Revolving door

My house door became a revolving door of healthcare professionals coming in and out. Next to call was care coordinator and psychiatrist.

I would find out much later on that a friend I had disclosed to how I was feeling, who also worked in the CMHT in a different locality, had called the care coordinator saying that I was unlikely to be fully truthful to the psychiatrist and was not well. The care coordinator told her it was best to not tell me that they had spoken as I already had mistrust in services.

I was not happy the psychiatrist was there. I was adamant I would not take medication. She said other options could be a mother and baby unit. I refused this. She wanted me on antipsychotics. I refused saying I was not psychotic. We finally agreed I would start on 50mg of sertraline, an antidepressant. She gave me the prescription slip but I was already certain that I would not be cashing it in. By this point I believed they would some how poison the medication they wanted to give me. Why would they? I couldn’t really explain this but I just knew that the government was out to get me.

The psychiatrist said she wanted to discuss with the team tomorrow about what would be the best way to support me. I said to her I did not want to be discussed. Little did I know that this discussion she would have would lead to more professionals knocking at the revolving doors.

They are out to get me

One day on a walk back home a van stopped in the middle of the road and I panicked that they were going to jump out and take baby boy from me. I ran back home with baby boy fearful of what would happen.

I was now in a world where I believed the government was out to get me.

Care coordinator visited the following week and as I sat on the floor playing with baby boy I disclosed this event. I can’t recall what was said but I believe she wanted me to see a psychiatrist and start medication. I said no. Yes I’m stubborn but I was also convinced that there was nothing wrong with me. Everything that was happening to me was real. Why wouldn’t anyone believe me?

CMHT came to call

One day mental health services lady came back as she said she would. This time husband was present but also this time she came along with another lady, a Community Psychiatric Nurse, my now care coordinator.

I was not happy. I had said I didn’t want to be referred to the CMHT. I felt ashamed that as a psychologist I was being seen in a service I used to work in albeit a different locality but within the same NHS Trust. I asked to be discharged but they said GP would be unlikely to take responsibility of the care of me.

I was even further into the mental health system now. The care coordinator arranged to see me again.

The report

The social services lady returned for a brief visit to introduce the family support worker.

The family support worker visited on her own at a later date. We discussed her purpose and both agreed there was no need for her services. I was bonding with my baby boy and taking him to groups. I was depressed but was meeting my baby boy’s need. She said she would discharge me.

I hoped that this discharge would mean social services wouldn’t return but not long after family worker visit I received a report from the social worker concluding her assessment.

This report would be so damaging to the beliefs I hold about myself that my mental health would further deteriorate. The belief of not being good enough would be confirmed by numerous statements in the report. Assumptions and presumptions made created an inaccurate picture of our household. Health visitor played a big role in the misinformation fed to the social worker which in turn influenced her interpretation of observations and events. This report also did not give an opportunity for my husband’s voice to be heard. This would lead to the report affecting him almost daily to this day.

This report would also portray me in a way that confirmed the beliefs I was failing my baby boy and as a result of this I started to think he would be better off without me.

Confession

It got to the point that I needed to come clean with my husband. The strain of dealing with services and keeping it from him was not helping my mental health. Plus he needed to know. He deserved to know. It had gone too far without him knowing.

I told him everything one evening sobbing in distress. I felt like I had betrayed him and I feared he would leave me. I had created a web of lies and what he thought was reality was not what he thought at all. I felt like I was in pieces but goodness knows what husband was experiencing. Little did I know that the social services event would continue to haunt us both in different ways.

He was understanding and though shocked he didn’t get angry or cross with me. I realised how lucky I was to have him as my husband. I had deeply hurt him and although I would like to say this would be the last time I would do so, I’m afraid to say I would betray him again.

The green car

Later that same day social services rang. I again repeated what I said to the mental health team lady. I explained to her that I was fine. I reiterated I was not psychotic and didn’t need medication. I asked her to close the referral but I think my adamancy came across the wrong way. She said she wanted to meet me and I reluctantly agreed. I realised that protesting would look bad.

The next day she arrived in her bright green car. I let her in without fuss. I find it difficult to remember the details of our conversation. But I remember her saying that I was not engaging with the mental health team and was being difficult to get on the phone to speak with. I was flabbergasted. First, I answered my phone each time and there were good reasons why it took three attempts to have a proper conversation.

Social worker stayed for nearly two hours and I felt I was being interrogated. I had also booked a food delivery that day but forgotten about it. She looked out the window and asked if I was expecting one. I was and said blatantly that I thought she would have been gone by now. She helped me with the shopping and we returned to the interrogation. We agreed that I would engage with mental health services as it was obvious I was struggling with depression.

