Just One Thing- Getting Help for your Mental Health

Dr Rebecca Moore, a Consultant Perinatal Psychiatrist in London, working in London in the NHS and privately.

Rebecca has been working in this field for twenty years and is incredibly passionate about all women being able to access high quality bespoke care to maintain their emotional and physical health during and after pregnancy.

As well as writing frequently on social media to raise awareness of common maternal mental health difficulties, Rebecca organises the annual Birth Trauma conference in London. She has a book about birth trauma coming out later this year.

I asked Rebecca to tell me Just One Thing she would say to new parents and parents-to-be…. “There is help out there”

“Lots of women sail through pregnancy and the postnatal period but for most women it’s a time of huge change and mental health conditions are common.

Changes in our moods and feelings can occur all through pregnancy and after birth, some of these are entirely normal, we may have a weepy low day or feel anxious or not be able to sleep.

The difference comes when you have changes in your mood all day and most days and when it starts to affect your day to day life.

This might be constantly feeling sad or tired and not eating or sleeping or perhaps feeling on edge, nervous, panicked and with repetitive thoughts about being a failure or a bad mum.

Rarely it might include thoughts of self harm or plans to harm yourself or thoughts of harm to your baby. If you are having these thoughts in particular please see your GP as soon as possible.

I in 7 women have some kind of mental illness during or after birth but we know only 50% seek treatment, far too many women are suffering in silence.

If you are feeling mentally unwell it can feel unbelievably daunting to tell someone but please do, find someone you trust and tell them and make a plan together. This doesn’t have to be a healthcare professional necessarily it might be a friend or partner.

Every mum fears if they speak out about their mental health they will be judged or in danger of losing their baby, please let me tell you as someone who has worked in this field for over twenty years this is not going to happen.

There are so many treatment options out there now, it doesn’t just mean medication. It might be looking at your diet, exercise, hormones, sleep, peer groups or supports or therapy.

If you see a healthcare professional and you feel they are dismissive or not understanding you see someone else, most GP surgeries have professionals working there who are interested and more sympathetic to maternal mental health issues. Alternatively there are some really good phone support lines such as PANDAS, Samaritans or great apps like the Best Beginnings site. Twitter has a fabulous PND hour every week Wednesdays 8-9pm.

In the moment feeling unwell plus not sleeping plus having a new baby can feel so horrendously overwhelming and difficult. I want you to know it will pass, it will get better, please let someone know how you are feeling and then there are all kinds of things that you can try to make things feel a little easier. There are so many other women out there experiencing the same thing, you are not alone, you are not a bad mum and it is not your fault. I have seem women with no prior history of mental illness be at the point of suicide and with the right treatment and support be dramatically better within a few months and all the while parenting their baby. We women are amazing, it is not a sign of weakness to ask for help, it takes real courage to say I am struggling. But you know the moment you say it virtually every other women you meet will say that happened to me too or I felt like that too.

If you do seek help, it’s helpful to know that, while treatment can be variable around the UK, you should be offered-

GP assessment, they can initiate medication and review you and also refer on for therapy.

If there is a perinatal team near you, sadly there isn’t in every area yet, ask to be referred.

All women who have a moderate to severe illness should be offered an assessment with a perinatal team.

There are also many things you can look at, which affect each and every one of us:

Sleep, it’s really tricky as a new mum, but rest when you can, take every opportunity to lie down and rest even if you can’t sleep plus good general sleep hygiene (trying to go to bed at the same time every day, in a  cool dark room. Try a wind down routine with a warm bath, oils or other scents to promote sleep. Try and switch off all electronics at least an hour before bedtime. Some women find Epsom salts in the bath really helpful.)

Water, try and drink some! I am terrible at this but remember herbal teas and tea count too.

Food, again I get it as a new mum it’s awfully hard, but even quick snatched things can be more nutritious. Lots of protein with nuts, meat, fish, cheese, tofu, as many plants as you can, avoid excess processed foods, if you have no time buy good quality soups or salads – and don’t be afraid to ask friends to bring food when they come to visit.

Blood tests, some GPs are amenable to this, and it’s always worth testing Magnesium, Vit D and B vitamins postnatally along with anaemia.

Exercise, it will help a lot! Walk with baby in the daylight, do 10-15 minutes of an exercise class free from the internet at home, identify with your partner what you love most whether it be running or swimming and carve a one hour slot that is yours to do this in.

Meditation – Headspace and Calm Apps have 2-5 minute sequences, it needs practise but over time can really help calm and quiet the mind especially at night and it only takes 5 minutes of your day.

Social role/worth – this is huge as we transition to being a mum and leave the structure of our career.  Don’t assume everyone is making mummy friends immediately, it takes time for all of us! I was so lonely after my daughter was born and it took me a long time to find like minded friends and mums. There’s so much more out there now like exercise classes for mums, walking or running groups, going to the cinema  to a baby screening – or online chat groups so you don’t have to leave home if you don’t want to. Take your time and find out what suits you.

Partner– your relationship will change and alter, you will have times when you are both knackered and snappy and hate each other with a passion. Take a breath, try to be kind, it will pass with time usually and if it doesn’t consider some couple therapy, it can really help.

Your body – it’s not the same, you might love it, loathe it, not really take any notice of it. Try to gradually reconnect physically, I found yoga really helped me ground back into my new body. Some women find massage especially of their scar really helpful. Or just buying a gorgeous new bra or new pair of shoes did the trick as well!

A word on incontinence and your core, as this is one issue I think we should all see as part of routine postnatal care too. Incontinence is so common post birth and so easily avoided with good physiotherapy care post birth. It’s usually not well provided or provided at all by the NHS, consider a one off specialist physiology assessment, there are some great practitioners around offering mummy MOTs post birth.”

Dr Rebecca Moore, Consultant Perinatal Psychiatrist

You can chat with Dr Moore on Instagram and  Twitter. Listen to her most recent podcast on Motherkind.