It has been quite the few years for perinatal mental illness. From the EastEnders postpartum psychosis Christmas storyline a few years ago that I was involved with , the UK Maternal Mental Health Awareness Week that I help to coordinate as a member of the Perinatal Mental Health Partnership ,maternal mental health are the words on everyone’s lips. Which is wonderful.
But for us mums who have suffered or are suffering, it’s on our minds all the time. Being pregnant or having a baby and feeling like a shadow of your former self, has affected women for thousands of years . It’s with us all the time and it’s with us until we recover.
I had postpartum psychosis and anxiety and all I wanted to do was recover. I had my son and fell into a dark deep pit of hell. A doom watch came over me and convinced me my baby was a mistake, I hallucinated about being buried alive and I became so ill, I could see absolutely no way out from the hell I was in. It took almost 2 months to get me the correct treatment and when I emerged from my illness, I knew I needed to use my experience to help others. And this starts with empowering mums with knowledge about their symptoms and how to get help.
Whether you are at the start of what you believe to be or have been diagnosed as having a perinatal mental illness, mid-way through, where the horror of the start may be being chipped away by a sprinkling of golden good days here and there, or nearing the end where the fog has almost cleared, you can see the brightness of life before you with your baby and a smile allows itself to come through and the relief is feeling you want to bottle up forever, you need help and support.
And there is help and support available, provided by people who know what they are talking about and who know what may help you. Everyone’s experiences are different – whether its depression , anxiety, psychosis, OCD, feeling full of sadness , feeling full of fear , feeling alone – but what makes help great is it can be adjusted to help you in your situation.
It may feel like it but you aren’t alone. And it may not feel like it, but you will get better. The whizzy medical bods who like looking at graphs and number porn say that ‘1 in 7 women in the UK will be affected by problems with their mood during pregnancy and afterwards’. All these feelings tend to be termed under the Postnatal Depression in the media etc. but they shouldn’t be – not all the feelings are related to depression. So, the medical bods put these feelings under one banner and call it the perinatal period.
I am not a doctor. I have no letters after my name that signifies I’m a medical brainbox and I can’t diagnose you. I am a mum who has recovered and thought my only way away from my feelings of utter despair was to not be here anymore. But I am. I’m here and I am well and you will be too.
So I may not have a medicalology but what I can do is point you in the direction of good, accredited, proper, real, and decent, not made on the Christmas market type sources of support that can help you.
So, ready? Have a look below and we can go through symptoms and tell you where you can get help. I promise you are going to be ok.
Overview of Perinatal Mental Illness
I feel like a sack of potatoes have been thrown at me and I can’t get up. Does it have to be a big sack of potatoes or can it be just a little one? What do I do?
Whether your symptoms are classed as mild, moderate or severe, if they are making you feel bad then it’s bad and you need help. From one end of the spectrum of feeling low, you don’t need to be psychotic to deserve help. I see lots of women say ‘but I didn’t think I was ill enough’. You’re ill enough if it’s affecting your life. Whether it’s made you feel teary at the exhaustion of being woken up 27 times a night or hallucinate that your baby is God, (or like me, make you take your clothes off and run into the road while clinging to your hubbys ankles), you are woman and you need to roar. Roar that you need and deserve help. And if you feel you cant, hopefully some of the things in this post will help you take that brave first step.
Perinatal mental health support in medical terms is a bit of a postcode lottery. In one place you might have an amazing dedicated team who fall asleep with the NICE guidelines on mental illness after a baby on their pillow and have a Mary Poppins handbag of amazing treatments to help you. In another place, you might find yourself in front of GP who doesn’t look at you when you pluck up the courage to go and see them and thinks Postnatal Depression is a modern day concoction of middle class mummies who want to have it all but can’t. And then you may find an online doctor who has bought their degree via the University of Google, will only give you treatment options if you buy their book and who suggest a dab of apple cider vinegar on your temples will ease the anxiety away. Avoid these people, stick with malt vinegar and only use it to make your chips taste nice.
Someone once messaged me to say the reason I got ill was because I ate bread. I was unaware eating a product made out of flour, yeast and water and baked in the oven could make me hallucinate , run down the road with no clothes on and fill the garden with juice extractors. Because it’s not true. And I follow a low carb diet, so I seriously doubt a multi seeded sandwich roll resulted in me ending up in a psychiatric unit.So please continue to eat your cheese sandwiches – you have had a baby and need energy to not only look after them , but you as well. Because you being well is important.
For details on mental health in pregnancy and after birth and the symptoms and signs of perinatal mental health problems, please have a look at the links I post throughout . These are proper medical pages and will give you good info.
For a good overview of Perinatal Mental Illness, the NHS website below is good and isn’t overwhelming. Maybe bookmark it on your phone: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/mental-health-problems-pregnant.aspx
The Baby Blues
Ok. So , you come home from hospital and alongside having a sore fandango, wearing a lilo in your pants to soak up your postpartum bleeding and being unable to do a poo for fear of your stitches coming apart, you also feel a little bit sad, weepy and very very tired. Doctors tend to call this initial feeling the Baby Blues.
The Association Of Postnatal Illness say that ‘after the birth of a baby about half of all mothers suffer a period of mild depression called the blues’ and Babycentre say 8 out of 10! In normal terms – this means most mums then. And most mums I know have experienced teariness, exhaustion, and feelings of being overwhelmed, but these feelings pass very quickly and usually need no medical support.
Symptoms of the Blues are :
– Emotional and upset when they have the blues and they cry for no particular reason.
– Tired and lethargic
– Anxious and Tense
– Difficulty sleeping
Why do I feel like this you wonder ? Apparently its bloody hormones. GRR to them. Your body has just produced a baby and it all goes a bit haywire and your hormones start arguing with each other and have a minor falling out. Your boobs are filling with milk and your lovely home is now filled with a crying baby and cards are arriving and you can’t wee without it burning and it’s all just tooooo much.
But….this particular falling out doesn’t last and your hormones sign a peace agreement. The medical wonders say if you have the blues, these feelings may last for a few hours or, at most, for a few days and then they disappear and don’t need to be worried about. If they last longer than this though, seek medical help as it could mean something more serious is happening. Have a look at this link from the Association of Postnatal Illness for more information on the baby blues.