She left eventually and later that day the mental health lady called and said she would write to GP to get me started on 50mg Sertraline. I reluctantly agreed but later that day I changed my mind and told her I didn’t want to take it. This news got back to the social worker and I got another call from her. She wanted to visit again. I said fine. What was the point in arguing. It would make things worse.

She visited again and stood outside the door but no one came to answer the door. She rang me obviously thinking I had stood her just up but it transpired she was standing at the wrong house. Two seconds later she was in front of my house in her bright green car. I had a smirk on my face as I opened the door. She didn’t find it amusing.

That visit lasted a whole morning and by some miracle baby boy stayed asleep throughout it. Social worker had come with an intervention. She had printed on A3 sheets big bold statements of how my mental health was messing up my baby boys life into adulthood. I was under attack. I was already feeling not good enough and struggling with mood, and now here was someone trying to say I was doing damage to my baby boy. Angry I went through each statement and argued my side. I had fight in me. The one thing I wouldn’t allow was for my struggle to affect baby boy. Some may argue that inadvertently I was but me and my husband would have strongly and firmly said no. He was talked to, loved, cuddled, never left to cry, taken to baby groups, smiled at, played with, well fed and clean. I showed her photos of baby boy smiling and being loved. Also realise that each visit baby boy was either needed to be put to sleep or was asleep so she didn’t really have much opportunity to see me interact with him. She would later put in her report that of what she did see, was me going through the motions for the sake of her presence there.

At the end of the meeting I felt bruised. I had been in a ‘fight’ trying to defend myself. She offered to see me again but I declined. She suggested a family support worker from the children centre. I wasn’t sure what the purpose of this was but I agreed. I also agreed to perinatal mental health team lady to visit me. Having received the mental health team assessment letter made me realise I should cooperate and get help.

In between these visits and following the second visit from social services I started to get suspicious of things around me. I started to worry about vans and cars outside being social services surveillancing me. I was adamant that a green car was following me.

Mental health lady visited me and I explained about this happening. She said that she would have to refer me to CMHT as I was displaying psychotic features. I argued I wasn’t and I didn’t want any referral made. She arranged to come see me again.

Services

This is going to be difficult to write… this is when things started to feel like they were getting out of control and people’s supposedly good intentions made a bad situation worse.

My health visitor contacted my GP surgery after visiting me when I had disclosed the baby boy possessed experience. In fairness she had a professional duty and probably felt out of her depth hearing these experiences.

Later that evening baby boy was asleep upstairs when there was a knock on the door. A lady was stood there holding a professional looking bag. She introduced herself as a doctor from the surgery and explained how my health visitor had been in contact. I wouldn’t let her in initially. I was thinking what the hell do you want and what are you planning to do. I was scared. I pleaded with her at the door that she didn’t need to come and everything was ok. She clearly wasn’t going to leave so I reluctantly let her in.

The visit did not last long. She asked how I was and I broke down. I said I didn’t want medication and shortly after the visit ended. She didn’t say anything more and I was left thinking that was it. It was merely a check in visit. How wrong was I…

The next day I had visited my mum in the morning and was getting ready to leave. My phone rang and someone introduced themselves as someone from the perinatal mental health team. I panicked. What was going on? Why were they calling me? Where did they get my name and number from? I explained to them I didn’t need their services and I hadn’t agreed to any referral being made to them. I said I couldn’t talk with them then and there as I was in the car leaving my mums house. She was adamant to continue the conversation and get me on medication. We finally agreed she would call later at a better time.

Back at home, baby boy needs to have a nap and is cranky. He is crying and I’m trying to rock him to sleep when the lady rings again. Talk about bad timing. She attempted to have a conversation with me whilst baby boy screamed in the background. I could barely hear what she was saying but she thought it was an ok time to keep the conversation going. I continued to tell her I was fine but she said I was not well and could she and a colleague come out to see me. I said no. I then had to explain that she would have to call me again in a bit as I needed to get baby boy to sleep. I couldn’t have a proper conversation with baby boy screaming the house down.

Finally baby boy was asleep and she rang me again. This time was a good time to ring but a bad time of what was to come. I find out that GP had referred me to them. We spoke about their concerns that I was psychotic. I was determined to come across as sane and stable and explained that the experiences were a result of sleep deprivation and traumatic experiences, and I was not psychotic. I struggled to find the right word to describe the thoughts but what I wanted to say is that they were ego dystonic and so no concern was required. Eventually we agreed they were probably intrusive thoughts and that I was depressed. Again I firmly said I would not take medication.

