Wednesday, 20 May 2015

Tips for anyone visiting an MBU

I posted these during #PNDHour tonight, but thought I'd share here too:

Here's some tips for people visiting friends and family in an MBU.  Psychiatric hospitals can be scary, forbidding, places.  But your visit is a chance to inject some normality, and can really help a mum's recovery.

- Bring healthy, fresh food! Anything from M&S works
- Make yourself at home, however weird it all seems 
- Help with things like bathing baby, especially if mum can't do it alone 
- Bring news from home, especially happy news
- Bring clean clothes for both her & baby
- Take them both for walk around garden
- Take some nice photos of the pair of them - they will appreciate these like gold dust later!

Inside a Mother & Baby Unit


Tonight's "#PNDhour" is all about Mother and Baby Units (MBUs).  So I thought I would jot down some reflections on my time in one.  MBUs are acute psychiatric inpatient wards for women who are either pregnant or up to 12 months post partum.  The majority of patients have acute and severe depression and/or anxiety, or postpartum psychosis.  But there are also (in my experience) some who are there on dreaded "parenting assessments", or those who may have learning difficulties or social problems.  There are around two dozen MBUs dotted around the country (this is not quite enough, but we are lucky in comparison with the USA, which has only one or two!).  They tend to be located within large psychiatric hospitals, and are led by a specialist consultant psychiatrist, a ward manager, mental health nurses, healthcare assistants and nursery nurses.

I was an inpatient, along with my newborn son, from the 19th November 2012 to the 31st January 2013, at the Channi Kumar MBU at the Bethlem Royal Hospital. The hospital is run by the South London and Maudsley NHS mental health trust.  I was a "voluntary" patient, technically - but it was made very clear to my family, who had brought me to A&E just two days after arriving home from the maternity ward, that I would be sectioned otherwise.  I would also have been sectioned if at any point I had tried to leave.  

So, yes, it was a "secure" place.  There were no door handles or hooks.  The  duvets were rubber and the bedroom doors had windows.  On arrival, these were all the first things I noticed, and it only made me feel more paranoid and scared.

Looking back, of course, I see the reason behind all the design features.  And I know the staff there made it as homely and as cheerful as possible.  There were 16 bedrooms, three shower rooms, a dining area (we had no access to the kitchen) and a nursery, which also had a (locked) milk room and a baby sleeping area.  I was given a tour on the night I arrived, but I was so exhausted and out of my mind I didn't take it in.  My husband left the pair of us that night completely distraught.  This wasn't where we were supposed to be.  The Boy had a beautiful nursery all ready and waiting for him back home: expensive mobile, hand knitted blankets, rows and rows of babygros and sleep suits all washed and ironed and neatly folded.  Now he was whisked off to the MBU nursery, to be cared for that night (and, it turned out, many many nights subsequently) by strangers.

The other ladies I met gradually over the course of my stay (keep in mind for at least the first 3 weeks I was "The Crazy One").  We came from all walks of life (a cliche but true!) but shared a very personal and intimate experience.  We bonded over Occupational Therapy, feeding tips, explosive poo's and all the other new mum topics of conversation.  The staff too came to be important figures in my restricted life as an inpatient.  They were, for the most part, incredibly kind and patient.  They all shared duties, so you were as likely to be under one-to-one nursing from a nursery nurse than a RMN.  And similarly the mental health nurses were all dab hands at feeding and changing newborns.

And what of my illness?  I was admitted with suspected postpartum psychosis. Very quickly it became clear the psychosis was getting much worse.  But I was in a safe place.  My hallucinations raged and raged, as I fought my sleep deprived mind, not to mention a lethal urinary sepsis.  The staff had seen it all before, which was some comfort to my frightened family who thought they were losing me forever.  

My psychosis loved the MBU.  Paranoid?  That strange man (a student on work experience) is following you and monitoring your every move.  Confused over names and faces?  We will introduce you to dozens of new people all with strange names and confusing job titles.  Think someone has taken your baby? We will have a constant stream of crying infants being carried up and down the corridor.  Hallucinations about suffocating?  We will keep you in a small bedroom.  It was an easy place for the psychotic mind to wander.

But I was safe.  For the first few weeks, when my illness was at its worst, I was under one-to-one care.  That meant I had a member of staff with me at all times, 24 hours a day.  The Boy was, at this point, primarily cared for in the nursery.  But I was always encouraged to spend time with him and to do as much of the practical care as possible.  I was so unsure of myself, I assumed everyone there could look after him much better than I could.  It was a sign of my recovery when I started to prefer doing everything myself and taking proper charge of him.

Soon enough, the time came for our gradual discharge.  What started as a precious few hours home leave on Christmas Day turned into days and weeks of leave until I was happily discharged into the care of my GP and a perinatal Community Psychiatric Nurse.  We also had fantastic follow-up care from a specialist Health Visitor, who made a lot of time for us and made sure my anxieties were allayed. 