Antenatal/Prenatal Depression and Anxiety
As the super helpful NCT website says, antenatal depression can rear its ugly head while you are pregnant. Said baby is still in womb, giving you piles. You could have just found out you are pregnant and instead of feeling like those mums on Facebook who post a pic of their wee stained stick with the words ‘2 weeks pregnant’ while jumping up and down for joy with flowers round their head , you think jeepers, this does not make me feel spritely at all.
Or you could sail through said pregnancy, get to 7 month and suddenly get walloped in the head by the depression dodge ball which you haven’t dodged at all. It’s knocked you down and you find it hard and almost impossible to get-up.
This is a real illness. Don’t feel shame because being pregnant is tinged with sadness – antenatal depression and anxiety are becoming recognized and your GP can help. NCT have produced this simple webpage for more information.
Birth Trauma and PTSD
Giving birth can be traumatic but our antenatal classes con us into thinking if we master how to give birth on a bed made out of tofu and meditate ourselves into an orgasmic state, then we will simply feel like we are giving birth to a raindrop, hum the pain away and spend the next 20 years talking about how you could give birth every day. Which is beautiful.
But for some, birth isn’t that straightforward and can be a terrifying, anxiety inducing experience which leaves a big emotional mark on the mum. The Birth Trauma Association say that ‘when we talk of birth trauma, we mean Post Traumatic Stress Disorder (PTSD) that occurs after childbirth. We also include those women who may not meet the clinical criteria for PTSD but who have some of the symptoms of the disorder’.
The BTA outline characteristic features of PTSD as including:
– An experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby).
-A response of intense fear, helplessness or horror to that experience.
-The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. The individual will usually feel distressed, anxious or panicky when exposed to things which remind them of the event.
-Avoidance of anything that reminds them of the trauma. This can include talking about it, although sometimes women may go through a stage of talking of their traumatic experience a lot so that it obsesses them at times.
-Bad memories and the need to avoid any reminders of the trauma, will often result in difficulties with sleeping and concentrating. Sufferers may also feel angry, irritable and be hyper vigilant (feel jumpy or on their guard all the time).
Birth Trauma / PTSD is very real. Giving birth isn’t a bed of roses and can be an upsetting and difficult experience and you shouldn’t feel any shame if you are experiencing it. It can put women off having more much wanted children and that’s a horrible feeling to experience.
The BTA have a really helpful link on how and why you should access support here http://www.birthtraumaassociation.org.uk/help.htm
For more information see http://www.birthtraumaassociation.org.uk/default.asp
Sometimes people call this Maternal OCD. You don’t hear much about this but you should – it’s not as rare as people think and can be distressing. The RCpsych page has piles of very good info so please take a look but as a quick view, RCpsych say the main symptoms are as follows:
INTRUSIVE THOUGHTS. I have put this in big old letters as these thoughts plague LOADS OF MUMS BUT NO ONE TALKS ABOUT THEM. These are basically thoughts or images that keep coming into your mind. These are sometimes called obsessions by docs. They can be very upsetting and you can visualize things you don’t want to see. These are more common than people realize and when I spoke of mine, I found others had them also. Remember, however distressing the thoughts or visions, please don’t hold back from telling medical professionals about them. To treat you properly, they need to know your thoughts and feelings. And I guarantee, you won’t be the first to talk about these kind of symptoms to them.
So – let’s talk about intrusive thoughts. This may be triggering, so if you need to stop reading, stop. This blog is for info to help you but if you feel like you can’t read anymore, then put your phone down and stop reading. You can always come back to this when you feel ready.
Ever had that feeling, as you are stood waiting for the 17.58 train to Brighton, eating a Mars bar and reading about how to contour your cheeks like Kim Kardashian, that you want to jump in front of a train as it zooms past? Yep? And you think, that’s a bit weird, of course I won’t jump in front of the train, and you finish said mars bar and the thought leaves your brain in a second.
When I was younger, I had thoughts of grabbing scissors and hacking my hair off. If I HAD DONE, I WOULD HAVE CRIED FOR 27 YEARS, but I found it hard to shake the feelings. I once chucked the scissors up in the air to put them on top of the cupboard but they just fell down on my head and then I got my husband to put them away as I was convinced if I had them, I would perform a bob on myself reminiscent of a 3 year old cutting out shapes – one side short, the other down to my knees and a fringe that is half way up my head performing the conga.
Well, imagine having these thoughts all the time. About your baby. ARGH. Scary isn’t it?
When you are pregnant, people throw advice at you. Your mum says she fed you on a concoction of evaporated milk and strained prunes when you announce you will be breastfeeding, your auntie says she put your cousin, in her pram, down the bottom of the garden with a fly net over her so she didn’t eat them as she screamed and the random lady in Costa tells you that you shouldn’t be eating a caramel shortbread if you want to have a boy. No one tells you however, that when you give birth, it is possible that your mind can fill with terrifying thoughts that will cover you like a black cloak and refuse to go.
I know of one woman who developed a deep fear of batteries being near her baby. She could not stop the thoughts of them exploding near her baby’s face and so she went around the house and took the batteries out of everything. Her mind was filled with horrible thoughts of her baby’s face being burned by batteries and this impacted on her life in so many ways – she didn’t accept toys from well-wishers that were battery operated, the remote controls were rendered useless and clocks stood at a standstill around the house. Her husband told her it was complete and utter madness to march around the house opening up radios and emptying batteries into the outside bin and her mother in law told everyone her grandsons mother wasn’t right in the head. How nice.
Some mums have visions of hurting their baby and refuse to pick up knives or go in the kitchen. They visualise dropping the baby on its head so avoid holding their baby.
The one that NO ONE DARES TO MENTION are the thoughts of a sexual nature. Mums I have supported or spoken to who have had these thoughts are deeply deeply distressed by them and absolutely won’t tell a health care professional about them – with the fear of their baby being removed from them and them being labelled a paedophile and put on the sex offenders register. They have told me that the thoughts just pop into their brain like a poison that won’t go away and totally grips them. They say they would sit in fear, unable to move with thoughts of “what if I actually do what is seeping through my brain? Am I actually capable of this? The fact that these awful awful thoughts and images won’t go is terrifying and disgusting me” and it makes them want to avoid their baby. They say they think , this is my baby, I love them and I want to protect them from any harm and I am thinking these thoughts , these thoughts of harming them in the worst possible way myself ? Does this mean I am going to do it? Should I even be here as their mummy? Should I go and take them out of the way of my harmful thoughts?
