Perinatal Mental Health During COVID Times…

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GUEST BLOG by Nancy McLaren Kennedy

BIO: Firstly, Nancy is my friend and colleague at The Royal. She is also a Peer Specialist/Mental Health Worker in Women’s Mental Health at the Royal. Nancy has a Master’s in Social Work and is the proud mom of three teens.

Most people have heard of postpartum depression. Not as many people have heard that you can experience anxiety, bipolar disorder or psychosis for the first time while pregnant and after giving birth. Depression is not the only type of mental illness that can emerge during the perinatal period.

Before the pandemic, 1 in 7 perinatal people would have a mood or anxiety disorder. We know these numbers are higher for black, indigenous, people of colour, LGBTQIA2+ people and people who have experienced trauma.

Although I could not find an exact percentage, one Canadian study reported a significant increase in depression and anxiety during the pandemic compared to pre-pandemic numbers. COVID and physical distancing has really changed the way people experience pregnancy, birth and postpartum.

During COVID, formal and informal support for perinatal people has been impacted. Pre-pandemic a person who gave birth would go to their midwife or doctor’s office for an appointment and they would sit in the park with others. Their parents, friends or relatives would drop by to chat, hold the baby or do a small chore. With physical distancing and COVID regulations, these meetings and supports diminished, if not altogether disappeared.

New parents are also concerned about the physical safety of their baby and this can lead to stopping visits with friends and family. Participants in the peer groups that I co-facilitate have told us that in addition to depression and anxiety they are also experiencing loneliness and isolation.

During the pandemic, pregnant people have had to give up their expectation of an in-person baby shower and spending time with relatives while they are pregnant. Birthing people would have limitations imposed on the number of people who could be present at their baby’s birth. There would be restrictions on coming into and leaving the hospital while their partner is labouring.

In Women’s Mental Health at the Royal Ottawa Health Care Group we recognized that pregnant people and people who have given birth, would need support during the pandemic. We were not able to offer in person services so we moved to online delivery. At the Royal, in the Women’s Mental Health program we have peer facilitated groups that include: Journaling as a Wellness Tool-Perinatal version, Life with a Baby and 2 Wellness (virtual) drop-ins. Our groups are built on peer support principles: we don’t try to fix anyone and we believe that people are the experts of themselves.

The reason I am interested in supporting pregnant and postpartum people is because I also struggled with mental illness during my perinatal period, years ago. When I was pregnant and after I gave birth to my son, I thought it was normal to be sad all the time, crying, worried about the safety of my baby and having intrusive thoughts of dying and my baby dying.  This is not a normal part of pregnancy and early parenthood. After the birth of my twin daughters, I again stopped sleeping, felt unreal and began to hear voices. I was hospitalized and moved towards wellness with medication and informal peer support from people who had similar experiences.

I knew I wanted to use my lived expertise to help other women experiencing mental illness during pregnancy and birth. I wanted to show people that it is possible to have a mental illness and then feel better. You can get pregnant, give birth and be a mother/parent/caregiver with a mental illness.

To register for one of our virtual groups you can email me at: nancy.mclarenkennedy@theroyal.ca

Recovery is possible after experiencing perinatal mental health issues. Help is available.

Delusional Disorder

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By Anita Manley

This is a difficult topic for me to write about, as it is very personal and will reveal many details of my symptoms and beliefs when I was mentally unwell for about 10 years (a gradually worsening illness). It makes me feel very vulnerable– but, I’m told that there is strength in vulnerabilty. I’m hoping that by writing about it, I will help educate people about delusions — a form of psychosis.

Beginning in the early 2000s, I started having delusions. Although previously diagnosed with bipolar disorder, I had never experienced delusions in my life before then. I have since learned that delusional disorder, although rather rare– usually appears in middle to late life.

The types of delusional disorders include:

  • Erotomanic. Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behaviour is not uncommon.
  • Grandiose. A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
  • Jealous. A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
  • Persecutory. People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
  • Somatic. A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
  • Mixed. People with this type of delusional disorder have two or more of the types of delusions listed above.

    As for me, I would have been categorized as ‘mixed’.

    Although for many years I could socialize and function quite normally, I strongly believed that my former psychiatrist loved me (I was in love with him, too). I believed that he was communicating with me through other people (my friends, family and even strangers), through transceivers that everyone had implanted in their ears– and, through songs on the radio. I also believed that there were cameras in my home and car and that people who I knew, but could not see, (known as my angel family) were watching me. I also had an inflated sense of self. So basically, my ‘mixed’ delusional state included: erotomanic, grandiose and persecutory– for years!

    It was so difficult living in this constant state of confusion and eventually I became so preoccupied with these delusions that it caused major disruption in my life– eventually, I lost my job, access to my beloved children, all family and friends, and ultimately became homeless.

    Now, after receiving proper intensive care, treatment and medication at The Royal, I’m happily living in recovery. On December 1st of 2021, I will have been living in my beautiful little apartment that I got the keys to 10 years prior. I’m so thrilled that my delusional thinking is behind me– and, I’m leading a fulfilling and healthy life. I’m reunited with my daughters, I’m in a loving relationship with my partner, and my eldest daughter is expecting our first grandchild very soon. I am beyond grateful to be fully present… in my current life.

    Recovery is possible! Even from serious mental illness. There is always hope and it helps when people around you believe that you can get better.

