Why its okay to take mummy’s little helpers while bringing all your milkshake to the baby yard.

Happy pills.
Smilers.
Mommy’s little helpers.

They come in an abundance of names and have changed many a life. What what you say? I say antidepressants.

I am a big personal advocate for medication. In the midst of a Postpartum Psychosis , when I was terrified of everything and everyone, when I thought I was floating to the sky and the walls were suffocating me, when I spent 100 quid on bags of potatoes and filled the garden with juice extractors after a spree on the shopping channel at 2am, they cleared the fog so I could focus on recovery. I did all this while also having a 24 hour all you can eat milk canteen pumping on my chest.

As you may know from my other blogs, breastfeeding became important to me almost overnight. I had assumed I would mix feed my son so before he was even born, along with the 87 cans of caffeine free diet coke and value strawberry angel delights I became obsessed with, I would order those readymade cartons of formula. I just assumed I would use them. And then I gave birth, became terrified of being near my little boy, refused to look at him or be in the same room as him but felt a desperate pang to feed him myself. I do not know what it was. I found the very idea of being near him beyond comprehension. I remember the day that I ran out into the middle of the road screaming ‘I’m trapped, take me away from this world, he has trapped me’. My partner brought me back into the house, I slumped myself on the floor, crying my eyes out. My mum was there and said ‘Evelyn, what is it love, tell me how you feel, please’. I looked at her, angry and I can remember clear as day saying ‘I hate these feelings, I can’t bear it, I can’t. even.bear.to.look.at.him’. My mum started weeping and said ‘but he is so precious Evelyn. Look at him love, please, cuddle him, please love’, and I just stared at the carpet. And then he started crying. And I did what I was later to realise I always did when he did this – I picked him up , my partner held him to me and I nursed him. I found it hard to look at him but my boobs would tingle when he cried as if they ached to comfort him.

The feelings I experienced were so confusing and terrified me. I was , what was later described in therapy, grieving deeply for my old life. I felt dead, void of positive feelings towards the future and scared of the life waiting for me ahead. But I found myself needing and wanting it nurse the child I didn’t think I wanted.

The day I was hospitalised in a psychiatric mother and baby unit was when I had a sense of realisation that I wanted to not only be my sons mother and carer but I also wanted to feed him. After John had found me wandering around in a daze, I had run into his parents’ room and began crawling round the bed on all fours. I was screaming for someone to help me. John was talking on the phone to a psychiatrist and I was walking up and down the stairs over and over, talking to myself. I suddenly heard another voice. A family member was on the phone to the doctor’s surgery and was asking for the GP to prescribe some tablets for me to dry my milk up so they could bottle feed Joe. And this was when my brain bolted. I knew I was ill. I knew I was terrified of my role as a mum and the terror of this being a job I would have forever like it or not, filled me with a fear that I had never ever experienced. I was confused, scared, and lost in my own thoughts but I knew something. I knew I wanted to feed my son. I knew I could do that. It was the one thing that I could do for him that no one else could.

I was admitted to the mother and baby unit later that day and prescribed antidepressants that were compatible with nursing and it was amazing. I was able to begin recovering while doing the one thing that was important to me

Yet so many women are still told it is not possible. It is in lots of cases. Of course, for some, it is not possible, but it is not a blanket rule.

Ten years on, I coordinate the UK Mental Health Awareness Week with a small group of people affected by perinatal mental illness. Up to one in five women experience mental illness during pregnancy and the first year after birth – that is what perinatal means. However, apparently only around 50% of these are diagnosed. I want to arm women and families with knowledge so they can get the care they need and deserve and one of the things we at PMHP look at during the Awareness Week is breastfeeding and antidepressants. We get so many emails from women saying they think they may have to stop feeding to take any medication and are desperately sad and upset about it.

I need help. I do not want to feel this way – how do I get help ?

