TW MH: ⚠️Let’s talk about this year’s Mental Health Awareness Week theme…. ANXIETY.
I had my first notable panic attack aged 13; and it changed the course of my life. I hadn’t realised all the things I’d been doing, seemingly small, but all the while, obsessive behaviours, that had embedded themselves into my life and daily routines since childhood.
Earlier that year I had taken an intentional overdose and by the end of the same year I was being homeschooled.
I moved to a new school but the anxiety continued. I had one friend, 🫶🏽 and the rest of the world thought I was nuts.
I only felt safe around my mum, and I was so terrified of something happening to her, that my relationship with her became fraught under the weight of my illness. This also coincided with me having such horrific menstrual periods to the point I would faint, and I was prescribed a cocktail of heavy duty drugs, including, a large dose of SNRI’s with a side of benzos by aged 14.
I didn’t like who I was and I didn’t understand the level of anxiety I was masking. In large because I didn’t have access to the tools required to understand or make changes, and being the only person I knew my age on antidepressants…. it was a lot.
Therapy didn’t work, because I wasn’t well or focused enough to engage.
If I felt threatened I would lash out. If I felt like I was going to be abandoned, I would act out irrationally in a bid to push people away, so I could ‘get ahead’ of their leaving. Basically, I was constantly trying to control the narrative of my life, and let me tell you, trying to constantly predict the unpredictable, is EXHAUSTING.
To this day, I live my life around a cycle of anxiety, but I understand it so much better now.
We all have anxiety. Anxiety is a normal reaction in the brain which occurs to protect us from a potential threat, but what happens when that threat isn’t there anymore?
A common analogy that a therapist once used to described anxiety to me, is like sensing a tiger in long grasses. We need our brains to cultivate a certain level of anxiety, to protect us, it’s in our genetic makeup to be alert to danger, but when we’ve established there’s no tiger, normality should resume. For those of us with long standing anxiety, or anxiety disorders, this often isn’t the case, and our brains become hyper-vigilant. This means we are on look out for the threat at all times, and our life can become very limited because of it.
There’s a lot we can do to reduce the level of anxiety we experience. Awareness of the debilitating ways in which it can show up in our lives is crucial. Because the reality is, we don’t all present in the same way. Not everybody who lives with anxiety will suffer panic attacks, some will have specific triggers or phobias that make them anxious, others’ may not know the cause of their anxiety.
I know myself that a lot of my anxiety stems from childhood and that any kind of hormonal fluctuation will exacerbate it’s effect.
There are also lots of services that provide support for those of us living with anxiety, which I will list below.
Anxiety UK offer both phone and text support for anybody experiencing anxiety.
No Panic offers advice, support, recovery programs and help for people living with phobias, OCD and any other anxiety-based disorders.
IAPT provide free short-term skills based therapy for those who are registered with a GP in England.
I’m going to be presumptuous and assume that the majority of you that follow me know, I have PMDD.
Premenstrual Dysphoric Disorderis a severe negative reaction in the brain to the natural rise and fall of estrogen and progesterone. It’s suspected this reaction arises from a cellular disorder in the brain. Symptoms can worsen over time and or around reproductive events such as menarche (the first menstrual cycle), pregnancy, birth, miscarriage, and perimenopause. Three weeks ago I chose to turn off my ovaries. A subcutaneous implant of GNRH Analogue was placed under the skin of my abdomen to shut down ovarian function. This process is called Chemical Menopause or medically induced menopause. It should (if it works) put my body into a reversible menopausal state. If this works well and symptoms subside I’ll hopefully be added to the waiting list to have my ovaries removed. This isn’t a first line treatment, nor is it an easy one to endure but for the sake of my health specifically my mental health I felt I had no choice but to utilise this option.
So why the fundraising and what’s this about Teal Tuesdays?
April is PMD awareness month. A whole month dedicated to raising awareness for those of us living with a premenstrual disorder. And this year IAPMD the charity that facilitate awareness month are making Teal Tuesdays their big fundraiser.
How do I get involved? That’s the easy part. Below is a simple step by step guide to taking part.
Why do you need donations? Donations help IAPMD continue to provide vital spaces and educational resources for patients, healthcare providers, and researchers. A donation of just US $25 can fund a 1:1 peer support session for those in need. Funds raised also help IAPMD to further research Premenstrual Disorders and support their mission to create a world where those with a PMD can not only survive – but thrive!
Can I host an event or do my own sponsored thing? Yes absolutely. IAPMD have curated a list of ideas to make it easy and fun to participate.
Image used with permission
Why Teal? The official ribbon colours for PMDD are teal into black and like many charities have a colour that represents them, IAPMD wanted theirs to be a signature colour for those who fundraise for them. Plus, it’s a great colour and IAPMD can’t wait to see what you do with it!
Can I buy something to wear? Yes! Bristol based designer and fellow PMDD patient, my mate, Amy Steel of One Tuff Muvva has donated some super fun designs that you can purchase on T-shirts and a variety of other items. Find them here.
Note from me: PMDD is a debilitating chronic illness that is widely misrepresented and dismissed. It takes a person on average 12 years to get an accurate diagnosis and many women are misdiagnosed with Bipolar Disorder. This charity has not only helped me understand my condition better with their comprehensive resources, their groups have answered many of my questions. Though international IAPMD have a small team and each one of them work tirelessly to make Premenstrual Disorders visible. Their mission is to create a world where those with a PMD can not only survive; but thrive. If you are someone who was assigned female at birth, a woman, wife, mother, daughter, sister – I urge you consider making IAPMD a cause you get behind. PMDD & PME can and does ruin the lives of those living with it. Without information and awareness sufferers will continue to be misdiagnosed and incorrectly treated. It can occur at any age and worsen over time. IAPMD is the only charity of its kind providing international support to PMD sufferers worldwide.
I wanted to write this post – no scrap that actually, I NEEDED to write it. Not for sympathy. Not for ‘attention’ well for attention to the topic maybe, but for my truth. The need to share my truth of this awful rollercoaster I’m on with my health.
To the outside world my life has never looked less complicated. I’m married to the best man I’ve ever known. I have two beautiful kids. I’m writing and advocating – two of the things that set my soul on fire.
So what have I got to be so hysterical about? This week is the 4th week I’ve not been able to stay up for longer than 3 hours a day. My body is not working as it should. My mum, husband and two of my best friends have all looked after my kids during half term: a week when I should be making memories with them. 3 weeks ago I caught a common cold that left me in bed for 5 days at my mum’s house. Off the back off that came a Fibro flare, my joints seized and neuropathy took over my extremities. This week I had some blood tests which show my inflammatory markers are high again.
The pain I’ve been trying to hide has left me angry and ashamed. I’m angry because I’m tired of having to explain that I’m sick, even though I don’t ‘look’ it. The physical and mental toll of being unwell is too much.
I’m angry at the world for not understanding my needs.
I’m angry that the sound of two people talking at once now cause visceral reactions in me, that make me want to run into oncoming traffic.
I’m angry because I’m ashamed that once a month during PMDD I am hysterical and I’m ashamed that I can’t look after my own children without help.
I’m ashamed at the way I respond to stress and stimuli.
I’m ashamed at myself for not being more grateful on the hard days.
I’m ashamed that I can’t cope with life in an admirable and inspiring way; because society deems that’s the way disabled people should cope.
That I’m not thriving despite anything – I’m surviving at best.
“I’m scared to be around them, in case I fuck them up with my very existence”
Yesterday I walked the dog in the rain and thought about throwing myself in the river. I don’t want to do that, but it’s a thought that niggles for 10-15 days a month, sometimes grows arms & legs & tells me my life, my wonderful life, with my beautiful family isn’t worth sticking around for.
I could and would never intentionally leave my kids, but this knowledge terrifies me too, because sometimes I’m overwhelmed by it. I’m scared to be around them, in case I unintentionally fuck them up with my very existence.
