In the follow-up to Episode 35 (Part 1), perinatal psychotherapist Sarah Edge shares her contrasting experience with her second pregnancy. Her debilitating experience with Hyperemesis Gravidarum (HG or extreme sickness) took a significant toll on Sarah’s mental health. Sarah developed postnatal depression and terrible anxiety after the birth, leading to intrusive thoughts and hallucinations. The experience was terrifying. Now recovered, Sarah talks about how she has used it to inform her own therapeutic practice.     She provides practical advice for others suffering from similar conditions and highlights the importance of seeking help early.

*Trigger Warning* Extreme vomiting, feelings of suicide.

In This Episode We Discuss:

[00:00] Teaser quote

[01:53]  Introduction to Sarah

[03:49]  Understanding Hyperemesis Gravidarum (H.G.)

[06:25]  How H.G. contributed to Sarah’s difficulty bonding with her daughter

[08:09]  Getting support and medication – the importance of being taken seriously

[12:46]  Advice for mums experiencing sickness in pregnancy. How Pregnancy Sickness Support helped Sarah

[16:00]  Much needed support from Sarah’s husband and her work

[19:58] Her second birth – no immediate ‘rush of love’

[22:39] Feeling ‘high’ then a crushing low – severe anxiety, intrusive thoughts and hallucinations

[29:30] A desperate visit to Accident and Emergency (A+E)

[35:47]  Starting medication

[38:13] Building a bond with her daughter

[42:52] Turning personal struggles into a professional passion – the importance of shared experiences

[50:10] Matrescence

Key Takeaways:

1.    Hyperemesis Gravidarum (HG) is a severe form of pregnancy sickness, affecting around 1-3% of pregnancies and causing incredibly debilitating symptoms.

2.    A 2020 study by Imperial College, London found that “women with HG are around 8 times more likely to suffer antenatal depression and 4 times more likely to have postnatal depression”.

3. For help with HG, go to Pregnancy Sickness Support. They are a charity dedicated to alleviating the suffering of all those affected by pregnancy sickness. They offer peer support and a helpline, 0800 055 4361.

4.    The HER Foundation is another great organisation, dedicated to helping those suffering hyperemesis and those who have survived it. Providing education, research, support and advocacy globally, to improve the management of HG.

5.    Listen to Episode 18 with Dr. Andy Mayers ‘Bonding, Guilt and Pyschosis: An Expert View’, to learn more about mother and baby units.

6.    You can learn more about Sarah’s therapeutic process through her Instagram page, MaternalMentalHealthWellbeing.

7.    Sarah has a Maternal Mental Health Journal, which can be purchased through Amazon.co.uk. It’s a guide designed to support mental health during pregnancy and in the postnatal period.

8.    Matrescence is “the process of becoming a mother. Those physical, psychological and emotional changes you go through after the birth of your child.” (Cambridge Dictionary)

If you enjoyed this episode, please share, rate and subscribe. It really does make the difference in helping others find it – which means helping more parents in need.

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Next Episode:

Next time I speak to Kavita Trevena, founder of ‘The Unlikely Mummy’, a non-profit organisation and community supporting parents and families. Kavita talks movingly about her own experience of postnatal depression and post-traumatic stress disorder following the births of her two children, and how she has used this experience to help others.

You are not alone and will not feel this way forever.

We hope these support services are helpful (please note we do not check or monitor them individually).

Action on Postpartum Psychosis (APP)

Moderated Forum, click here to find out more.

Email: app@app-network.org / Tel: 020 3322 9900

AIMS for better birthing.

Email: helpline@aims.org.uk

This email will go to a group of AIMS volunteers and someone will respond as soon as possible. / Telephone: +44 (0) 300 365 0663 (leave message)

Andy's Man Club

A non-judgemental talking group for men

https://andysmanclub.co.uk/club-information/clubs/ info@andysmanclub.co.uk

Association of Postnatal Illness

Helpline: 10am – 2pm – 0207 386 0868 / Email: info@apni.org (Live chat online facility)

Best Beginnings

Free NHS-accredited Baby Buddy app offering 24/7 App support for new parents

Birth Trauma Association

Email: support@birthtraumaassociation.org.uk

CALM

Contact CALM on their national helpline: 0800 58 58 58 (5pm-midnight)

Cedar House Support Group

Email: lwise@talktalk.net (Liz Wise) / Mobile: 07773 283556

Contact: for families with disabled children

Support, advice and information for parents with disabled children.

• helpline: 0808 808 3555
• website: https://contact.org.uk/

Contact a Family

www.cafamily.org.uk

Contact a Family offer support for all childhood conditions, are also able to put families in touch. Featuring a directory of conditions and rare disorders online.

Helpline: 0808 808 3555 (lines open Monday – Friday 9.30am – 5pm)

Dad Matters

Support dads to have successful relationships with their families, with mental health and accessing services through peer support and signposting.

kierananders@homestarthost.org.uk

0161 344 0669

DadsNet 

Offers support and knowledge through a community of dads on practical parenting and fatherhood.

Dope Black Dads

A digital safe space for fathers who wish to discuss their experiences of being black, a parent and masculinity in the modern world. hello@dopeblack.org

Family Lives

An organisation providing immediate help from volunteer parent support workers 24 hours a day, 7 days a week. Helpline: 0808 800 2222 / www.familylives.org.uk

Family Rights Group

Support for parents and other family members whose children are involved with or need social care services. Helpline: 0808 801 0366 / www.frg.org.uk

Link for information on Fathers Reaching Out

Run by paternal mental health pioneer Mark Williams, offering support to dads.

Link to Fatherhood Solutions

Scott Mair is a consultant in paternal mental health and parent education, Peer support trainer. Dad, Husband, Army veteran. 

