Tag Archives: Depression

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.

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

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

Unwanted pregnancy far outweighs any side effects of contraception? How dare you say it’s that simple!

Women on hormonal contraception are more likely to be treated for depression

fullsizerender-1Recent research has shown that women taking hormonal contraception are more likely to be treated for depression. And we already know that those with pre-existing depression may have their symptoms worsened by the pill.

Tell us something we don’t know.

I’ve avoided hormonal contraception completely since a devastating experience in my teens. Mood changes are the top reason why people discontinue using the pill.

But some of the responses to this research have made me pretty angry. I’ve been trying to make sense of why for the last couple of days. Maybe this is really obvious stuff. But maybe it needs to be said again and again until people start to listen.

Unwanted pregnancy far outweighs ALL side effects?

The worst comment I‘ve seen is “avoiding an unwanted pregnancy far outweighs all the other side effects that could occur from a contraceptive”. That’s the sort of thing someone who hasn’t experienced depression might say. I wonder if an equally debilitating (and potentially life threatening) physical health problem would be treated so casually.

I was prescribed the combined pill in my teens with no guidance, no discussion of side effects and without being offered alternative options (I wrote about it in an old blog post here).

The causes of mental health problems are complex and under-researched – but I’ve always felt that the six months of desperation, confusion and trauma I suffered before realising the pill was to blame was the start of long term problems with depression and anxiety. I still occasionally have nightmares where I’m trapped in that time and those feelings.

I had an abortion in my twenties. Unwanted pregnancy can be awful (and can be associated with an increased risk of mental health problems too). But the mental health consequences of getting medication like hormonal contraception wrong can also be devastating – and can last a very long time.

When I posted these thoughts online, others immediately agreed – “Yes, yes, yes! I’ve had both an unwanted pregnancy and a termination and long-term mental health problems aggravated/caused by the pill. And it wasn’t the first one that was more traumatic and terrifying”.

I feel the need to clarify that I’m not suggesting people have terminations instead of taking the pill – but that I need to do this at all just shows how reductive the discourse on this topic tends to be.
Continue reading

What I’d tell my 2015 self about dieting, body positivity and accepting medication

One year on...

One year on…

Yesterday we celebrated our first wedding anniversary. Our wedding was a magical day but, in the two years since we got engaged, life has taken some unexpected turns.

My mental and physical health has taken quite a bashing.  I’m not fully recovered – and I’m working hard to challenge and change thought patterns and reactions that have been deeply ingrained for many years. But I’m gaining more perspective with each month that takes me further from the trickiest of times.

So what would I tell the Clare who said ‘yes’ under that tree on Hampstead Heath in 2015.

You can’t control a wedding diet – change the dress, not yourself

I thought I would be able to diet just enough to feel comfortable in a gently corseted dress – and then stop afterwards. But my disordered eating lurked much closer below the surface than I realised. It wasn’t long before my eating, exercise and emotions got horribly tangled. I thought I would never go back there but I slid into militant calorie counting, restriction and purging through exercise with the excuse that it was ‘just for the wedding’. The dress was too big, I spent our honeymoon struggling to find a manageable balance and it took my periods stopping to shock me into making a change.

You need medication – and that’s fine

“You were so proud of yourself,” my mother in law said. And I was. I had been fighting my medication for years, trying to cut down and come off. Stopping was the hardest thing I’d ever done.

And when I finally fought through the initial withdrawal symptoms I thought things would get easier. Instead they got harder. More chest pain. More tears, panic and anger. Suicidal thoughts. More running. More fighting my body. It took three months to realise I couldn’t do it. That nothing was worth the destruction those months had wreaked on my body, our health and our relationship.
Continue reading

We need to talk about mental health and trying to conceive #takeoffthetape

Find out more about Mind's campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Find out more about Mind’s campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Mind has been asking people to #TakeOffTheTape and share something that makes them anxious. Something they haven’t spoken about before.

I thought I would use the opportunity to write about something that’s hardly spoken about at all.

I’m finding it incredibly hard to balance trying to conceive with managing my mental health.

We don’t talk about this. We don’t even talk about the first twelve weeks of pregnancy much (as I’m well aware from my work with the Miscarriage Association). Trying to conceive often happens in almost complete secrecy. I didn’t realise how it would interact with my fluctuating mental health and I wasn’t prepared.

It’s taken a while to get to this stage. The doctor who removed my coil last year strongly implied that it would be best to continue with my efforts to come off my Citalopram. She moved me to Sertraline (it’s considered safer in pregnancy) and told me to try and reduce my dose completely over the next month.

