The Reality of Mental Health Issues in Pregnancy.

I had a nervous breakdown in 2010. While I was recovering, I met a man and fell pregnant. I wrote this in November 2011, when I was around 3 months pregnant with S...

I was on antidepressants for just over a year. I got a new job, I met a new man, I thought I was ok. I would forget to take my pills for days at a time, and still be fine. I toyed with the idea of coming off them for good, and even lowered my dose. And then I fell pregnant, and suddenly coming off them was more than just an abstract idea. I stopped taking them. I was fine. Yes, I was tired – but isn’t everyone in the first few months of pregnancy? Everyone said how well I was doing. I believed them. We were all wrong. The truth is that I wasn’t doing well; the truth is that when you’ve been on medication for over a year, it takes a while to come out of your system. And that while is like sliding down the sides of a very deep pit. A pit with a deep, sticky pool of quick sand at the bottom and no ladder to aid escape. And most of the time you’re not entirely aware you’re sliding, but every now and then you look and realise the sky and the sun are just that little bit farther out of reach; that smiling happiness you used to know is that little bit harder to remember. And then you hit the bottom. And you start to sink. And then you realise that everything that came before was just a sick joke, and that you’re back down where you were before.

Except before, when you couldn’t sleep or concentrate or speak to anyone or ask anyone for help, you could buy a bottle of vodka and get good and drunk. Or take a couple of pairs of sleeping pills and lose a weekend. And now you’re pregnant and you can’t get drunk or take anything stronger than bloody paracetamol. So 3am just becomes this horrible mocking thing that you just resign yourself to. And the tears and the despair and the horror and the panic attacks and the horrible realisation that you can’t even fucking kill yourself to end the misery, because now you’re responsible for another human being. And killing yourself would be tantamount to murder. So, basically, you’re fucked. I’m fucked. This is all fucking fucked. And I have no idea what to do.

This is how it happens. It’s not a sudden jump into a massive pool of crazy; it’s gradual. The madness creeps up, insidious. To start with you might have a few days of feeling ok; good, even. You can do this, it’s not so hard. Followed by maybe a half day of feeling like you’re Chicken Licken and the sky is falling in. And then, gradually, over time, you find that you have half a day, tops, where you feel like you could probably cope, if you really concentrate. Followed by a week and a half of unrelenting hell. I have fallen into the bog of eternal stench and there are no ladders to help me get out.

Madness is sneaky; it creeps in the back door while you’re busy doing other things. And once it’s there, it’s like the worst kind of unwelcome house guest, the kind that turns up with a bag of dirty laundry and stinky shoes, and you just groan and know it’s going to be a long while before it leaves.

I split up with the man I so idolised a few months ago. Then we get back together. And then we split again. And back and forth it goes, until I can’t remember why we were ever together, or why we were ever apart. He wants to “be there” for me, but he doesn’t understand what’s going on in my head. How can he, when I don’t even know, and have no hope of explaining it? For the briefest of times, I’m sleeping at his house once or twice a week, and he sleeps on the couch. We spend time together and it’s nice, and we make plans and agree on trying to Work Things Out and tell each other that This Time it’ll work, we’ve got it right. And then one of us panics over something and it stops, and then we miss each other and it starts again. And my brain is so fucked, I can’t tell if it’s him, or me, or both of us that’s being ridiculous and difficult and needs to just man up. I know that for both our sakes, I should just walk away and never look back – but I can’t because this is his child too, and he has a right to see it. So I have to suffer with the back and forth and the to and fro. One minute he wants us to be together, then he loves me but he just wants to be friends. Then he’s bringing me stupid little gifts at work. He’s worried about me, he cares for me, he wants to be my friend. I want to run for the hills. He doesn’t understand that while he’s changing his mind like a teenage girl, what I really need is to be stable in my environment. That the only way I have even a sliver of hope of getting through this is with boring, monotonous routine and reliability and stability. I realise later - too late - that the instability is his game plan. He deliberately never lets any situation remain the same for too long. Nothing in his life is predictable or easy to follow. It's how he controls me and others around him.

I have no patience these days. And when I say no patience, I mean absolutely none. People getting in my way in the supermarket, people on the phone at work who won’t just shut up, family members who ask too many questions, children who make too much noise. I spend my entire life biting my tongue, my jaw set, my blood pressure soaring and my heart pumping in my ears. I hate everyone. I hate everything. There is nobody I will not kill in my mind if they stand between me and wherever I’m trying to get to. One day, queuing in Marks and Spencer while a young child runs around and around the queue, I am reminded of something a friend said to me last summer, when I was mid-breakdown: that my rage over the tiniest things was a sure sign I should probably be medicated.