One mum told me she would have flashes of thoughts throughout the day, so much so, that she didn’t want to pick her baby up or change its nappy. She would say, why can’t I just be a normal mum? They make me think that I am evil and disgusting
These are deeply deeply distressing thoughts but I need to say this very clearly:
Thoughts of harming your baby do not mean in any way that you want to do this or will do. Quite the opposite in fact.
The charity Maternal OCD (who are absolutely utterly BRILLIANT) says ‘obsessions can be focused on anything from germs to symmetry. When OCD presents itself during motherhood, the responsibilities for the life and well-being of a helpless infant may be experienced as a chronic stress’ and lists some symptoms as :
– Fear of contamination to the mother, child or anyone in contact with the child e.g. perceived risk of HIV, food poisoning
– intrusive thoughts of stabbing/hurting /dropping /touching the newborn baby
– Doubts that harm could come to child e.g. bottle steriliser not working
– Perfectionism e.g. everything around the house has to be a certain way
2) Anxiety – usually as a result of the thoughts. Then, thoughts or actions you keep repeating to try to reduce your anxiety. These are called compulsions.
The charity Maternal OCD says that ‘to try and eradicate the anxiety attached to the obsessions, mothers with OCD will act out rituals to ensure their child is safe and no harm will come to them. In fact, this makes the OCD worsen. Although the anxiety attached to the obsession reduces short-term it returns stronger and stronger. This means that potentially the mother is acting out rituals for a significant amount of her day’.
They list some examples of these below:
– Hyper vigilance when meeting new people or going to public toilets, this will include avoidance of touching other people, planning a day out around toilet breaks and using excessive wet wipes and hand sanitisers
– Hiding anything sharp around the house
– Constantly checking the gas is turned off, the petrol pump is working correctly
– Waking earlier than necessary and going to bed later than necessary to ensure the house is ‘just so’
– Constant reassurance seeking from friends, family members and maybe health professionals that the child is unharmed.
If you experience any of the symptoms, please tell your doctor. There is a great article at http://bjgp.org/content/67/661/376tes which informs health care professionals on how to normalise intrusive thoughts for concerned parents. It states:
Intrusive thoughts or images of causing harm to one’s infant are common in the general population.
Experiencing the intrusive thoughts makes them no more likely to harm their infant intentionally than any other parent is to harm their own infant intentionally.
There is no need to avoid triggers or situations that give rise to the intrusive thoughts or images. Avoiding them actually tends to increase the frequency of the thoughts and it also advises that “Intrusive thoughts of harming one’s baby are common among clinical and non-clinical samples alike. However, they may become more distressing and harder to cope with in mothers who are suffering from mental health problems. Such thoughts can be elicited through careful and sensitive questioning (especially emphasising to parents that these are common and do not mean that they will act on them).
Once parents are able to acknowledge and talk about these thoughts and appreciate that experiencing them is very common, they often diminish in significance and frequency. Where they persist, treatment for intrusive thoughts is available using standard cognitive behavioural techniques.”
So please take this as reassurance that it’s okay to open up to your doctor about your feelings.And this is what you need to remember. Having these thoughts does not mean you will act on them. There are lots of treatments, from CBT to medications to support you through to recovery and help to minimise the thoughts. Maternal OCD have a whole page dedicated to treatment options and emphasizes how these symptoms are very treatable – http://maternalocd.org/about-perinatal-ocd/ .
Maternal OCD also have a great page on how to access help if you have Perinatal OCD and details both professional and peer support – please take a look http://maternalocd.org/finding-help/ .
You aren’t alone with these thoughts and there is help to get you through what is a very distressing time.
Some extra info pages on Perinatal OCD are below.
When we ran the 2nd annual UK Maternal Mental Health Awareness Week in May 2018, we asked the charity Maternal OCD to run a Facebook live session to talk about the illness, how to get help and to answer questions live from mums and health care professionals. They did and it was an incredibly gentle and insightful session. The session was delivered by Maria Bavetta who runs the charity and has lived experience and a psychiatrist and the recording is below . It’s been viewed nearly 5000 times and feedback from mums has been that it’s a really useful session.
Health Care Professionals – you may also find this useful to watch as a training tool and for guidance on how to support mums who present symptoms of Maternal OCD.
It’s here https://www.facebook.com/PerinatalMHPartnershipUK/videos/762568750601030/
Postnatal Depression and Anxiety
Everyone knows the term Postnatal Depression or PND as its more commonly referred to but even though the term is known about, mums feel a real sense of shame when admitting they think they are suffering. You don’t need to feel shame – motherhood is no picnic in those early days.
As a mum ,you may have just pushed a melon sized person out of your nether regions or had major surgery to evict them from your tummy, you can’t wee for fear of bursting your stitches , you can’t sit down because your stitches appear to have been too thoroughly done by what appears to be the local seamstress, if you have had a c section, it feel like you are going to break in half at any point, a river of blood is gushing out of you for 6 weeks, your boobs look like they have won the golden ticket to the playboy mansion , great auntie Vera wants to come and stay and help out for the first 3 weeks which is worse than the devil coming over to play with fire in the garden and your baby appears to have laughed in the face of evolution and doesn’t ever sleep. People say oh it’s the best thing ever isn’t it and you’re standing there with sick down your top and someone else’s poo under your fingernails and you think what the dickens , I feel awful. I feel like crying. FOREVER.
Symptoms and feelings like those listed below may go quickly like the baby blues, which I talked about earlier. But if they carry on, they could be leading to postnatal depression or anxiety.What you must remember though throughout all of this is – you are a good mum, a lovely person, a god damn warrior. Social Services won’t swoop your baby away and thinking distressing things doesn’t mean you will act on them. You are going through a hard time and you can’t just snap out of it. At the moment you are in a hole but you will get out of it.
You aren’t awful. Don’t feel ashamed. You are a good mum.