FiveXMore

A grassroots organisation committed to changing Black women and birthing people’s maternal health outcomes in the UK. Email: fivexmore@gmail.com

Gingerbread

Single parents, equal families. Help and advice on the issues that matter to lone parents. Helpline 0808 802 0925 / www.gingerbread.org.uk

The Hub of Hope - A directory of mental health support around the UK.

Link for the Lactation Consultants of Great Britain – for support with breastfeeding.

LGBT Mummies

Supporting LGBT+ women & people globally on the path to motherhood or parenthood.

Email: contact@lgbtmummies.com

Make Birth Better (Birth Trauma Support)

Email: hello@makebirthbetter.org

Maternal OCD

Peer support available, email info@maternalocd.org to arrange

Mayah's Legacy

Supporting and empowering anyone who has experienced pregnancy loss to advocate for themselves. Email: info@bigoutreach.org / 0300 102 1596

The Motherhood Group

Dedicated to sharing and supporting the black maternal experience through peer support, projects and advocacy. info@themotherhoodgroup.com

Motivational Mums Club

Offering Trauma, Mindfulness and Meditation sessions for Mothers and Mums to be with an NHS Mental Health Specialist, who’s also a Mother. motivationalmumsclub@gmail.com

Music Football Fatherhood - hello@musicfootballfatherhood.com

Open conversations around fatherhood, including blogs, peer support and podcasts.

Muslim Women’s Network

Helpline: 0800 999 5786, open Mon-Fri 10am–4pm with support offered in English, Urdu, Punjabi, Mirpuri, Putwari, Hindko and Bengali. Email: info@mwnhelpline.co.uk

Online chat: www.mwnhelpline.co.uk / Text: 07415 206 936

National Autistic Society www.autism.org.uk

Support and advice for parents and carers of autistic children, including support to develop a greater understanding of their child’s needs and accessing services that meet the family's needs.

Netmums

Netmums offer peer support via their Maternal Mental Health Drop-InClinic.

NHS Services for Mental Health Issues

Contact your local GP surgery. Call the NHS on 111 and press 2 for Mental Health Team

or contact a local NHS urgent mental health helpline

If you are in crisis, visit Accident & Emergency at your nearest hospital.

PANDAS

Helpline open from 9am-8pm every day – 0843 2898 401

Email support available – info@pandasfoundation.org.uk

Perinatal Wellbeing Ontario

PRENATAL, PREGNANCY AND POSTPARTUM SUPPORT & CONNECTION in Canada

info@perinatalwellbeing.ca

Petals Baby Loss Charity - click for information

Petals offers free-of-charge specialist counselling to anyone who has experienced pregnancy or baby loss. Tel: 0300 688 0068

Web: petalscharity.org/counsellingcontact/ Email: counselling@petalscharity.org

Click for information on The Samaritans

Tel: 116 123 (this is a free telephone number and will not appear on the phone bill)

Web: www.samaritans.org / Email: jo@samaritans.org

Sands Charity information link

Emotional and practical support for anyone affected by the death of a baby.

0808 164 3332 /Email: helpline@sands.org.uk

Shout

Text SHOUT to 85258 to start a confidential conversation with a trained Shout volunteer.

Twins Trust

Twinline is Twins Trust’s listening service for parents of twins, triplets and more. All

0800 138 0509 / email asktwinline@twinstrust.org.

Web: twinstrust.org/let-us-help/support/twinline.html

Tommy’s

Tommy’s has a team of in-house midwives who offer free support and information for women and their families at any stage of pregnancy and after the birth.

Web: www.tommys.org

Email: midwife@tommys.org

MUSIC by Joseph McDade

A ginger biscuit is not going to solve somebody vomiting 30 times a day!

Hyperemesis gravidarum, or H.G., is extreme sickness in pregnancy.

It's what Kate Middleton (Princess of Wales) had.

Extreme vomiting, but also really intense nausea.

It's much different to morning sickness.

Still remains probably one of the most difficult things I've ever been through.

And it is linked with experiencing postnatal depression and prenatal

anxiety and depression because it is a really serious condition.

It can be really difficult to communicate to people around you how much you

are suffering because people know it as "Oh, you have morning sickness."

It was really, ---really brutal.

And I believe that that experience not predicted my experience of

postnatal depression, but I feel like it had a major impact and I

think it certainly contributed to it.

Having a baby is meant to be the most joyful time of your life.

But for many mums, and dads, it can be the hardest, and at

times the darkest of places.

Welcome to Season 3 of Blue MumDays, the podcast for anyone

struggling with parenting.

You need to know that you are not alone.

And these awful feelings will not be with you forever.

Just one word - all the stories shared here are from the heart.

These are real conversations and may be triggering, so

please listen with discretion.

Your wellbeing is so important, so if you need to take a breather or stop listening,

please know that you can at any point.

Today's episode covers hyperemesis gravidarum (extreme sickness during

pregnancy), and feelings of suicide.

We will also signpost you to help in the show notes.

Thank you.

This episode was recorded ----- during the winter of 2022.

Today's guest is Sarah Edge.

Sarah is a perinatal specialist psychotherapist working in South

Manchester, with a special interest in supporting women with infant-feeding

guilt and trauma- usually following a period of difficulty breastfeeding.

Sarah is a mum of two and suffered from anxiety following

breastfeeding difficulties after the birth of her son, and P.N.D.

(Postnatal Depression) and an adjustment disorder following

the birth of her daughter.

Writing has always been a part of Sarah's personal wellness.

But after her experience of motherhood, she began to write professionally about

perinatal mental health and infant feeding guilt and how to recover from this.

Some of her work can be found at www.fedisbest.org and

in Therapy Today magazine.

Welcome to Blue MumDays - I'm so pleased to have you with us today Sarah.

Hi Vikki, hi.

I'm really excited to be here.

So Sarah, can you tell us a little bit about how the experience

was when you had your daughter?

Yeah.

So I know I spoke a little bit about my experience having my son, my first born.

It was really different having my daughter ... I suppose the first time I went into

it with maybe kind of like blissful naivety, because I didn't have a clue.