That word again: SHAME in my opinion parents are shamed for their struggles. Especially mothers.
She’s not doing enough her kids are acting out.
She’s doing too much her kids are neglected.
She needs help – those poor kids.
And on it goes, the shame cycle.
For example: usually, after a post like this I get an influx of messages from kind strangers, telling me they’re sending love, and solitary one or two messages from people I know in person. My real life friends. It’s a tough one because whilst we absolutely should not rely on external validation as a coping mechanism, it can still be difficult to tell your brain that. With social media now being our go to resource for almost everything, you think your friends and family have seen it, you think they’re rolling their eyes. And because of those insecurities, it’s hard to dismiss the notion that these feelings, intrusive thoughts and so on, are feelings we indeed should be ashamed of.
I wish she’d keep it to herself because it makes me uncomfortable!
I dunno why she writes all that stuff there’s no need it’s so cringe.
She doesn’t know how lucky she is.
If she were really feeling that bad she wouldn’t be posting about it.
And it got me thinking, is this what we want our children growing up to believe? That when they feel bad about their life they must keep quiet? That if it’s so bad they’re even possibly thinking of ending it, nobody wants to hear about it. They should only tell a doctor or someone close to them because other people, the rest of the world, might feel uncomfortable if the whole truth is shared with them? Should we be teaching our kids that their feelings don’t matter because they’re cringe to read about, silly to other people who might not understand them? Attention seeking.
It’s not about attention, but even if it is – so what? Don’t people who might be feeling suicidal, or so unwell they’re struggling to keep themselves safe, deserve attention?
Aren’t we all – just trying our best to survive, with some of us finding it easier or harder than others at different times. It’s not about comparison, who has it worse, or wanting a pat on the back for speaking out…. It’s about acceptance on a grand scale. It’s about making small changes that will lead to larger societal shifts in how we relate to each other.
For me personally, the problem isn’t with recognising feelings of shame. I’m aware of them I’m aware of behaviours that stem from them. No, for me it’s about self compassion, that’s the one thing I can’t seem to grasp and it’s a major road block in helping me execute strategies to deal with shame and all of its associated emotions.
I made some decisions this week that I hope will help me tackle this moving forward.
My world has been spinning out of control again recently. I’ve felt once again overwhelmed and incapable of coping with so much responsibility whilst being so unwell. I’ve not felt like ‘me’ and some days, I’ve not been able to articulate what being ‘me’ feels like. The worst part is -or one of the worst part(s)- as I come out the other side now, is, I know all of these feelings are down to PMDD. Yes I still have overwhelming responsibilities and health issues, with seemingly endless insecurities, in spite of PMDD, but none of them feel as overwhelming when I’m not premenstrual. Such a scary illness… I can’t even… so I won’t…. Instead I’m going to list 5 things that have helped me cope and survive the past week during the latest luteal maelstrom.
I was lucky enough to spend the weekend in Weymouth with my mum and Ciara and truthfully, I had never needed the time away more. The weekend arrived when my panic and anxiety was highest in my cycle. Being around my mum is helpful because she’s very understanding. Though it’s still difficult sometimes to be around people when you’re not at your best. Below are some of the things that helped me through those days and I know they benefitted not only me, but Ciara and mum too.
1. Watching the sunrise.
There’s something so therapeutic about watching the sun rise. There’s a sacredness to being awake before the world officially starts it’s day. Of course there are always a few people milling around, but the first morning light is like a balm for my mind. Even better that this time I got to watch it by the sea. To view the sun’s reflection and listen to the waves lap at the same time is magical. I’ve always felt quite lonely and not very safe at the thought of going outside at the literal crack of dawn, but winter months bring a later sunrise and in the last fortnight I’ve made the effort to get up and out twice to watch it, and can report it was so worth it. There’s a placidity to it that calms my jangling nerves and puts me in a better place to start the day.
2. ‘Fancy’ dress-up
Let’s face it, we’d all like to pretend to be someone else once in a while, right? The sheer effort somedays to put a face of makeup on and make it outside is too much to bear thinking about, but somehow going out of the norm is strangely comforting. I loved being this witchy woman and picking pumpkins with my mini. I wasn’t even bothered at all the weird looks I got -and there were a few- if anything though, I got a confidence boost from them. Sounds weird I know, but with Halloween fast approaching there’s literally no better time to have a bash at being someone else.
3. Creative craft
It’s not ironic that I write my worst days. Ask any creative and they’ll tell you some of their best work was created during times of extreme stress or melancholy. Even without delving into the history of creatives and mental illness, for many of us craft and creativity can be a therapeutic outlet. In fact it’s even seen used in practice such as mindfulness and some forms of CBT. I often try to get creative with the kids when I or they are feeling stressed. It’s a great way to connect without any pressure. It’s something we both, particularly Ciara and I, find really relaxing. This (pictured) creative practise was simply ‘free’ drawing on pumpkins and it was soothing for us both, a great way to wind down from the day’s stressors or after lots of high intensity activity. It’s also a cute Halloween craft and a great idea for rainy days.
4. Creative Writing
As above. The creative process is a calming and therapeutic one. For me, words will always be my go-to outlet. Writing all my thoughts really does help me to process them. This notebook created by my friend and literary idol Emylia Hall, founder of the creative writing course Mothership Writers is full of motherhood writing prompts and gorgeous illustrations. It was the perfect accompaniment to a really rubbish week. I can honestly say I felt better during and after using it. It’s definitely going to be a permanent fixture in my self soothe kit.
5. Nature: Preferably involving wildlife
You don’t have to be an animal lover to appreciate the beauty of wildlife. Some of my favourite de-stress activities include animals in their natural habitat. When I first suffered with lingering PND after Ciara was born back in 2016, a common favourite was feeding the ducks and I’ve resorted back to doing this whenever I feel low. Earning the trust of wildlife requires being present and patient and that’s why it’s such a great grounding activity for when you feel as though you’re losing your mind. This little squirrel pictured, was a little too tame to be honest and made himself comfy on my thigh in wait for Ciara to snap open a monkey nut. It left me with a smile though, and there’s a lot to be said for simple pleasures.
This blog is not intended to substitute medical advice or the advice of a trained professional. If you need to speak to someone about your mental health, please make sure you do so. Be that your therapist, GP or an organisation such as Samaritans. And remember that if you’re concerned about your ability to keep yourself safe please call 999 or go to your nearest A&E.
In the interim though, these few simple, accessible and affordable techniques may help you focus on the present moment. Particularly for those rollercoaster mental health days that are often up and down. To prevent spiralling out of control all together, maybe one or two of these activities can help you process your thoughts a little more clearly. I’m by no means an expert, apart from in the field of my own lived experience, but everyday I am seeking small but manageable ways to be more mindful and regain a modicum of control over the often obsessive thoughts that plague me during both PMDD and times of high stress. We could all do with taking more breaks, and so I hope this blog will be helpful in encouraging you to do just that.
Having suffered with this illness for more than 20 years I feel I am equipped to answer questions relating to the condition and as a result of my own experience. However, it’s important to note I am not a medical professional and all answers are my own words, with no association to any organisations that are linked in this article. Relevant links are included so that you are able to corroborate mentioned treatment options and use diagnostic tools.
How did you obtain diagnosis?
This question came up several times, with many of you saying you had tried and failed to have PMDD accurately represented when speaking to GP’s and medical staff. In my experience from discussing PMDD within the online community I have come across similar tales and it’s one that follows a similar trajectory to that of my own experience. I first suffered from mental illness at aged 13, suicidal ideation, attempts and thoughts occurred, followed by bouts of extreme rage, panic attacks and enduring anxiety. It wasn’t until some years later I had made the connection between my feelings and my menstrual cycle. I remember seeing a GP aged around 19 when I said I believed I was suffering from a hormonal imbalance. I didn’t know at this stage that PMDD is a reaction to normal hormone fluctuations, an imbalance was my assumed interpretation. She told me all women suffered ‘some PMS symptoms’ and that there was no diagnostic blood tests that would give insight into my mental health and it’s correlation with my cycle. Since then I have seen the GP and several gynaecologists in excess of 100 times for the same problem. When I finally began to be taken seriously around age 23, my GP still referred to my condition as severe PMS. Last year aged 33, I became so unwell during pregnancy and after the birth of my son that I was hospitalised and it was only then, under psychiatric care that a psychiatrist referred to my illness as Premenstrual Dysphoric Disorder. More recently this year when seeking further intervention privately, the Gynaecologist (whom is also head of his department in an NHS hospital) again confirmed a PMDD diagnosis.