I thought I wanted the baby to live next door and was using up three rolls of toilet paper a day because was am crying so much. Oh god, the tears. They started when my parents dropped us home from the hospital, I clad in DVT socks with legs the size of a squeezable orange carton and the realisation hit me that this baby was here forever and I was in charge of it forever. And the tears then didn’t stop for the next 7 weeks. Wahhhhh . This was a big first indicator that I wasn’t revelling in motherhood.
As the RCpsych pages say, PND or anxiety symptoms can look like these:
Unable to enjoy anything
Loss of interest in sex
Negative and guilty thoughts
You might think that you are not a good mother or that your baby doesn’t love you
You may feel guilty for feeling like this or that this is your fault -You may lose your confidence
You might think you can’t cope with things.
Anxiety can be awful after having a baby. For me , the symptoms were at times worse than my Psychosis. I had a deep fear of my baby and the thought that he was now here forever filled me with such fear, that I felt like I was in a constant panic attack.
My doctor asked me if I felt like I wanted to flush the baby down the toilet – she could have phrased it a tad better but I was just very scared of him. I couldn’t dump him like a boyfriend I suddenly stopped liking and I couldn’t sell him like a flat that I had got bored with – he was here forever now and the fear of that consumed me . But my symptoms are only one experience.
Some anxiety symptoms are below – these again are taken from the RCpsych website.
You may feel like:
Your baby is very ill
Your baby is not putting on enough weight
Your baby is crying too much and you can’t settle him/her
Your baby is too quiet and might have stopped breathing
You have a physical illness
You will never get better
You may feel like you won’t ever not feel like this -You may be so worried that you are afraid to be left alone with your baby.
When you feel anxious, you may have some of the following:
Fear that you may have a heart attack or collapse.
Action on Postpartum Psychosis says that ‘Postpartum Psychosis (PP) is a severe, but treatable, form of mental illness that occurs after having a baby. It can happen ‘out of the blue’ to women without previous experience of mental illness. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk. PP normally begins in the first few days to weeks after childbirth. It can get worse very quickly and should always be treated as a medical emergency. Most women need to be treated with medication and admitted to hospital’.
I was one of those women .You may have heard of this illness for the first time since the soap EastEnders featured it as a major storyline. The charity Mind worked with the BBC to get the portrayal of the illness right, as did APP and myself and another mum, Kathryn Grant, been acted as consultants to the storyline and met with the researchers and actors to discuss our experience.
It is a scary illness – lots of varying symptoms as shown below – for me, I felt very scared of ‘something’. I hallucinated that I was floating and thought the sky was able to be ripped apart. I was terrified of being in the same room as my son and had bright flashes in front of my eyes. Again though, these are my symptoms. My friend spent a day thinking she was the President of North Korea which was terrifying enough in itself.
As they are the very best source of info on PP, here is APP’s list of symptoms: There are a large variety of symptoms that women with PP can experience. Women may be:
– Excited, elated, or ‘high’. -Depressed, anxious, or confused / excessively irritable or changeable in mood.
Postpartum Psychosis includes one or more of the following:
-Strange beliefs that could not be true (delusions). -Hearing, seeing, feeling or smelling things that are not there (hallucinations). -High mood with loss of touch with reality (mania). -Severe confusion.
These are also common symptoms:
-Being more talkative, sociable, on the phone an excessive amount. -Having a very busy mind or racing thoughts. -Feeling very energetic and like ‘super-mum’ or agitated and restless. -Having trouble sleeping, or not feeling the need to sleep. -Behaving in a way that is out of character or out of control. -Feeling paranoid or suspicious of people’s motives. -Feeling that things are connected in special ways or that stories on the TV or radio have special personal meaning. -Feeling that the baby is connected to God or the Devil in some way.
Treatment for PP
PP is classed as a medical emergency and if you suspect you have it or your wife, partner, daughter, sister or friend may have it, you need to take her to a GP or hospital. Mums and little’s are often treated together in specialist psychiatric mother and baby units so to avoid the separation of mother and baby, wherever possible, by joint admission. I went into a mother and baby unit. It was fab.My bed wasn’t chained to the wall and I wasn’t made to wear a straitjacket while watching the TV. It was safe, calm, warm and purposeful and it started my recovery.
I’ve written about my experience in the unit here which I hope you will take some comfort in https://smalltimemum1.wordpress.com/2015/11/22/i-need-a-bed-of-strawberry-creams-in-a-place-of-recovery-dreams/ .
Once discharged, the local specialized Perinatal Outreach and Community Psychiatric Team visited me every day at home. Don’t be scared if you need to go into a mother and baby unit or see a perinatal team at home. They are great and will help you get better x
See http://www.app-network.org/ for more info.
Again, during the 2nd UK Maternal Mental Health Awareness Week in May 2018, we asked APP to run a Facebook live session to outline the symptoms of Postpartum Psychosis . Two healthcare professionals and a mum with lived experience led the chat and it has had more than 6000 views. Again, Health Care Professionals may also find this useful. Link is here https://www.facebook.com/PerinatalMHPartnershipUK/videos/764093897115182/ .
When you are feeling in such a way as described, suicidal thoughts may come into your head. It is very important here that if you feel like you are going to hurt or harm yourself and or attempt to take your life, you need to see a doctor right that very instant. Health Care Professionals are trained to deal with crisis situations.
Its ok to call the GP urgently and say you need to see a doctor and tell them why – It’s ok to go to casualty and tell them you are having these kinds of thoughts. You aren’t wasting their time. It’s ok to call your local mental health crisis team. If you don’t know their details, google crisis team and the area you live in and a number should come up.
All these things are more than ok – they are essential. You need and deserve help. You can and will get better. You deserve to be alive. People want and need you to be alive. You are a good person and you aren’t well. I reached the depths where I thought suicide was the only way out as I couldn’t see beyond my illness but there are services, medications, support networks that can help you recover and find your happy again.
If you are feeling like death is the only way out, you need urgent help. GP, Casualty, 999. Contact them.
The NHS has a very helpful page specifically for people who are experiencing suicidal thoughts. Take a look if you need to:
I want to get better from my perinatal mental illness – what should I do?
