Mental Health – and Money

I have realised that in telling you all about myself I have missed out quite a large area, which is my mental health.  I have been following Rosey @PNDandMe and #PNDChat almost since the moment I started on Twitter, and I should probably tell you why.

My family has always been very open about mental health, because a number of my relatives have struggled with it including my father, so I was fortunate in that I never had any idea of stigma.  I just always knew that mental health was the same as physical health: you had a problem, you tried to get it fixed, you talked to the professionals.  Unfortunately though, that doesn’t make it any easier to identify what you are actually struggling with yourself.

Looking back, I can see that I have had anxiety for a very long time, probably since my teens, and a little bit of depression thrown in there as well.  I was certainly struggling at university, but it is easy to overlook that perhaps because when you are at university you can blame it on too much alcohol, not enough sleep, chaotic relationships – all kinds of things that when you’re young can seem to be the reasons why things are a bit odd.  But looking back I think anxiety was a big issue.

Easy to blame problems on partying when you’re young

When I was in my twenties I had my first experience of counselling.  I had been with Phil (now my husband) since I was 22, and I am not sure what age I was when we decided that I needed a bit of help, but it was certainly before we got married.  I was struggling with anger, mainly, which stemmed from anxiety – I had bouts of anger, could be very cruel to Phil and to myself, and just be unpleasant to be around and clearly unhappy.  We found a counsellor locally through my GP, and we paid for me to see her a few times. She was helpful.  It was the first time I had started to sift through everything and obviously by the time you are in your twenties there is quite a lot to sift through, so it was the tip of the iceberg.  I can’t remember how we afforded it, I suspect we had some help from my parents, but it was useful.

The next time I had any professional help was just before we got married.  I was struggling with what I now know is social anxiety – I remember a particular incident when we were at a friend’s wedding and I just found it so difficult.  I was opting out of social situations, I was wandering off, I was leaving situations early, I was going away without saying goodbye – I just remember so many times when I behaved in what must have been quite an odd fashion, because I just didn’t know how to cope with these situations.  I was having, if not physical panic attacks, then certainly that feeling of “I can’t cope with this and I must leave this situation”.

So Phil looked into Cognitive Behavioural Therapy (CBT) and I went to see a private therapist called Patrick who was very helpful.  It was my first experience of CBT and it was fantastic.  Really helped with the social anxiety.  I can’t remember how many sessions I had but once I was signed off by Patrick I knew I couldn’t go back to see him because he was moving back to Ireland.  Once it was over I took the theory of it with me, but I didn’t practice any exercises afterwards.  Which was fine, because I can’t believe now I ever struggled with social anxiety, that is not something I would say I have a problem with anymore.  So CBT worked for that, but I didn’t keep up with the idea of using the techniques more generally.

And then we come to the point where I had children.  Before you have children, you have a number of coping strategies – wherever you are in your life, we all have issues and things that make life difficult for us, and we have our coping strategies.  Some of us have sleep – sleep was one of my big ones, if I could rest and get a good night’s sleep things were easier, and if things were particularly difficult I could hide under the duvet all weekend.  As anyone with children will now, sleep doesn’t happen when you have a baby!  There are other coping strategies you don’t realise you are using until they are taken away from you: time to yourself, time away from other people for instance. Having a baby means that you are permanently around another person, you are permanently responsible for something and it is something incredibly important, which if you struggle with anxiety is obviously a trigger.  You don’t get much sleep, you don’t necessarily eat that well, and life is completely and utterly different to anything you’ve experienced before, so you are totally out of your comfort zone.  Anxiety comes roaring back.

I definitely struggled with postnatal anxiety, although at that point I still didn’t know that “anxiety” as the word for the things I struggled with.  I knew I was having a hard time postnatally, I knew I was tearful and low and upset; I did the Edinburgh questionnaire and of course I came up as borderline, because I didn’t have postnatal depression, I had postnatal anxiety.  If you read my feeding story you will see that in the end it was a question of giving up breastfeeding and getting a good night’s sleep, because that’s the only coping strategy I knew. So that’s what I did, and I slept, and baby slept through from 18 weeks which was a big help.

And then I went back to work when Edward was 7 months.  And this was a problem, because work had always caused anxiety for me.  I don’t deal well with the workplace, with all the responsibilities and the constant judgement – because that’s what working life is, constantly being judged, having appraisals, doing things that your boss will then judge, that’s what it is.  Obviously as a working mum you are trying to organise a lot of things, there are still nights when you don’t get that much sleep for instance when baby is ill or teething, and I really struggled.