 

I look back on our MBU time with a mixture of emotions.  Certainly some of the most horrific, frightening, catastrophic memories were from that place.  But it also gave me the strength to heal and allow me to become the mum I am now.  I am truly grateful to every single member of staff there (and all the fellow patients) who helped me and my son on our way.  I campaign now for more access to MBUs.  I am also a patient representative for the Royal College of Psychiatrists' inspection and accreditation programme

Monday, 11 May 2015

Life as an "expat"

For the last five months my family and I have been living abroad.  As we are middle class white folk we get to call ourselves "expats" (see this fantastic Guardian comment piece: http://www.theguardian.com/global-development-professionals-network/2015/mar/13/white-people-expats-immigrants-migration ) but really we washed up in the Caribbean as immigrants, just like many millions of people around the world.

We travelled with just three suitcases.  The Husband's work secondment had arranged accommodation and a car - what more did we need?

The last few months have taught me that, really, we need very little.  All the paraphernalia (detritus?) of life in London - for the most part, completely unnecessary.  All we really need, it seems, is a week's worth of clothes and a washing machine.  A couple of picture books and a few favoured toys.  A small amount of toiletries and plenty of sea water, sand scrubs and fresh Caribbean air.

We've missed our treasured friends and beloved family back home, but we've found it easy to keep up on Skype.  And to make new friends - on a tropical island there is no room for stuffiness, just a lot of open arms and willingness to adopt a new family into island life.

We've missed, it's true, the hustle and bustle of central London - the night life, the culture, the endless events and activities.  But the slower pace of life has left us with plenty of time to enjoy quality time together.  Walks along deserted beaches have replaced dodging the crowds on the South Bank.  And we enjoy what events do happen here all the more for it.  Instead of queuing for the latest trendy London restaurant, we can pop into any number of local places here and tuck into the same always-delicious fish tacos and conch fritters.

I've learned that, contrary to my first fears, I'm actually pretty self-reliant.  I've cared for The Boy singlehandedly for five months, including a week where I was flat out with 'flu and several days when he turned into a terrible toddler tyrant from the seventh circle of Hell.  I've managed my own mental health fairly well too, which is a relief as mental healthcare out here in the Caribbean is fairly minimal.

But I'm looking forward to getting back to our local community in London, where help is never far away and where Grandparents, albeit not on the doorstep, can at least visit without having to book transatlantic flights.

I think we will come home with a much greater appreciation for our home, and friends, and general way of life.  I hope we can bring home some new Caribbean habits - the "what does it matter?" mindset and a disregard for both materialism and consumerism.  

Plus lots and lots of rum cocktails, of course. 




Wednesday, 29 April 2015

Career advice-to-self

I recently read this short article - https://www.linkedin.com/pulse/career-advice-i-wish-had-25-shane-rodgers - with great interest.

As someone who stumbled from job to job during my twenties I wish my 50 year old self had stepped back in time and given me some much-needed guidance, like the tips in the article.  But then we live and learn from our mistakes.  And I'm lucky that after a few years off work, first to work on my mental health and then to have a child, I now have a genuine "do-over" opportunity.

I'm sure aged 50 I will have even more to say, but at the grand old age of (almost) 35, what pearls of wisdom would I share with my 21 year old self?  Or, put another way, how will I approach the world of work differently now?

1. Self-worth is not measured by the fullness of your social calendar.

2. Other people's success (financial, renown, or otherwise) is of little to no concern.

3. You "need" a whole lot less material things than you might think - if you can't escape with a suitcase you're doing something wrong.

4. The people you fear "letting down" are proud of you already - you only ever had to show up.

5. Never be ashamed to admit you don't know the answer.  Being open and asking for help will save you a lot of embarrassment in the long run. 

6. You don't always have to love what you do, but if you can't look yourself in the mirror at the end of the day it might be time to move on.  Ditto respect for your coworkers and managers.

7. If you can't be anything else, just be kind.  People will forget almost everything else you do, but will always remember an act of kindness.

This last one comes from The Husband:

8. Always manage expectations.  It is better to pleasantly surprise a client or manager, than to let anyone down. (The Husband has an impressive range of techniques for this - he has been known to sit on finished drafts of work, just so as not to over-deliver and provide time for more deadlines to be set!)

Monday, 30 March 2015

Bipolar and me

Every day is bipolar day for me.  But according to social media today is "World Bipolar Day 2015" so it seems fitting to dedicate a post all about being bipolar.

I'm a relative latecomer to this, only being diagnosed retrospectively following a brush with psychosis.  My official diagnosis is something along the lines of "Bipolar affective disorder current episode severe depression with psychotic symptoms".  So, at its worst, bipolar robbed me of my sanity and left me psychotic.  Treatment took many weeks (months) and some very powerful psychotropic drugs.  Getting through that took its toll on everyone around me, but we got there.  Now, I live with a milder form of bipolar, the type which brings me periods of moderate to severe depression, followed by periods of slight mania (doctors like to call these "hypomanic episodes").   Most days, you would never know anything was wrong.  Social services haven't come to remove my child, and while I'm not economically active at the moment I'm pretty sure if I wanted to hold down a job I could.

