My experience of postnatal depression was largely rooted in intense anxiety. This is the second of three posts about the worst of my anxiety-induced symptoms (insomnia, intrusive thoughts and derealisation/depersonalisation) and how I managed or overcame each of them.
*Please note this post contains reference to disturbing intrusive thoughts that may be triggering for some, please proceed with caution*
This is the hardest post I’ve written so far. Generally, I’ve found writing this blog to be very therapeutic. I’ve found it quite easy to be honest about the symptoms and thoughts I’ve struggled with, some would maybe say too honest! But this is more difficult; this is about awful, frightening, unwanted thoughts that plagued my mind for many months. Violent images would assault my brain at regular intervals and leave me questioning who I am.
But I feel I must speak out about this. It’s a symptom of anxiety that isn’t always readily spoken of, a symptom that brings so much shame and despair, so if me writing it down here gives even one fellow sufferer comfort then it’s worth my minor discomfort about admitting it.
Intrusive thoughts for me fell into several categories: something happening to my baby, existential thoughts about life and death, hurting myself and, worst of all, hurting my baby. There is nothing more frightening and distressing than having a thought which makes you question, at worst, your sanity and, at best, your moral fibre.
I can’t remember the first time I experienced, what I now know as, intrusive thoughts. In my memory I feel like I had them ever since Caterpillar arrived but I think it’s more likely they began around the time that insomnia began eating into my mental wellbeing. That was certainly the first time I began thinking about dropping my son. The bottom of my stairs is tile and during those sleepless weeks I experienced very vivid images of stumbling and dropping him to the hard ground. I have always had a powerful imagination and when I say these images were vivid I mean special effects, HD, technicolour bloody vivid. I would think of it every time I came up or down the stairs, or even passed the foot of the stairs. I would imagine the event and I’d see the aftermath too. This wasn’t helped when one morning I actually did stumble down the last couple of steps whilst holding my baby, hurting my foot in the process. My husband couldn’t understand my hysterics, I’d only bruised my big toe. I begged him to stay home from work, saying it was because I couldn’t walk properly, but in reality it was because I felt I needed someone to be there to stop my son plummeting to his death. I had many other worries of this nature but, upsetting as they were, I was at least able to brush them off as the combination of my worrier nature and powerful imagination.
As PND got worse, and the anxiety grew in intensity, the thoughts turned much darker. I’d read years before about a child who had suffocated on nappy sacks and now every time I changed Caterpillar’s nappy I would eye that packet of sacks and worry that somehow my newborn son, with his limited motor skills, would reach over, take one out of the pack and place it over his head.
What if I placed it over his head?
Woah. WHAT? Where the hell did that thought come from? Oh my God, did I just imagine killing my own baby? What is wrong with me? I know I’m struggling to bond with him and I’m worried I don’t love him properly but am I that person? A child-killing psycho?!
And now I’d had the thought I was obsessed. Every nappy change my heart would race when that “what if” thought came along. Don’t think about it don’t think don’t think don’t think. But if someone says don’t think about pink elephants what the hell do you think about most? So it got worse. It spread to other things – bath times were tricky, as was crossing the road with the pram.
These thoughts increased the other, more physical symptoms of anxiety. Increased the sleeplessness and made me feel insane. I was simultaneously terrified of being “locked up” but at the same time wondered if I should be.
I also had ITs centred on hurting myself. The anxiety left me in a constant state of terror, the idea of living like this became unbearable and the concept of suicide kept flitting across my mind like a dark scary shadow. I still knew I didn’t want to kill myself but I kept thinking I would lose control and do it anyway. I made my husband take every packet of medication in a carrier bag when he left the house each morning, leaving me only my safe daily dose. I was terrified of knives, it was hard to make dinner because I couldn’t chop vegetables without thoughts of pushing the blade into me.
These thoughts blast into your mind very suddenly, and usually quite visually too for me. They completely catch you off guard. I would be going through the motions of daily life when BAM – knife, kettle, nappy sack, bus! I was obsessed with the thoughts and obsessed with “getting rid of them” but trying to rid myself only gave them more power and brought them to mind more regularly.
I spent much of this time thinking I was “going crazy.” I constantly questioned whether these thoughts were, in fact, hallucinations. I comforted myself that if I realise they aren’t real then they aren’t delusions or hallucinations by definition. So why won’t they go away?
But I did overcome them. Intrusive thoughts are one of the few areas of recovery that I now feel truly confident about managing.
The simple truth is we all experience intrusive thoughts. Discussions with my therapist made me realise that random thoughts come at us quite regularly as we go through life and it occurred to me that I’ve always had occasional odd or inappropriate thoughts like this. Have you ever been in a formal meeting and imagined leaping over the desk into the lap of the old man from Finance? Have you ever been at a church wedding and wondered what would happen if you took off your clothes and streaked down the aisle? Have you ever waited for a train and had a microsecond urge to jump off the platform? These are all examples of random, intrusive thoughts I’d had very occasionally all my life, and the sort of thing my therapist said she’d had too, she described that last example as the brain’s defence mechanism. You aren’t going to do any of these things, they are just errant, passing thoughts.
The difference between someone who is well and someone who is unwell is how you react to that thought or image. If I’d been well I would have thought nothing of those first couple of unpleasant thoughts, written them off, and promptly forgotten I ever had them. End of story.
However, when you’re anxious you fixate on the thought. You question it, analyse it, wonder what it means about you, attach emotion to it, fear it, run from it, are sickened by it. Obsess about it. And like with all anxiety, the more you worry and focus your attention on the thoughts and feelings, the more your mind thinks there actually might be something to worry about and the more it brings those thoughts and feelings to the surface. Anxiety is simply a vicious cycle of creating adrenalin when it isn’t needed. It feels terrifying but really your mind is trying to help you.
I plan to write more about how I manage anxiety in general in a future post but in terms of managing intrusive thoughts I used a simple technique recommended by my CBT therapist. When that thought enters your mind don’t run away, don’t fight against it, just sit with it. It will feel awful but I’m afraid you have to suffer that temporary discomfort to achieve the ultimate goal. Acknowledge the thought, recognise it as what it is: only an errant thought, not an action, not a reflection on who you are as a person. Then let it go, watch it drift away from you. Visualisation sometimes helps you to distance yourself from it – I imagined the thoughts as movies being projected on clouds and then I’d watch each one drifting away from me across the sky.
It’s a simple technique but it’s bloody hardwork because it takes a lot of time and practice to see results. When you are having many thoughts a day it can feel exhausting to do this every time but I promise you it worked for me. Soon it becomes second nature and much more easy to disregard them, I didn’t need the clouds visualisation after a short while, I just became more acquainted with the method of disregarding the thoughts.
Intrusive thoughts will never disappear completely, they are just part of the human mind. I still have them but rarely and when I do I’m so unbothered by them that I hardly notice or remember.
If any of this is familiar and you currently feel overwhelmed with scary or unpleasant thoughts try not to panic but please reach out to a professional. A good therapist will want you to be completely honest, will not be shocked and will not judge you. They should be able to give you useful techniques for managing these thoughts and feelings.
You are NOT your thoughts.