I've always been prone to stress induced hallucinations. At their worst, these hallucinations were joined by delusions and periods where I was convinced that I was being hunted or about to be killed. Monsters would prowl my hallway and gunmen would be poised on the stairs, waiting for me to use the toilet in the night.
The stress of my first miscarriage led to me running off into the night with the intention of jumping into a river. Fortunately for me, when I got to the river, I realised I had underestimated its depth and that it was more of stream. When I got home and admitted to my partner what had happened, he took me to my GP, who referred me to a psychiatrist. There I was diagnosed with borderline personality disorder which he felt had manifested at around 17 years old (I'm now 26).
For those who don't know anything about it or don't understand it, borderline personality disorder (or BPD) is name such because it is borderline to cluster A (schitzoid/odd ) and cluster C (anxious/fearful ) of personality disorders. It has symptoms which come from both groups. The symptoms are (for me, at least):
- Unstable emotions - I react very strongly to situations. The feelings are very persistent and sometimes people don't always understand the triggers. Instead of sadness, I may feel grief. A mildly embarrassing situation for most will often lead to days, weeks, or even months or years of shame for me. I'm prone to dysphoria (opposite of euphoria). While I can sometimes become literally overjoyed, it is the negative emotions which pervade the most and intrude on my life.
- Behaviour - Impulsive behaviour can give temporary relief and distraction from unbearable emotions. I used to disappear on long walks - sometimes at 3/4am and probably left myself open to danger. When I met my husband, he helped put a stop to this behaviour and now my impulsiveness is channeled into less harmful behaviours, such as cleaning the house or starting an ambitious craft project. Things which won't hurt anyone should I need to do them at 3am.
- Self-harming/Suicidal Behaviours - I won't go into detail here. I don't think it will be helpful. I have some scars - most of them very old. I'll leave it at that.
- Sense of self - This is an obscure concept for me. The only thing I can say about myself when I'm asked to describe myself is that I don't know myself. My emotions fluctuate to such extremes, and I exert such a high level of control over myself, I don't know where I begin and the BPD ends. And I look at myself differently depending on who I am with. I can relax around my husband so I feel differently about myself around him than, say, the mothers at a mum and baby group. I've no self-esteem because that comes with a self-identity. Conversely, I sometimes have issues establishing ideas of who others are depending on how I am feeling. I need to be carefully not to idealise people or to turn them into a villain. Often, when I feel strongly about a person (usually as a result of their behaviour or words), I have to stop associating with them for a few days so I can rationalise my perception of how they really are.
- Cognition - When my feelings become extreme, I stand back from them. I completely disassociate. The result is that I "lose" chunks of time, unsure of the details of things which happened. I have experiences where I am so outside myself, my face is like a stranger's when I look in the mirror. There are significant events in my life which I don't remember because I disassociated myself.
As I regained control, I had two further miscarriages. While they were equally heartbreaking, I didn't go off the rails after them. It was while I was awaiting testing for recurrent loss that I conceived Elodie. I was horrified. We had been trying to avoid pregnancy and I felt another loss was inevitable - especially as we hadn't got round to finding a cause for my losses.
I was supposed to be put straight through to a consultant ob/gyn but my referral was lost in the system and meanwhile I was left with basic care, just waiting to miscarry. So sure was I of a fourth loss, I didn't eat properly or take care of myself the way a pregnant woman should. I mentally disassociated from the baby growing inside of me and tried to carry on as normal. Not easy when you feel sick to your stomach. As my 12 week scan neared, I began to feel a bit more optimistic. I was beginning to feel as though maybe "life finds a way" (to cheesily quote Jurassic park). Sadly, two days before my scan, I was reminded of the fragility of life when my middle aged cousin died during a routine surgery.
I was numb for my 12 week scan, maybe only feeling a sense of relief I mightn't need to endure the pain and mess of a miscarriage. I showed off my 12 week scan with a smile, willing myself to seem normal and happy but only feeling distanced from everything. When I got back to my midwife at 16 weeks, she asked me how I was feeling. I told her I felt no connection to what was happening and that I may as well have been a surrogate for all I felt towards the baby. She smiled and said that hearing the heartbeat on the doppler would help. It didn't and I told her so. She reassured me that my 20 week scan would help and seeing the baby in such detail would help me bond more.
I asked to find out the sex at my 20 week scan. I hoped that getting more of an identity for my baby would help with a connection. It did help a bit to find out I was having a girl but it set off a series of fears that if I felt too much of a connection to my daughter, losing her would destroy me.
Time and time again, doctors and midwives would reassure me that my chances of losing her were small. I pointed out that 25% of women experience one miscarriage, 4% of women experience two in a row and 0.1% go on to have a third. Statistics were not my friend - they did not reassure me.
At about 32 weeks, Elodie lodged her bottom under a rib. Because I am hypermobile, I suffered intense pain. The hospital couldn't (or wouldn't) help me and they insisted no suitable painkillers were pregnancy safe. At 33 weeks I went to the antenatal ward in hospital begging for help. By this point, depression had well and truly set in. I broke down into tears and confided in the midwife that all I had been through made me very depressed and I was beginning to resent the baby for everything. I was deeply ashamed of that resentment. It took a lot to admit it.
She suggested I go home and see my own midwife to arrange some counseling and mental health support. She looked at my pregnancy notes and her expression turned grim when she read "borderline personality disorder". She then said she would admit me onto the ward as it was a faster way of accessing help. I agreed and went onto a four bed bay, grateful that the three other beds were empty. My husband gave me a hug and promised to visit in the morning and then left. A few minutes later, a doctor came onto the ward and he shouted at me. He told me I was ungrateful - that so many couples had to endure fertility treatments to conceive and that I "only had two months" to withstand the pain. The shame burned so deeply I wept all night for ten hours.