Diagnosis is a huge relief, it allows us to stop gaslighting ourselves into believing we are raging hypochondriacs. BUT clinical diagnosis is not necessary for treatment of the condition. Your GP can advise, and treat PMDD symptoms even whilst still referring to it as PMS. If these early treatments such as lifestyle changes, hormonal birth control and SSRI’s work for you, you may never need a formal PMDD diagnosis. That’s not to say you won’t want one for your own clarity. If this is important to you, I suggest keeping on at your GP for specialist referral. If you are struggling to get a diagnosis and believe you have PMDD please head over to IAPMD for help and information on diagnostic criteria and talking to your doctor. They have an array of tools to help you cycle track and a glossary of terms that will help you explain exactly how your condition affects you see: Iapmd toolkit.
You also have fibromyalgia, do symptoms of both conditions overlap?
In short, yes. In detail, a higher percentage of fibromyalgia sufferers are women. A symptom of the condition in women can include painful and heavy periods dysmenorrhea. It’s also known that many persons living with fibromyalgia will suffer mental health problems, so it’s my opinion and personal experience that it’s fair to say symptoms overlap. PMDD can trigger a flare up in fibromyalgia pain, more prominent and prolonged fatigue, as well as sensory overload, brain fog and migraine attacks. The key difference between the two is that PMDD only occurs during the luteal phase of the menstrual cycle, which occurs between ovulation and menstruation. Instead, fibromyalgia symptoms can and do occur at any time during the menstrual cycle. I am often alerted to the arrival of PMDD by waves of crippling anxiety and intrusive thoughts that disappear when my period arrives. However some physical symptoms that might be triggered by PMDD end up lasting long after it’s end and will alert me to a Fibro flare up. Also with my experience of fibromyalgia, pain doesn’t ever disappear entirely. I always have some form of baseline pain. Many people also report joint pain with PMDD along with migraine attacks, these are present premenstrually as a result of PMDD and can occur and worsen at any time with fibromyalgia.
Can PMDD come on at any time in life?
Yes, it absolutely can. Some people find their PMDD starts or worsens with a reproductive event, such as menarche (which is when mine started) after pregnancy/birth or miscarriage (when mine worsened) or with the onset of perimenopause. For some it will seemingly come from nowhere. It is believed that PMDD can also be linked to genetics, childhood trauma and depression.
Is PMDD a disability?
Here in the UK, you are covered under the Equalities Act and therefore thought to have a disability if you have an impairment that is either, physical or mental and the impairment has a substantial, adverse and long term effect on your normal daily activities. Depending on the severity of your symptoms you could be covered under the act with a PMDD diagnosis. When explaining PMDD to my employer I advised how it affects me, for example: I suffer menstrual migraine attacks that leave me bed bound for days, along side extreme fatigue and joint pain. As well as this I also suffering debilitating anxiety, intrusive and suicidal thoughts and panic attacks, which make carrying out daily activities impossible. Cognitive impairment such as brain fog and an exacerbation of any underlying symptoms are also worsened with the onset of PMDD. The fact these symptoms occur every month, and last for 2 weeks makes this a long term condition with substantial impact on my life and ability to function.
Why do doctors prescribe SSRI’s for PMDD if it’s hormonal?
After diet and lifestyle changes SSRI’s are a treatment option to help manage the mood and anxiety symptoms that are present with PMDD. Whilst you may feel you aren’t depressed, some women (myself included) have found benefit in taking SSRI’s, both month round and only or double dosing during the luteal phase of your menstrual cycle.
Are palpitations a symptom of PMDD?
PMDD has many, varying symptoms. They range from severe mood alterations, to debilitating physical symptoms. I personally do experience palpitations during both ovulation and the luteal phase. I’m also extra sensitive to stimulants such as alcohol, sugar and caffeine during this time. All of which make palpitations worse and more noticeable. If palpitations are persistent it’s always best to get them checked out to rule out other possible causes, though I know many people experience them alongside profound anxiety, so if this is one of your PMDD symptoms it could also be exacerbating your palpitations.
Summary
PMDD is a chronic and debilitating condition with a range of symptoms that vary in severity.
There are a range of treatments used to treat PMDD and their effectiveness is very individual.
PMDD can and does exacerbate underlying conditions, this is sometimes referred to as PME (premenstrual exacerbation)
PMDD can occur at any time during a person’s menstruating life.
I hope this information is helpful. For more detailed and expert advice head to IAPMD where you’ll find everything you need to learn more about PMDD.
This week if I had to use 3 words to sum up my HRT experience I’d use: BLOODY, ENTHUSIASTIC and BRAVE.
Bloody
I’m still bleeding two weeks after the last time I told you I was bleeding. Which isn’t ideal. It’s not spotting either, it’s a couple of pad changes a day. The main cause for concern here is I can’t really tell what is or was my menstrual period and so I don’t know my cycle as I normally would and therefore struggle to determine how my symptoms relate to which phase. However, for now, I’ll take the blood. I don’t want to put up with it forever, of course that would become troublesome, but so far the blood I’m losing is a minor problem and is being outweighed by positive changes and more calm.
I’m also unsure whether this bleeding is related to the oestrogen gel, or the progesterone in the mirena coil as both report similar effects. It still needs noting though, because it is a troublesome symptom if it continues long term, and I don’t want to have to add an additional progestin treat it.
Enthusiastic
I chose this word because for the most part it’s how I’ve felt in the last two weeks. Potentially this suggests it’s when I’d usually be in the follicular phase, or that HRT is doing the job it was prescribed for. The trouble with me is, I am a pessimist, after decades of cyclical hell I’m almost programmed to think it can’t be working. However if I’m being honest, with both you, and myself, I have felt better, less anxious and more able to cope. It’s summer holidays -I mean if there was ever a time that was going to tip me over the edge this would be it! But I’ve managed to get out with both kids, I’ve caught up with friends (just having the energy and enthusiasm for this, is hugely positive) In the last few days I’ve suffered migraine attacks and felt fatigue and muscle pain (which I think is related more to Fibro than PMDD) and still my mood hasn’t plummeted. Moreover I’ve not been plagued with those awful intrusive thoughts. All of this, for me, is quite something!
Brave
I chose this word because I have done things I’d usually panic doing, like driving places I don’t know, on my own, and trying to get my steps up, increasing my movement. I’ve still had anxiety around doing these things, it doesn’t just disappear, but it’s anxiety in relation to normal life stuff as opposed to being crippling, as is normal during PMDD.
Gynae Appointment
I saw the gynaecologist to discuss my treatment plan and review my use of HRT. He got full marks as soon as I entered, when he thanked me for my email. I was relieved to hear that he had taken the time to read it, it was long! I explained all of my symptoms to him over the past two decades. He asked me how I cope during PMDD and I explained to him that for the most part, I don’t. Some would argue this, but I am forever calling on my mum and husband to come and help with the kids or indeed in a panic that they then have to talk me out of. I told him I’ve been in crisis so many times premenstrually that I almost feel it’s normal. That I swing from feeling like ‘I’m going mad’ to being able to cope. He fully supports a PMDD diagnosis. To be honest just hearing those words as opposed to the ‘severe PMS’ my GP always uses was such a relief that I ended up leaving in tears.
What was even more positive for me was the options he presented me with. Just finally feeling as though I have some was effectual in calming my racing mind! I’ve always known the treatment pathway, I’ve just never been able to get a doctor to consider me for the next stage before now!
