The prospect of having another baby after experiencing PND, Anxiety & OCD previously can be really daunting. As this pregnancy progresses I can feel the tendrils of anxiety beginning to creep in at the edges. My mind fills with questions like “how will I deal with those endless triggers?” and “what if I’m as ill as I was last time?”
It can be easy to become overwhelmed by these questions and worries so in an effort to be proactive I’ve begun to put strategies in place to help protect myself from perinatal mental illness this time around. I thought I’d share them with you today.
Consider or plan your medication
The earliest decision I had to make upon finding out I was expecting was whether or not to continue taking my antidepressant medication. Following the fairly minor setback I experienced a few years ago I began taking 20mg of Citalopram again. When I first found out I was pregnant I decided to wean myself down to 10mg but as the days and weeks wore on and my anxiety about miscarriage got quite severe I decided to stick at 20mg.
As with most medications during pregnancy, there is very little research into their effects on the baby, but studies that have been done on the group of antidepressants Citalopram is a part of have found only a very small risk, and the vast majority of healthcare providers will advise you to continue with your current dose.
Even the tiny risk is enough to make me feel terribly guilty but I have to frequently remind myself that my health is also a big part of the baby’s health which is the attitude most doctors take. Both my midwife and GP advised me to carry on with the Citalopram and didn’t seem at all concerned so that’s what I keep in mind when I can.
After the birth I may consider upping my dose to 40mg (the dose I took when I had my first experience with PND) to protect me further from potential symptoms or setbacks but I’m going to cross that bridge when I come to it, depending on how I feel.
Please note that different types of medication have different factors to consider so please be led by your healthcare provider.
Read more: Antidepressants for PND & Anxiety
Get practical & professional help in place
This is really important. I’ve been completely honest with all the professionals I’ve met so far during this pregnancy. I’ve spoken to them candidly and at length about my PND & Anxiety experience five years ago and made sure they’re totally aware that I might need some extra support following the birth. This means they are able to shift me over to specialist care if necessary.
Originally we considered putting me under the care of the specialist mental health community midwife but on further consideration I decided to stick with a regular midwife for now with the understanding that she can move me across if she or I think it’s necessary. Likewise, I’m comforted by the fact that Essex’s Perinatal Mental Health team are on hand should I need them in the future. I feel very lucky to have good support in place in my area of the country but even if your county isn’t as PMH equipped it’s still important that you to be open and honest with all your healthcare providers so they can offer whatever extra support they have available.
On a similar vein, it’s good to get practical help lined up to. Consider what aspects of parenting you found particular difficult first time around and discuss with family & friends what they could do to alleviate some of that anxiety.
This is something I’m working on at the moment. So far I’ve been doing well; I’m not experiencing any abnormal anxiety symptoms and feel well and optimistic. However, I’m very aware that my illness didn’t really manifest during pregnancy last time, so I haven’t had to deal with many triggers so far. Once the baby arrives the triggers are going to be huge; every waking moment will be filled with the sights, smells, sounds and emotions that were the backdrop of my prior illness. This is going to be overwhelming at best and devastating at worse.
In an attempt not to be blindsided, I’m mentally facing those triggers in advance where I can and preparing my reactions to them. During the next few months I even intend to surround myself with much of our baby paraphernalia so I can expose myself to the smells and sounds of each item without the baby or hormones present yet. I’m hoping this will help me cope with some of the feelings heading my way.
Watch more: Managing Triggers Video
Regular readers know that I’m a big fan of affirmations and believe they can have a huge impact on your thinking processes and inclination toward either positivity or negativity. I created a printable some time ago which contains my top ten affirmations for Anxiety recovery and I plan to print this and display the individual affirmations around my home before the baby arrives. I’m also planning some new ones specifically for #PregnantAfterPND so please keep an eye out for those.
Write a letter to yourself
I wrote this letter shortly after we made the decision to try for a second baby. Since I spent so many hours trawling the internet for hope, comfort and recovery stories when I was unwell I figured some encouragement and recovery hope from myself would be something really useful to look back on. You can read my letter here or why not write one to yourself?
Lastly, I’m working on creating different expectations for this early motherhood experience. A big part of my previous PND & Anxiety was panic triggered by the idea that motherhood wasn’t anything like I’d anticipated. My bond with and feelings for my son were nowhere near what I’d hoped, baby care and sleeplessness was so my tougher than I ever dreamed of and I didn’t feel anywhere near the happiness I’d expected to feel as a new mum.
This time I’m hoping to manage my expectations to a more realistic level. I’m excited to meet this baby and I’m really looking forward to becoming a mum to a lovely new person, however I like to hope that I’m entering the experience with my eyes wide open this time, thus eliminating any potential shock or disappointment.
Of course, no matter what plans we put in place or how strong we feel in our recovery there is no way to completely guarantee our mental health, however I hope that these strategies can at least reduce my symptoms and boost confidence in my ability to manage the struggles that may arise.
I’d love to hear from anyone who has been through pregnancy and new motherhood after a PND / Anxiety experience so feel free to share your tips or experiences below or drop me an email to firstname.lastname@example.org.
You can also follow my follow my #PregnantAfterPND video diary on my Instagram where I’m updating several times a week (just hit the Insta Stories Highlight with the pregnant woman icon).