THIS POST WAS UPDATED – AUGUST 2023
My battle with perinatal anxiety & depression was a long and scary journey.
Throwing hormones into the mix, along with a history of managing anxiety-related issues and panic attacks, was probably always going to be a recipe for disaster. But pregnancy was the point in my life when I finally needed help. Of the medicated kind.
The factors at stake for me during pregnancy were not only the worries related to the actual pregnancy, but risks to my sanity, family, income-earning ability, and my job role.
let’s look at the definition of perinatal:
Perinatal mental health (PMH) problems are those which occur during pregnancy or in the first year following the birth of a child. Perinatal mental illness affects up to 27% of new and expectant mums and covers a wide range of conditions.
NHS England
As a result of working full-time, I put a lot of additional pressure on myself. It’s fair to say I wasn’t exactly working for a business where having kids was fully supported. I think this is improving, but there is still a lot of work to do in the corporate world. Women shouldn’t have to choose between having children or succeeding in a career. Businesses need to ensure both options are achievable.
Although I know my mushy brain raised red flags at work, it was too early to announce the pregnancy. We were still within the three-month period, and to be honest I didn’t want anyone to know, because I thought it made me look weak.
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Working full-time during pregnancy and having pre-existing anxiety issues was a lot to deal with. I hope telling my story will be of some benefit to you.
In this post, I will cover the following topics:
- What is antenatal depression
- My backstory
- The pivotal moment I knew I needed help
- Antidepressants
- How I think mental health services for women during pregnancy could be improved
- Why are women still afraid to speak out on mental health matters?
- Techniques that helped me through
- What the experience taught me
Mummy comes second
Often, we neglect our own mental health to be a mummy. Self-care comes bottom of the list and there aren’t enough hours in the day to complete every task on the never-ending list. I found out the hard way. You don’t realise you’re neglecting yourself until it’s too late. At this point, the damage is already done.
From my own experience, health services need to be more proactive in respect of pre-pregnancy mental health problems. There is a lot of information and help out there relating to postnatal mental health problems. But my experience didn’t fit into this category. It made me feel like this was supposed to happen to me after I had the baby, not now. Surely? Why was this happening now?
Looking back, the impact of this shameful thinking only made matters worse. I was afraid to speak out and visit the doctor, for fear someone would think I was an unfit mother. The anxiety talking in my head would tell me, you can’t look after yourself, how can you look after a baby?
What is Antenatal depression?
Tommy’s describes it below:
I’ve also found these resources for anyone who needs to read more on the subject. You can filter by area and will see a range of therapists, charities, and support groups.
Please read on for the full story of my battle with antenatal depression…
My backstory
I was two months into the pregnancy when I started feeling the symptoms listed in this article:
I was at work full time, struggling with the office-environment heat. Eating properly was just not happening, due to a constant sicky feeling (I felt permanently sick throughout pregnancy but was never actually sick!). I was far away from the toilet and needed to pee every 20 minutes – you get the picture. I actually lost weight over the course of my pregnancy, due to not getting enough nutrients.
My hormones and worries made it incredibly difficult to concentrate on my work tasks and I became paranoid that I was unable to do my job. I was seeking reassurance from a management team, who were used to me just getting on with things, however difficult the task was. Although I know my mushy brain raised red flags at work, it was too early to announce the pregnancy. We were still within the three-month period. And to be honest I didn’t want anyone to know, because I thought it made me look weak.
We need our tribe
A mental health specialist once made the point, the people we refuse to tell during this three-month period are the very people we would need if something unforeseen was to happen. This has stuck with me, and it’s true. In the future, I probably wouldn’t open up in the workplace, unless I felt comfortable in doing so. But I would definitely let my friends and family in, sooner than I did before. They are the tribe you need around you, at such a testing time in life. It takes a village and all that jazz (it really does BTW – safety in numbers with toddlers, hehe).
The pivotal moment I knew I needed help
I tried to plod along for a bit. We had a holiday planned (pre-planned before pregnancy). And I remember spending every waking moment of the getaway fixating on work and the conversation I’d had with a manager before leaving. The manager in question was trying to gauge why I was being so mushy in the brain (baby brain is real people). I wasn’t really capable of communicating verbally at that point and therefore, it was all a bit of a mess.
The damage caused by keeping these feelings to yourself at such a vulnerable, unpredictable time in life, is colossal. Then going through possibly the worst trauma of your life and trying to look after a small baby who is totally relying on you. It’s a lot to cope with. And we should be able to open up about it without fear.