And then the second time I think I went in with this sort of confidence

of like, "Oh well I sort of know it's hard this time, it's going

to be different because of that".

You are often kind of prepped for the delivery's going to

be more straightforward, the second time you have a baby.

And I sort of thought that that would be the same for all sort

of areas of early motherhood.

I mean my pregnancy was very different with April, my daughter.

The birth was very different.

The immediate postpartum was different, not all of it worse,

you know, by any stretch.

But it did start on a difficult kind of foot, because I developed

hyperemesis (gravidarum) in pregnancy with my daughter.

So what's that, for people who aren't familiar with the term?

Right, so hyperemesis gravidarum, or H.G., is extreme

sickness in pregnancy.

So a lot of people might know it because it's what Kate

Middleton (Princess of Wales) had.

So it's, I don't know exactly, I think it's suffered to some degree

in up to 3% of pregnancies, but I wouldn't want to be quoted on that.

Extreme vomiting, is the kind of like only way to describe it, but

also like really intense nausea.

It's much different to morning sickness.

I was signed off work for a number of weeks.

I didn't return to work until I was

17 or 18 weeks.

I was still vomiting at that point, but just a lot less.

God you poor thing.

Yeah it was terrible.

It is one of - it still remains probably one of the most difficult

things I've ever been through.

And it is linked with experiencing postnatal depression and prenatal

anxiety and depression because it is a really serious condition.

And it can be really difficult to communicate to people around you how much

you are suffering because people know it as "Oh, you have morning sickness."

And I've had morning sickness.

I had morning sickness with my son.

And whilst it's absolutely vile, it's horrible, it's awful, it

isn't anything like having H.G.

- they're very, very different.

And it was, brutal.

I think that's the, the word I would use - it was brutal.

And I believe that that experience kind of set me off on a path of not predicted

my experience of postnatal depression, but I feel like it had a major impact and

I think it certainly contributed to it.

I am not surprised.

I mean, it sounds so utterly miserable.

I was very lucky that I didn't have much morning sickness, but I know how

debilitating it can be when you feel nauseous or you're constantly throwing up.

Yeah.

And how women who are going through H.G., how they can possibly

carry on with their life and you had a little one to contend with at

the same time, in terms of your son?

Yeah, I didn't carry on with my life, my life as I knew

it, and and how I was a mother to my son kind of completely stopped.

So I couldn't get out of bed, barely.

There was very little I could kind of eat or even smell.

I was being sick up to 30 times a day.

My goodness.

Probably sometimes more than that.

It was really, really brutal.

My daughter was a wanted pregnancy, so I'd tried to get pregnant with her.

But I was certainly questioning whether I wanted to continue with the

pregnancy because the guilt I felt for my son - because his mother had

just kind of disappeared, I was a shell of a person in a bed, vomiting.

Yeah, it was really, really hard.

And I think it probably contributed to difficulties bonding.

I didn't feel the same in my pregnancy, kind of emotionally

towards my baby as I had with Jack.

So when I'd found out I was pregnant with Jack, I'd kind of felt instantly bonded.

I did talk to my bump.

I did sort of hold my bump.

I liked to watch him move while I was in the bath.

I don't remember having any of that with her.

I kind of just remember pregnancy being this really painful, horrible experience.

I mean, I never enjoyed it the first time, but there was certainly elements

that were nice and I don't feel like I had any of that the second time.

So that was kind of a big difference between the two, yeah.

Again when we talk about expectations of pregnancy and what it's

meant to be like and what we're sort of shown in the media and in social

media, is this incredible, glowing, wonderful, just joyous looking woman,

living her best life, her skin - the best condition it's ever been in!

Whereas actually for a lot of us, we feel really frumpy.

We might have piles or heartburn, sciatica...

you know, it's not always rosey like that, is it?!

It's tough on a body!

Yeah, yeah!

And how were you able to help yourself feel better?

Were you given treatment?

Was there self-help things you could do?

Yes.

So, I had, an amazing G.P.

(General Practitioner/Doctor).

She was brilliant.

T hey signed me off work pretty much immediately.

They diagnosed me with H.G.

So there was no kind of "Oh suck it up, try bit of ginger".

I was taken really seriously and that was really important.

I was given medication.

So the first one that I was given - oh gosh, Cyclizine, I want to say?

- didn't do anything at all.

I'd actually gone to the doctors saying that I wasn't able to keep

water down, I was vomiting, there was blood in it, s o I was concerned there

was something wrong with my stomach.

That must have frightening.

It was very frightening.

It was very painful on my throat, the stomach acid had kind of begun

to wear away at my oesophagus and it was that that was bleeding.

So it was that that I could see, which is better than it being something kind

of going on and there being blood in your stomach obviously, but it still

meant I needed to stop being sick.

And the medication that I'd previously been prescribed wasn't working.

I didn't feel any different.

So at that point they prescribed me Ondansetron and that did work.

It didn't stop me feeling sick, but it definitely stopped the

frequency of how often I was being sick, it made it much, much less.

So that did help, but it wasn't a miracle cure.

My energy levels were still through the floor.

I was still very sensitive to smells.

I also had this horrible symptom, very common with H.G., where

I was producing excess saliva.

Which sounds kind of weird, but to the point where you can't

keep it in your mouth I suppose, when you start to feel sick.

probably should warn people before they listen to this, especially

if they're feeling a bit unwell, maybe give this episode a miss!

But that kind of salvation you get before you're sick, it's like that to an extreme.

And I wasn't unable to kind of swallow it down because that would

just make me instantly vomit.

So I was walking around with empty coffee cups, kind of having

to spit into it constantly.

And it was really horrible.

And that's actually a really common symptom of H.G.

and can definitely be kind of an indicator if you've got something like

that going on to go and see a doctor.

But yeah, so symptoms like that kind of didn't improve until

I was probably about my third trimester when I stopped being sick.