Then she mentioned …. social services… my heart stopped. What on earth was going on here?! I demanded to know who referred me and she said the health visitor. I pleaded and pleaded with the lady to tell them to stop the referral and un-refer me. She explained she couldn’t but she would talk to them. I was devastated. The stigma of social services was at the forefront of my mind. Worse, what would my husband think of all this… I had been keeping so much from him and I couldn’t face letting him know that I had myself in this mess. I feared he would be angry with me. It was my mess and I needed to sort it out without him knowing. This was a big mistake and being deceitful was always going to end badly.

A turn for the worst

At the beginning I found my health visitor to be very supportive. Probably unusually she visited me weekly for the initial months as she saw me struggle with my mood. She even contacted my GP on a couple of occasions and warned them that I may not attend the postpartum medical review appointment.

I did attend and broke down in tears but I remained resolute that I would not take medication. I was determined to be in control of how dealt with the depression. I was a psychologist after all. I knew the theory and the techniques/strategies but the thing is, it’s difficult to apply these when you’re in the deep waters trying to make sense of what’s going on. I was also breastfeeding and didn’t want medication. The GP then said the following words which would in turn become a prophecy- some ladies become so depressed they end up in hospital. I scoffed internally. No way was that going to happen to me. I wasn’t anywhere near there. Little did I know that the prophecy would be fulfilled.

I was struggling with sleep deprivation. One night when baby boy woke I thought I could not do this anymore. I gave my husband baby boy and I left the house in the middle of night. I did not go far before I thought about baby boy getting hungry. Mother instinct kicked in. I returned home and fed baby.

Then one night I had an unusual experience. Baby boy woke for a feed and as I looked at him I feared he looked possessed. His eyes scared me and so I closed my eyes as I breastfed him and placed him back in his cot. Exhausted but unsettled I went back to sleep. The next morning his bodysuit scared me. It felt evil and I felt uneasy inside. I didn’t feel right…

I told my health visitor the next time I saw her of this experience and this set off a chain of events that would turn me into a mental health patient in a system I worked in. I was losing grip on my life and reality…

The Body & Mind Remembers

Every night for the first couple of weeks as I lay in bed with my husband I would interrogate him about the details of the labour. What happened? What was said? Who was there? By continually going over the details of the traumatic event, I was processing it and those fragments of pain and trauma were falling into a narrative that would allow me to eventually come to terms with what had happened. However there were still gaps in our knowledge and we would later contact the hospital for a debriefing. We had someone senior come to visit us to answer our questions and the information we gathered was the glue that helped me put the final fragments into place.

My body was also still holding onto the trauma. My leg would shake as I dropped off to sleep as if I was having a contraction. I would have flashbacks of the labour and see the faces of health professionals with looks of hatred for me. This happened for quite some time but the intensity weakened and its hold on me loosened.

Mental distress can also manifest in other ways. It is common to have intrusive thoughts and images of harming infant postpartum (examples can be found here https://bjgp.org/content/67/661/376). I was in this boat but it did not distress me because of my clinical experience and profession I was able to normalise these thoughts. They were just thoughts and I knew that it was normal for mothers to experience this postpartum. I would find out later that sharing the specific thoughts I had with a fellow mum struggling with OCD (when I was in a mother and baby unit 6 months later-more to come on this later) helped to normalise what she was going through.

The mind and body was telling me things weren’t right and more was to come.. the trauma had left an imprint. I no longer had the intrusive thoughts, flashbacks and shaking legs, but I had the depression that was strengthening its grip around me. I was spiralling into unchartered territory of motherhood and postnatal depression.

Alone agony

One thing that started to change without intention was the relationship with my husband. I started to feel distant and resentful towards him. To me he could continue to live a near enough similar existence pre-baby boy whereas it felt like my life had been turned upside down. Of course this is not fair because he was also going through his own journey in becoming a father. But selfishly I felt like I was the martyr.

One memory still remains strong. Late one night baby boy woke again ( 24 hour schedule of 2 hour snooze before wanting a feed) and my left breast was in agony but it was its turn to be the feeder. I knew I had to grimace through the pain of pins and needles breaking my skin otherwise I would end up with bigger issues. I sat up in bed and held baby to my left breast for a feed and I started to cry. Husband lay beside me fast asleep but stirred for a moment to ask if I was ok. I said no. He went back to sleep.

Now I don’t blame him or feel anger about this but in that moment I felt desperately alone.