For all of the things listed above, it’s super important to seek help. There are lots of ways of doing this.
– Contact your midwife, doctor or health visitor and tell them you are worried that you may have a problem with your feelings during your pregnancy or after the baby is born. Perinatal means up to 12 months after your baby is born so even if your child isn’t a gurgling little baba anymore, doesn’t mean you can’t be suffering!
-Doctors are used to seeing mums with these symptoms. Most docs are fab, some, as is life, not so much so. Ask the receptionist who is nice, who has a kind ear and who won’t stare at a computer screen while you are with them. If it’s too much to say in person, write it down and pass it to the receptionist if you can.
– If you see a doctor as they are as useful as a chocolate condom, then book an appointment to see another doctor. You can see 7865 doctors if need be. You deserve to be listened to.
– If you are a friend or relative of the person who is unwell, you may have to encourage them to make the appointment and go with them as they may not be aware of, or believe that there is a problem.
Accessing help from Health Care Professionals
It’s really hard to open up to a doctor or health visitor about how you are feeling .So , if you haven’t yet told your doctor about your feelings since having your baby, this may be useful for you.
The Smile Group have this great checklist you can complete and bring to the doctor should you not know what to say or how to say how you are feeling http://www.thesmilegroup.org/help-from-the-professionals/
Dr Stephanie De Giorgio is a GP who suffered from PND herself. During the 2nd annual UK Maternal Mental Health Awareness Week in May 2018, she ran an FB live session to tell people its okay to open up to their doctor, even if they have intrusive thoughts. Please take a look – it’s an incredibly useful session and Stephanie opens up about her own experience and shows you aren’t alone.
Health Care Professionals– please watch this. PLEASE. The Royal College Of GPs always sends out tweets asking doctors to always check on mums and their emotions and I can’t express this enough. If you are unsure how to help when a mum says she is suffering, have a watch and you will get some tips.
It’s here – https://www.facebook.com/PerinatalMHPartnershipUK/videos/763409700516935/
The Perinatal Mental Health Toolkit – http://www.rcgp.org.uk/clinical-and-research/toolkits/perinatal-mental-health-toolkit.aspx is a clinical resource for health care professionals to help them support unwell mums. However, it’s also a great resource for anyone but if you look after women and are a HCP , please use it.
Perinatal Guidelines in practice – https://www.guidelinesinpractice.co.uk/mental-health/practical-implementation-tips-perinatal-mental-health-problems/453729.article Dr Stephanie, who was referenced earlier, has produced these guidelines to support healthcare professionals when diagnosing an unwell mum. This again is a useful resource for anyone.
As HCPS, you may also find it useful to show mums this little film called Perinatal Positivity. Perinatal Positivity uses the real voices and experiences of women and men who have had mental wellbeing difficulties around the time of pregnancy, childbirth and beyond. The people who made it hope it will help mums emotionally prepare and find support, if needed, at this time. There is a subtitled version of the film on their clips page. It’s brilliant https://perinatalpositivity.org/
I wrote this for HCPs about supporting mums with maternal mental illness https://smalltimemum1.wordpress.com/2016/09/20/a-spoon-full-of-sympathetic-sugar-really-can-help-the-medicine-go-down/
Medicated and Mighty – what will get me better?
There are many effective treatments for perinatal mental health problems such as medication, therapy and support from charities. The vast majority of women make a good recovery. This is an illness like any other and it is vital that you receive help if you need it, so do not be afraid to ask for it.
Medication – sometimes you won’t need this, sometimes you will.
I thank the medication gods – I took so much at one point I was a human maraca but I got better. I’m still on a low dose now – I see meds like that song ‘Tequila, it makes me happy’. There is no shame in needing meds – they can help the awful fog in your head clear so you can focus on recovery. If you broke your leg you would wear a cast. Wouldn’t you? You wouldn’t roll down the street attempting to not land in a pile of dog poo because you thought you could pull yourself together, think happy thoughts and leg would magically be unbroken.
The charity Mind have a fab page on medication here which you may find useful to read http://www.mind.org.uk/information-support/drugs-and-treatments/medication/#.Vsbx1ErfWrU .
Breastfeeding and Medication
If you are breastfeeding but need meds, that’s ok. There are lots of medications you can take while nursing. I was on anti-psychotics and anti-anxiety meds that were compatible with feeding and if you are wondering what meds are ok, or your GP isn’t sure, then the person to contact is Wendy Jones. Wendy is lovely. And super helpful.
During the 2nd annual UK Maternal Mental Health Awareness Week, one of the main messages we wanted to give mums and families was to empower them with information on how to access support to help their recovery from maternal mental illness.
As one of the main areas of concern from mums is if they can take antidepressants if they are breastfeeding, so we made this little video with the help of Wendy ,which gives info on what anti-depressants you can take whilst nursing. It’s very good and informative and has helped over 15,000 mums!
Also, Wendy’s webpage is below and there is a tab with her contact details. If you are feeling too anxious to talk to Wendy, she is happy for you to send an email.
Health Care Professionals – I beg you – please stop telling mums that in order to take any anti depressants, they have to stop breastfeeding. Please watch Wendy’s session, look at the Perinatal Mental Health Toolkit and look at these factsheets from the Breastfeeding Network which simply set out which anti depressants are suitable when breastfeeding https://www.breastfeedingnetwork.org.uk/drugs-factsheets/ .
Let’s talk – therapy!
You don’t have to be a millionaire to go therapy and you don’t have to lay back on a sofa while someone with a clipboard nods while you are in a puddle of tears. Therapy is amaze balls. It can get to the root of why you are feeling the way you are and then help you develop coping strategies. I had CBT and EMDR therapy – which sounds ridiculous. – I had to follow a flashing light around the room to get over my trauma but it god damn worked. There are loads of different types of therapy so if offered to you, give it a whirl.