Some people that suffer H.G.

are sick the entire way through, they're sick through labour.

Yeah, and I had it relatively mildly compared to how some

people suffer - I didn't end up in hospital, I didn't end up on a drip.

But it's a really serious condition and it can have huge implications

for the mother and for the baby.

Hmm.

Yeah, yeah.

When you're pregnant, you are very careful about what you eat.

You are very careful drinking lots of water, good nutrition.

Presumably if you're being sick all the time, that nutrition isn't

necessarily benefitting you or the baby.

So...

what was done to sort of help support the actual growing of

the baby and your health as well?

So my baby was growing fine.

She was on the 50th centile, whilst I was kind of really vomiting, which

was a lot different to my son who was always on the kind of 99.9th.

He was always, he was always big!

And my daughter was kind of averaging around the 50th, but she was growing

steadily so they weren't too concerned.

I clearly was keeping enough calories in to sustain a pregnancy.

I wasn't putting on any weight, but I wasn't losing masses either.

Like some people lose a hell of a lot of weight.

But once I stopped vomiting, her weight hugely jumped.

So she then jumped up to like the 99th centile like my son had been,

so clearly she wasn't growing to her full potential or to what, you know,

she would've done had I been eating adequately the whole way through.

But actually babies born to H.G.

mothers are often really healthy.

That actually your kind of body prioritises the health of the baby and

will make sure that they get everything.

Both my children have been grown on crumpets and lemonade and

like not a single vegetable or (laughs) barely an orange juice!

And they're both fine!

That's to reassure any mum going through that or any mum experiencing

fussy eaters that they will survive!

They will!

They absolutely will.

Do you have any advice for women who are going through this or

who suspect they might have this?

I think it's to see your G.P.

as soon as possible, you don't need to wait for it to get worse.

I think there's this kind of expectation that, "Oh well if I am keeping something

down" or, you know, "I've not lost masses of weight, then it doesn't matter."

Of course it does because suffering matters.

The impact on you matters.

So to see your G.P.

But there's also a charity called Pregnancy Sickness

Support and they're wonderful.

They have peer support they can hook you up with, because it can be very difficult

to actually even go out to the doctors to even actually make an appointment.

And I mean, now we're kind of in the era of Zoom and things are available.

But there are kind of people that have been through it that

can offer peer support to you.

So there are places that can offer you that support.

And I think to also kind of just know that the response from everybody isn't

going to be great because there's a lot of misunderstanding about the condition.

So when you are speaking about it, it's kind of that if it feels like you can't

tolerate or cope with misunderstandings, to choose who you communicate with.

Because it can be really hard.

I find it really hard to have like suggestions like "try

ginger," kind of "Oh I ate ginger biscuits when I felt like that".

To try and say to somebody that "that's not what this is".

This is different - a ginger biscuit is not going to solve

somebody vomiting 30 times a day.

It might help if you're feeling sick as you wait to kind of ingest something

and get some food in your stomach.

You know absolutely, that can be appropriate and good

advice in some circumstances.

But if somebody is suffering from H.G., just don't even

mention the word ginger at all!

That would be my kind of best advice, but definitely speak to somebody.

There are people that understand what you're going through and

there are doctors that are really good at managing this condition.

And you can request, you know, if you go to a surgery that's got multiple G.P.s

you can say, " Can I request somebody that has experience in treating H.G.

or somebody that is experienced in kind of maternal physical health".

You can request to see somebody with that experience, that's

your right to to do that.

That's really good advice.

So thank you so much.

And I'll make sure I put the link to Pregnancy Sickness Support

in the show notes so that people can click on that link easily.

But it might be with the best intentions, but it just goes to show that advice

can be - unwarranted advice - can sometimes actually be quite harmful.

And absolutely, it is with the best intentions, you're

right, that nobody wants to kind of further cause suffering at all.

It comes from misunderstanding and from not enough information

about the condition.

But then it also feeds into what we were saying before with

your experience with your son.

It invalidates, you know, unwittingly invalidates your experience and the

extremity of what you're going through.

And I can see how that would have a harmful psychological effect

when you are, you know, if you are battling something entirely different.

So with your daughter, I mean, it sounds like a very, very tough pregnancy.

Really tough pregnancy.

How was your relationship with your husband at that time?

Was he very supportive?

Yeah, he was amazing.

I can't fault him.

It was really tough on him, he basically had to do everything.

My mum was coming up a lot to help take care of Jack.

He was kind of going into extra days of nursery.

I cannot imagine what it would be like to have multiple children and have

a condition like that, or not have a supportive partner or family around

that can kind of pick up that slack.

I certainly couldn't do it now, you know, with my two children,

that would be impossibly hard.

But it did impact our relationship and it kind of massively changed the dynamic.

I wasn't used to being sort of needing looking after.

It was very, it was very frustrating.

I think frustrating is the word I would kind of use to describe my whole

experience in motherhood - that I felt frustrated a lot of the time.

I suppose the feeling held back or not capable or, yeah, the vulnerability being

really scary and really not, not pleasant.

And it absolutely put a strain on you know, my husband.

His job at the time were not supportive - they didn't get

it, they didn't try to get it.

It was a really difficult time for us.

I think what you said just then really resonated in terms of being

frustrated when you're not well and I think a lot of us mums, we tend to be

'doers' and we're so used to doing and achieving, that it's actually very hard

for us to be incapacitated and actually accept that we are going to have to just

take some time out and not be constantly striving for something or actioning stuff.

And again, it just goes to show how little understanding there is with employers and

how actually a bit of support from your husband's employer would've made a huge

difference to your family as a whole.

Yeah, yeah, absolutely.

And my employer - perhaps not my employer as a whole - but

my immediate boss was amazing.

He couldn't have been any more supportive - they were sending flowers

to the house and messages saying, you know, "Get well, take your time."

He was - and my kind of team - were really, really supportive and

it does make a big difference.