I have been there. Given birth and thinking at some point soon the hills will be alive with the sound of sweet gurgling baby noises but instead, ferocious waves are crashing around in your head. You are overwhelmed. You are crying. You are having thoughts enter your head which are scaring you. You may be questioning whether you love your baby. You want someone and something to help it get better.

You deserve help and support. Please open to a health care professional and tell them about your feelings so they can work out what the best treatment is for you. Even if the thoughts you are having you are scared off . I did an Instagram Live last month about Intrusive Thoughts in the Perinatal Period with Catherine Benfield where we discussed thoughts that are about harm or are sexual in nature. Trigger warning if you do watch and if you have have been having these kinds of thoughts, you are not an awful person at all. Not in anyway. Please let the Instagram Live session reassure you – https://www.instagram.com/tv/CCWoFeHF4Me/?igshid=11en4xnqxzltq

If you aren’t sure how to open up, you could fill in the GP Appointment Checklist – a simple but innovative perinatal mental illness appointment checklist was developed by my friends Smile Group for mums who find it challenging to articulate how they feel when speaking to GPs, HVs or midwives http://www.thesmilegroup.org/help-from-the-professionals/ . If the midwife or HV is visiting your house , you could pass it to them or if you are seeing a GP over an e consultation because of Covid, you could email a version for their attention ahead of your appointment.

At the start of lockdown , I pulled together this directory of perinatal mental illness support during Covid-19 and beyond.

The article is here : https://smalltimemum1.wordpress.com/2020/03/31/support-when-mums-need-it-most-perinatal-mental-health-support-during-covid-19-and-beyond/

The aim of it is to provide a supportive platform which can reassure families and signpost them to vital resources and support which is what people need most at this time. While we are a few months later and some service provision will have changed , the article provides an overview of services for mums experiencing perinatal mental illness during this unusual time.

The article covers :

1 – Overview of online perinatal mental health support

2 – Online Perinatal Mental Health Peer Support groups / forums

3 – Perinatal mental health charities offering their support in new ways during the isolation period

4 – Maternal Mental Health Online Courses

5 – Useful details of national mental health charities and groups

6 – Regional perinatal mental health support in their usual form

7- Support for BAME mums

8 – Other groups/apps/organisations that provide support to mums

9 – Breastfeeding Support

10 – Covid Support

11- Support Resources

12 – Suicidal thoughts / Help in a crisis

13 – Perinatal Mental Illnesses and their symptoms

Disclaimer

I am not a doctor. I did once receive a letter addressed to Dr Steve Caravan which was meant for me, Miss Eve Canavan but alas, it was not the career choice for me. Therefore , this blog will not be me telling you what meds to take as this is not appropriate for me to do – we need to look at the guidance from health care professionals and so I have placed it all in here in place so it is easy to navigate.

This blog is not about feeding choices or how women choose to feed their babies. It is about plonking all the breastfeeding and antidepressant information in once place , at a time when everything can feel too much and overwhelming.

Perinatal Mental Health Toolkit

Your GP has resources to help you if you are experiencing perinatal mental illness. These include the Perinatal Mental Health Toolkit which gives doctors access to things which will help them support unwell mums.

It is below, and anyone can look at it, not just GPs. As someone with lived experience of perinatal mental illness, I, alongside several other women, supported the creation of the Toolkit, giving advice from the lived experience viewpoint.

http://www.rcgp.org.uk/clinical-and-research/toolkits/perinatal-mental-health-toolkit.aspx

It contains clinical which offers information on presentation, diagnosis, and treatment both with medication as well as psychological treatment. There is significant geographical variation in the provision of specialist perinatal mental health services across the UK and it is important GPs know where to access further information.

It is absolutely BRILLO-PADS. Thanks for it Dr Carrie Ladd.