The stormy beach of my mental health

When Edward was 8 months old Phil and I had real problems, I was very unhappy, I had a couple of mild panic attacks at work, and we took the decision that I needed some help. We decided that I was going to give up work, even though we couldn’t afford that at the time, and I was going to have more CBT with a private therapist.  All of this had a financial implication, and we once again had to have help from our family.  I don’t know what we would have done without that.  Money is unfortunately the key. We found an incredible private therapist, Julie Ruta, who since that time has changed my life, quite frankly.  I had probably 8 months seeing her and it was just amazing.  She was the one who told me about Generalised Anxiety Disorder (GAD), we identified that that was my main area of concern, although there was some depression in there, and she taught me some brilliant things for dealing with it.  We looked very closely at so many aspects of my life, so many different ways of coping, and as I say it changed my life. When I finished with Julie I was really positive about my ability to cope.

The autumn after I finished CBT with Julie I actually had a few “tests” to go through – I had a miscarriage and I had to have surgery on my scalp.  So I had a few instances of being in hospital (I did not used to deal well with hospitals) and these things were stressful anyway, but I dealt with them very well.  It gave me hope that I was able to move forward in life using the tools that Julie had given me.  I knew this time that I needed to keep up with the CBT exercises and practice the techniques. I then fell pregnant for a third time and as you will know, my youngest son David has a congenital heart defect and the weeks surrounding his birth were very stressful.  I coped pretty well whilst we were in hospital because we got lots of attention and support, from friends, family and medical professionals.  The day David came home was one of the hardest days – I remember throwing a cup at the wall about 3 hours after he had come home because I just didn’t know how I was going to cope.  I don’t know why, looking back, I didn’t go back to see Julie then but I tried to push on through using the tools that I had.

We had a few months before David’s second operation, and my goodness that was a stressful time.  That Christmas was probably one of the worst times Phil and I have been through as a couple.  Just before David had his second op Phil and I had a couple of sessions of relationship counselling, again from a private therapist, as we needed a little bit of reassurance and a bit of assistance because we were struggling. David did remarkably well during and after his second surgery, and once he came home again as far as I was concerned we were all set to get on and enjoy life.  He doesn’t need another operation until he is 3 or 4 years old, so I just wanted to look forward and have some fun.

Beginning to build a shelter from the storm

We had a holiday with friends, and when we came back David was 8 months old, the same age Edward had been when the wheels came off so to speak.  I have no idea if the timing was a factor, but the day after we returned from holiday I dropped into the deepest mental health hole I’ve ever been in.  This was depression this time, it was frightening and it was frightening for Phil. Our lovely GP came to the house and prescribed anti-depressants.  Phil took 3 weeks off work so I could just disappear into bed and recover.  So not only money this time but also Phil having sympathetic employers were a key to me getting the help I needed.  I was however able to self refer to Trafford Psychological Wellbeing Service this time around as I was pretty ill, which meant I got 6 weeks of CBT on the NHS.  It was very basic, quite different from what I had had with Julie, but it was what I needed.  It was back to the absolute basics of CBT and that’s what I needed: a reminder of the simple tools and the simple ways of coping, and it reminded me that I hadn’t been doing the exercises.  It doesn’t work if you don’t keep up with the techniques.  I went back to doing the exercises everyday until I felt ready to space them out a bit more.

I now have a relapse plan in place, a note of my red flags for when I am likely to start to struggle, and I have started to build what I call me “house of mental health”.  I saw myself as having been on a windswept beach with no shelter, buffeted by everything life threw at me, and I realised I had to build a strong house that could withstand all weathers.  So I put my tools to use and instead of trying to just “get fixed” I took it really slowly and gradually started to put myself back together.  10 months later I feel I have built a pretty good house, but I know that it will need constant maintenance.  I have so much in my toolbox though, and I know I can go back to see Julie at any time – no waiting list required.

Building my House of Mental Health

I have worked hard to help myself.  I have had wonderful support from some very good friends.  I have had medication and some therapy from the NHS.  Ultimately though it has been our ability as a family to finance private therapy that has kept my life and relationship on track.  I feel incredibly lucky.  And I feel angry on behalf of all of those friends of mine who would also benefit so much from the kind of help that I have received.  Because they are priced out of the market.