I've got friends that have had to drag themselves into work because they're

afraid of losing their job, they're kind of being sick constantly at work.

It must be so, so hard to manage all of that.

But I think kind of what happened for me and my husband Nick, was

we were like "Everything is going to be okay once the baby's here."

And it was perhaps that building up that expectation that like

"This'll be the hard bit.

We've had our fair share now of kind of challenge, it's all going to be

fine once she's here" and perhaps setting ourselves up for really high

expectations and kind of not considering that actually after a period of ill

health or difficulty, that you need some recovery time, that actually...

Totally!

... SARAH EDGE: I hadn't kind of factored that in.

It was almost like, "Well the day I stop being sick, I'll just carry on my life".

And actually I found it really hard going back to work, I

really struggled with work.

I kind of was desperate to go on maternity leave, I just

thought "I can't hack this".

Yeah, so it was, a really tough time and I'd kind of massively built up in

my head that "Once the baby's here, everything is just going to be okay."

And you know, you'd had your experience with Jack with the

breastfeeding, and knowing that it's okay to go onto formula if

you are really, really struggling.

So what happened then, because you are obviously leading up to a

difficult experience post-birth.

Yeah, so I did go into my second birth with more confidence.

I'd had a positive birth the first time.

There had been difficulties, but overall it was a positive experience.

I wasn't frightened of childbirth.

I felt like it was going to go more smoothly.

Because I knew she was going to be my last baby after H.G.

I was like "I'm not doing that again, ever!"

I knew she was going to be my last, so I kind of had got in my head like

"Oh, I'd really like the waterbirth.

I'd really like the whale music".

But I was kind of managing my expectations.

And with the feeding I felt really confident.

So I went to the hospital with formula in my bag, with sterilised bottles in my bag.

And when they asked me how I was feeding, I said "Well, I

am going to try and breastfeed.

I would like to breastfeed."

But I was kind of really clear that the single hint of a problem, like anything

- the tiniest problem with the latch, anything - I was like, "I'm going to be

moving immediately to formula, because I can't take that experience again".

And actually they were very supportive of that.

They were like, " we'll help you to breastfeed."

And actually, kind of immediately after the birth, breastfeeding

was established very quickly.

Her latch was really good.

And so I was kind of quickly confident that "Oh, actually this is okay.

I can do this".

And it almost sort of validated for me how difficult it had been with

Jack, because I'd seen then almost like how it's supposed to work.

That actually when it does work it....

I mean obviously it can work after difficulties.

And you know, the support being there is really, really important.

But actually this didn't feel like an ordeal.

It kind of felt natural.

She latched, she fed, there wasn't excessive pain.

She was gaining weight.

That all felt okay.

And I had my 'formula cupboard', I used to call it.

My backup, like my safety net.

And I just had this cupboard like full of formula and bottles and I

used to like stare at it every day.

And I'd be like, "If I need it, it's there and that's okay."

And I felt really sure of that and I never actually needed it.

Which was really lovely for me to be honest.

It was a really healing experience and kind of, yeah, everything immediately

felt like it was going to be okay.

I didn't have any rush of love when she was born, so I do remember

having this feeling of "Hmm, I don't really want to hold her."

I wanted my husband to hold her.

But I didn't worry too much about it.

I was kind of like, yeah...

The birth was kind of painful and I sort of felt like I needed a

bit of a "Oh!", like a breather.

And I didn't feel too concerned about that or about our bond.

And actually for the first kind of six weeks, I would say I felt really good.

So I felt like better than I'd felt like ever.

In hindsight I can recognise that I kind of was on a bit of a high

and what comes up must come down.

But I thought, "Oh, this is what it must feel like when you

have a kind of straightforward birth and breastfeeding is easy."

So I kind of put it down to that.

I was like, "Oh, well it must be that, and that must be why I feel so good."

But I wasn't kind of needing as much sleep.

, I wasn't getting much because I had a newborn, but I didn't feel exhausted.

So it was almost like "Oh!"

And a part of me was like, "Oh, is it something in the breastfeeding

that makes you like able to stay up all night without feeling tired?"

And all these kind of thoughts were going through my head and I was

like, "Oh no, actually I feel great".

But very, very quickly, so it didn't creep on me, almost...

my mood fell off the cliff.

It was like, I kind of woke up one morning incredibly anxious,

yeah, like feeling really on edge and kind of absolutely convinced

that I was going to lose my mind.

So for me, my anxiety very much centered around that I was really

worried that I'd got bipolar.

Because there's a family history, but also I'd had this period of kind of high

... not manic, but I'd been in a good mood.

And then now I was in this kind of real anxiety, depression and I was kind of

absolutely convinced that I was days away or hours away from a psychotic episode.

So I've never had a psychotic episode, I don't know what it feels like to go

into one, but that kind of really severe anxiety I was experiencing, to

me felt like "This must be what the edge of a psychotic episode must feel like".

And I was kind of sure that I was going to lose grip on reality

and I was going to harm myself.

I never kind of had the same worries with April about her.

So with Jack I kind of worried about him, that he was going to die or that

he was going to starve or there was something going to happen to him.

I didn't have that with her.

She sort of felt weirdly very robust and she still sort of does,

and I never worried about her.

The worries were all about my own health and my own mental I was really,

really concerned I was going to kind of lose my mind and then harm myself,

like that I would sort of lose my mind and jump off a bridge or lose

a grip on reality and crash the car.

There was kind of all of these really horrendous, intrusive thoughts and anxiety

that would either kind of pin me to the bed being unable to move, it would be like

paralysing, or I would become incredibly restless and my only way I'd either have

to sort of pace about or I would drive.

So I couldn't tolerate any whining or crying, that was kind

of what really would set me off.

And, my son had been quite a calm baby with a temperament

that was, you know, mild and...

there's no such thing as kind of good and bad babies or easy babies.