We concluded that I will remain on the HRT for another few months unless I do not see any continuity with the improvement, or I experience a relapse. The next phase is chemical menopause which is induced by injection of GNRH analogues. As it’s an open referral to a private hospital, it’s left open so I can call him any time and book the next available appointment for the GNRHA shot. If I go down this route I will leave the mirena in situ and continue to use Oestrogel. I would then trial the medication for 6 months before deciding whether or not to have surgery to remove both of my ovaries and Fallopian tubes (Bilateral Salpingo Oophrectomy)
No major surprises at this appointment I knew what was to come next, I just thought I’d have to fight harder for it. Relieved to say I didn’t. The consultant explained that to obtain the injections for chemical menopause, I would need to have the first one in secondary care (Private treatment centre) and then I could be referred back to primary care to receive the injections on the NHS. This was really reassuring considering my mum paid for my appointment and I have £14 in my current account, so there’s no way I can afford private healthcare in the longterm. That said it was still worth every penny to us as a family, to enable me to have these discussions with a knowledgeable doctor whom is experienced in Premenstrual Disorders. I feel like there’s hope, and options and both of these were in short supply before my appointment.
I plan to write another blog really soon to answer questions relating to PMDD, but please remember IAPMD are the oracle when it comes to premenstrual disorders, so head on over there if you need advice, questions answered, or resources to support you.
If I could sum up the last three weeks in three words they’d be INSOMNIA, ANXIETY, and HOPE.
Insomnia
So let’s start by telling you about the insomnia. I’m not going to sugar coat it, it’s been horrific. It began almost as soon as I started using Oestrogel and unfortunately it remains. If you’re reading this, you’re probably a HRT user yourself, menopausal, someone who thinks they may have PMDD or a PMDD sufferer. Or maybe you’re none of the above and have no previous insight into hormone replacement therapy at all… I know it can be confusing when deciding whether or not to try a new treatment, especially with how the media portray HRT as either a wonder drug (and for many it is) or a carcinogenic. But like with anything we put into our bodies, there are side effects to consider. For me, insomnia has been one of the most problematic. As a mother and someone whom lives with chronic fatigue and on occasion hypersomnia, I have found this particular symptom difficult to navigate. Mainly because, if you’ve ever lived with insomnia you’ll be aware of how it can feed into anxiety. Just how dark the depths of the night can become when sleep is evading you.
Anxiety
Since beginning HRT I’ve had loads more energy – which to some would be deemed a positive side effect. However, for me it’s not been so good, because the energy I seem to now have in surplus, is creating a quagmire of anxiety and ‘nervous tension.’ In short – I can’t relax. I’m feeling often keyed up and on edge.
A few other notable side effects have been:
Hot flashes
Nausea
Breakthrough bleeding – though this could be attributed to the recent mirena coil I now have in situ.
Hope
But I’m still hopeful…. Mainly because what else have we got if there’s no hope? And also because it’s very early days and adding in additional hormones was always likely to cause some symptoms particularly when you’re adding them to treat a hormone sensitivity and not necessarily a depletion as you would in menopause.
I’ve also just finished reading I BLAME THE HORMONES by Caroline Suzi Church and that gave me hope. It’s something I want to review on its own blog post, because the similarities between mine and Caroline’s PMDD trajectory are so similar, it’s more than I can possibly squeeze into a paragraph on this blog, but if you have PMDD you absolutely need to read it! Not only is it scarily accurate, a whole half of it is dedicated to treatment and self help. It really is a wonder of a book with so much insight into reproductive mental illness.
Positive changes
Finally, I need to finish by saying there have been some positive side effects, though fewer, it’s important for me to be transparent. Many people have great results using HRT and as mentioned above I am still really hopeful that I too, will get to experience more of these going forward. One positive change I’ve noticed is a reduction in the severity of my overall joint pain. Which is pretty huge considering I’m in pain almost all of the time. I’m not pain free now by any means, but my joints are beginning to allow more range of movement and I can only attribute this change to coinciding with my use of HRT. Another thing that’s improved is the horrific intrusive thoughts I was having. They are not gone altogether, but when it comes to feeling out of my mind I’ll take every single win (however small) I can get and this is one that suggests HRT could be the right direction for me.
I’m in a new relationship with a great guy. I’ve been dating him for seven months, we met through work and have been inseparable since. The relationship is moving fast and we’ve already talked about moving in together. But I’m so insecure, every-time he goes out with his friends I’m convinced he’s cheating on me. We’re both 28 and my last relationship was two years ago. My ex who I thought was the love of my life cheated, and it killed me. I know my new partner is already getting fed up of some of my comments about his social life, but I can’t stop myself from saying them or feeling jealous when he’s out…. I even feel insecure when he’s at work or the gym. I know how this’ll sound and I am embarrassed, but I feel so paranoid when we’re not together. I don’t text him all the time when he’s out, but the next day I’m so stressed about what he might have been up to, that I avoid talking to him altogether sometimes. He’s never given me any reason to doubt his loyalty to me but he is a lad’s lad. He’s getting annoyed with me over my ‘jealously’ what can I do?
Emma – Swindon Uk
Dear Emma,
I’m sorry you’re feeling like this. I’ve been there; and don’t doubt that almost every woman I know has at some point in time been where you are also. You probably already guessed what my advice is going to be, and that is to start unpacking the insecurities that have embedded because of the infidelity with your ex. Whether that be with a therapist, or with yourself. Jealousy and fear are like mould in a relationship, it starts off as the odd spec but if you don’t treat it, it grows at a rapid pace. Before you know it, your whole house is covered in rot. You obviously, though not unsurprisingly, have some trust issues. But your new man isn’t your ex, and it’s unfair and unrealistic to expect him to be penalised for someone else’s mistake. I myself have trust issues, mainly from a fear of abandonment, and I’ve been in relationships that have torn me inside out wondering ‘what if.’ When I met my now husband, I was forever waiting for him to let me down. And on occasion he has, and it’s likely will again, because he’s human. I had to learn to trust him regardless. What I’m trying to say is, your partner might fuck up by staying out late with the lads or forgetting to text you back, but that doesn’t mean he’s being unfaithful. I suggest being honest about how you’re feeling with your partner. You may find that rather than making him want to run a mile, it’ll help him understand and for you both to learn to compromise. You might worry that being honest with him will push him away, but your snide comments and avoiding him when your pissed off, is likely to do so much faster than an honest conversation will. It’s normal to fear history repeating itself, but moving in together is a huge step that requires a lot of trust. You don’t want to be the girl that goes through his phone and smells his shirts after nights out. That’s no fun for either of you. Talk to him now, explain that you have trust issues but you understand they aren’t his issues, and you want to work on them. Chances are he will be able to both reassure you and help you work through them. From experience I can promise you that any work you do on yourself to overcome this cycle of insecurity will pay dividends. Break the cycle now. I’ve included some links to organisations that may be able to offer you some support. In Swindon you can also self refer to talking therapies who provide free cognitive behavioural therapy, which focuses on changing the thought process and can be particularly useful if you have a specific anxiety – which in your case seems to be around trust, and probably also self esteem that was shattered by your exes betrayal.
I’ve mentioned on my socials recently that I’ve become more accepting of certain aspects of my life. First and foremost I’ve accepted the fact that I am disabled. It’s taken me seven years to fully get on board with the idea that this is something I must accept. In fact, my acceptance came very recently whilst attending a course of Dialectal Behavioural Therapy. One of the sessions was based solely on radical acceptance and what it means.
So, tell us, what is it?
In a nutshell: Radical Acceptance is a skill in Dialectical Behavior Therapy (DBT) that helps people learn how to accept very painful events, challenges, people, or aspects of their life. It’s one of the skills found in the Distress Tolerance module of DBT.