Being bipolar has given me a new identity, and placed me in a tribe to which I feel a deep sense of belonging.  It has helped me reconcile some of my past behaviour.  While I would never use it as an excuse for my recklessness, it certainly helps to explain much of my teens and twenties!

It might just have helped me be that straight-A student (top of my year upon leaving high school and graduating university).  I never found studying difficult, and I always had something clever-sounding to say in lessons (and debates, and public speaking events...).  I cared a little too passionately for my friends, and always went that extra mile to help them out and to make them smile. Occasionally this landed me in deep trouble!  And I hate to think of all the times I could have been caught doing something seriously naughty due to teenage love / friendship.

Now, well into my thirties and a wife and mother, I think my manic periods manifest in different ways.  I take on a lot of different responsibilities, always volunteering for this or that, and bake a ridiculous amount of complicated cakes.  I play with my son with gleeful abandon and have developed a healthy attitude towards regarding other people's opinions of me. None of this is likely to land me in trouble as such, but I do wonder what would be different without the bipolar.

So, I choose the crippling depression and the long, dark, days.  I choose the tears and the anguish.  I choose the nothingness and the blank stare.  I choose the excruciating trips to the GP.  I choose the concerned phonecalls from family.  I choose it all - just as long as I get an equal share of joyful, energetic and happy days.  An equal share of loving without limits and living without boundaries. 
(The kind of thing I am want to do during a particularly hypomanic period!)

Monday, 23 March 2015

"As featured in..."

Kathryn is always keen to share her story of mental illness and wellness, and to increase awareness of postpartum psychosis in particular.  She is a media volunteer for the charity Action on Postpartum Psychosis, and has also taken part in the Time To Change "Can you tell?" campaign for Rethink Mental Illness.  Kathryn is happy to hear from any journalists or editors with an interest in mental health.

Bumps & Grind blog has featured in:
- TOTS100 "Good Reads" A Trip Down Psychosis Memory Lane, March 2014
- Mumsnet Bloggers Network featured blog
- Mumsnet Bloggers Network "Blog of the Day", From SAHM To WAHM, June 2014
- Guardian Society Blog Round-up, Presenting at a Conference, June 2014

Kathryn has given television interviews to:
- ITN evening news (on birth trauma)
- Channel 4 evening news (on postpartum psychosis).  See health editor Victoria MacDonald's feature here: http://blogs.channel4.com/victoria-macdonald-on-health-and-social-care/helping-mothers-terror-postnatal-psychosis/2227
- Good Morning Britain (on postpartum psychosis)
- Channel 5 evening news (on being discharged from psychiatric hospital).
She has also given print interviews, including to Rethink Mental Illness' "Your Voice" magazine.


Kathryn has presented on "Motherhood and Madness" to Bournemouth University's Festival of Learning conference on maternal mental health.


Thursday, 19 March 2015

Some god-awful attempts at poetry

Written in a fit of poetic splurging during The Boy's naptime earlier today.  If there is any rhyme or reason to this, they represent Illness, Recovery and Parenthood.  Be gentle. 

Psycho world
The world is spinning away from me.
I hear voices I recognise, see faces I know,
But the harder I look, the more intently I hear,
The further and further they go.

The world is spinning away from me.
I've lost my grip on everything.
All that I know, all that I ever knew,
Has disappeared into a box marked 
"Nothing".

The world is spinning away from me.
The fear takes control of my head,
If I open my mouth, or reach out my hand,
I'll know for sure I am dead.

The world is spinning away from me.
The safest place to be is inside my head.
The best I dare hope for, the best case scenario,
Is that this is Hell and Earth continues on in my stead.

But slowly, so slowly...

The world begins to come back for me
The drugs gradually do their work.
Allowing my mind to realise
This was life after all, 
A hellish, dark, tortuous pit,
But specific to me and my worst fears,
And - thank goodness - not the end of life as we know it.


Survival
Nothing and no one can touch me now.
I've been to the back of beyond
The bottom of the pit
The arse-end of society.

I lost my dignity, my humanity.
But - guess what?
Life is not a one-shot game

You are allowed to fail.
Allowed to go back to the beginning
And start again.

The confidence that comes,
When you've reached the bottom
And survived.
Is unbeatable.

The knowledge that this gives,
The peace that comes from knowing
How futile keeping-up-appearances can be.
Is unshakeable.

Who can touch me now?
I'd like to see them try.
Come at me with words, deeds, targets, tests...
All of it matters less
Than the beauty of 
Survival.

Parenthood
It's not about who you become
How life changes
What it teaches us.

It's about the new person
You have introduced
Into the mix of life.

It's not about you any more
Your hopes and dreams fade
Into your tiny bundle of EVERYTHING.

It's about all of them
From their most basic need
To their most incredible dream.

It's everything for them,
Your unspoken word and
Your every waking thought.

It's parenthood, you see,
The circle of life if you like
-
And you won't mind one bit.