SISSY ROSE

My first pregnancy ended in a miscarriage, so when I fell pregnant again with my now 2 year old daughter I was over the moon with joy. Although I was terribly sick during the first trimester, I still loved every second of it and made sure to do ‘all the right things’. I will always remember attending birth classes, and how at the end of the last session my instructor mentioned that we shouldn’t be worried if we don’t feel an instant connection to our baby - sometimes it can take time, and I thought to myself, ‘What kind of monster doesn’t feel a connection to their baby - how is that even possible?’. Well, it turned out that I became ‘that monster’.

The day arrived and I gave birth to a beautiful healthy baby girl. There I was lying in bed, weak, exhausted and in pain. Finally, I was a mother. She was the cutest little baby girl. Yet I felt nothing. The only emotion I felt was anxiety. Had she eaten enough? What if she starved? Is she too hot, too cold, is she breathing?

The following day we were discharged, and we called my mother-in-law around to help give her a bath. I couldn’t watch, I ran to the other room. What if she bangs her head or drops her?! I just couldn’t bear the thought. The next few days continued like this, with awful anxious thoughts racing through my head, and then suddenly the darkness hit. I felt dead inside. I didn’t want to see or talk to anyone. All I could see when looking at my gorgeous daughter was resentment; I didn’t want to care for her.

It all came to a breaking point on a Friday afternoon. She was extremely unsettled, so I called my husband home to take over and I went to have a shower. Standing under the jets of steaming water, I broke down. My tears mingled with the spray as I bawled and cried hysterically. My husband ran in, not knowing what was going on or what to do - he had never seen me like this before. He called my mother for help, telling her that I was really not doing well, but she just blamed it on the ‘baby blues’. The following week we flew home to Switzerland for Pesach and I spent the majority of the time in bed, crying, hardly taking care of my own baby and missing most of the meals.

When Pesach was over, we flew back to Manchester, and the very next day found me sitting in the doctor’s office, telling him everything that I was feeling and what had been going on. He diagnosed me with severe PPD/A and put me on medication and a course of therapy. Ashamed and embarrassed, my husband and I made sure to keep all of this quiet. I felt like a complete failure - my friends and siblings all had a lot of kids and none of them had gone through this and had to go on medication – why had this happened to me?

Over the next few months my depression went from bad to worse, each day was more of a living nightmare than the one before. I felt scared, alone and in such a dark, dark place where I hated every second of my life. I would sit on the couch crying my eyes out. One moment I would be sweating and my heart would be racing, the next moment I would be shivering and trembling with cold. I had a constant knot in my stomach - some days I woke up crying hysterically, asking my husband to please not go to work as I couldn’t handle being home ‘alone’.

Things slowly started to improve at around 7 months and that’s when I decided that I needed to tell my closest friends what was going on. They did have a hunch that something wasn’t right - I had never joined them for baby classes or met them for lunch. One evening we sat in the car and I told them everything that had been going on. Of course, they weren’t surprised because they knew something hadn’t been right, but they had had no idea to what extent I had been suffering. They didn’t judge me or look at me any less, they just felt sad for me; sad that they hadn’t known and that they hadn’t been able to be there for me at a time when I needed them most. ‘From now on,’ I was told: ‘If you ever feel sad, anxious, alone or down, call straight away and one of us will come over. Even if it’s in the middle of the night we will stay on the phone with you!’ It was such a relief - I finally didn’t have to pretend or put on a show. I wasn’t lonely anymore. And yes, I still felt sad and anxious but I had my wonderful understanding friends who would always be there for me. I did call them up, anxious about things that most moms don’t panic about, but they understood why I was panicking, they calmed me down and helped me.

Slowly but surely, I got better. Things became easier and more enjoyable. I actually started to enjoy my daughter’s company - I used to have to force myself to talk to her (it’s important for their development so yes, I actually had to force myself to talk to my own child) but now I love it. I love her, I’m maybe even somewhat obsessed with her.

Looking back, I can’t imagine ever not having that instant love and connection with her but I understand now that it wasn’t my fault and I don’t have to be embarrassed about it. I wasn’t well. I didn’t ask for this to happen to me but it did, and I was finally able to take control and get the help I needed. My doctor told me I should consider myself lucky for seeking help relatively early. He has mothers coming to see him a year in, still suffering, and only then realising that something’s not right. Just like when you have a headache you take paracetamol, I had to take medication for my ‘headache’, and I shouldn’t have to be ashamed of it. If only I had told my friends sooner, I wouldn’t have had to go through it alone; they would have sat next to me while I cried and taken me out to cheer me up.