Radical acceptance for me personally has been about the above, accepting my illnesses and the fact they are life limiting, but that there are still moments, days, weeks, that are good. Sometimes even great. Radical acceptance has also played a role in how I relate to my pregnancies, my early motherhood experiences and things in my past that I cannot change. Major regrets and mistakes that I have made that have played an overwhelming role throughout my life.
So are you saying we should accept people who treat us badly, or forgive ourselves or others for things we’ve previously felt were unforgivable?
No. Foremost, radical acceptance doesn’t mean forgiveness. You can regret something you have done, dislike the part of you that did it and still accept that it happened. Similarly with actions of others. For example if you’ve been in an abusive relationship and your partner has hurt you badly, radical acceptance isn’t about forgiving the person who hurt you, or continuing to accept abuse. It is about accepting a situation, to help you gain the most peace and enjoyment from your life. If hatred for that abusive partner is eating you up, or if because of the trauma you suffered, you’re too scared to go out, practising radical acceptance can help you move forward to live a life more inline with your personal values. You do not have to forgive someone’s mistakes, you just have to stop letting them take up space in your head. I know it’s not easy. Another example for me: I have many regrets but one in particular has been eating away at me for over a decade. Everyday I was continuing to punish myself by telling myself I was not a good person. My ruminating became so bad it was affecting my parenting, I was having daily panic attacks and feeling as if my family would be better off without me. When learning about radical acceptance the psychologist advised me that I didn’t need to forgive myself, I could still hate what I’d done and understand that I could not change it. I could accept that it happened and try and build a life for myself, or I could continue to ruin my life by going over and over the same thing. In doing the latter I was hurting my family because they were worried for me, and that only served to make me feel more guilty and unloveable. RA is complex at first, but once you come to learn more about the concept, practice radical acceptance of the little things, like spilling cereal all over a freshly washed floor, the easier it becomes to do it with the big things. Like me with my regrets and my health.
Another one that I’ve been practicing (if you’ve been following my blog for sometime you may have come across me talking about this before) is the acceptance that sometimes people won’t like me and there’s absolutely nothing I can do about it. I don’t like everyone, in fact I’m quite selective in the people I call friends. But when it comes to others not liking me, I have been known to take it really personally. I’m not sure why, maybe it’s an abandonment thing, or a need for external validation. Anyway, the point is radical acceptance has helped me manage the impact of this and get outside of my own head.
If it were that easy we’d all do it
I know. And it isn’t easy. Therapy never is though. I think the first thing to remember with RA is that it’s about not fighting with your reality. Not actively trying to overcome something. Instead allowing the feelings you have about it to be there, but not take over. One of the psychologists on the course I attended, gave a good example of how to practise RA in the everyday. She used the analogy of being late. You know you’re late, you could stress and rush to get to your destination faster but you’re still going to be late. And if you stress and rush you’re likely going to feel worse. So accept that you’re late and are still going to arrive late, but this way, hopefully in a much calmer state.
You may never fully accept trauma you’ve experienced, and that’s ok.
The idea of practising radical acceptance isn’t to negate every bad feeling you’ve ever experienced, but to better manage those feelings when they are taking over your life.
Try it with the small stuff, and if it feels too traumatic to build up to the big stuff on your own, consider a course in dialectal behaviour therapy. My personal experience of DBT is that it’s worth it’s weight in gold when learning to manage painful and intense emotions. Being a big ol’ bag of emotions almost permanently, it’s been a freeing and life changing experience for me.
This month is premenstrual disorder awareness month and I have teamed up with The International Association Of Premenstrual Disorders as a PMD Awareness Champion. Over the course of the month I’ll be sharing my personal experience of living with PMDD, as well as catching up with other PMDD warriors. This year’s theme is Connect The Dots and I talked to several women I’ve connected with via Instagram to find out how they connected the dots, between their hormones and their mental health.
I asked these brave women three questions which were:
1. When was your ‘light bulb’ moment? 2. How did you connect the dots? 3. Do you feel as though you’ve found a manageable treatment and if so, would you mind sharing what that is?
I’ve included my own answers below too.
Me, Steph:
I can’t tell you exactly when I knew it was PMDD because hormonal changes have affected me my whole life.
If I look back now I can see how the most traumatic experiences in my life were either in relation to my menstrual cycle or my reaction to such experiences was exacerbated by my hormones and their fluctuating.
For me, I was quite aware of the fact that hormones played a big role in my life and on both my physical health and mood, from a young age. In childhood I had a hormone condition called Premature Adrenarche. PA is diagnosed when your adrenal glands over produce sex hormones. Adrenarche can happen in both male and females, but obviously for females and AFAB individuals, puberty means periods. A lot of my dot connecting came down to PMD’s running in my family, thus having knowledge of them from other sufferers. Since menarche my moods have been severe during luteal, so bad that I was diagnosed with clinical depression at 13 years old and prescribed antidepressants. I also attempted suicide. It wasn’t until some almost ten years later, and I got my first iPhone, that I started cycle tracking using an app. Along with my mum’s knowledge of my symptoms and their severity, we pieced it all together and it became apparent that my symptoms were very obviously cyclical.
Over the years I have had many successes followed by, ultimate failures with treatment. Many treatment options have worked for a limited amount of time, until 𝐏𝐌𝐃𝐃 comes back with a vengeance. For example I’ve tried countless antidepressants and birth control and they have all helped for a period, until they don’t anymore. I can also say it’s definitely worsened in severity and duration since having children. Symptoms have also increased, such as allergies. I’m now allergic to the hair dye I’ve been using for a decade and silver. Migraine is relentless and an attack lasts for days. Treatment wise, I have biweekly B12 injections, try to manage my sugar intake, take SSRI’s month round and use progesterone only contraception – The latter has limited success in the treatment of PMDD, but combined with other methods works ok for me at the moment. What I have found really useful is, since the birth of my son 9 months ago, I have been having intense Dialectal Behavioural Therapy. DBT involves learning distress tolerance skills, and how to dial down the intensity of emotions. Skills include using holistic treatments too such as cold therapy. I really feel DBT has been invaluable in treating symptoms of PMDD particularly.
After giving birth I began mapping how I was feeling along side some cbt for PTSD due to a traumatic birth experience and I started to realise every cycle I was physically and emotionally not well
Research, research, research
CBD oils have been amazing, I live with chronic pain which worsens around my cycle and impacts sleep so these help me get into a deeper sleep, SSRI’s all month too. And lastly, the fitbit app tracking my cycle to rationalise why I’m feeling the way I’m feeling (I can pretty much tell exactly when I’m about to ovulate or bleed based on my emotional state)
For me, it was when I stumbled across the PMDD Information page on the Mind website.
After years of various tests and being told by the doctor that I’m ‘fine’ this was huge. I ticked every single box for PMDD symptoms and I just knew that this was what I was going through each month.
I went back to the doctor armed with this new knowledge plus a symptom diary that i’d been keeping for the previous 6 months and they agreed that the diagnosis was PMDD.
Yes. But it’s just sticking to it that’s the problem! My go to treatments are regular B12 injections, keeping on top of my SSRI intake, Ice hats, pain medication, plus loads of water and trying to cut down on sugar and fatty foods (even though this can seem like the most impossible task in the universe, during hell week!)
My lightbulb moment came when the doctors kept telling me I was ‘just’ depressed and giving me SSRI’s and the pill and wouldn’t listen that I only felt this way some of the time rather than fully. Hormonal contraceptives do not agree with me and I knew there was more to it than that but trusted them that they know what they’re doing.
It took a long time but I noticed that I felt immediately relieved and lighter as soon as my period started so good old google came to the rescue and I started reading about PMDD
I felt like for the first time what I had been going through was valid and real when no one seemed to believe me or understand.
