Warning: A non-numeric value encountered in /home/cathe080/public_html/wp-content/themes/Builder-Cohen/lib/builder-core/lib/layout-engine/modules/class-layout-module.php on line 505

Even a tiny chink of light a long way off is better than just sitting in the dark

Snow. Have you been enjoying it or been annoyed by it? I love watching the blizzard rage outside whilst I wear my cosiest clothes and drink hot chocolate. I also love venturing outside picking out the patches of virgin powder to stamp through and indulging in the way it crunches and creaks beneath my feet. It’s the most oddly satisfying feeling.

I had grand plans for some pictures of my gorgeous girl in the gorgeous snow, but she had other ideas, screwing up her face like I’d snuck her a lemon to suck. It’s the joy of having a two year old. She’s two going on twenty, with strong feelings about EVERYTHING. She knows what she wants and she knows how to articulate it. Mostly. When she can’t find the words she turns into a weapon of mass destruction. Boom.

I can identify. I’ve had times when mental illness has robbed me of my normal emotional coping skills and has left me with a limited range of coping skills. When I had postpartum psychosis this was embodied as anger. I felt such rage at not being understood. It was like I’d been plugged into the mains and I had this raw current of electricity running through me and I would verbally zap those around me when they said something I felt was stupid or contemptible (basically anything I disagreed with, which was a lot of things). I felt giddy with the righteous power of just saying exactly what I thought and I can still remember the tingling feeling in my fingers and the furious heat rising through my body before I would unleash a tirade.

The depression was different, there wasn’t any energy for anger. Yet I felt the same rawness in response to any vaguely trying circumstances. My coping skills were dismantled in a way that meant crying and hopelessness were my go to responses for most circumstances. I had no resilience. If I was a ball I’d sag when I was meant to bounce.

For me, getting well and staying well is about reclaiming those coping skills, something that’s easier said than done. When I was ill one of my most common refrains was that I just couldn’t cope and that’s why I find it can help to have a list of go to things to try when you feel the first glimmers of illness. For instance, one of the most important skills to ward off illness is self-care, something I have never been adept at but which I now try to practice every day. Instead of pushing through an interminably difficult piece of writing, I stop and take a break to do something I enjoy, then go back to more ready to take on the task. Equally, if I feel the niggle of anxiety I go for a walk or try deep breathing or do a word search or watch some crappy TV. These distraction techniques help me avoid getting caught in a spiral of being anxious about being anxious. Which is so easily done, and so difficult to break out of.

I found that when I was depressed going through the motions of applying coping skills, even when I had zero faith they would work, was helpful. I had to be cajoled by my husband and the improvement was just by a tiny degree and at a great cost in terms of mental effort, but when you’re at the bottom of a blackhole seeing even a tiny chink of light a long way off is better than just sitting in the dark.

Anxiety is like a spider with rollerskates

Anxiety is like having a spider with rollerskates controlling your mind. Your thoughts move in a fast, uncoordinated and terrifying manner as its scrawny legs shoot around your brain tripping cascades of neurotransmitters and switching your fear centres fully on. Like most people I’d experienced anxiety triggered by particular things – exams, job interviews etc – before Bea was born, but since her arrival I have endured anxiety as a mental illness. It just arrived one day and parked itself firmly in my brain, never letting me feel at ease with myself or my surroundings. At times it has left me unable to leave the house and I have swallowed pills, scribbled in a mindfulness colouring book and tried most relaxation exercises known to the internet in an attempt to rid myself of being shacked to anxiety’s interminable mental treadmill.

If you saw me during the peak of my anxiety the first thing that would strike you would be movement. I’d be the world’s biggest failure at musical statues, a jiggling, wriggling, writhing mass of motion. I would pace up and down the room, shaking out my hands as if they were dripping in anxiety and I could physically rid myself of the illness. The movement wouldn’t stop even when I tried to find some peace at the end of the day. Where once upon a time I would lounge like a lioness on the sofa indulging in some Netflix or a favoured boxset, under the influence of anxiety I would bounce my leg and tap my toes through the programme, never settling, never stopping.

