Thursday, 26 October 2017

Breaking the Silence: Perinatal Mental Health

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Guess what? I'm having a baby!

This news is unlikely to come as a shock to you, as it's highly likely you've found this post via a myriad of social media accounts where I have already been sharing this news for months. However, on the off chance you've just popped in out of the blue, here's the low down: a baby boy is currently growing in my now sizeable tummy, it's exit is scheduled for mid December and we are super excited!

This means at the time of writing this post I am 33 weeks pregnant, with just a few short (or very long if you're me) weeks to go. Now you may be thinking; "what an odd time to start writing about pregnancy! For goodness sake, it's nearly over!" And I get you, I really do, but I'm now ready to tell you why that is, so grab a cuppa (it's a long old story) and let's talk...

Yay, I'm pregnant! Now what?

I am not planning to go into any detail about my journey to having a baby, but let's just say I was flabbergasted and DELIGHTED when I found out I was finally growing a tiny human. I was speechless for the first time in my life (which my husband will happily attest to), and absolutely thrilled, but the anxiety set in almost immediately. It was super early, and I soon learned, there was a LOT of things that could go wrong.

Perinatal Mental Health

In my head, over the first twelve weeks, I convinced myself that the anxiety I was experiencing was just because I found out early, and that all would be right with the world once we made it to that elusive twelve week scan. However, there was a part of me, that just never felt quite 'right'. There was days I wouldn't leave my my bed, because I was convinced something was going wrong, and I paid for two early scans out of our own (shallow) pockets. 

Eventually, time finally ticked by and we had our twelve week scan. We had to rearrange to get a better look, but we were given the ol' thumbs up and started to share our news. I was thrilled, finally, this heavy feeling of anxiety would go away! I would not be predicting the worse, I would be OK now. I honestly think this feeling lasted until the next morning, when I suddenly was hysterical at the idea we had shared our news with the world too soon, and I would be "punished" - this is a thought I frequently have experienced throughout my pregnancy, the next few months were much of the same. I spent a lot of time in tears, and eventually my family started to really worry about me, and encouraged me to visit the doctor.

I'll be honest, I had NO IDEA where to turn with my feelings; was it the doctor? the midwife? or someone else entirely? I had been convinced by some of the people I confided in, that my anxiety was "normal" - but they weren't in my head (also, please don't ever do this to someone, always advise them to speak to the experts please!). I didn't even know what I was going through had a fantastic code name like "perinatal mental health". I had been a member of an online forum from even before my pregnancy, and they were the first to mention it! 

As a huge side-note; it's at this point, I should say that I think it is WILD that with a degree in psychology, a job in the mental health sector and my prior personal experience of mental health problems, that I was not aware of perinatal mental health issues especially given that upto to 20% of women will experience mental health problems in pregnancy.

Since experiencing it myself, I have found that there is a massive lack of information out there, which is what has prompted me to share my own experience, despite how scared I am about doing so. I so wished I could have found a personal account of perinatal mental health and so if this post can help one single person either; reach out for help, know where to find help and what to ask for or even just make them feel less alone then I will consider this post a massive success.

When I finally, couldn't function any longer, I went to the doctors, with all my symptoms and the new magical code written down, completely wracked with anxiety, and feeling like I was wasting the doc's precious time. I walked in, plonked myself down, and cried my way through my little list. Instantly, the doctor recognised that I needed help, signed me off work and referred me to the Perinatal Mental Health Team. I was so relived when I got home - I was right, I was getting a break and I was getting help! It was incredibly hard for me to sign off work, I loved my job and I didn't want to let anyone down, but the sheer relief from getting to step back was a clear sign that the break was needed, and now I was going to get some help! I'd be happy as Larry in no time...right?

Meeting the team; what does that mean?

First of all, I was sent a letter to confirm where I would like to attend (there was a choice of around six locations). I was provided with a number and I simply had to call to confirm and make an appointment. Unfortunately the first appointment available was weeks away, and I was concerned at this point about returning to work without speaking to anyone. Fortunately, I was able to get the courage to call back and explain that I really wasn't doing too well, and I would be returning to work soon, and was kindly fitted in sooner. I would encourage anyone, to do this too if you feel you can't wait. More often than not, it does produce results.