But he had a milder temperament and was less challenging.

Whereas my daughter really knew how to make her needs known and communicate that.

And she still does!

She would kind of cry and she had a loud cry.

And that would kind of really trigger off this anxiety.

And I couldn't tolerate her crying.

So if I drove around, she'd be more settled.

So we'd sometimes kind of drive for hours and then we'd stop, I'd

feed her, we'd drive a bit more.

and that probably went on...

I knew I was getting kind of worse and worse.

It was probably over a couple of weeks that I began to become more

concerned about my mental health.

I was hearing things as well.

So I was hearing kind of sounds that - lots of parents do this, but like, can

think that they can hear their child crying - you know, when they're in

the shower or when they're downstairs.

I was really getting that a lot.

And also I was having kind of very mild visual hallucinations

that I was aware weren't real.

I was imagining spiders walking down the wall.

And I'm not scared of spiders, so I always find that that's a weird thing that I saw.

Because you'd think if I was very anxious you'd see spiders because

you're sort of scared of spiders.

But I'm not.

Yeah, I was beginning to kind of see things that weren't

real, and I knew weren't real.

So I was becoming increasingly concerned that, I suppose all of

this contributed to the fact that I was convinced "I'm losing my mind."

It must have been so frightening for you.

Can you sort of remember how it felt in the middle of the night when your

daughter woke you up and she was crying?

That sort of extreme feeling of anxiety?

Yeah, I suppose for me, the middle of the night wasn't the worst

time because my husband was there.

And that was another kind of really key trigger.

I didn't want to be left alone with my children.

I was really frightened about being alone.

So I would say I was worse during the day than I was at night, because

I was better if somebody was with me.

So actually kind of from the outside, if somebody was with me like a friend, or

you know, family member, they probably wouldn't have known I was that bad or

that what was going on inside was that disturbing to me or was to that level.

Because I was kind of much more relaxed if somebody was with me.

I really, really had this intense fear about being left alone.

But certainly I do remember that and I remember it with Jack, that kind of

feeling really anxious around sleep.

And then that feeling of when you're being woken up again, it kind

of, it just fills you with dread.

You sort of go into that 'fight or flight', don't you?

And your adrenaline's going, so no wonder you are even more exhausted

and depleted because you are on such a state of high alert really.

But I think that ' not wanting to be left alone' thing is

probably a very common feeling.

And one of the reasons why I committed to or decided to do

this podcast was so that...

Because I remember how it felt when my husband would go to work

on a Monday morning and the whole week of being alone during the

day stretched out in front of me.

And I wanted there to be something for women like us to listen

to every Monday if they were feeling low or isolated or alone.

So an incredibly frightening experience for you, and it must

have been very frightening to seek help if you were worried about the

possibility you might have bipolar.

So what happened?

Did you speak to your G.P.?

How I got help was I'd spent a weekend afternoon driving

around kind of in one of those really restless, anxious states, convinced I

was about to have a psychotic episode.

And my daughter was like in the back of the car, kind of, you know, totally

oblivious - she was probably about 16 weeks old, maybe, something like that.

And I came back home and kind of entered the house and sort of

immediately said to my husband " I actually can't tolerate this.

Like, this feeling is intolerable.

Like, I'm going to do something to myself, I need to get help".

And I didn't even feel like it could wait until the Monday.

So I actually drove to A and E (Accident and Emergency), and

thought "I'm going to tell somebody I'm in a mental health crisis" and

that was what I was experiencing.

And this was in the summer of 2020, so we were kind of in a lockdown.

You know, all of those things definitely didn't help.

And I arrived at A and E, crying my eyes out, kind of clearly

looking very distressed with an, an infant daughter, like in my arms.

And I got to the doors of the hospital and a security guard

said, "What are you doing here?"

And I said, "I really want to speak to a health professional."

I kind of didn't really feel like I wanted to tell the security guard

that I was having suicidal thoughts.

But yeah, they became quite sort of like, "Well you need to

tell us why you're here here.

We're in a pandemic".

They were kind of kept sort of quite forcefully asking "What's wrong?

What's wrong?"

and looking kind of really concerned.

And I was really frightened in that moment because I was really aware - you

know, I'm a professional, I've worked in child protection previously - I

was aware that I was this incredibly distressed woman, like clearly visibly

distressed, holding an infant in her arms.

And I was like, "What do I do now?"

I don't want to go in because ... this isn't feeling safe.

This isn't feeling like a good, helpful situation.

But if I walk away, I was kind of aware that they potentially could

call the police to follow me with concerns the welfare of my child.

So I was kind of stood there like trying to make this assessment

of "Oh my God, what do I do?"

I'm really regretting this decision now.

Really worried about children's service is going to become involved.

There are going to be other professionals contacted.

But luckily, some health professionals had seen the kind of commotion at the doors

and sort of immediately brought me in.

And there was a perinatal mental health specialist there on the day, which was,

I mean, I don't know what it would've been like without her, but I got a

better response with her being there.

There was no kind of heavy handedness, there was no mention of like other

professionals or children's services.

She talked to me about how what I was experiencing was anxiety and it actually

sounded like I was having a panic attack.

Hmm.

Which even instantly, that gave me some relief because you imagine

that panic attack is actually one of these episodes where you're kind of

rocking backwards and forwards and you feel like you can't breathe, or you're

going to die or have a heart attack.

Whereas that wasn't what I was experiencing.

And it was also not over kind of a couple of minutes.

Like I would have these episodes where they would last sort of hours.

But she was explaining to me how you can have these episodes of, of panic or panic

attacks that last three to four hours.

And clearly the way mine was manifesting was in this fear that I

was about to have a psychotic episode.

Um, but she was really good because she said to me " People that are about to go

psychotic don't usually know that they're about to go psychotic because they've

lost that kind of grip on reality.

So it suggests what you are experiencing is anxiety."

She was a mental health professional.

She said to me, "I've been where you are".