Coming off medication

In fact it took me three more months. I’ve been trying to come off anti depressants for a while anyway (after a muddled fifteen year relationship with them) and trying to conceive gave me the strength to make it through a hideous withdrawal period. It was probably the hardest thing I have ever done. Alex didn’t have much fun either. I’ve written about it here.

I’m more vulnerable to hormonal changes now. I still have very dark times when everything seems hopeless and I can’t see a way through the next ten minutes let alone the rest of my life. Difficult images and ideas jostle with an endless repetition of fears and doubts. Sometimes the same phrase over and over again. They whisper just below the surface of my consciousness. They’re loud enough to wear me down and shrink my focus to a single point of constant worry – but not quite conscious enough for me to recognise what’s happening in a way that helps me stop.

One these days I’m separated from the world by thick glass that bounces every negative thought straight back at me, infinitely magnified. My attention is forced inwards but my mind is everywhere but present, infecting all it can with worst case scenarios. I can’t look up and out, can’t see the variety of the world and my place in it, can’t take a long deep breath. My chest physically hurts and I feel constantly sick with the fight or flight chemicals flooding my poisoned body as it tries to deal with the powerful threat of my mind.

The inevitable uncertainty and lack of control

These times are getting further apart and each one adds detail to our understanding of the best way to manage them. But trying to conceive has made my anxiety worse. It’s given it another peg to hang its hat on. Issues with eating and body image are often about control (with an emphasis on control over your body) – and anxiety hates uncertainty. But trying to conceive is a very uncertain time. What my body does – and doesn’t do – isn’t completely under my control.

I was managing my mental health to the extent I felt I was in a position to come off medication – in order to do something that has made the problem worse again. The irony isn’t lost on me – although on bad days it just makes me  want to cry.
Continue reading

Standing up to stigma – why I blog about work, projects & my mental health in one place

Pressing pause

Linked in

Should my LinkedIn link to my blogs too?

Every time I go to press ‘publish’ on a tricky post exploring my mental health I pause for a moment. The way my blog has developed means that my personal struggles and successes sit alongside blogs about my work and details of my skills, training and experience.

Should I keep them separate? Will employers reject me if they read that I took Citalopram for 15 years or that I use exercise to manage my anxiety?

I know stigma and discrimination around mental health in the workplace exists. I spent 2014 time to changeproviding evidence based reports on mental health policies and support in a number of organisations across a range of sectors for the Time To Change Organisational Healthcheck programme. Tom Oxley writes a good piece about how the programme worked on pages 10 and 11 of this newsletter.

I spoke to people in every workplace who said that they wouldn’t tell their manager if they were experiencing a mental health problem. Many said they would lie about taking time off.

”I’d probably say I had a migraine or something”

Those who had been honest about taking time off for a mental health problem said they felt that now they had more to prove.

Unfortunately in some cases I could understand why. Some managers said they felt people with mental health problems couldn’t ‘cope’. Others saw investment in employees’ mental and physical health as a burden rather than something that makes moral and business sense.

”You’ve got to be careful or people will just take advantage, start using ‘depression’ as an excuse.”

”We need people on top form to do this job – if you’re depressed you just won’t be able to cope.”

1 in 6 employees are currently dealing with a mental health problem. Like colds, flu, delayed trains, bereavement and accidents it’s always going to be part of a workforce. It’s how employers deal with it that counts.

My mental health is part of what makes me. It’s part of what makes a life – and in many cases it’s part of what makes me good at the work I do.

Pressing publish – every time

In the run up to Time To Change’s Time To Talk Day on Thursday I thought I’d share some of the reasons why I press publish on those tricky posts every time.

Continue reading

The Regret Tape and the I’m Not Good Enough Mix – new metaphors and thinking tools for managing anxiety and depression

I’ve recently come off Sertraline after 15 years on various SSRIs. It’s been a long and tricky journey but I think I might be almost there. I’ve written a bit more about that here.

Using metaphors to identify, share and understand my mental health

Mix tapesDuring this period I’ve found two metaphors very helpful.

I love a metaphor when it comes to managing my day to day mental health. Metaphor helps me identify and pin down my experiences. This is a step towards understanding and managing them. It helps me regain perspective and use the language of shared experience to transfer and talk about some pretty intangible feelings.

Getting my nose away from the oil painting

I haven’t had much perspective recently. Feeling anxious seems to magnify individual moments. It’s as though I am living life too close up. I don’t have the capacity to see beyond the worry I’m experiencing right now.

van goghMy nose is right up against the canvas rubbing in all the tiny flaws and bumps. From here they look huge and distorted. But we all know an oil painting looks better from afar. The swirls of dark colour and the lumps of paint add texture and depth to the bigger picture.