I’m over 12 weeks now. Apparently after 12 weeks the risks from the particular pills I was on are very low, almost negligible. My GP is of the opinion that, in my case, “the benefits outweigh the risks.” Apparently the worst that can happen is that the baby has a bit of “withdrawal” when it’s born. And if you’re breastfeeding, it doesn’t even get that because you’re still passing the drug to it in your milk. When they tell you these things, what they’re not saying is that if you give in and take the psychotropic drugs, what you’re essentially doing is feeding a mind-altering drug to a brain that is not even developed yet. And to continue feeding it to a newborn just continues to fuck with its brain more. They tell you there are little to no risks, that the baby will be fine, but really, what do they know. This is a drug not recommended for children under 18 because it changes the basic structure of the brain, but it’s perfectly fine for a baby? Fifty years ago they were feeding women Thalidomide for morning sickness with gay abandon, and look how that turned out. I know that if I relent and start taking these pills again, I will be pumping these chemicals directly into my baby’s brain, which seems ridiculous when I’m abstaining from alcohol and Ibuprofen and Vitamin A and a million other things for 9 months. If I can’t take Ibuprofen, which is 50p from Tesco, why is it fine to take Zoloft, which you can’t even fucking get hold of without crying to your GP and getting a prescription?

So I’ve decided, against the advice of my GP and my midwife, and probably the local mental health team, if I’d kept them informed, not to go back onto the pills. For one thing, last time they took a good few months to start working, and in the end it was a mixture of the pills, 3 months off work in a blur of alcohol and daytime sleeping, and help from the local mental health trust that got me back on my feet. There seems little point in starting up on the pills again, when I know they’re not a miracle cure, and they’ll take ages to work, and I can’t afford 3 months off work. Better to just try and soldier on as I am. 

And so, I plod. I go to work with a big mask on and pretend everything is fine. I laugh when they make jokes about me being a single mother and make oh-so-witty personal comments about my on-off relationship with the father and about his reputation for being a bit rough. I take it on the chin when they laugh at me for falling asleep at my desk. I pretend not to notice the impatience and loathing that bubbles beneath the surface whenever I’m off sick. I’m fine. Everything’s fine. I go home and stare blankly at whatever is on TV until I can stand it no longer, and then I go to bed and stare at the ceiling. These days I’m more likely to cry for seven hours than to sleep for that amount of time. Experience tells me there’s little point in picking up a book to try and read in the middle of the night, so I just toss and turn and think about how shit everything is. Then I get up early for work, because I can’t sleep and I may as well just get it over with. Just like before, I turn into a robot going back and forth, around and around. My days merge into one, punctuated only by arguments with the ex and panic attacks. Some days, I’ll wake up feeling ok and think perhaps that fabled day where I get my pregnancy glow and am awash with oestrogen has finally arrived. But by lunch time, it’s gone again. 

I’m stuck.

I should just man up but I can’t.

I can’t enjoy being pregnant like normal people; I can’t just snap out of it like people think I should; I can’t just be like everyone else. 

And I also cannot just end it by jumping off the tallest building I can find.

Before, that was at least an option; something to comfort me in the middle of the night when the horror took hold: “if it’s still this bad at the end of the week, you can end it,” I would promise myself. Now I don’t even have that, and it will never again be a viable option. I have nothing. I try to think of the baby in my belly as comfort, but all I can think is that I’ve let the poor thing down already. I have nowhere to live, no money, no plan for how to sort everything, no idea how I am going to do this. Neither of us stands a chance. Plath’s Bell Jar has descended once again and this time there is no lifting it.

And the worst part is that I can’t ask for help, I can’t admit failure. Nobody wants to hear that a pregnant woman might be preoccupied with thoughts of throwing herself under a bus. After last year I can’t make my friends worry again like they did before, it’s not fair. I can’t tell people I’d really just rather not be here at all. They’re all so excited at the prospect of another cutesy baby to coo over, they could never understand how I could be so totally consumed with blackness and despair. I'm supposed to be excited. I'm supposed to be glowing. Why am I not glowing? 

Last time I felt like this, I couldn’t eat, and all I did was drink – so I lost a fair bit of weight, and that was like my consolation prize. This time, my waist has disappeared and my belly is ever-expanding. My clothes don’t fit me because my belly is too big for them. This is not cause for celebration and excitement. I can’t afford to buy pregnancy clothes and there is nobody to buy me new underwear when the bras I am wearing are cutting into my skin, leaving marks that are still visible after 8 hours in bed. I’m fat and frumpy, and I can’t go to the gym and punish my body for 2 hours to try and feel better. 