Guidelines In Practice

There is also this great article written by my mate Dr Stephanie de Giorgio for GPs about identifying and counselling women with postnatal, perinatal, and current or previous mental health problems, non-pharmacological and pharmacological treatment options and when to refer to secondary care.

https://www.guidelinesinpractice.co.uk/mental-health/top-tips-perinatal-mental-health-problems/453729.article

Medication in pregnancy and breastfeeding

It also has a whole section on this advising that the decision to use medication to treat a mental health problem during the perinatal period is a complex one and individual to each woman. Clinicians should be able to help women make an informed decision and the following resources may be assist them to do so.

• The UK Teratology Information Service provides information for healthcare professionals on the safely of drugs in pregnancy.
• Best Use of Medicines in Pregnancy provides patient information leaflets on the safety of drugs in pregnancy.
• UK Drugs in Lactation Service (UKDILAS) The UKDILAS service provides evidence-based information on the use of drugs during the breastfeeding period. This website contains links to articles on the safety profile of individual drugs or groups of drugs.
• LactMed the Drugs and Lactation Database of the US National Library of Medicine.
• MHRA Toolkit on the Risks of Valproate Medications in Female Patients (patient card, patient booklet, healthcare professional booklet and acknowledgement of risk form). There is now strong evidence that the risks of using sodium valproate in pregnancy are too high to be considered acceptable and clinicians should urgently review their prescribing of this drug to women of childbearing age. MHRA film on the risks of taking Valpraote medications during pregnancy.
• A systematic review of evidence base of psychotropic medications: Management of psychotropic drugs during pregnancy Chisholm M & Payne J (2016)

The Breastfeeding Network

What a brilliant organisation these are.

At the Breastfeeding Network, they are in contact with, and support thousands of new mums every year and around 15% of the calls to their old Drugs in Breastmilk information service related to mental health issues.

They also advise on their website that research also shows that more than 3 in 5 women stopped breastfeeding earlier than they wanted to. This shows the importance of providing good quality breastfeeding support and evidence-based information on the safety of anti-depressant medication for mums who do want to breastfeed.

They have detailed, evidence based, information sheets on anxiety and breastfeeding, feeling depressed and breastfeeding, feeling anxious and breastfeeding, OCD and breastfeeding, Bipolar disorder and breastfeeding and postnatal depression treatments and breastfeeding. These are written by their qualified and highly experienced pharmacist and can be downloaded or printed out to discuss with your midwife, health visitor or GP.

Drugs in Breastmilk Antidepressant Factsheets – https://www.breastfeedingnetwork.org.uk/antidepressants/

You can call the National Breastfeeding Helpline which is open from 9.30am-9.30pm 365 days a year on 0300 100 0212 to talk to a trained volunteer, who is also a mum who has breastfed. The helpline also welcomes calls from partners, family members and friends.

GP Infant Feeding Network

The GP Infant Feeding Network (UK), also known as GPIFN, has developed this website as a clinical resource for General Practitioners (GPs) working in the UK. The website was developed as an independent, voluntary project by UK GPs with assistance and input from colleagues working in infant feeding, maternity and early years.

They advise that the website can be used as a basic reference for learning more about infant feeding issues that may present to the GP. It also signposts to further information from trusted independent sources.

The intention is to help GPs in the UK easily find evidence based information on infant feeding which assists their practice and enables them to complement the work of those supporting healthy infant feeding.

Home

https://gpifn.org.uk/maternal-mental-health/

Dr Wendy Jones MBE – Facebook Lives

During each UK Maternal Mental Health Awareness Week, Queen of Pharmacists Dr Wendy Jones MBE delivers a Facebook live for us about Breastfeeding and antidepressants. Wendy is a bit of a hero to nursing mamas and is truly an incredible, kind, and supportive resource. Take a look at a previous Facebook live she has done about this very subject here https://m.facebook.com/story.php?story_fbid=826557897700531&id=587696788088228.

Wendy’s website is here – https://breastfeeding-and-medication.co.uk/

Breastfeeding myths.

There are so many wild rumours about breastfeeding that they can really overwhelm people and make your boobs feel oiled bursting out of their bra for relief. These myths only serve to not support women who wish to feed so I was very honoured to recently have queen of boobs Shel Banks join me on Instagram Live for a Supporting Mums session on this very subject.