I’m not saying that this kind of anxiety is necessary or important to make up the picture of a life – it really isn’t. BUT I have found that whispering ‘remember the oil painting’ to myself has reminded me to step back and question whether the worry that’s causing overpowering anxiety right now will matter at all in a year (or even a month or a week). It’s helped stop those tricky surges of panic become uncontrollable.

My anxiety and depression have a tape collection

Continue reading

Coming off anti depressants – withdrawing from Citalopram and Sertraline

Day six in Foster’s brain and all is reasonably calm…

trainers and pillsAs I write I’m on the sixth day without any form of SSRI at all. This is new territory for me. I’ve taken them every day for 15 years (with terrible healthcare making it much trickier).

Three months ago I moved to Sertraline. Two months ago I was down to 1/4 of a tablet per day. Then I started alternating days. One month ago I moved to one day on and two days off.  Over the Christmas break I’ve been attempting one day on and three days off.  This time round when it got to day four off I decided to keep going.

It’s been a LONG time coming. I’ve been bobbing around the 20-30mg mark for years. I tried to come off them in 2008 but didn’t get below 10mg Citalopram before an abortion and a move to London meant I needed more support again. I tried in 2012 but again couldn’t drop below 10mg. In  2014 I got to 5mg before it became unbearable and ended up slowly and frustratingly working my way back up to 20mg.

Dealing with withdrawal symptoms

My chest sometimes feels uncomfortably tight and I’m still welling up at the slightest thing but I haven’t had any big uncontrollable surges of irritability (horrible), anger (scary) and panic (painful) since before New Year. The worst day was the first time I got to three days without. That afternoon there was little to be done except pick my sobbing self up off the bathroom floor and breathe deeply in showers as hot as I could bear. I would lie completely still in bed hoping for sleep but fearing the threat of my mind building, rushing and slipping away into a place of panic and pain that felt unknown and terrifying. It’s really scary to feel genuinely out of control of your mind. Luckily there was only one afternoon that bad.

I only feel completely safe when I’m exercising and in the calm and blissful hours afterwards when I’m myself again. I’ve ran hundreds of miles. When my knee gave out I cycled hundreds more. I discovered spinning. I’ve been chaining Kalms and I haven’t had a good coffee or a glass of wine in weeks (interestingly when you’re recently married and of a certain age people tend not to push alcohol on you, even at Christmas!). But I’m nearly there. I really think I might be.

Luck, love and incredible patience

I’m  very very lucky to have such supportive and loving friends, family, work and (most of all) my husband Alex. My family love me unconditionally even when I’m unforgivably difficult. My friends make me feel myself again just by being in their company. But Alex is endlessly patient. Those surges of anger and irritability disguise themselves as reactions to things happening day to day. They show their ugly faces in snippy comments, slamming doors and helpless tears. He recognises these as symptoms. He knows that deep down they’re not my fault. He doesn’t react to them as if they are.  This is perhaps the most helpful but also the most difficult thing someone can do to support your mental health. He’s an absolute hero.

(I’ve also written about managing depression and anxiety in relationships here)

New understanding and techniques to manage my mind

There’s been plenty of dramatic lows and a few proud highs in this particular journey. But a lot of the experience of living with and managing this stuff is the day to day mental grunt work. Looking after yourself. Recognising triggers and identifying negative thoughts. I’ve been doing a lot of that too.

I love a metaphor when it comes to managing my mental health.  Metaphor helps me identify Mix tapesand pin down my experiences. This is a step towards understanding and managing them. It helps me regain perspective and use the language of shared experience to transfer and talk about some pretty intangible feelings.

Over the last few months I’ve found a couple of new ways of thinking about my experiences which really help day to day. The tapes and the oil painting. I’ve written about them here: The Regret Tape and the I’m Not Good Enough Mix – new metaphors and thinking tools for managing anxiety and depression.

I don’t know what’s going to happen next and I’m going to try not to beat myself up if it doesn’t go quite as planned. But I’m cautiously pleased and proud to have made it this far. The sun is shining and I’m off out with the dog (he helps a lot too). I might even treat myself to a (decaff) coffee.

P.S – An important extra

It’s worth emphasising that I spent a long time reducing my Citalopram and then Sertraline slowly in 2015. I did the withdrawal and reduction with advice from my doctor. This is a personal account of an individual experience. Mind has a lot of great info on coming off psychiatric drugs which it’s worth looking at if it’s something you are thinking about.