My thoughts were equally agitated, flitting about like demented butterflies, never landing too long on one subject but always remaining within the confines of fear. My husband would try to logic me out of each fear, but even if he succeeded I would soon find another thing to fear. One of my biggest areas of concern was people. I worried that they were watching me, I worried they could tell I was crazy, I worried that they would see what a bad mum I was. I stopped being able to go out of the house. Worst of all was the belief that my anxiety was a symptom of utter cowardice, of an inability to cope, a feeble fear of everything life was throwing at me.

Thankfully the tide has now turned and anxiety no longer holds me in its thrall. I wouldn’t call myself normal (who would?) but I can now sit still, I don’t fear people (except clowns, yeesh) and I can think in a straight line. They may not seem like it but these are all accomplishments. I don’t know how I came out on top – psychology, pharmacology, time all probably played a part. It worries me that I don’t know exactly how I beat my anxiety because that means I’m unsure about how to keep it at bay. All I can do is keep doing the things that seem most likely to have helped me beat it. Vitally, if anxiety ever does rear its head again I’ll know to ask for help early on because I now see it for what it is – illness not weakness.

An unusual first date

This week I met someone new. I felt like I’d signed up to the weirdest version of First Dates, and I wasn’t even going to get to meet Fred (ooh la la!) I had worried about what to say to my date, I had worried about what to wear, expecting them to analyse everything about me – was my wardrobe too crazy or not crazy enough to warrant seeing her?? She was a psychologist, and I was exceedingly nervous about meeting her. I had seen a psychologist on the ward of the mother and baby unit but since discharge in January my treatment has focussed on the pharmacological (with the exception of the support of a superb community psychiatric nurse). I paced the room as I waited for her, anxious about her, anxious about her questions, anxious about having forgotten my anxiety questionnaire (seriously, you just needed to look at me, I was a visual anxiety score). I had built up this image of someone peering at me behind spectacles whilst asking about my deepest and darkest fears, taking notes and saying ‘mmmhmm’ every so often.

She walked into the room and sat down, I still couldn’t sit but she said that was fine. The first thing I noticed was her nails – they were immaculate. All painted white, except for the fourth finger on each hand which was a deep royal blue. It was exactly the kind of thing I do when I want to express myself or when I want to put my war paint on. In preparation for seeing her my nails were gold with a black cracked effect on top, giving the impression of a gold, sliding leopard print. She was dismantling my stereotypes.

She then did something very useful. She monologued. She talked about what psychology was, how she fit within the broader community psych service, how our sessions might go, confidentiality and so on. The soothing rhythm of her voice slowed everything down and I was able to sit opposite her and take it in. The fact that she did the talking took the pressure off me to contribute until I felt I had been able to assess whether we might get on. By the time she was done I felt like maybe, possibly, she wasn’t this intimidating person I had built her up to be, and perhaps these sessions could actually help. So I began, tentatively, to talk, explaining that I was having a busy and anxiety provoking week with seeing her for the first time, giving a talk at my former mother and baby unit and attending my grandmothers funeral all in one week. She was understanding and sympathetic towards my anxiety and she tried to get me to CBT my way through a couple of points. For example, following my talk at the mother and baby unit I was overwhelmed with positive comments. However one person made an ambiguous comment and I fretted over it, worrying that she was being critical and saying I’d given the wrong kind of talk. My husband agreed it was ambiguous but suggested that given how positive everyone else had been, it wasn’t worth a second thought. But I gave it a second thought, and a third and a fourth. The psychologist tried to suggest that if we interpreted the comment differently, or simply discarded it as being an outlier amongst the otherwise uniformly positive feedback, then the same event (i.e. the comment) could have a very different effect on me (i.e. nothing, compared to massive anxiety). It’s the beginning, I’m taking tiny little newborn steps down what will be a long road. I’ve no idea if it will address my anxiety, but I feel a little more hopeful that we have another strategy, another method of attack to take on this monster.

Confident Cat

I used to be a confident Cat. Aware of my achievements, secure in my ability to communicate and engage with others, and comfortable in a professional context. Being ill has changed many things about me, but one of the things I struggle most with is the decimation of my confidence. Now I feel waves of anxiety when I have planned to meet someone, even someone I know well. I worry about my ability to carry a conversation, I feel like there is little of value to say about my life and I picture running out of thoughts and words. I’ve started work on book number II and part of that will involve interviewing people, a thought that currently terrifies me so I’ve been hiding in the realms of Internet research instead. There’s a lot of Internet to hide in.