All the things I would normally turn to as a way of somehow relieving this are gone now.

There is nothing; there is no relief, no comfort, no solace.

All that’s left is this unending guilt I have for a child not yet born.

How can I offer this child a chance of a happy life? How can I take care of it and raise it properly, give it a good start in life? I can barely bring myself to heat a bowl of soup for my tea. I feel like I’m dying and yet still alive. I am convinced that, were it possible to expire through mental illness alone, I would be long gone by now. Instead I drag myself around, a wraith. The ghost of Vicky past.

The people at work start to notice something is wrong. I’m simply too exhausted to keep up the façade. My boss tells me I look tired and I tell him I’m not sleeping He pulls a face that says “ok I can’t cope with women and feelings, please don’t cry, let’s talk about movies.” I don’t blame him. 

Other people ask me what’s wrong and I don’t know what to say. Frozen with fear, I know I could never tell them the truth. I try not to cry when they ask if I’m ok. I stop laughing at the jokes they make about my life. Eventually they stop making them. I hear only snippets of conversation, and don’t bother trying to find out what they’re on about. I stop trying to explain to the young lad-about-town who sits opposite me why being housed by the council somewhere on the other side of the county would be suicide. That no matter how much I shy away from human contact, I still need to be close enough to friends and family that I could visit if I wanted. He doesn’t understand mental illness, and no amount of tears will make him. He represents the majority of people in this world, and I hate him for it. I’m sure he’s of the opinion I should just pull my socks up and get on with it. I know he’s not the only one who thinks this. I’m past the point of caring. It’s all I can do to wash my hair before I leave for work. 

These people don’t care about me; they’re not my friends, they just don’t want me to go off sick and leave them in the shit. My life is like Eastenders to them: cheap titillation between phone calls. They all have their opinions about what I should do; I feel like an interactive reality show. And when I don’t heed their advice and things are still shitty, they sit there with their arms crossed, thinking to themselves, “well she doesn’t take good advice, what does she expect.” Everyone, but everyone, thinks they know of something I’ve not tried or heard about. Either practically, to do with finding somewhere to live and a way to furnish such a place, how to resolve the situation with the ex, how to raise a child alone with no money, or metaphysically – if only I’d just get up and join a gym/go to a yoga class/pay for therapy/paint on a grin and pretend, everything would be peachy. Well everything is so very not peachy, and it never will be. They don’t realise that when you feel like this, you can’t see the silver lining, all you see is clouds. You can’t just pretend, because you’ve been pretending for so long that you’re just exhausted to the point of complete flatness, and now all you can think of is sleep and blackness and death and nothingness.

I am at that point now, where I wonder which is the real me – the one before the pills, where I was almost dead more times than I care to mention, where there was no hope, no sleep, no happiness, no enjoyment, no contentment? Or the me for the last year, reliant on a reasonably high dosage of a psychotropic drug, changing the very mechanism of my personality and making me able to get out of bed, to smile, to laugh, to enjoy things? Because when I look around me, other people are like that without pills. They just wake up in the morning and they know what to do, they know who they are and what to say and how to function. If I need a prescription medication to be like them, does that mean that’s not the real me? 

What if the real me is this insufferably miserable mess?

My refusal to find any enjoyment in anything, my constant negativity and Eeyore outlook on life is just another of the many things that wind me up and make me want to scream. I dread to think what other people must think – “just lighten up!” Is this me? Is this my true personality? Am I really this insufferably gloomy? Oh, good grief. I can’t even stand myself – no wonder I can’t keep hold of a man for more than 5 minutes! No wonder I’m pregnant and single and alone, with nobody knocking on the door! 

Then again, I feel so terrible I would only hide behind the furniture if someone did knock the door. 

They can’t win – and they don’t even try any more.

I’ve reverted to the mentality of a toddler. Come and show me some attention! Why don’t you want to know what’s wrong? Why don’t you care? Nobody cares, I’m all alone! Why are you here? Stop crowding me, I didn’t invite you, I don’t want to make polite conversation with you! I have nothing to say, leave me be! Go away! Wait, where are you going? Why aren’t you sticking around to try and fix me? Why won’t you fix me? Come back and fix me!

This story seems miserable, but it does ultimately have a happy ending. When I was pregnant, my boss told me he thought having a baby might be the thing that would sort me out. At the time, I thought he was bonkers. Now, I find that actually, he was right. I am one of the lucky few for whom becoming a mother saved me. Yes, I still have horrible days and low moods - but I also have a beautiful, bouncing child who never fails to make me smile. Even in my bleakest moments, S makes everything seem ok. And I know I have to make everything ok, so that she can have a chance of growing up happy.