Things such as when and how much poo should a week-old baby be producing if breastfed? What does green poo mean – has my baby been fathered by an alien? Do oats up milk supply as I have eaten 4 packets of hobnobs? Can I have some wine when I am breastfeeding, or will it make my baby drunk and climb on a table singing The Wheels on The Bus while pooping into its nappy?

Take a look as Shel is so reassuring and kind – https://www.instagram.com/tv/CDi6GFMFkEp/?igshid=1ggkuzq59xkgw

You will get better. I promise .

For me, medication saved my life and I will be forever grateful – it really was the only thing that helped me when I was unwell. Medication freed me from the hysteria of hallucinations and I will forever praise them for giving me the gift of my life back.

Diamonds may be a nice present but for me , the best I ever had was becoming Eve again and learning not to be scared of my baby. Who cares if I had to shake, rattle, and roll along the medication yellow brick road to get here?

I wrote this about antidepressants if you fancy another read – 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/

Eve xx

Follow me on Instagram – https://www.instagram.com/eviecanavan

Twitter – https://twitter.com/eviecanavan

Facebook – https://www.facebook.com/Smalltimemum1/

Follow the Perinatal Mental Health Partnership – https://www.facebook.com/PerinatalMHPartnershipUK/

I wanted to close my eyes forever but I deserved for them to stay open.

Trigger warning – mention of suicide.

I never thought I’d know what it felt like to want to die. To feel like breathing and living was the hardest thing in the world. To feel so trapped in my own mind, a mind that once belonged to me, now scaring me into despair. To feel afraid of being alive for a single second longer.

But seven years ago, this feeling hit me. It consumed me. Death seemed to be the only way out of terror of my thoughts. I couldn’t see properly, I couldn’t dress myself, I couldn’t read or write. And I thought I couldn’t stay alive.

Having a baby was supposed to be the making of me. I never thought that within a few hours of becoming a mother, I would experience my first symptoms of psychosis. I had heard that women could feel sad after giving birth for a few days and a few weeks. I had heard of postnatal depression but I hadn’t heard of what was happening to me. When I looked at my baby in the cot by my bed, I didn’t feel a pang of love. Instead, I felt trapped by his presence. Within a few hours of his birth I honestly could feel my mind disintegrating and a wave of fear I had never felt before came over me like a doomwatch. My eyes started the flick back and forth and my body temperature rose. I started breathing heavily and found myself drawn to looking at the windows. Without any force from me, my mind started to try and hatch an escape plan from the hospital- how could I get out and away from the baby? And even more terrifyingly, away from my new life, away from this world. A world that 5 hours before, with my pregnancy belly , I was elated and excited to be a part of.

3 days after having my son, I started experiencing hallucinations. The fear of being trapped forever in this life consumed my every waking moment. I struggled to eat, I could barely speak, I had forgotten how to get dressed. I felt myself float from the sofa to the corner of the room and look down on myself and I was convinced the duvet cover was dancing.

As my mind realized escaping this world wouldn’t be easy, I looked to the sky for answers. If only I could get to the clouds and unzip them I thought. Then I could get to space and be free wouldn’t I? But I wouldn’t be because I would still exist. Where would I go after space? I realized there was no escape and that I was trapped, locked in a life I felt too scared to breathe in. This feeling was the most single most terrifying feeling I have ever ever ever felt.

These feelings lasted untreated for six weeks. My life was a blur with a baby. I ran out of the house naked, I clung to my husbands feet to ensure he never left me and I felt smothered by the air around me. I thought the houses on the street were moving back and forth and I was utterly tortured by fear of being near my own baby on my own. I shook with nerves. I shook with fear. This baby was here forever now and in my mind, I was going to feel like this forever.

Unless I found a way out.