It’s fair to say my worries, and anxiety levels about being bad at my job, pretty much ruined my experience on holiday. As much as I told myself to put the thoughts out of my head, they would come back. Even trying to forget about the drama at work was exhausting.
Upon my return from holiday, I booked an appointment with the doctor. What I experienced during my appointment didn’t help me at all. They were reluctant to prescribe antidepressants during pregnancy and were unable to explain why. I was left to muddle through at work and I am sure you can all imagine, things worsened. My mental health was in serious decline and I didn’t know what to do.
Why it’s vital to reach out for help
The situation wouldn’t improve until I had the help I needed. My instinct told me this was the case, but I felt like the doctors were not listening to me. This resulted in me worrying and playing out situations in my head, which only fuelled the negative anxious thoughts I was already having. When you’re at your most vulnerable, you shouldn’t have to fight to access mental health services and the solutions you need.
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Antidepressants
I knew I needed medication at this point. Something to help me out of a black hole. So I could focus on growing a child and balancing the pressures of daily life.
Around this time, I also experienced very rude reception staff when trying to make appointments. I was speaking to them following a few hours of sleep, worrying all night and I just needed help. I ended up crying down the phone twice and I honestly don’t think they are adequately trained to deal with people experiencing mental health problems.
Complaining to the GP
I made a complaint and left the doctor’s surgery, following an incident where they asked me to visit reception. I nearly had a panic attack and was afraid to approach the reception desk due to the treatment I’d received previously. I didn’t need rude people dealing with my care, on top of my existing need for help and my current, very fragile mental state.
Talk about adding to my mum-guilt. Making an expectant mother feel like they are harming their unborn child, by seeking out medication to help both parties.
Mind.org provides a lot of useful information about taking anti-depressants during pregnancy. When I was in the midst of trying to convince a doctor to prescribe the medication I required (it’s ridiculous I even have to write this in a blog post), I wish someone had provided me with the information I needed to make my case.
The doctor’s viewpoint on medication during pregnancy
I was asked to go away and try other techniques to avoid medication and the doctor insinuated, had I been on medication before pregnancy, it would be fine to continue taking it. Talk about adding to my mum guilt. Making an expectant mother feel like they are harming their unborn child, by seeking out medication to help both parties.
Waiting in limbo for a solution
I personally spent two months in limbo, before finally receiving medication, which eventually helped. Including the adjustment period, I would estimate I spent five months of a nine-month pregnancy suffering, unnecessarily. Antidepressants take a while to start working, and initially, you have some pretty severe side effects. I was already walking around like a zombie and new medication didn’t help the situation.
Based on my experience, I know we need to change the system to avoid negative outcomes at a time in life where a woman should be happy and thriving.
I was desperately trying to find a solution to ease the pressure. My mental health issues impacted my well-being, my job, my relationship. In addition to the confidence, I had to be a good mother. Also, my ability to buy things for the baby and it made the whole experience pretty grim.
A difficult pregnancy
I look back on my pregnancy now and don’t remember having one good day. I probably did, but I was plagued with uncontrollable anxiety and depression. As well as trying to manage all other areas of life.
It’s definitely had a bearing on my decision to have another child. I have anxiety about what another pregnancy would be like. Would I be a mess again, unable to cope, or worse this time? Whilst also trying to care for a toddler. I also don’t have much faith I would get help from a doctor if I needed it. And I know a lot of other people who feel like this.
The research on taking antidepressants whilst pregnant
From conducting my own research, I was only able to find one study which mentioned the medication I was on. And how it could have an impact on an unborn baby. Surely, I thought, having a healthy mother is vitally important. Given the way I was dealt with by the doctor, I expected to find endless studies backing up the reluctance to prescribe the medication, but that just wasn’t the case.
How I think mental health services for women during pregnancy could be improved
Whilst in hospital Let’s just talk for a second about how calling anyone with anxiety issues, ‘difficult’, can be extremely damaging in itself. It made me feel like an inconvenience, like I wanted to go home straight away.
Unfortunately, the health service is understaffed, and staff do not have time to speak to you one on one and deal with your anxiety issues. Whilst the people caring for me were lovely, salt-of-the-earth people, who were clearly meant to be in this job. I still felt like a burden.
Traumatic experiences during my stay on the postnatal ward
I remember the morning after my C-section, with only basic over-the-counter medication, to deal with a major operation and a serious infection. Being called “difficult” for not wanting to sit up in bed until I had my painkillers. Let’s just talk for a second about how calling anyone with anxiety issues, “difficult”, can be extremely damaging in itself. It made me feel like an inconvenience. I wanted to go home straight away, but I couldn’t as I was under observation.