I just don’t know how bad each cycle is going to be, however I did find an SSRI useful for a while, they’re not for everyone and I no longer take them. I’ve found that taking things easier/slowing down and planning things for the parts of my cycle where I know I’ll be more positive and less likely to cancel helps because I don’t then feel like I’m letting people down or being unreliable which is a big thing for me – getting outside whenever you can works wonders too even if you don’t feel like it or it’s raining being in nature does more good than people realise
My light bulb moment was when I was with my ex partner and he called me a psychopath. I was so upset and angry that I punched a hole in the wall. I scared myself with how angry I got. I was so angry that he called me that, but it made me think about what I had done to warrant that, and I thought “shit, I’m not a psychopath, but I’m not myself either, somewhere in between maybe”. It was going round and round in my head, and for a few days every month leading up to my period, I was so deeply upset, I didn’t want to be here, and it was like a cycle that I couldn’t get out of. Why am I like this? This isn’t me. But in the moment, I couldn’t see it.
It wasn’t until I was out the other side of those few days that I could reflect on my behaviour and feelings and realise properly that it ISNT me! I spoke to my GP, who put it down to “bad periods”.
I told them this wasn’t just bad periods, bad periods don’t make you suicidal, aggressive, or run away. Bad periods are tummy cramps and a heavy flow.
I pushed for more help, tests, anything. I was advised to have therapy for my dark thoughts, and they prescribed me SSRI’s. After I gave birth, they changed me to ca different SRRI. But the main help for me is telling my close people “it’s coming” or “it’s happening”. I find myself apologising in advance. “I’m not going to be myself for the next few days and I’m sorry”. Which makes me even more frustrated. No one that I have met so far, has ever heard of PMDD. Except a few queens on Insta! I try to explain it to people by saying “it’s like the volume is turned up full blast on everything. My emotions, the hurt, the anger.” You could say something to me on a normal day and I’d brush it off. But say the same thing to me on those few days and my world comes crashing down. The best treatment I’ve found more than telling people, or medication, or therapy, is reminding myself that it’s all in my head. Sometimes that can be hard, and it doesn’t take the thoughts or sadness or anger away, but it makes them more bearable, knowing that I am ill, not crazy. My ex partner didn’t help, but now he’s gone it’s so much clearer to see. I’m poorly. I have been diagnosed with PMDD, it’s not just in my head but at the same time that’s all it is. Finding others who are going through the same thing and trying to raise awareness for PMDD to others as well as medical professionals helps too. I felt like I was going mad, because I was told I was, and felt like I was. But it was all in my head and that’s where it stays. Like you say (sic) Cunty Carol just comes to visit a few days a week, and where I used to be terrified of her unpredictability, now I can at least say “fuck off Carol, I know why you’re here and I’m okay with it, close the door on your way out”
Last year I wrote a post titled Unhappy New Year and in short it was about what a shit show 2020 had been for us all. At the end of the blog I gave myself some small resolutions, to be less judgemental and apply less blame, find the positives etc. It wasn’t until I read back over the post that I realised I have achieved most of them. I think my mindset is definitely different these days. Whilst I won’t pretend I’m Lady Optimistic I am more optimistic than the me of previous years. I’m also, so much more self aware. Aware in general. I have therapy to thank for most of these changes.
The first half of 2021 was awful for us. Worse than 2020, tenfold. With me being in a wheelchair, trying to homeschool and work from home, a baby on the way that I wasn’t managing to care for as I’d hoped, gestational diabetes along with other complications made me so unwell. It all felt as though I was on a rapid decline. As Kaiser’s due date neared, my mental health worsened. Most of you know what happened next, but in case you don’t, I was hospitalised and my labour induced after psychiatric evaluation. It was decided that for the sake of my mental health and the health of our baby, he needed to be born.
I’m six months postpartum now and on my road to recovery of perinatal mental illness. I’m working hard to regain my mobility, manage my chronic illnesses, care for a newborn, and five year old, keep house and balance my hormones, oh and avoid covid, there have been many, many, bumps.
However, I believe despite the awful ordeals we have faced, the fact everyone in the house contracted covid over Christmas resulting in a real scare with Kaiser (currently all still positive and feeling really quite bad) as well as living with perpetual lack of sleep, we’ve smashed 2021. As a family we have worked harder than ever, there are broken pieces where we were once whole, and there have been rivers cried too. Our marriage has taken a hit, and parenting two children instead of one has been a huge change for us. But, having weekly therapy, finding a decent medication combination, owning my shit, being brave, digging deep, along with all that mindful bollocks previously discarded as useless information I’ll never need has been put to great, life changing use.
I don’t believe I made it through 2021 on luck or a wing and a prayer. No, I made it through this year with sheer determination, love, and hard mental graft.
Two days ago I was back in the hospital I birthed Kaiser in. I’ve been there only once since I had him, and that was recently to find out I had a tumour (benign) in my left breast. During that appointment I had my mum holding my hand. The second time was two nights ago, alone, with a baby who’d just tested positive for covid along with a husband at home who’d also tested positive so couldn’t be there to support me and our son.
I sat in the hospital room and cried alone, whilst the nurse told me my baby would need oxygen. I cried again when his levels were back up and we were told we could go home.
I’m still suffering anxiety six months postnatal, but most of the time it’s in response to ‘normal’ anxiety provoking situations, like hospitals and poor health. The rest of the time I’m using the tools it’s taken me six months to master, to manage it. I’m trying to show myself compassion and I’m working really fucking hard on gratitude too.
As I write this late at night after finally getting my kids to sleep, oscillating between shivering and sweating buckets with a fever. I decided to think about whether I have any resolutions for 2022, and the truth is I do, but my main and most important one is, I plan to continue to heal. For myself, and for my family. My kids deserve a mum who isn’t falling apart at the seams, and I deserve the love and care I so readily give to others.
If I could give my readers any advice for the new year, it would be that you treat yourself with more kindness.
Ok so I’ll throw in a few more for good measure… here goes
Love the people who treat you well
Have empathy for the ones that don’t (unless they’re just c*nts, then fuck them) but try the empathy first. It might surprise you.
Stay in your own lane. Comparison is the thief of joy.
Tell people you love them, tell them often.
Stay in the present, if it’s not happening right now, it’s not happening.
Get more fresh air.
You don’t need permission to rest.
Don’t look back, unless it’s to see how far you’ve come.
HAPPY NEW YEAR FROM ME AND MINE TO YOU AND YOURS XOXO
What a year. I can’t believe that just six months ago I felt as though my world had imploded without any real warning. I woke up one day and didn’t feel like me anymore. I was afraid for my sanity, for my mobility, for my family and our future. I couldn’t see past six hours without having a panic attack let alone six months. I led in my bed, day in day out for 7 months, unable to walk. As my son’s due date approached my mental health declined. I felt consumed by all consuming, claustrophobic, fear. Wracked with perinatal anxiety. I was broken. I guess that’s why they call it a breakdown. But here we are now, a family of four, surviving interminable routine and carnage, poor health and therapy, work and parenthood simultaneously. Loving each other through it all. It’s not been easy, it’s been hard getting here, ridiculously fucking hard in fact, but it has paid dividends to keep going.
I’ve got everything I need this Christmas. Genuinely. I feel so content with my family. When I say this I mean content as in they are enough, not content as in getting loads of sleep or life being perfect, unfortunately! Ha! I know how blessed I am, I’ve always known it, but I really feel it this year. After everything we’ve been through I have a desire to keep them close and let them know how much I love them. The only thing I want for the big day is more of that contentment (as well as good health & freedom for all, world peace too, but I’ll refrain from getting too ambitious.)
I am not the same old me I was last Christmas. Granted, I’m still a stressy, messy, bitch with a foul mouth who is always exhausted…. but I am also different. I’m softer round the edges. More vulnerable I guess, if that’s possible, but stronger too. I believe that what doesn’t kill us can leave us with a lot of unhealthy coping mechanisms, and I by no means, have ditched all mine. I haven’t turned into a preacher or someone who promotes their new lifestyle as some big epiphany, desperate for people to follow. But I am interested in change, in finding fun and contentment in new places. That makes me further away from those unhealthy coping mechanisms than I once was and I’m proud of that. I suppose what I’m trying to say is, I’m more open to learning better ways to survive and enjoy the mundane in the everyday.