The first person I met with, was basically there to assess my needs. The perinatal mental health team encompasses many different departments (such as social services, psychology and psychiatry) and many professionals (such as social workers and CPNs). I will be honest and say I don't remember much of that day, apart from sitting down to talk about myself - past and present, and discussing the many options available. The lovely lady I met with, suggested that I be referred for CBT (Cognitive Behavioural Therapy) which was my preferred option too, given my own history of success with CBT. I was encouraged to think about medication, but I was listened to when I said "not right now, thank you".

A slightly smaller side note: I want to be super clear - I am a big advocate of medications, however I really struggled with side effects the last time I was on medication, and I didn't think I could manage them at the same time as all the "side effects" of pregnancy. There are plenty of safe medication options during pregnancy, and I would encourage anyone to consider them as an option.

After this initial meeting, I was referred to CBT with a CPN (Community Psychiatric Nurse) for an appointment which took a little while to come through, but eventually I had a time and a date and off I went. 

At the time of writing, I have been attending my appointments for several months, and have regained some of my confidence, attention and concentration. The anxiety had a huge impact on my concentration, which is why, I didn't read, or write until very recently. I missed reading a lot, and I'm grateful to be at a place where I've started reading regularly again.

So is Larry feeling happy now? 

It is always difficult to assess something when you're in the middle of it. At the time of writing, I have had a big gap in my appointments (which you may have seen me discussing on twitter), which has left me feeling a little let down. I have went six weeks between appointments, partly because I had to cancel my last appointment (I was too ill to attend thanks to a nasty cold) and partly because (unsurprisingly) there are a lot of people needing help out there, and not enough professionals to help.

I would say that things have improved for me overall, and I would still urge ANYONE that is struggling to reach out. Despite what I've mentioned above, I don't regret for a second reaching out, and knowing that someone else (the right kind of someone else) is looking out for me, and my baby. 

I'm incredibly grateful for the kindness of every single professional I've so far came into contact with and discussed my anxiety with (my midwife in particular, is wonderful, and ensured I would see her every time I went to appointments from my first appointment), and I am so appreciative of all the help I have received so far. 

I am still suffering from quite extreme anxiety, and what I suspect, is an element of OCD too. Right now, I am scared to share this post, because it is talking about my baby, and loudly, so naturally something bad will happen right? I had one of the days I couldn't leave my bed again at the weekend, it started off a small mishap, then the world starting caving in. I still refuse to go to my hospital appointments without wearing a specific necklace - it happened once that I was in a rush and I forgot, and I was obsessed with not having it all the way to the appointment. I sometimes experience panic attacks when we paint a room or build furniture, and I often have to "hide" the items we've stockpiled (such as nappies and wipes), as sometimes it can result in a panic. 

BUT (and it's a big but, just like mine) I am finding ways to manage the anxiety, to fight it and to make it just not quite as bad as it could be. Sometimes, it's not about going right back to "normal", but learning to cope, and that's what I am doing every day.

If you are you pregnant and struggling, please don't go it alone...

Confide in a friend or family member you can trust - this is important, you need someone to talk to about this stuff in-between appointments, and/or while you're waiting for your first one. If you don't have someone you can trust, consider joining a forum like Baby Centre where you can talk to other mothers in the same position. Also, please feel free to drop me an email, if you'd like to chat.

Talk to your GP and/or your midwife - If you are referred through your GP, it's good to talk to your midwife too - they are taking care of you and your baby, so it's good to have a note of it in your files, and they (should) make an extra effort to consider it.

Ask to be referred to the Perinatal Mental Health Team  - it's really helpful to know what you want before discussing it with your GP - unfortunately, not all GPs are up to date (or interested...) in mental health, so it can make the process quicker and easier for you.

Consider joining a perinatal yoga class - I didn't mention this above, but one thing I've also found incredibly useful, is Yogabellies perinatal yoga classes. These classes are incredibly gentle, keep you active but also focus on breathing techniques to keep you calm during labour (or any other time during your pregnancy), I can't recommend them enough, but any similar classes would be helpful, not just for relaxing, but for meeting other people in the same position as you!

Useful links: 

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