During my stay, I was in agony, and I kept receiving the pain medication at the incorrect times, which resulted in some nasty withdrawal symptoms from the whole, traumatic ordeal. Whilst I would only wish to thank the staff involved in my care (they do their absolute best every single day and you can see that). These circumstances resulted in my anxiety levels rising, in a situation and surroundings where there was nobody but my hubby to understand or support me.
The need for a birthing partner who knows you well
They even sent my hubby home, so there were periods when I didn’t have anyone to understand me. And I couldn’t get out of bed or look after myself!
Being in my head at the time, I was honestly afraid of how I would be judged in that situation. Would the nurse caring for her think I was an inadequate mother? Were they making notes about me and recording what was happening? Would I get a visit from social services? Because I was clearly unstable for thinking like this?
He was initially sent home during my labour period, at the pivotal moment when my pain was increasing and I felt like nobody was listening when I said that. Things progressed quickly in his absence and he was called back. However, the endless number of factors that worsened my anxiety during his absence had already made me defensive and less likely to open up. From this point, I felt trapped. And my anxiety spiralled.
The system, funding, and government intervention need to improve. It simply isn’t good enough to have a lack of care, over-tired staff, and possible negative outcomes. When you are dealing with the care of a new mother and child.
The pandemic worsening the situation
To send partners home when they are really the only ones looking after the expectant mother and taking time to understand their needs is unacceptable. The anxiety about mothers being left to fend for themselves only worsened during the pandemic. This Independent article goes into more detail. This Guardian article also touches on the issue.
Possible solutions?
I also don’t believe a one size fits all approach is sufficient when you are dealing with mental health. It would help to have mental health specialists visit patients in the antenatal ward. But it’s all about the lack of funding for services. And whilst some NHS trusts have this specialism, most still don’t. It’s also vital to allow birthing partners to stay with the expectant mother, especially when staff are too busy to care for their needs.
I am eternally grateful to the staff at our local hospital for ensuring our post-pregnancy outcome was as positive as possible given their resources. I am aware some of the issues discussed in this article can lead to negative outcomes for babies and parents. And my thoughts go out to anyone who is impacted.
Need help?
If you are impacted by any of the issues we have touched on in this article. Here are some charities that could help: Tommy’s or Bliss. They are fantastic charities doing a lot of work to help improve maternity services. I’ve also recently come across PaNDAS which specialise in postnatal Depression. Pregnant then screwed is a charity advocating for women’s rights at work.
Why are women STILL afraid to speak out on mental health matters?
The following quote is from a Glamour article and summarises how one woman felt about admitting there was a mental health issue during pregnancy:
“It’s comforting to know that I’m not the only one who feels ashamed. A woman I know recently told me that when she was pregnant, her mind was in a particularly dark place but she feared that telling someone she felt depressed could result in her baby being taken away when he was born. For months she resisted medication because she thought that being a medicated mom equaled being a bad parent. She has since started medication but is too ashamed to tell her in-laws, and she has gone from wanting multiple children to writing off any future pregnancies.”
Why is this still a problem in our society? And why isn’t someone helping pregnant women be honest and get the help they need? I do think mental health services have improved and are continuing in the right direction, but we still have a long way to go.
The quote above describes the way I felt and the way I was subsequently made to feel by a doctor. How many expectant mothers are turned away and then never have the confidence to ask for help again? As I am quite a strong person, I persisted and luckily got the help I needed. Doing this took every ounce of energy I had though. Just before getting the medication I needed, I booked 10 days holiday from work, because I just couldn’t carry on. I was even afraid to take sick leave because it would be questioned in respect of my pregnancy. I don’t know where I would be without the medication I started taking during pregnancy.
Adding a label to my experiences
It would have been beneficial for the doctor to mention or label, what I was experiencing could be a battle with antenatal depression. Nobody ever mentioned this term to me and it’s only now, looking back on the situation, that I know what it is. It has a name and I can talk about it now.
Is someone spying on me?
During my pre-pregnancy appointments and my stay on the ward (4 days), I remember feeling as though I was being watched. Checked up on, and questioned a lot. The obstetrician was obviously aware of my anxiety issues and I was overweight, which required additional check-up appointments.
Seeing through an anxiety lens
Maybe the staff weren’t acting any differently, just doing their job. The point is I felt like this throughout my care. Up to the point of discharge from the hospital post-pregnancy.
The damage caused by keeping these feelings to yourself at such a vulnerable, unpredictable time in life, is colossal. Then going through possibly the worst trauma of your life and trying to look after a small baby who is totally relying on you. It’s a lot to cope with. And we should be able to open up about it without fear.