I’m less inclined to sweat the small stuff whilst simultaneously being more interested in the big stuff. My tolerance for a lot of things is greater, but less for small talk. I’ve always struggled with chatting aimlessly about the weather and the like, I’m too nosy, too inquisitive, I want to meet people and know them, not skirt around edges with hollow pleasantries. Similarly I’d rather be quizzed on my life than have it glossed over, skipped or ignored. I’m over hanging on to dead end relationships and chasing things that don’t bring me joy. Whether that be friendships that are more effort than fulfilment, or doing things I don’t enjoy anymore, for example forcing myself to be somewhere I don’t want to be. This year I have no desire for big boozy nights feigning Christmas cheer. I mean obviously the pandemic has some impact on those kinda outings, but I honestly think even without the plague, I’d still just want to be snuggled up close with my nearest and dearest.
Transitioning from one child to two has been a lot. I’m already anxious about how I’m going to cope with a baby that hates sleep whilst I’m trying to eat my turkey dinner. However, I’m ok with those kind of anxieties, they’re normal, they make me feel normal, whatever ‘normal’ is. The biggest change of all for us this year is of course the fact we have an extra person round the tree to love. And love him we do. ❤️🎄
If you suffer from anxiety, or the feeling of impending doom and inexplicable terror that comes with panic attacks, the debilitating calamity that is intrusive thoughts, the unrelenting personality shift before your menstrual cycle because of PMDD? I hear you. I see you. I am you.
If you suffer from one or all of the mental illnesses mentioned above, you will know that logic is about as far away from fear as is possible. You may as well fly a rocket to Mars and you’d be no closer to logical thoughts during a panic attack. I’ve been having therapy for five months. The single longest stint I’ve ever managed to stick at anything relating to my mental health that doesn’t come in a blister pack. Full disclosure I take the pills too, I need them, but therapy is a different level of healing. It’s eye opening, confronting and real hard graft.
During these five months I have had breakdowns, many breakdowns. I have also experienced breakthroughs. These tend to be subtler, less outwardly monumental, but I can tell you from experience they are transcendent and quite awe-inspiring when you become aware of them.
I’m going to give you an example of one of my recent breakthroughs.
I am currently waiting for several hospital appointments, one of them may end up being quite life defining so it’s pretty important. With anything of importance for me, almost always comes anxiety. Throw in a self diagnosed terminal illness via Dr Google and we’re talking full blown life limiting panic attacks. But, not this time. I got my appointment letter a few days after the referral was made, though supposed to be seen within two weeks the NHS backlog means the clinic are running two weeks behind. Where as this kind of delay would usually lead to more panic, endless overthinking and probable sleepless nights, something has shifted in me and I feel different.
My logical brain has always known that there is little point in worrying about something that hasn’t happened yet, but regardless of my knowledge I have never been able to stop myself from said worry.
Worrying about tomorrow, steals today’s joy.
After going through what I have in the last five months, being scared of my own brain and constantly coming up against new challenges in trying to change the way I think, I decided right at the beginning of my recovery that I no longer wanted to live in fear. Of course simply not wanting something isn’t usually enough to stop it from happening. But with subtle changes and a keen desire to get better, engaging and working hard during therapy sessions and opening up fully to my mental health team, I have noticed a shift. I still feel anxiety around the appointment of course, but anxiety itself is a normal healthy human response. It only becomes problematic when it interferes with our everyday lives. And in this instance, relating to this appointment….I’m so happy to say it’s not doing that.
I don’t want to waste time worrying about an outcome that I cannot predict or influence. I don’t want to fear the worst only to find out when the time comes that it’s not the worst, then look back regretfully that I had wasted precious moments living in fear.
What if it isn’t a tiger in the long grass? What if it’s just a fluffy little kitten?
I won’t bullshit you, I know I’m not always going to be able to rationalise in this way. So many factors contribute to my own personal experience with anxiety and panic, that there will inevitably be times when I falter, and times when I fall. But what I’m doing right now, today, is I’m saying no to worrying about things that aren’t within my control. Isn’t anxiety itself a deep rooted need to control our fears and possible catastrophes?
How did I get here?
I took on board the offerings of tips my therapist suggested, such as grounding and breathing techniques and practised them even when I didn’t believe in them.
I reminded myself that if there’s a possibility that my world might fall apart, there’s also a possibility, it won’t.
I take prescribed medication religiously and stick with it for the recommended amount of time.
I’m trying, I say trying because I don’t always succeed, to implement healthier lifestyle changes, such as getting more exercise and eating healthier.
I write my feelings. It’s a personal favourite in helping me to process them.
I try to stay more in the present moment.
I have an amazing mental health team that I talk to regularly, even when I don’t think I have anything to say.
I know these things aren’t easy to do, I know this because it’s taken me twenty years to even begin to start really healing. But along with the above list, I also believe that celebrating small wins is a great way to remind ourselves that even when we are not where we want to be, we are further forward than we once were.
Me this week on a particularly bad day. Reminding myself it’s just a bad day not a bad life. Also me this week on a better day
Some people when they hear the words intrusive thoughts automatically assume that the person experiencing said thoughts is hearing voices. Some people think OCD, and others believe intrusive thoughts to be a sign that a person is bad, and will act on their thoughts.
So what are intrusive thoughts?
Intrusive thoughts are unwanted and or distressing thoughts that are often reoccurring. They are likely to leave the thinker very upset, distressed, disgusted, confused and ashamed.
It is thought that 1 in 5 women and mothers will suffer perinatal mood and anxiety disorders, and 57% of those will have experienced intrusive thoughts. Mental health professionals are not entirely sure why more women in the perinatal period experience intrusive thoughts, but it’s believed to be related to a variety of hormonal, environmental, and emotional factors. That said it’s a common symptom of PMADS. Typically, the thoughts that occur in the PP (perinatal period) are fears that surround our children, ‘What if I harm the baby?’ But the thoughts don’t always stop at physical harm and can be of any distressing nature, including sexual fears too.
To be clear before you read on, suffering from intrusive thoughts is NOT a reflection on a person’s character, desires or beliefs. The thoughts themselves go against all of our beliefs and natural instincts as mothers and do not align with our values, hence the very word for them being ‘intrusive.’ We don’t want these thoughts, we can’t bear them and it’s the very reason we are left feeling as though they are ruling and ruining our lives.
During pregnancy with my second child, I became overwhelmed with intrusive thoughts; some of them too abhorrent for me to share —though in some ways, I wish I felt I could share them all, then maybe they wouldn’t have consumed my brain! It got so bad that at just shy of 38 weeks I was hospitalised, under psychiatric care, my labour was induced and I was medicated for my mental health.
After my son was born and I was again assessed by a psychiatrist, she told me thoughts that are violent/harmful or as mentioned, occasionally sexual in nature, are the most common types of intrusive thoughts during the perinatal period. I asked her why this was, and she gave me a fantastic analogy.
You have this tiny human to care for. It’s your most important job, above any other. The thoughts that you are having are in direct conflict with your own anxieties about what could happen to your child. The thoughts are the very things you want less than anything in the world to happen.
But how do you know I’m not just a psychopath? I asked.
‘Because psychopaths don’t phone me up hysterical about upsetting thoughts, you pose absolutely no risk to your children. These thoughts are only hurting you.’
At this stage, I felt so out of my mind I didn’t know if I posed a risk to my children. I felt like I couldn’t think straight. But Dr M was adamant in her statistics in relation to harm caused by intrusive thoughts. Athough it didn’t ease the thoughts initially, it helped me to understand I wasn’t alone and other women and new mothers went through this too. She then went on to say (I feel like this is a big one…) the only person you pose a risk to, is yourself with your judgement about the thoughts.
I found that particular line about judgement really interesting because I realised quite quickly that it WAS the judgement that was keeping me in a cycle of constant fight or flight and inciting suicidal ideation. I felt as though my family would be better off without me.
