Category Archives: Writing my mind

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.

 

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

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.

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

Eating problems and early pregnancy

Recovering from eating problems

Over the last year, I’ve been facing up to eating problems that have dogged me my entire life. This became particularly important as we tried (and for a long time failed) to conceive. It was really hard going but I got my cycle back and my hormones balanced – by the time we conceived my levels were fine. I gained weight until my BMI settled in the mid/high normal range that seems to be where my body naturally wants to hang out. I preferred being smaller but I was (slowly) teaching myself to feel positive about the changes.

This is what recovery looks like for me. After 24 years with these thoughts and feelings, I’ve pretty much accepted that I’m never going to be completely free of them. But I’ve learned to manage them in a healthier way, enjoy exercise and let myself eat without feeling too guilty (usually).

A naive hope for eating problems and pregnancy

I had nurtured this (naïve) hope that during pregnancy my muddled relationship with weight and eating would somehow vanish. Or at least become a lot easier as I nurtured my amazing baby growing body, forgiving weight gain and enjoying my new curves. HA. Load of bollocks.

Continue reading

Depression and anxiety in the first trimester

A toxic mix

I had some very low periods and dark thoughts during the first trimester of pregnancy. The myth of pregnancy as a calm, exciting and enjoyable time is still pervasive – but there were times when I felt unable to take pleasure in anything, distant from Al and scared I wouldn’t be able to feel anything for the baby either.

  • Nausea and exhaustion were draining and left me more vulnerable.
  • Pregnancy was constantly pushing all my eating and weight ‘triggers’ and making that much harder to manage.
  • I couldn’t do almost anything I used to enjoy or that helped me manage my mental health – challenging myself with long runs, tiring myself out with speedy bike rides in the hills, skiing with friends, winning races, revelling in that gorgeous post-exercise feeling – even drinking tea and having a long steaming hot bath.
  • Nowhere felt like home – my supercharged sense of smell means that the smell of the house made me sick. It’s exhausting to have nowhere comforting to retreat to.

All of these are manageable individually but they made a toxic mix when combined with existing mental health problems.

One big anxious thought

I have a diagnosis of clinical depression and anxiety – but it’s tended to be anxiety I’ve struggled with over the last couple of years. Anxiety get’s its claws into whatever is going on and warps it out of all proportion. In the first trimester, there is a LOT for it to hook onto. Al always tells me to try not to think ‘big thoughts’ when I’m anxious but for a lot of those first 14 weeks or so I just felt like one big anxious thought.

But I also felt that dark, flat, stifling darkness of depression again. It was actually pretty scary at times – mainly at night when things often feel the most overwhelming. I’m certainly glad I kept up the Sertraline.

Referrals and support

I’m feeling a lot better now. I have a referral to the obstetrician who specialises in mental health – but my appointment isn’t until June. In the meantime, I spoke to an amazing midwife who really seemed to understand and agreed that 27 weeks was very late for starting any additional perinatal mental health support. She referred me to see a psychologist a little earlier. I’m not sure how (or if) these appointments will help but I’m keeping an open mind and making sure I have as much support in place as possible in case things get harder again.

Read my other blogs about the first trimester:

Signs of change and coping with cheese – how my eating disorder recovery looks now

vd9j4ghMental health problems have a way of taking over. I’m lucky enough never to have been hospitalised or signed off work. Life has always stumbled on. But moods and behaviours creep in and twist their tendrils around daily life. They trick you into thinking they’re normal, into nourishing them. It’s not until they start to suffocate and strangle even the simplest of things that you recognise their power. And then it’s too late for an easy fix.

This year I’ve started the long process of hacking away at the thicket and pulling up roots that go incredibly deep. It hasn’t been easy. But now I’ve made some space it’s much easier to see what a tangle I was in.

Eating new food

I recently turned 33 and enjoyed a breakfast made for me by Alex without having to purge it through exercise.The day before my birthday last year I was panicking over choosing something nice (and therefore different) for my birthday breakfast. I cried outside the bread shop. I ended up with toast and even then it was a tricky day.

Letting go of control in the kitchen

I no longer have to have control in the kitchen. I’ll eat something made for me by someone else – even if I didn’t see whether they used butter or check how much oil they added.

Reaquainting myself with cheese

I had cheese on toast for the first time in two years last week (cheese has been a scary food for years).
Continue reading

Recovery is long, messy, uncomfortable and emotional – but i’ll keep trying (and talking)

Glad to have an eating disorder?

I'm not linking... but you can Google...

I’m not linking… but you can Google…

Apparently Liz Jones is glad she has an eating disorder. In her latest piece for the Mail, she tells us that recovery is so hard that it’s easier not to try. She’s lived with an eating disorder for so long that she’d rather take refuge in behaviours that feel safe than deal with the messy and fluctuating business of balanced eating.

She’s lived with an eating disorder for so long that she’d rather take refuge in behaviours that feel safe than deal with the messy and fluctuating business of balanced eating.

Yes, recovery is bloody hard work

She’s certainly right about that.

If you’ve lived with a restrictive eating disorder then gaining weight is quite literally your biggest fear. Recovery means choosing to face it and having the courage to live with it every day. It can be weeks, months or years before it stops being scary and difficult at least some of the time.

Food isn’t just nourishment. It’s both punishment and reward. It’s at once the scariest and the most important thing. Recovery means learning to manage this complex twist of emotions at least three times a day. Forever. It means dealing with other people’s opinions and comments on your changing body.

You’ve probably developed tests and checks to make sure your body is ‘right’ – restricting or purging until you ‘pass’. Recovery means ‘failing’ those tests without spiralling into self-doubt and recrimination. Hundreds of times a day.
Continue reading