The importance of reaching out for support

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By Anita Manley

 

I remember being in such a dark place that I wanted nothing more than the pain to end. In my distorted mind, I thought the only way out was suicide.  Fortunately, I made it through those terrifying days, continuing to live — and am I ever thankful that I did!  I also remember feeling as though I was a burden to everyone, since I was so depressed and couldn’t contribute.  Hell, I couldn’t even get out of bed to have a shower.  My family insisted that I was not a burden, that they loved me dearly and that “this too shall pass” — and they were right — the dark rain cloud did pass, and sunny days reigned again.

You are worth it! Every human being on this earth has value and contributes in their own unique way to the universe. You are not a burden (even when you are struggling the most). You are lovable and you deserve the best. You do!  Believe it.

Lately, I have heard of so many of my friends battling with feelings of self-worth. Depression. Anxiety. And, some with suicidal ideation — wanting to end their life as feelings of shame and desperation take over.

Please — in times like these — reach out for help.

Fortunately,  in all cases, my friends have come through this by seeking support from others.  One drove herself to the emergency department. Is she ever glad she did!  Today she is living a much better life after receiving life-changing trauma therapy. She is so much happier now, has greater self-esteem — and celebrates each day, each week since the day she chose not to take her life. (For inspiration follow: The Maven of Mayhem on Facebook, @maven_of_mayhem on Instagram, and @MavenOfMayhem on Twitter).

Another friend reached out to family for encouragement, and to medical professionals to request a change in medication. Yet another, asked her support network to get together socially (at a distance), reaching out for basic needs and for medical requirements.

How can we be that supportive person…  to our loved ones in need?

According to Ann-Marie O’Brien, Lead of Women’s Mental Health at The Royal (@StrongGirl51 on Twitter):

“It begins by asking, ‘How can I help?’ The person seeking help is the one who gets to define what help is.”

Recently, I have reached out to medical professionals — for my own help. When my family doctor suggested anxiety medication, as she heard so much anguish, pain and anxiety in my voice: I replied persistently, “No… I just need to talk to someone about it.” I am not against medication — I take it every day to help me stay well — but I know that I do not need more at the moment.  Then, when speaking with my psychiatrist, she offered an increase in anti-psychotic medication. I repeated firmly, “No… I just need some psychotherapy. Can you please refer me to a psychologist?”  Fortunately for me, I was refered to a psychologist for psychotherapy after advocating for myself clearly and persistently. The person seeking help is the one who gets to define what help is.

Don’t be afraid to reach out to loved ones, friends, or professionals for help when you need it. You are worth it! Repeat this to yourself : “I am worth it. Life will get better. I will not be in this dark place forever.” Advocate for yourself.  If at first you do not get what you need, repeat your needs calmly and persistently over and over again, until you get what you are looking for.

Choose life! Reach out for support. You are worth it!

Crisis Services Canada 1-833-456-4566 or text 45645

National Suicide Prevention Lifeline (USA) 1-800-273-8255

photo-of-people-s-hands-4672710

Reach out for support. You’ll be glad you did.

 

 

Building stronger connections…

Written by Anita Manley

Within the past year, I attended a Family Support Group at The Royal in Ottawa that covered the topic of validation. Although this communication skill was not new to me, the session reminded me to use validation as an effective communication skill more often when communicating with my loved ones and peers.

Validation (as defined by dictionary.com) is: recognition or affirmation that a person or their feelings or opinions are valid or worthwhile.

Seems simple enough, doesn’t it?… but how often did I want to offer advice on an issue instead; or not even meaning to – be judgmental? Or even worse, minimize the person’s feelings by beginning a sentence with “At least”. More often than I’d care to admit!

After sitting in on this seminar, I’d try to catch myself every time I was communicating with my loved ones and peers. Instead, I really listened to their concerns, without judgment or offering advice. I would say, “Wow, you seem really frustrated, stressed and angry”. Connecting with their emotions. Everyone needs to know that their feelings are normal and reasonable in the situation.

By validating people’s feelings, I found that they opened up to me more. They would want to engage further. In the case of my daughter, Julia (24), she would carve out more time in her very busy schedule to spend time with me. If your goal is to develop a closer relationship with people, then validation is key.

In this seminar, it was also emphasized that you do not have to agree with someone’s opinions or choices to acknowledge their emotions are valid. For example, a person does not have to agree or buy into the delusions someone is having in order to validate their feelings.

In hindsight, I really wish that people in my life had practised validation when I was in the depths of psychosis. Instead of connecting with the emotions I may have been feeling, they argued with me: “What you are saying is not true/real. You cannot be trusted. You are paranoid.” If instead they had said “Wow, you must feel stressed (vulnerable, spied-on, or exposed)” upon revealing to them that I believed there were cameras in my home and car; perhaps I wouldn’t have felt so alienated from everyone in my life. After all, how would you feel if you truly believed there were cameras in your home watching and listening to everything 24/7?

I know that by using validation as a communication skill, all of my relationships are much stronger, especially with my daughter, Julia. Since January, we have been meeting one day a week for lunch and we both enjoy connecting regularly.

It’s not perfect by any means, but the effort has paid off. Sometimes I slip into offering advice, but I always try to deliver the messages: I believe in you! and – You Matter! – through validation.

Mother’s Day brunch in Montreal with Julia. May, 2019
Mother’s Day in Montreal with Julia. May, 2019