I was overthinking every single thought and if I dared speak out about my thoughts, rather than feel better, I’d worry about other people’s judgement instead. That was until I met the most wonderful community psychiatric nurse. For the purpose of this blog I’m going to refer to him as Neo (He will appreciate the reference.) Neo has changed the way I think about intrusive thoughts, but more importantly, the way I feel toward opening up about them.
Maternal OCD is a mental illness that affects women in the perinatal period and includes intrusive and obsessive thoughts followed by compulsions completed in order to relieve some of the discomfort from the thought.
Ironically for me, my most intrusive thoughts were about convincing myself I had, or was going to develop severe mental illness (the irony isn’t lost on me.) I first believed I was developing psychosis, I was sure I would go on to hear voices telling me to kill or harm my children. This made me feel disassociated often. Despite not actually hearing voices I was convinced they were coming and I would be sat in my bedroom listening for them. I later googled intrusive thoughts which convinced me I was suffering from severe OCD, despite not having any compulsions. Another common thought for me, was passive suicidality, such as thinking I could just walk out in front of a lorry. Or consume all of the insulin in my possession. These thoughts would come to me during calm activities such as crafting or cooking tea.
When I discussed how I was feeling with Neo, he followed the protocol of having me fill out an OCD assessment, and we discovered that yes I was having obsessive and disturbing thoughts, but I didn’t have the compulsions in that were traditional in a person with Obsessive Compulsive Disorder. I’ve since learned not everybody with OCD experiences compulsions.
Looking back I can see the fear of speaking up about the intrusions was what held me back in my recovery and I would then worry that I was constantly reassurance seeking.
The truth was, there was an element to seeking reassurance, but for the most part I was doing what I needed to do, engaging in therapy and opening up in a safe space.
The mind plays tricks on all of us occasionally, and thoughts are the perfect segue into us believing we are not good people and therefore convincing us we’re unworthy of the love and compassion we so desperately NEED to give ourselves, particularly in the early stages postpartum when you wonder if you’re doing anything right.
Once I finally said aloud that one of my biggest fears was I didn’t want to be alone with my baby because I was terrified I would have a psychotic break and harm him whilst he slept. I was only then able to unpack the thought and see it with clarity for what it was, ‘just’ a thought.
If we all talked about our deepest darkest thoughts, we might be less bothered by them, but even today there is so much assumption and stigma attached to thoughts. People believe that if you think something you must feel it. With intrusive thoughts it’s the exact opposite.
The vulnerability of a woman who has just been through childbirth is like no other time in her life, the fear that we feel is immense. I personally (and wrongly) believed if I told the truth about my thoughts in the early stages postpartum, my children would have been taken away and I would have been sectioned.
You don’t have to open up about every thought in order to dismantle their hold on you though, you can put in to practise strategies and use them for all thoughts that cause you distress.
Neo recommended a book for me to read during my recovery and it’s called The Happiness Trap and is written by Australian doctor, Russ Harris.
In the pages of The Happiness Trap, Harris provides tools to defuse yourself from negative thoughts; and the book itself centres very much on acceptance. It took me a while to come round to the idea that I would ever accept distressing thoughts, but the idea is not to engage with them, just to accept them for what they are, random mental events and words.
If you’re suffering from intrusive thoughts in the perinatal period I would urge you to talk to your doctor. I know it’s hard, you may be feeling judged and terrified, but I promise you the road to recovery starts when you learn that you are not alone with in how you feel.
Organisations that can provide support during the perinatal period are:
I won’t say I’m cured, because that would be a lie, but I’m working towards how to better manage intrusive thoughts and not allow them to take over my life.
Included at the bottom of this page is a link to ‘Buy Me A Coffee’ (or book, in my case) please don’t be put off by this! Currently, Divamum makes no money, and whilst I love writing, in order to keep growing I have decided to accept donations. Just to clarify you are in no way obligated to make a donation and at no point will this become mandatory, it’s just there as an optional extra for anyone who would like to and all information is available via the link.
Huffing spectacularly in a bid for attention, my five year old turns up the volume on whichever device she’s glued to, whilst readjusting her headphones. Meanwhile the baby, who has just turned two months old, screams as though someone is pouring boiling water on his fluffy brown head (I can confirm this was definitely not the scene.) So shrill are his screams, I can still hear them even when he eventually falls silent, an eternal imprint in my echoic memory.
It’s funny really, because I remember so vividly his sister making the same sounds. The torturous cries of an inconsolable infant, a sure fire way to make you feel as though you are royally failing in the parenting game.
When my husband waltzes in from his 9-5 with a smile on his face ready to greet the family, I am already in tears. A red faced baby thrusts violently in my arms and the five year old looks as though she’s about to pack her shit and leave home. He takes the baby from me whilst the other one needs her tea cooking. Another drawback of levelling the numbers, is you get one kid each to look after. When you only have one to pass between you, the minutes in which the other parent takes over feel like a luxury spa treatment.
Your attention will constantly feel as though it’s paying mind to the wrong child at the wrong time. Because how can you know who needs you more when they both need you for differing reasons at the same time? One needs a hand because she got her head stuck in between the sofa and the wall, and the other has been waiting 30 seconds for their milk and their wails let you know…. It’s 30 seconds too long.
What’s that saying ‘If my first baby behaved like this, I’d never have another one’ I clearly didn’t get that memo. There’s also a saying which promises you never get two children the same, I cough when I hear this one now, but whilst pregnant with my second I prayed to god it was true. Turns out, the joke is on me.
Even the most stoic of mothers (that’s not me by the way) struggle at some point, but if your little gremlin has some digestive issues, colic & reflux mama’s I know you feel my pain. Not even touching on if you yourself are struggling, my chronic illness & relentless anxiety make this mountain a hard slog, that sometimes feels so overwhelming you wonder if you’re actually losing your mind.
So if you’ve read this far, you’ve probably been wondering who the hell writes this stuff and what kind of message am I sending? Where’s my positive outlook? My gratitude, for two healthy children? And you’ll be pleased to know it’s right here:
It’s true your kids will pull you in every direction, make you feel like you just can’t give enough of yourself, they’ll unintentionally make you feel guilty as hell – but they will also make you feel needed, whole, and complete.
They will push every button, overload your senses and make you wish they were born with built in pause and volume control. But, it’s that sensory invasion that will have you laughing until you cry, your heart swelling with pride, and have you sluicing tears of joy when you wave them off for their first day at school! Yay – someone else’s problem for the next ten years. (That was a joke, don’t @me)
The jealously you might notice from your older child will on occasion be replaced with an adorably primal sibling bond. Watching them teach their younger sibling, watching them do everything imaginable to make them smile for the first time -including cannon balls off the sofa- is priceless. Maybe they’ll grow up to hate each other, but maybe they’ll grow up to be the very best of friends, either way you’ll have fun watching them grow.
Your anxiety, will occasionally be replaced with minor worries, like have you got any bread for their packed lunch or the fact you forgot to pick up nappies on your weekly shop. It will of course also be redirected to your kids if they’re not the source already. I can’t promise you a reprieve because I know only too well, mental health doesn’t work like that…. But I can promise you a reason to live, or in the case of this blog, two reasons.
If you’re a chronic pain sufferer like me, you won’t get any relief, but what you will get is distraction. They will keep you so busy some days you’ll unknowingly forget about the pain for a while.
It won’t be easy, it won’t even always be fun, and some days you might wonder what the fuck you have done….. but you’ll never regret it. No matter how hard. For me, these kids have given meaning to a life that lacked direction. They’ve given hope to a pessimist. They’ve brought joy in my darkest moments and they’re my reasons for staying alive.
One last saying: The days are long but the years are short.
In other words – you’ll soon be sipping cocktails and eating tapas in Benidorm whilst your teenage kids are trashing the house in your absence and sleeping till noon.
Diva Mum 