I know what it's like.

And I was met with so much empathy and so much understanding and non-judgment

. Because I was kind of begging to be admitted.

So I was saying to them, "I need to go in a mother and baby unit.

I can't tolerate feeling like this anymore.

I can't manage like this anymore".

I kind of felt like I needed - not that a mother and baby unit is a break or a

holiday - but I felt like that way I would have somebody with me all the time and

I wouldn't solely responsible for April.

So in the night I would be having like a full night's sleep.

I wouldn't be the only person kind of responsible for her, for feeding her.

I was really desperate.

And she kind of basically said to me, "One, you're not unwell enough.

And two, there isn't any space, even if I wanted to refer you".

She said, "I'm going to do an urgent referral to the

perinatal mental health team.

They will contact you on Monday., which they did.

And I kind of to them then about therapy and about medication and...

yeah.

And it started, to get better.

That was kind of my crisis pinnacle moment.

But it did begin to get better after that.

Hmm.

That must have been such a mixture of emotions for you, because on one

hand, the relief that you're not going to have a psychotic episode, or it's

very unlikely, that it is anxiety.

But also the disappointment that you couldn't be admitted.

And, you know, it's something that I've, I've spoken with Dr.

Andy Mayers about, in another episode where we talk about Mother

and Baby Units and about how they have such an important role to play.

But what happens to the mums who are still going through a very, very tough

and traumatic time, but aren't ill enough to be admitted in that situation.

And, you know, sometimes those gaps in care can be so alarming, even, you

know, for you in that very vulnerable, very distressed state, holding out

till Monday can be really tough.

Or if you take antidepressants, they normally say "It's going to

get worse for the first three weeks and then they'll start to work".

Or "You might be seen in six to 18 months", depending how long the waiting

list is for therapy or counselling.

So, yeah, it's really tough people to sort of hang on in there.

So, so what happened after that?

Was it a gradual relaxation of that anxiety?

Or how did it get better?

There was a bit of a process with medication.

So I agreed that I wanted medication after that.

I had a reluctance to, to take antidepressants, but I kind of knew

at that point that I needed to.

But the first tablet that I was prescribed Sertraline and I took a dose of

that and had a really bad reaction to it.

Yeah, I couldn't stand up properly.

I had this sort of like horrendous vertigo.

I wasn't really sure if I was like laid down or stood up.

I didn't sort of know where I was in kind of space.

I'd lost my balance.

I was having really extreme suicidal thoughts, and I think

it's quite a rare reaction, but it's not completely unheard of.

When I spoke to the doctor, they said like, "Mmm, that's not

suitable medication for you."

Yeah.

Yeah.

So what happened then was I was prescribed Fluoxetine, because it

tends to have less - well, this is how it's explained to me - that it has

kind of milder side effects, it also can be given in much smaller doses.

So they make it in like an oral solution, which means it could

be administered in tiny doses and very, very gradually built up.

And so that's what I did and that worked.

And I began talking therapies.

So I was having person-centered counselling at the same

time, and it was gradual, but there was an immediate relief.

I'd say within a couple of weeks I could, you know, I wasn't

in any stretch kind of better.

You know, I would struggle to say that I was 100% recovered or better now, I

think I'm still dealing with some of the after effects of that experience.

But it did , I quickly knew that it was going to get better and

it did quickly begin to improve.

But it was a long process.

And it wasn't linear either.

So it wasn't kind of, you know, from that crisis moment that it's just been

like this upward trajectory since then.

I don't think it ever is, is it?

It's...

a massively jagged line, isn't it?

Up and down.

Up and down.

Yeah, hugely.

And there were definitely dips.

You know, there still is.

But I suppose I haven't felt as 'in crisis' as I felt

on that day since that day.

And how would you describe your bond with your daughter now?

Has that grown gradually over time?

, SARAH EDGE: yeah, it grew over time.

It took longer.

It took longer than it had with Jack.

I had this sort of instant sense of responsibility towards her, but the

'love' feeling or the kind of "Oh I really love you" took longer to come.

And this real sense of...

because I, I was really worried when I was pregnant with her that I wasn't

going to love her as much as I love Jack.

Because I just couldn't imagine loving anybody as much as I love Jack.

And so I was really frightened about that and about that kind of impacting her life.

Like her being aware of the fact that I loved Jack more.

And so when she was born and for a bit, I did love Jack more.

Uh, that was really frightening because everybody had told me, "As

soon as you lay eyes on her, that feeling will go, that will vanish.

You know, you'll, you'll love her equally."

And I was kind of like, "Oh no, I'm going to be like the one

person that this happens to".

And I was scared to kind of say that - it felt so, so mean.

But there was a point - and I wonder how old she was, it's hard for me to

remember - but as a baby, quite a few weeks in, where I did sort of look at

her and think "No, I do love you the same now, I do know what they mean".

But that definitely wasn't, it wasn't instant.

But my bond with her is yeah, is, is, is great now, I love her.

And watching her and Jack together, their bond is one of

the loveliest things to watch.

They just absolutely adore each other.

And I kind of feel like what they have potentially missed out on

in me, they've kind of gained in each other, if that makes sense?

Yeah, totally.

But it also sounds like they haven't missed out anything.

With you, from everything you are saying.

And I can totally relate to that, that sense of grieving, the time

that you wished you'd been more open to the full experience of motherhood

and the joyful side of that.

But it sounds to me that they aren't lacking in any way, you know, and...

Yeah.

It felt like she was kind of very oblivious as a baby.

Like when I said to my husband on that day when I went to A and E, I said

"I'm going to have to go to the hospital."

Um, I knew I can't even have a breakdown in peace because she's

going have to come with me, because she wouldn't take a bottle!

Yeah!

(Laughs)

So I was literally breastfeeding her in A and

E, explaining that I felt on verge of a psychotic episode.

And she was completely like ignorant to the kind of chaos

or the crisis that was going on.