But I must write the book so I must overcome these issues. I’ve tried to push myself outside of my comfort zone, something my community psychiatric nurse has been encouraging as she fears I’m too reliant on my husband now. She’s right. I worry about walking between places by myself, picturing a tsunami of things that could befall me, and consequently I depend on my husband’s presence on virtually all journeys. I used to be such an independent creature, travelling to India, South Africa, Tanzania and Peru by myself. Now I struggle with the 5 minute walk to Sainsbury’s.

I’ve tried pushing myself by making playdates with friends, despite the sense of trepidation it gives me, because invariably when I get there we have plenty to talk about and the conversation carries just fine. I can do it. I just fear I can’t. And I get so much from these encounters in soft play cafes and coffee shops. I’m grateful to the women who meet me, who make the effort to reach out, they have no idea how valuable their time is to me.

Playdates are a sensible step, but I’m not always a sensible soul. One of my personal quirks, that has not been altered by illness, is my tendency to go all in. Which is how, despite my fear of Sainsbury’s, I found myself with tickets booked for a trip to London. By myself. My inspiration was strong – a free dinner at Claridge’s and the opportunity to meet the Dean of Harvard School of Public Health, an accomplished woman with experience of maternal mental health research. My fear was also strong – the tube, a hotel, streets bustling with busy people. But I wanted to prove to myself that I could do it. I stayed in a bit of London I knew well and didn’t stray from it, apart from my trip to Claridge’s. It’s a bit that holds the Wellcome Collection (which houses my favourite exhibition and bookshop) and the British Library (one of my favourite spaces). I knew those streets, I cried when I saw them again, like meeting an old friend after a long time apart and with much water under the bridge. The atmosphere was made all the more nostalgic by the busker playing Adele’s Someone Like You, “Old friend, why are you so shy? Ain’t like you to hold back or hide from the light…” I made frequent, often tearful and fearful, calls to my reassuring husband. I chain ate Valium. But I did it. I had a pretty positive evening, made much easier by the kind and clever conversation of the dinner guest to my right. Together we were bold enough to approach the Dean, who was a pure delight to speak to. Thoughtful and insightful when I asked questions, compassionate when I told my story of psychosis and depression.

I did it. But it came at a price. I thought once I proved I could do London I could do anything, like ripping off the proverbial plaster. Instead I returned even more anxious. I don’t know if it was the massive build up of adrenaline from the trip, or seeing the gap between how I used to breeze through London compared with my now terror-stricken tube riding, but something made me even more fearful of speaking to people and of venturing out alone. Perhaps I used up my annual allowance of bravery on that one trip.

Now I’m not so brave, but I am still slowly pushing out my boundaries with more manageable challenges. If you have any tips or advice for reclaiming confidence after maternal mental illness I could do with them! Today’s challenge is going to a book group. I’ve read the book, I think I understood it, but I’m incredibly nervous about the prospect of discussing it with bright literary types. But I’m going to do it because the world I currently inhabit is too small for me. I want it to be bigger, bolder and brighter. I want to reclaim that fiercely independent Cat I used to be. And one day I will.

Recovery: The long and bumpy road

The past tense. It’s something you use daily. There are many opportunities when I get to do the same – ‘I did a good job at work’ ‘I handled a nappy full of exploded…rainbows’, ‘I patiently (well, at least slowly) explained something to my husband’. But not when it comes to recovery from mental illness – then I must use the present tense. 20 months after my baby was born, I’m still ambling down the road to recovery. Sometimes I wonder if I’ll ever reach the end of it, or if such a thing exists.

I have days when everything seems fine and we go to a cute cafe or walk alpacas in the sunshine (like actually, no hallucinations, I promise!) Then there’s the other days. The dark days when I have to drag my soul to partake in anything other than breathing and lying on the sofa. They are only occasional now, thankfully, but when they hit I have to reach deep, so deep to find the will to do something as simple as leave the house. For my baby’s benefit I force myself to walk to playgroup and smile and chat to people. I contort my face into the correct shape, whilst my mind races for the ‘right’ thing to say, hoping beyond hope that I don’t betray the void inside. I hold back tears, pushing them, shoving them back into my face with the force of my mind, staring hard towards the sky to stop them spilling down. Though I feel the fear of discovery at the time, on reflection I’m reasonably sure nobody has a clue about what’s bubbling beneath the surface. I’ve carved my ‘mask of managing’ beautifully, it is exquisite – chatty, happy and absolutely impenetrable. Yet as I write, I let it slip – demonstrating its existence to the world. I worry about doing this, just as I worry about how long I will be wearing it for.