I said I wanted the baby adopted. I hatched what I thought were master plans to get our life back without it. My dear sweet husband was banging on the doors of every doctor , nurse and hospital to get me help while I made endless manic lists of my thoughts whilst screaming for the pain to be taken away.

But my mind could only take so much. Six weeks of terror, hallucinations and fear culminated in a massive meltdown at 3am one night. A visit to an out of hours doctor , after being dressed by my husband ended when she asked me if I had planned my own death. Of course I hadn’t and I will tell you why – I was so confused at that point, I barely knew my own name. I thought the baby had been sent to test me, I was scared to go to the toilet, I couldn’t remember how to do a wee. I was scared of noise, of air, of breathing. I was so scared of living , that my brain could not think of anything else.

She said if I hadn’t planned my suicide, I was considered low risk and to go home. Astounded, my husband didn’t accept this. He wanted his wife back. He wanted me back for us , for our baby, for our life. Seeing me like this wasn’t just hard for him though and everyone else but mostly, it was horrific for me. I was in an absolutely desperate desperate state and he could see that. He knew how much I wanted to not feel like that for one second more.

The next morning I woke up and declared I was scared of being alive

I felt like Iwanted to close my eyes and never open them again.

But that didnt happen.

Two hours after that, I was hospitalized in a psychiatric mother and baby unit. I had screamed until my mouth bled before my admission and was convinced I could smell burning flesh as I walked to the ward. But walking through those doors gave me a wave of hope.

It was warm. The nurses were kind and calm. I was spoken to gently and with care and my baby, the baby I feared, was in the unit with me. I got a diagnosis – postpartum psychosis and I started medication. The walls slowly stopped moving, the fear slowly started to fall away. Slowly slowly, I dreamt less of being away from the world and more and more, wanted to work to stay in it.

It took a week of a nurse being on duty outside my room 24 hours a day, for me to be able to close the door and be on my room with my baby on my own without feeling utter terror. It was a tiny step but the most significant turning point in my illness. And in my recovery.

And recover I did. I never ever thought I would feel like me ever again. To be so deep in fear that you forget what life can be like is awful but it does get better. I promise. It may take time but you will be okay.

With the help of my husband, my little boy,doctors, medication, therapy, a stint in the psychiatric unit and working to recover ,I’m here . And I’m alive. And I am so thankful. Because I deserve to be here .

Be kind ,be calm, be nice to someone you know is suffering. Open your ears and arms to someone you think may be in fear. Listen to that person in you don’t know who just needs a friendly hand. And that can be anyone’s hand.

If you are experiencing feelings that are making you feel that you can’t take anymore, go to casualty. Call 999. Go to your doctor. Call a crisis team. Call the Samaritans on 116 123 and tell your thoughts. You deserve to be here. Life doesn’t have to be perfect to be beautiful and you are worth it.

You are worth being alive xx

The NHS pages on suicide contain useful information and signpost to help and support. They are here. Please read them xx
http://www.nhs.uk/Conditions/Suicide/Pages/Getting-help.aspx .

Silvery stretch marks and spanx pants

This morning, as I was staring at how beautiful I am from the nose up, I noticed an intruder lurking on my face. Near where my non existent cheek bones are was a hair, approximately 3 metres long. It definitely wasn’t there when I went to bed so I can only assume I must have been eating magic beans for something to grow so bloody long, so bloody quickly. After attempting find my tweezers to extract it and failing, I tried to  cut it with my four year olds safety scissors. Don’t attempt to do this. It marks your face.badly. I then had the not so brainwave to rip it out of the skin with some Sellotape. I roped in the four year old to do the pulling off. He announced he wanted to be a ‘ripper offerer’ when he is a grown up while I lay there screaming. Still looking like something that belongs in a travelling circus.

I noticed that random hairs started appearing on my body after having my son. So aside from the going mad, I also had to contend with becoming a cul de sac version of the bearded lady. This mornings attempt a home wax job only served to remind me how much my body has changed since having Joe.