You can read some of the other blog posts in the pregnancy section below:
Reluctance to begin mummy-duties
My hubby describes me as being reluctant to visit our little pumpkin in the baby unit (she had to be monitored due to an infection). And he puts it down to my pain levels.
Being in my head at the time, I was honestly afraid of how I would be judged in that situation. Would the nurse caring for her think I was an inadequate mother? Were they making notes about me and recording what was happening? Would I get a visit from social services? Because I was clearly unstable for thinking like this?
Pressure to breastfeed
There is so much talk about breastfeeding whilst you’re there and you are made to feel inadequate, whether this is intentional or not. The surroundings also don’t help you get the rest you need: babies crying all night, women screaming in pain. Although I felt for all parties involved and could relate, it isn’t the best setting in which to recover from a major operation with out-of-control anxiety issues.
Techniques that helped me through
Stopping full-time work one month early
The pressure on expectant mothers from the workplace also has to stop! Slowly society is progressing in this area, but the progress isn’t quick enough for me or other poor mothers, who have additional guilt, added to the mixing pot of hormones, emotions, physically struggling, anxiety about life-changing circumstances, and the thought of being responsible for a new baby.
When it came to it, admitting I needed to stop working due to severe hip pain and mental health issues, really helped me. Although having to do this makes you feel inadequate. Nobody at work visited me, whether it be management or HR to ask how I was doing. The only sympathetic comments I got were from other expectant mothers. Who literally felt my pain in respect of lack of support.
Feeling isolated and lonely
It is isolating and lonely to feel like nobody understands how you feel. You’re so tired at that point. It’s too much to try and explain it to someone, who frankly doesn’t understand and doesn’t really want to. I stayed quiet for a lot of time and put my head down until I could finally finish work.
The day I finished work, I visited the doctor after not sleeping all night, feeling sick, and suffering from severe anxiety. And this was the route I took to stop working. It had to reach a breaking point before I could finally stop. They told me not to go back until after my maternity leave ended. The worry then became about limited time with my child. Was I wasting a month before the baby was here? Should I still be working?
Workplaces need to do better
I think workplaces and the government are also accountable for supporting women and making employees feel secure in having children and thriving at their jobs. You shouldn’t have to pick one or the other.
I am a huge fan of the shared paternity leave. The hubby & I have discussed doing it with a second child. Unfortunately, I don’t think enough people know about the option or want to take it up. Hopefully, this will change.
The pressure on expectant mothers from the workplace also has to stop! Slowly society is progressing in this area, but the progress isn’t quick enough for me or other poor mothers, who have additional guilt, added to the mixing pot of hormones, emotions, physically struggling, anxiety about life-changing circumstances, and the thought of being responsible for a new baby.
Self-care
During the month off work pre-pregnancy, I made time for self-care. Baths, naps, candles, chocolate, strawberry laces (even though they made me sick towards the end, with my limited stomach space). Anything that would lift my mood and make me feel a little better.
Although I was hesitant to finish work early, as I was only having 9 months at most with my little pumpkin. It was refreshing to have a month off before the baby came. I did all the things that made me feel better and stopped dragging my overloaded body to the train station every day. To a job where I didn’t feel supported. It was lovely to be out of the toxic environment.
The home was my haven
Nesting – we’ve all heard that term used. To describe a woman’s instinct to prepare for the impending arrival of a brand-new baby. I love this description from a Dad’s perspective.
My hubby was used to the nesting process (I’ve always been obsessed with cleaning). He’s the messy, unorganised one in the relationship and I’m the one who gets excited about new cleaning products. (standards have slipped though, now I have a toddler).
On the subject of men, I would also like to mention, this issue doesn’t just impact mothers. Men’s mental health can also be affected by pregnancy and the aftermath.
What the experience taught me
I have learned my lesson about prioritising the health of myself and my baby. Also, not caring about what other people think. Especially those who have no bearing on my life and the decisions I make. Ultimately you as an individual will know what’s best for you and you should push to receive the help you need. In the future, I would stick up for myself when it comes to doctors’ appointments and medication.
If and when we have another baby, I would do things differently this time. You don’t know what to expect when it’s your first pregnancy. You must experience it for yourself, in order to learn and grow.
Final thoughts
Everyone has their own way of coping with traumatic events and mine is blogging.
I can only relay my personal experience, feelings, and thoughts on this subject. I am aware there are a lot of additional factors and issues surrounding these sensitive subjects,
If you have been affected by any of these issues, let’s all speak out and raise awareness. That’s how change happens. Please feel free to get in touch, or leave a comment below. I would love to hear from you.