Again, the charity Mind have a great website on therapy http://www.mind.org.uk/information-support/drugs-and-treatments/talking-treatments/types-of-talking-treatments/#.Vsbz20rfWrU
I wrote a blog on treatment options last year. Take a look https://smalltimemum1.wordpress.com/2015/02/26/tear-up-those-anti-depressant-prescriptions-all-you-need-to-do-is-climb-into-a-magicians-hatnudge-the-rabbit-out-of-the-way-and-abracadabra-youre-cured-in-a-puff-of-pull-yourself-together-smo/
Sources of further help
Maternal OCD http://www.maternalocd.org/ : A charity set up by mothers recovered from perinatal OCD, who can provide support via email, twitter and Skype. For further details please contact: firstname.lastname@example.org
OCD Action http://www.ocdaction.org.uk/ : A charity providing a dedicated OCD helpline, email support and advocacy service. Contact details: 0845 3906232; email: email@example.com
Association for Postnatal Illness http://apni.org/ The UK’s leading PND charity provides telephone helpline, information leaflets and a network of trained volunteers who have themselves experienced PND. Helpline: 020 7386 0868.
APP http://www.app-network.org Association of Postpartum Psychosis offers support to those suffering Postpartum Psychosis and their families. APP are the specialists in this illness and for correct advice, please contact them. They also run a peer support forum.
Depression Alliance http://www.depressionalliance.org/ Tel: 020 7407 7584; email: firstname.lastname@example.org Information, support and understanding for people who suffer with depression, and for relatives who want to help. Self-help groups, information, and raising awareness.
Home Start http://www.home-start.org.uk/ Tel: 0800 068 6368. Support and practical help for families with at least one child under-5. Help offered to parents finding it hard to cope for many reasons. These include PND or other mental illness, isolation, bereavement, illness of parent or child.
National Childbirth Trust http://www.nct.org.uk Helpline: 0300 330 0700. Support and information on all aspects of pregnancy, birth and early parenthood. Local groups and telephone helplines.
MAMA – The “Meet A Mum Association” http://www.mama.co.uk Created to try and help thousands of mothers who feel out of their depth, depressed or a little isolated when their babies are born Helpline 0845 120 3746
The Samaritans http://www.samaritans.org/ 24-hour helpline 08457 90 90 90 (UK) or 116 123 (Ireland); Email: email@example.com. Confidential emotional support for those in distress who are experiencing feelings of distress or despair, including suicidal thoughts.
Tommys http://www.tommys.org Tommy’s pregnancy information service provides information and resources about mental health in pregnancy.
Tommys Midwifery-led pregnancy line http://www.tommys.org/mentalhealth is available for anyone worried about their mental health in pregnancy, or that of another (0800 0147 800).
Birth Trauma Association http://http//www.birthtraumaassociation.org.uk/ supports all women who have had a traumatic birth experience. It is estimated that, in the UK alone, this may result in 10,000 women a year developing Post Traumatic Stress Disorder (PTSD).They offer emotional and practical support to women and also their families. They can offer email support to mums suffering, for more information please see this link http://www.birthtraumaassociation.org.uk/support.htm .
Mums Aid http://mums-aid.org provides inclusive and accessible psychological therapies for mothers experiencing a broad spectrum of emotional and mental health difficulties during pregnancy or postnatally.
Black Thrive was created was to help change the stigmatism that exists surrounding mental health in the black community. They would like every person and family dealing with mental health to know they are not alone. Black Thrive is there for them https://www.blackthrive.org.uk/Family-support
The Asian Mums Network offer some great pages on Maternal Mental Health and these linked through here https://asianmumsnetwork.co.uk
JAMI – The Jewish Association for Mental Health https://jamiuk.org/
The Muslim Bereavement support network can offer advice to mothers who have lost a child http://mbss.org.uk/losing-a-child/
Praxis run support groups for migrant mums and their babies http://www.praxis.org.uk/volunteer-page-24.html
Channel Mum is an online community for mums https://www.channelmum.com
mumsmeetup.com connects mums locally and across the UK and mums are able to search their county and locality to find mums similar by age, age of child and circumstances (such as mums to be, working mums, single parent mums & more). Also, mums of children with disabilities are able to search by similar conditions and location.
Mumsnet – https:/mumsnet.com makes paremts life easier by pooling knowledge and advice.
Netmums – https:/netmums.com offers parenting advice , chat and support. Netmumsalso have a parent supporter network offering free online support and advice. https://www.netmums.com/support/netmums-parent-supporters .
Single Parent Helpline: 0808 802 0925
Young Mums Support Network – https://ymsn.co.uk
Pink Parents – pinkparents.org.uk offer a range of support services and social activities for all Lesbian, Gay, Bisexual and Transsexual families.
Tamba – the twins and multiple births association offer support for parents https://www.tamba.org.uk/support-menu
Pregnancy Sickness Support https://www.pregnancysicknesssupport.org.uk/ offers support to mums struggling with pregnancy sickness/ Hyperemesis. They have a national support network for women suffering any degree of nausea and vomiting in pregnancy to access support and comfort at times of isolation and distress https://www.pregnancysicknesssupport.org.uk/help/supporters-network/ .
Information and support for anyone affected by miscarriage.
Telephone: 01924 200799
Postnatal Depression Ireland http://www.pnd.ie
Moment Health http://www.momenthealth.io/ has a wealth on info on maternal mental illness including an emotions tracker.
The Every Mum Movement http://everymummovement.com/ contains information for mums on the illnesses, mum meet ups and how to ‘be mentally buff’.
Perinatal Mental Health Partnership https://www.facebook.com/PerinatalMHPartnershipUK/ . This is the group I am part of and you can follow us for information on the UK Maternal Mental Health Awareness Week.
Mind – Mental Health Charity http://www.mind.org.uk
Sane – Mental Health Charity http://www.sane.org.uk
Rethink – Mental Health Charity https://www.rethink.org
Bipolar UK – Mental Health Charity https://www.bipolaruk.org
Best Beginnings – https://www.bestbeginnings.org.uk/
Maternal Mental Health Alliance – https://maternalmentalhealthalliance.org/ . The Maternal Mental Health Alliance (MMHA) is a coalition of UK organisations with a vision to see all women across the UK get consistent, accessible and quality care and support for their mental health during pregnancy and in the year after giving birth.
International Help – Postpartum Support International http://www.postpartum.net/get-help/locations/international/
Peer support and support groups
Peer support can be incredible – talking to someone who has been through what you’re going through and got better can give you real hope. However, do check that if you are going to a peer support group, that they are properly safeguarded with trained staff and volunteers, who have access to clinical supervision and support for themselves. Support leaders can have peer supporter training, Mental Health First Aid qualifications an example.