However I have reasons to be hopeful when it comes to recovery. For instance, I’ve met mums who have gone on to achieve extraordinary things after maternal mental health problems. Like those who lead the work of charities like Maternal Mental Health Scotland (MMHS) or Action on Postpartum Psychosis (APP), both of which received awards at the Maternal Mental Health Alliance Conference in September 2017. I’ve joined them in helping others by volunteering with MMHS as a Change Agent. Through and with them, I’m contributing to the current redesign of Ready Steady Baby – the book all prospective mothers are handed in Scotland. We’re helping hone the messages on maternal mental health, and being part of that is immensely rewarding. I can’t change the path I’ve come down, but if I can help another mum get the help she needs quicker, or feel less shame about being ill, then I’ll have made a difference. A difference to them, and to me. You see, I have this drive to create something positive from the profoundly negative rabbit hole of postpartum psychosis and postnatal depression that I fell down. I believe it is this drive that will push me further and further towards being recovered, different from the girl before this journey, but, crucially, not less than her. I see this drive in other volunteers, a burning passion, and it gives me hope that together we will raise the profile of maternal mental illness and drive real change.

Volunteering has helped me with recovery, but there are probably as many ways to recover as there are women who have been affected. I’ve also found writing helpful, and I’d love to know how you or your loved ones have journeyed the road to recovery – what’s helped? What would you recommend? For me, for now, I have to use the present tense to describe my struggles, but hopefully one day with the help of writing and medication and exercise I will be able to put them firmly in my past.

A Welsh MBU Please

This week a report came out on the subject on mother and baby units (MBUs) in Wales. They currently have no MBUs and mums are being sent to England instead. This breaks my heart. When I was in the MBU my husband was able to come in every day, we were able to continue being a family through all the pain and stress of my being unwell. He rocked me whilst I cried, he made me smile when I thought I’d lost the ability to ever smile again, he gave me reassurance, love and hope. The first time I left the ward to walk the grounds, I did so clutching his hand. He was essential to my recovery. I can’t imagine trying to recover without the presence of the person who knows me and loves me most in the world. I also can’t imagine depriving him of that precious time with his baby. Mums aren’t the only ones who need to bond with their baby.

I know I was one of the lucky ones. Other mums in the unit I was in had traveled hundreds of miles across Scotland to be there, and were left without the constant support of their loved ones. The nature of highly specialised services is that some people will have to travel, but the idea that journey should be as far as from Wales to Manchester (as was offered to one mum) is ludicrous. Thankfully I’m not the only one who thinks so and today a report by the Welsh Government’s Children and Young People’s committee stated that the current care for women suffering from severe perinatal mental illnesses is ‘wholly inadequate’ and joined calls for an MBU in south Wales.

Presently, 60-80 women in Wales are treated in adult psychiatric wards, where their babies cannot stay with them. I was briefly admitted to such an environment because my daughter was over a year old, making us ineligible for MBU treatment, and I can say it was exceedingly distressing. It was the first time I had spent a night apart from her and that fact felt like a cold blade cutting through me. We had been together through so much, but now I had failed her, lost her. My husband brought her in, as I was fortunate enough to have a single room, but it wasn’t set up for babies. The MBU had toys and books and a dedicated playpen, plus wonderful nursery nurses who arranged splash play, weaning classes and baby massage. There were other mums who were facing similar challenges with their mental health and motherhood to talk to. All of this ensured I got well as quickly as possible and that I was equipped to be a (relatively) confident mum at the end of it. My time on the adult ward was cold, unfeeling and lonely by comparison, and it didn’t feel like an appropriate environment to bring my baby into.

In response to the committee’s recommendation The Welsh Government have pointed to their investment in community services, which are essential, but hopefully they will also see the need to go beyond that and provide the specialist in-patient care of a Welsh MBU. Surely Welsh mums deserve far better than ‘wholly inadequate’ care? I’d love to know if you think we need more MBUs, not just in Wales but in the whole of the UK.