When my husband came the next morning, I had abrasions all up my arm. I had been unaware that I had been clawing into my arms because I was so distressed. I asked him to come and pick me up after work, because I couldn't spend another night on the ward with that doctor. I packed my bags to leave, only to have a second doctor come up to my bed and threaten to section me if I tried to leave. He said that a psychiatrist would eventually be over to assess whether I was okay to go home or not. I explained to him and the other midwife that I was leaving because of the humiliation from the first Dr and she said, "what is it you think the Dr said?". That lack of belief was devastating.
In the meantime, the ward filled up with women and I was completely ignored. Some who were having worrying bleeding, others with threatened premature labour and being in that environment terrified me and made the risks I was frightened of seem very real. When my husband came to visit when he was done in work we discussed whether I would be better of going home and then being sectioned because I would get to stay in a ward where I wouldn't be third party to other womens' pregnancy complications. A kind midwife realised what we had planned and, allowing Chris to stay past visiting hours, told us if we stayed she would chase the psychiatric assessment up faster.
The psychiatrists arrived at midnight. They talked to me for a total of ten minutes. That was all they really needed to see I had no plans for suicide or plans to hurt my baby. They put in a referral to the community health team and said I would have an urgent assessment. I finally got back home at 1am.
It took a fortnight before a mental health occupational therapist called *Sharon came to see me from the mental health team. At this point, I was 35 weeks pregnant. She assessed me and said she would come and see me in 7 weeks "because by then the baby will have been born". I was devastated. One minute I was in such dire need I was threatened with sectioning, and then I had been all but abandoned and left to cope on my own. The only support I was offered was a council run helpline. (It turned out I hadn't even been referred to then anyway so they couldn't have helped me even if I had called). I explained to Sharon time and time again that I can't call strangers when I am distressed and I would not be using the number but that fell on deaf ears. I wrote to the mental health team discharging myself.
A few nights later, when the pain was particularly bad, I had bad paranoia. I locked every door in the house and hid in the bathroom while I heard monsters snarling outside the door. My husband rang my GP, who called Sharon demanding I be reassessed. At 36 weeks she arranged an appointment for a fortnight's time. The day before my appointment, I went into labour.
The labour itself was the easiest part of my pregnancy. Brief, painless and uncomplicated. I cried a lot when I heard her first cries. I knew it meant she had survived and I would take her home. Unfortunately, due to feeding issues, she developed jaundice and we had to stay in hospital for four days. During that time, my fibromyalgia flared up. I requested painkillers and midwives often forgot to bring them to me. I was going to be given my own medication to manage but a midwife decided I was a suicide risk and didn't let me have my own paracetamol. I've never attempted suicide, let alone an overdose.
I took my daughter home and for months I couldn't tolerate her. Her cries made me angry. I was ambivalent to her most days. Sometimes, I wanted to smack her or leave her in the bath and walk away. I loved her very much, but I was so numb and depressed it was hard to actively feel it. Apart from the feeds, my husband took charge of her care while I lay in bed with depression.
Sharon came to see me when my daughter was 3 weeks old. My midwife had told me the week before to ask for tablets for my mood. Sharon decided I was just tired and took a "wait and see" approach". She came back in four weeks. I told her nothing had changed and I was still depressed. This time she decided it was just my hormones and she would be back in another four weeks. She even refuted a diagnosis made by a senior house officer who diagnosed postnatal depression. This pattern continued until Elodie turned six months. She finally conceded that I was depressed but shrugged it off as she was moving to a different team. She said she was handing me over and that it would be the responsibility of the next mental health occupational therapist to deal with my treatment.
A CAF was set up which was useless. The local children's center basically scolded me for an hour, set up a plan which didn't take my fibromyalgia into account, and then gave up on me because I couldn't meet their goals. They closed the CAF.
It was a month before my new O.T, *Sally, was able to come. In that month, my husband and I had decided that not only was the team not helping, but the frustration of trying to get my point across to Sharon was actively damaging. I was going to discharge myself again.
In January, when she had arrived, I had only spoken to Sally for a few minutes before being able to instantly tell she was more on my wavelength. She actually believed me and took me at my word. It was really refreshing. My situation was complicated enough that a psychiatric consultation was needed to find suitable medication. For all Sally's competence, I had to a wait to see somebody.
Near the end of March, I finally saw a psychiatrist. After some discussion about my breastfeeding and what I had tried, he insisted I give an SSRI another try and put me on sertraline. Within an hour of taking the first tablet I was very high and experiencing acute delusions and confusion. I tried to hide behind the card display in my local Sainsburys because the staff frightened me and my husband had to guide me home and get me to bed. Sally called my psychiatrist who wrote a prescription for the breastfeeding friendly tricyclic imipramine. It started helping but left me prone to fainting. As this happened while I was carrying my daughter, I stopped the tablet.
Towards the end of April I became suicidal. I calmly told Sally I wasn't coping and that I had been considering admitting myself into hospital care via A&E. Sally kindly helped me bypass that process and put me under the care of an intensive crisis team. I stopped breastfeeding my then ten month old daughter to open up my medication options. A doctor from the team put me on lofepramine. The side effects were bearable and the tablets worked quickly. Soon, the daily visits from the intensive crisis team stopped and I was put back under Sally's care.
I don't consider myself completely recovered but I am coping these days. The last two months have been very happy months. I've bonded with my daughter. I delight in waking up, seeing her, caring for her and getting to know her. I love her all the time. I have patience and now miss her when I am away from her. While I am currently very happy and in love with my baby, I mourn the year I missed. All my struggles were dragged out over May 2013 to May 2014. I'll never get my first moments with my firstborn back and that fact, along with flashbacks of my "sectioning" make it still hard to move on.
*Not her real name