Please don’t attend support groups being run by mums who are still unwell. It’s not safe. The groups below are a snapshot of what is available across the UK .
Perinatal Mental Illness Peer Support Group – if you would like to join a Facebook support group for perinatal illness, this group may be useful to you. Part of an international group of around 15 support groups across the world, this is the UK and International group. The admin have Mental Health First Aid training and are recovered mums themselves https://www.facebook.com/groups/1732740973652517/
The Motherload – If you would like to join a mums group on Facebook to be amongst supportive non-judgemental mums, then The Motherload could be beneficial https://www.facebook.com/groups/wearethemotherload/
Association for Postnatal Illness- http://apni.org and helpline 020 7386 0868. Provides telephone helpline, information leaflets and a network of volunteers who have themselves experienced PND.
Cocoon Family Support http://cocoonfamilysupport.org/ . The fantabulous Cocoon Family support is a London based charity. It supports those affected by postnatal depression, and mothers who are struggling to deal with difficult emotions before and after birth. They provide a safe and supportive environment where families can get together with others who may be feeling similar to themselves. They also provide a range of services to aid and support recovery. They are based in SE1, NW1, NW3 and NW6 and can be accessed by people across London and its borders.
The Smile Group http://www.thesmilegroup.org/ . The SMILE Group was co-founded by Natalie Nuttall and Ruth Eglin in 2011 after they both experienced PND and felt passionate about the need for parents to benefit from sustained peer support at a local level. They run support groups each week for mums in Cheshire East.
Macclesfield – every Friday, 10am to 12pm Congleton – every Wednesday, 10am to 12pm
Raindrops to Rainbows http://www.raindropstorainbows.co.uk . Run by the lovely Steph who is trained to provide support and advice, R2R provide peer support to mums to be and mums in the North East. They currently have five groups covering Teeside, County Durham and South Tyneside areas. The website has full details and there is a Facebook page.
Open House Nottingham http://openhouse-notts.org/ . Open House (OH) was founded by a group fab Mums in early 2012 with the aim of supporting those who are or have been affected by any psychological and emotional condition which has developed during pregnancy or during the postnatal period. These include antenatal depression, postnatal depression, anxiety & OCD. They run drop in groups in Nottingham and details are here http://openhouse-notts.org/our-drop-in-groups/ .
Lotus Petal PND https://www.facebook.com/LotusPetalPND/ Support group run every other Monday 9.30-11am at Little Lions Children Centre in Essex. Run by Sarah, who is the nicest lady in the world, she welcomes any mum in Essex needing support. Contact details are on the Facebook page.
Juno Perinatal Mental Health Support http://www.juno.uk.com/ Juno Perinatal Mental Health Support was founded in February 2015 by a group of mums in Edinburgh who all have personal experience of perinatal mental health difficulties. They are kind, lovely women. They support mums through Weekly peer support groups across the city where we offer advice and information One-to-one befriending through our outreach program Access a subsidised counselling service out with our groups with a trained professional. They run four groups and details are here http://www.juno.uk.com/our-groups/
Bluebell Care http://www.bluebellcare.org/ Bluebell is a charity based in Bristol supporting mums, dads and families who are affected by antenatal or post-natal depression. They run regular, free groups Mums’ Comfort Zone, together with free creche provision, in South, North and Central/East Bristol. They prioritise the support we are able to provide (due to funding constraints) as follows: young parents from the Hartcliffe/Withywood/Bishopsworth area in South Bristol, parents from the Henbury/Brentry area in North Bristol and parents from St Pauls, Easton, Montpelier’ and Stokes Croft area in Central/East Bristol.
They also offer 1:1, informal, support via the Bluebell Buddy who can arrange to visit mums at home and/or in their local area for a cuppa and a chat. Dads can also access support through their Dads’ Zone group.
If you would like more information on their services please contact the lovely Ruth Jackson Telephone 07738628842 or Email firstname.lastname@example.org
House of Light http://www.pndsupport.co.uk/ Offering hope and support for women affected by Postnatal, Antenatal Depression & Anxiety in Hull. Call: 0800 043 2031 or01482 580499 text: 07854 220790 email: email@example.com
Mothers for Mothers http://www.mothersformothers.co.uk/links.html Support Group for mums in Bristol suffering from PND. Helpline details are here http://www.mothersformothers.co.uk/contact-us.html .
Homestart Bedfordshire http://www.home-startcentralbeds.org.uk/postnatal-depression-in-bedfordshire/ Home-Start Central Bedfordshire we run numerous pnd support groups throughout Central Bedfordshire.
Acacia Family Support http://www.acacia.org.uk Provide a free wide range of support and therapies to help mums recover from the symptoms associated with pre and postnatal depression. Their services are delivered across Birmingham and they include individual befriending sessions, group work therapy, telephone support, practical support in your own home and massage therapy for parents and your baby.
Cedar House Support http://www.postnataldepression.com/ runs PND support groups in the Surrey, Sussex and South London Areas. The groups are run by trained PND Counsellors.
The Guildford Group
This group runs from 10am to midday every Wednesday, term time only starting on January 13th 2016 at Boxgrove Sure Start Children’s Centre, Boxgrove Lane, Guildford, GU1 2TD. All groups are informal, confidential and a great support for the mothers. A crèche is provided and there is parking. Please contact Liz before attending: firstname.lastname@example.org/ 07773283556.
The Balham Group
This group is at St Stephen’s Centre (next to The Weir Link Centre) Weir Road, SW12 0NU.
This group will run every Friday, term time only from 9.30 to 11.30am, a crèche is provided and there is free parking.
It is necessary to book a place for this group, please contact Liz to do so. 07773 283556, email@example.com
The Surrey Heath Group (Mytchett)
This group started on Tuesday 12th January 2016 at Mytchett Children’s Centre, Hamesmoor Road, Mytchett, GU16 6JB and runs every Tuesday term time only from 12.30 to 2.30pm. A crèche is provided and there is free parking. Please contact Liz on 07773 283556 or firstname.lastname@example.org for further details.