The reason I’m sharing this with you is because PPD is spoken about enough in our community. It is still something that most women are ashamed of and keep quiet about and it shouldn’t have to be like this. You don’t have to suffer alone. Talk it out, get the help that you need and deserve. Don’t feel like a failure, because you are not! You are amazing and you WILL get through it. You are the best mummy for your baby even if you think otherwise right now. Your baby loves you!

I believe I went through what I went through for a reason and if I can even help just one struggling mother out there then it will have been worth writing my story.

At times it feels like the people of our community are neatly boxed up by the language we speak, our place of birth, style of dress, or the length of our wigs. Yet every one of us has ways in which we don’t fit in, and in essence we are all square pegs in a round hole, creating one beautiful, multi-diverse family. In ‘faces of our community’ we feature regular women living around us who have a story to tell, and by doing this we show that in reality each one of us has her own story, her own differences and individualities. To share your story with us either publicly or anonymously get in touch with us at contact@valourlifestyle.co.uk.

HEALTH LET’S TALK ABOUT PERINATAL MENTAL HEALTH

By Rivki Dwek

Leah lies awake watching the rise and fall of her sleeping 10 weeks old’s chest. He has just finished his midnight feed and she knows that she has a two and a half hour stretch before he wakes up again. She is exhausted and is aware that this is her chance to sleep, yet whenever she drifts off she wakes in a panic, her heart palpitating and her chest full of heavy pressure, imagining all the horrifying, tragic things that may happen to her baby whilst she sleeps.

‘Where is the tomato puree?’ asks Chana rummaging through the shopping bag her husband has just put down, ‘Where is it?’ She dumps the contents onto the kitchen table and turns to her husband in anger, ‘Why can’t you ever do anything right?’ she screams, ‘I ask you to do one thing for me and you can’t, why are you always so useless?’ She stops short, seeing her husband’s shocked face, then runs past him, locks herself in her bathroom and bursts into tears. What is happening to her? She feels as if she is losing it. She spends her days crying for no reason, uncharacteristically snapping and raging at her three-yearold, her husband, and just not feeling herself.

Rachel sits in her 8am meeting trying to concentrate on the day’s briefing but her heart is in her throat. Under the table, she prods her stomach, trying to feel movement, any sign that her baby is alive and kicking. As each second ticks by, she feels herself become increasingly anxious. ‘Calm down,’ she thinks. ‘You felt the baby last night; it’s probably just sleeping. She prods harder, ‘But what if…’ She blinks back tears, her mind flashing back to eight months ago when her previous pregnancy ended at 14 weeks. She tries to focus on her boss’s words but her mind is racing. Perhaps she should excuse herself and check into the antenatal triage; or perhaps she should go to the canteen, buy herself an energy drink, and see if the baby reacts.

Leah, Chana and Rachel are all likely to be suffering from a perinatal mood disorder.

We all have mental health and physical health problems; it just so happens that we talk and deal more with our physical health than our mental health. Mental health refers to our emotions, specifically our emotional reactions to situations and events. Often, when one begins to experience a mental health issue it can be a normal reaction to an unusual event. 4 women will suffer from a mental health disorder. Recent evidence has highlighted that fathers are vulnerable too, with 1 in 10 dads suffering with their mental health during this period.

A perinatal mood disorder, (PNMD) refers to a range of common mental health struggles that are triggered during the perinatal period. These can affect any woman (or man) regardless of age, income or culture. It can occur after one’s first baby or after one’s sixth baby. There is no single cause for perinatal mood disorders, and they are not triggered by something the subject has done wrong. They can be triggered by the adjustment to the life-changing event of having a baby, hormones or experiencing difficult circumstances such as a difficult patch in one’s relationships, a stressful move or job stress. We do know that some women with specific difficult life experiences are more at risk of developing a PNMD and that women with certain illnesses, in particular bipolar and schizophrenia, are proven to be more at risk of developing a severe disorder.