When I was pregnant and found out that due to my two wombs, that I couldn’t give birth vaginally, my wonderful consultant booked me in for a c-section. He told me I was the best in the business and that he would operate so beautifully, that no one would ever be able to see my scar. Amazing I thought. And he was right. No one will ever see my scar.but not because my consultant had finessed his skills with a knife. But because of the lovely shelf like stomach I seem to have adopted forever since giving birth. I Edward SCissorhands might have well as operated on me as my delightful stomach now hangs so much, it won’t be long before I trip over it. There have been times where I have considered lobbying for spanx on the NHS.

This reminds of the time where I almost cut off my circulation while wearing a pair of control pants. John and I were in America for 3 weeks a few years ago. We had gone out to a bar in Baltimore and I had worn a tight black dress and the obligatory control pants underneath. Only problem was, I couldn’t breathe in them. A friend had told me that you should always buy them in a size smaller than what you actually are, as they suck you in even more. After devouring this info and spending half an hour attempting to pull the bloody things up, I hobbled out of the hotel room looking like I had a broom up my arse. John kept asking why I was breathing so heavily and had to help me walk down the road.

Once we got to the bar, I couldn’t climb onto the bar stool. John had gone to the loo so I found myself being hoisted into the seat by two very helpful young men after I had slid off during an ill fated attempt to jump onto it. More disaster followed when our food arrived, and I was so constricted, I couldn’t swallow. I was forced to tell John how I had practically mummified myself under my clothes in an attempt to look like a supermodel. He instructed me to ‘take the bloody things off’ so I then slid of the chair and shuffled to the toilet. It took another half an hour to pull them off inch by inch and I was so relieved when it happened, I ran out of the loo and yelled in a very loud voice, ‘baby, it’s done. I’ve got NO CRACKERJACKS ON’. Everyone turned and looked at me and the realisation hit me that I had just announced to an entire bar of people that I was knicker less. John tried to reassure me that maybe crackerjacks isn’t the international word for knickers hence my declaration was probably lost in translation. Who knows. But it did teach me a valuable lesson in the art of knicker wearing and that I should attempt to keep my voice down in public places.

But I digress. My point here is that I guess childbirth has made me realise that your body can change in ways you never expected but it’s ok. The world is still turning, you’ve created and grown a life in this amazing body and yet we spend many hours and much money trying to fix what nature has bestowed on us. It’s hard. I remember when I came back to London after coming out of the psychiatric mother and baby unit. The combination of meds to help my mind return from where on earth it had gone had made me put on a lot of weight. I said hello to a family member whose first word were ‘bloody hell Eve,look how fat you are. And how are you doing now by the way?’. I burst into tears and walked into the hallway to be greeted by another family member who said ‘goodness, isn’t your hair brittle? You need to sort yourself out now and start making an effort’. The worst part was that I thought I had. I felt like going to the kitchen and smearing butter all over my arse and thighs as that’s where it eventually ends up and shaving my head a la Britney Spears. I also quite fancied attacking people with an umbrella as well but feared they would just think I was still crazy when it fact,it was them who were in the wrong.

My stomach may resemble a road map of lovely little silver lines and I won’t forget the day before I had Joe when I noticed a purple streak across the top of my bum. I thought John must have slept walk and mistaken me for a sheet of paper and drawn all over me but on closer investigation, it was revealed to just be a massive stretch mark. But it represents that I have done something wonderful. I’ve had a baby and my body has been through that and a severe mental illness.

Joe came up to me last year and pushed his belly button into mine. He said ‘ mummy, daddy said this is how we was joined when me was growings in your tummy’ and he kissed those silver lines which covered what was his home for nine months. Yes, I’m not a supermodel. Yes, I have baby hairs that resemble when I hacked at my fringe when I was seven,yes I have skin tags that do look weird and yes, I do have massive boobs because I’m breastfeeding a four year old. But I don’t care. I’m the queen of my own kingdom,I’m the boss of me , and I’m fabulous. A fabulous mum, with the body to prove it.