mind products are written to the Information Standard. This means that a first draft was reviewed by a number of people with personal and professional experience of eating problems. I love this stage of the writing process as it always gives you new things to think about, and opens my eyes areas I may not have considered or covered properly. We also make sure we consider and respond to all the feedback we receive – I’m looking forward to reading this too (whether it’s positive, negative or suggestions for improvement).

NICE recently updated their guidance around the recognition and treatment of eating disorders. These changes were reflected in the update too.

Miscarriage Association learning resources ‘Highly Commended’ in EVCOM Awards

Highly commended

I’m really pleased that the films I helped research and develop as part of the Miscarriage Association’s new learning resources for health professionals have just received a ‘Highly Commended’ in the Drama category of the EVCOM awards. These resources have been well received by health professionals too – they were given a 5* review in The Obstetrician and Gynaecologist in January.

I’ve written more about the work I did on the project here. The next step is to work with the Royal Colleges to accredit the resources. I’m currently researching the different options and approaches to accreditation at the different colleges.

Mental health in early pregnancy – the first trimester

Disrupting the balance

Little Foster-Pickup waves hello

I’m pretty good at managing my mental health. I know what helps, what doesn’t and how to recognise when I need to take better care of myself or ask for extra support.

But early pregnancy disrupted this balance. I’m nearly 17 weeks now and finally ready to write about the first trimester.

Awareness of perinatal mental health is increasing. Most people know about postnatal depression but I’ve seen more conversations about antenatal depressionperinatal anxiety and postpartum psychosis too. I’ve heard less about how to prepare for the way dramatic physical and psychological changes can interact with existing problems.

Taking antidepressants, managing eating problems and dealing with depression and anxiety

It turns out I’ve got a lot to say so I have separated them into three blogs.

Continue reading

Antidepressants (Sertraline) and pregnancy

Pregnant and taking Sertraline

I’m 17 weeks pregnant and still taking the SSRI antidepressant Sertraline. I thought I was pretty firm in that decision. An attempt to stop taking it last year ended badly.  But we had to try, if only to help us work out where we sat in the endless risk/benefit balancing act.

But I was still thrown when my GP (a new doctor who didn’t support me through withdrawal, relapse and re-prescription) told me I should try to come off – “You could just stop immediately on that amount – or you could take it every other day for a couple of weeks and then stop”.

She seemed convinced the main reason I found it hard to come off them last time was because I was anxious about trying to conceive. In the time we had it was hard to explain that it was considerably more complicated than that.

Mental health agendas vs. pregnancy agendas

When you are pregnant and also manage mental health problems you have lots of people telling you what to do. Different authorities often have slightly different agendas, follow different recommendations and suggest different things. It feels like an extra layer of disempowerment and it’s hard not to get caught between what’s best for your mental health and what’s recommended in pregnancy.

I have:

  • personal experience that strongly supports staying on antidepressants
  • a well considered and discussed (with a doctor and my husband) decision to start taking them again
  • an awareness of the power imbalance implicit in a doctor’s consulting room
  • access to – and knowledge of – a lot of relevant research that emphasises the importance of maternal mental health and the danger for both mother and developing baby of coming off when it isn’t appropriate
  • an awareness that the ‘risk’ referred to here is pretty small and that everything has risks and benefits – I shouldn’t take the fact that something has a risk associated with it as an automatic reason not to do it
  • an awareness that doctors are told to advise women to stop as there is very little safety info but this is a precaution and for some women, it can be better for them and their baby to remain on medication

Questioning my decision

But despite ALL this, I still walked away from the doctor feeling pretty wobbly and thinking “maybe I should, the doctor is telling me I should after all”.

It took another discussion with Alex and some more reading and research to help me feel confident in my decision again.
Continue reading