I think I’m struggling with perinatal mood disorder, now what? First of all, know this. You are not to blame. Neither are you the only person struggling, and there is help out there. It is perfectly normal to feel a range of emotions during the perinatal period. 80% of women feel weepy, irritable and low in the first two weeks after birth. This is called the ‘Baby blues’ and is caused by the change in hormones that occurs after having a baby. This usually resolves itself by two weeks post-birth. If it lingers for longer than this, or if you experience mood swings that are rapid and manic, it may be a sign of a PNMD.

Without doubt, motherhood can be extremely challenging and it’s perfectly normal to feel anxious and experience low mood from time to time. However, if symptoms last for two weeks or more and begins to impact your daily functioning, it is important to seek support.

What are the symptoms of a perinatal mood disorder? Symptoms can vary and women can feel one or two emotions or a whole range at different times. You may feel sad, depressed and cry a lot. You may feel inadequate and worthless, especially regarding thoughts about being a good enough mother. You may feel strong anxiety, tension and fears around motherhood, safety and other things. You may be unable to sleep, despite feeling exhausted or you may have low energy and exhaustion even though you are sleeping more than usual. You may have trouble focusing, remembering things and making decisions. You may suffer restlessness and irritability and find yourself snapping uncharacteristically and exploding into fits of rage. You may notice a change in appetite or a change in weight. You may experience scary and intrusive thoughts that you feel unable to control, and these may be accompanied by unwelcome vivid images. Some women feel despair and some entertain thoughts of self-harm and suicide. Sometimes, symptoms can take on a somatic nature and women suffer from tension headaches, chest pains, heart palpitations, numbness and hyperventilation.

It is important to mention that 1 in 1000 women will suffer from Postpartum Psychosis. If you or someone you know begins to hear, feel or smell things that are not present (hallucinations), start to believe and think things which are unlikely to be true or experience confusion, manic behavior and rapidly changing mood swings, then contact emergency services right away. Post-Partum Psychosis is a very serious illness that needs immediate medical intervention.

The good news is that for most, perinatal mood disorders can be resolved. Early intervention is key as there is a risk for PNMD to spiral and turn complex with time.

How are Perinatal Mood Disorders treated? PNMD is a real medical illness and needs to be treated as such. Treatment options depend on symptoms and severity. A range of therapies or medications can be used and in some cases a combination of the two. Recovery time varies but most women start to feel better a few weeks into treatment.

PNMD in our community Although there have been great strides in talking about mental health in our community, Perinatal mental health remains misunderstood and symptoms are often pathologized and passed off as a normal part of pregnancy and postpartum. Women are often told to ‘snap out of it’, ‘pull themselves together’ or told they are ‘ungrateful’. Additionally, a great deal of stigma surrounds PNMD. After all, many of us recognise the true value of motherhood and it is particularly difficult for a Jewish woman to admit motherhood has triggered emotional struggles. This is a major barrier preventing our mothers from accessing support. There is also a major fear that admitting one is struggling will result in them being seen as a bad mother or in the worst-case scenario having their children removed from their care. In fact, asking for help when you don’t feel right shows tremendous courage and excellent parenting. You are not to blame and you haven’t done anything wrong. Just like you wouldn’t hesitate to see a doctor if you had a pain in your stomach or a broken leg, you shouldn’t hesitate to seek support for perinatal mood disorders - they are real medical illnesses that need treatment. Similarly, there is a lot of fear around medication. Some women need to take extra iron during pregnancy or after. In the same way, some women benefit from taking medication for a little while, such as anti-depressants to help their hormones balance and recover during the perinatal stage. There really is no difference.

The risks of not seeking help for PNMD can be terrible. It is imperative to seek support.

A word about Menucha Menucha is an organisation specialising in Perinatal Mental Health. Set up by women with experience in perinatal health, it was developed with the Orthodox Jewish woman’s voice at its core. We provide high quality perinatal mental health support with advice, referrals, specialised culturally appropriate psychotherapy and Perinatal Occupational Therapy. We also help mothers access physical support. We are an extremely safe service and confidentiality is of top priority. Since launching, we have helped over 80 women recover. If you have any further questions about Perinatal Mood Disorders and think you or someone you know might benefit from our services, please call 0300 222 5764, Monday - Friday: 9.30am - 1.30pm, Monday - Thursday: 8pm - 10pm