West Kent PND support group https://westkentmind.org.uk/what-we-offer/mums-support-group
Kyra Women’s Project http://www.kyra.org.uk/ is based in York/Selby and offers a range of support services.
If you are in the Isle Of Man , then take a look at this https://www.gefthemongoose.com/headland/maternalmentalhealth/ and support group details are here https://www.netmums.com/isle-of-man/local/view/support-groups/antenatal-postnatal-support/postnatal-depression-support-group-1
If you are in Sheffield , look up https://lightsheffield.org.uk/support/
If you are in Forth Valley Scotland , check out Aberlours Perinatal Befriending service https://www.aberlour.org.uk/services/perinatalbefriending/
NCT offer Early Days courses for new mums https://www.nct.org.uk/courses/postnatal/early-days
If you are in Guernsey,contact the Guernsey PND support network http://guernseypnd.org/ . They can be contacted via email email@example.com or you can call their confidential telephone line 01481 520657 .
Their regular coffee evening’s are held at Caritas Coffee Shop, Mill Street, St Peter Port and they have given them exclusive access so it’s very private. These are an informal way to come with or without your kids for free coffee and cake and a warm welcome. They are held quarterly on the first Monday evening of each third month from 7pm.
Merton and Wimbledon PND support groups https://www.gettingiton.org.uk/services/merton/post-natal-depression-support-group Located at: Merton Abbey Primary School, High Path, Merton, London, SW19 2JY and Patrick Doody Clinic, Pelham Road, Wimbledon, SW19 1NX and other venues.
Support groups run by a health visitor, offering the opportunity to meet other mothers who are experiencing post natal depression and share ideas on how to cope with these feelings. A home visit is offered prior to attending the group and a crèche and refreshments are provided. There are 3 groups run a year and they are held in various children’s centres across Sutton and Merton. A referral is required from health professionals or the client themselves.Telephone: 020 8254 8274/8273
Marlow women’s group – This group offers social activities to local people over the age of 18, particularly young women experiencing post-natal depression or social isolation. There is a free crèche for anyone who wants to bring their children with them.
Telephone: 01494 463 364
If you are in East Sussex, the NHS run a Perinatal support group https://www.esht.nhs.uk/leaflet/postnatal-depression-and-anxiety-support-group/
If you are in Sheerwater , Cornerhouse run a pre and postnatal support group on Mondays http://cornerhouse.cc/services/depression-support-woking-runnymede/
If you are in St Austell , UnTangled run a support group for those experiencing and affected by pre or post natal depression. Contact Cara on 07917008776 or via firstname.lastname@example.org .
In Stockport, Rose Buddies Mums and Tots Arts and Crafts Group is run by Mums for Mums struggling with low mood. Sessions are free, but they do welcome a donation towards their running costs when you can. No need to book. For info see https://www.stockport.gov.uk/groups/rose-buddies-post-natal-depression-peer-support-group
Bluebell PND Counselling Service http://www.crossreach.org.uk/bluebell-pnd-service
(Provide generic counselling and a specialist perinatal depression service. Cover central belt of Scotland)
CrossReach Perinatal Services: Lothians http://www.crossreach.org.uk/postnatal-depression-support-whole-family
(Provide postnatal depression counselling service in the Lothians)
Southside Counselling Service http://www.southsidecounsellingglasgow.co.uk/
(Counselling service covering Glasgow and surrounding areas. Provide a counselling service for women who experience pre and post natal depression.
Home-Start Glasgow North http://www.homestartglasgownorth.org.uk
(Home-Start Glasgow North is a voluntary organisation set up to increase the confidence and independence of families with at least one child under five years old who are experiencing difficulties. We are located next to Maryhill Community Centre)
Mellow Parenting http://www.mellowparenting.org/
(Mellow Parenting aim to support parents and their children in making good relationships
Birth and Beyond http://birthandbeyond.org.uk
(Provide a mentoring and counselling service for parents in Edin
Dudley – A new space for women with pre- or post-natal anxiety and depression.
Come along for a cup of tea and a chat with other mums who understan
Every 1st and 3rd Wednesday of the month, 11:00am -1:00pm, at Food for Thought, Victoria Street, Stourbridge DY8 1SP.
Please contact Tim at the Dudley Mind Head office on 01384 442938 or by email at email@example.com. http://dudleymind.org.uk/peer-support-groups/the-haven-mums-group/
Tamworth – https://www.singleparents.org.uk/organisation/tamworth-post-natal-depression-support-group
If you are in Ireland , Cuidiu parent to Parent supporters offer a listening ear to Mums who may be feeling low about being a parent or who are depressed. They have two ‘Parent Support’ coffee mornings a month in Dublin. Click here for more information on Parent Support or here for contact details of their Parent to Parent Supporters. https://www.cuidiu-ict.ie/Supports_Parenthood_PostnatalDepression
Southward support group for women who have had children removed due to care procedures http://www.together-uk.org/southwark-wellbeing-hub/the-directory/14159/mums-supportive-group/
#PNDHOUR And let’s not forget the amazing #pndhour run by the beautiful Rosey @pndandme. A weekly Twitter chat, it takes place every Wednesday between 8-9pm and a different subject relating to perinatal mental health is discussed.
Mums, currently ill or recovered, health care professionals and family members all take part to discuss experiences, share knowledge and provide hope. Join in if you can, it’s brilliant. Rosey has written a little explanation of it here http://pndandme.co.uk/pndhour-explained/. Rosey’s blog is here and it’s a fab resource on all things Perinatal http://pndandme.co.uk. Rosey’s page also has a fab tab which lists lots of brilliant blogs from those who have suffered http://pndandme.co.uk/pndfamily-help-support/ .
Am I alone? Can I read other people’s experiences?
You aren’t alone. You most definitely aren’t and there are lots of stories online from people who have written about their experiences. Remember, reading things could trigger thoughts and feelings so take care of you and only read if you feel ok to. If at any point you want to stop, then do. That’s ok.
My blog is here. I talk about being ill with psychosis and anxiety, recovery, medication and EastEnders https://smalltimemum1.wordpress.com
You will get better, you aren’t alone. You may slide up and down the snakes and ladders of the game of recovery but you will get there.