She was sort of smiling, it was like a day out.

We'd been in lockdown for most of her life.

She was having a really nice day.

She was smiling at all the nurses!

She the most settled she'd like ever been.

She was having a lovely time, but just totally, yeah, totally

oblivious to kind of what I was...

of course she was oblivious, she was a baby!

But yeah, it does make me laugh still that even in the kind of

midst of a breakdown she was still with me, still attached to me.

Yeah.

Well, I'm sure that must rub off in terms of her adaptability

and you probably don't have to tiptoe around her at night.

She'll probably sleep through anything!

Yeah, actually, she a really good sleeper now.

I'm so, so pleased.

You know, you've made a recovery.

I think with a lot of us, it's never quite a hundred percent recovery, that

there's always parts of the experience that you still need to process or lots

of emotional connections with that time.

It's a trauma, isn't it?

And it's one we will live with.

We cannot undo that experience.

And there is, there is legitimate loss there, you know, that, you talked about

then that, that loss of it not being the experience you kind of wanted and that

the joyful part of motherhood, that really resonates with me because there was

no joy, there was just purely survival.

That's how I felt, like in that first year with April was just survive it,

just actually come out the other side.

And for any Mums actually going through that now who are

really struggling, it's okay.

You know, don't put pressure on yourself to have all these incredible

experiences with your child.

And, you know, it is about survival and getting through it.

And every day you get through it and keep going, keep going.

But ask for help.

Do get support.

Absolutely.

Ask for help.

So you've actually taken your lived experience and that's

actually really filtered into what you are doing with your work now.

And the work you are doing with mums.

Yeah, so before I had my children, I was working as a

therapist and had been for years, but with children and families.

And after I had my son and that experience with infant feeding guilt and shame,

I kind of knew that perinatal mental health was an area I wanted to move

into, because I, I'd sort of said I wanted to have two children, and after

that I would go into private practice and focus on working with new mothers.

But after my experience of having April and having really lived experience of

postnatal depression and, this kind of just completely new experience of mental

health challenges, that kind of really cemented for me that I wanted to start

a practice that would've been useful for me, that I would've have wanted.

And I did have a wonderful therapist, but she wasn't a perinatal kind of specialist

or it wasn't a perinatal specific service, where what I offer, I exclusively work

with pre and postnatal mental health

Yeah, I love it.

It's been so rewarding to do.

And it was something that, to begin with, I was, I was a bit worried, well,

when kind of, you know, the N.H.S.

(National Health Service, U.K.) perinatal mental health services exist and N.H.S.

free counselling exists, how will this work in this space?

But actually I found that what still exists is the kind of stigma around mental

health and people worry about things being on doctor's records and things like that.

That actually people like taking ownership of their therapy and choosing

their therapist and say, "Actually I want somebody that has experience of this".

And somebody that kind of can say " It's okay to share those disturbing

thoughts or those things that you are really worried about sharing."

Because actually it's really, really hard to say, "I've

thought about harming myself.

I worry that in the middle of the night I might harm my baby."

Like, those things are really terrifying to say.

And if you can say them to somebody that gets it, that can tolerate it, can

hold it and feel safe, then actually you can begin to move forward and

kind of move on from this experience.

But it is so important to have that non-judgmental and safe

space to work through those things.

So it's you know, I didn't know whether I was going to get enough work

with, only working with, new mums.

But actually I have, and yeah, it's been a really positive experience.

It's been definitely part of my own kind of, I suppose, like pulling that silver

lining from your experience or sort of making good out of something bad.

It's kind of felt important for me to do that because I'm now in a place where

I can say, "I'm glad it happened to me.

I'm glad I have that level of understanding.

I'm glad I have that level of empathy".

That I can work really effectively with women that are going through

the same thing and kind of give back following my own experience.

And I think I said to you before when we've, talked that this experience

has a hundred percent made me a better therapist, but it's actually

just made me a better person.

It's kind of changed my life in so many ways and whilst it has been incredibly

challenging, I wouldn't undo it now.

It's amazing how many people have said exactly that same thing, and it, it

was something I was reflecting on this morning about, you know, would I have it

the other way that I'd never experienced the PND (Postnatal Depression)?

And I really hope this offers a ray of light and a bit of hope to people that are

going through it at the moment, that you will actually look back one day and think

it's changed your life in a positive way.

Absolutely.

How important was it for you, when you had your crisis moment

with the perinatal mental health nurse at the hospital, for them to

say to you, "I've been there too.

I know what it's like."

Yeah.

It was a really big part of, I kind of instantly trusted her then, I kind

of knew that she could hold what I was was feeling and experiencing and that

she felt like this kind of safe person.

Because for me, certainly if I talk from my kind of own personal

experience, I had this real sense of "Unless you have been through this,

like how can you kind of hold it?

How can you understand it?

How can you help?"

I sort of had this real yeah, sense that I needed...

One, that I really felt like I needed to speak to women.

So I was requesting female doctors.

But also that it did help that she was a mum and that she had also

been through that and she 'got it'.

And actually I've had kind of similar feedback from my clients to say "It

has been immensely helpful for me to know that you do get it, that you do

know what it's like", or that "That kind of trauma I'm experiencing is

almost like reflected back in you.

I can see that that has been part of your experience".

And I think, you know, in everything we do, we bring who we are as people,

but I think that probably happens even more so, in kind of a therapist sense,

that we're often drawn to areas of work where we've been personally affected.

That kind of concept of the wounded healer is well known.

And I'm no different from that.

Like this became my niche.

And I think you do offer something kind of special when you have a

lived experience of something.

What would you say to yourself, who was really going through it back then?

What message would you have given yourself

? SARAH EDGE: Wow, like trust the kind of process, Like

patience - I don't have any!

But to I suppose, kind of accept that it's a kind of long process.

But that doesn't mean that you're going to intensely suffer for a long time.

But that it is, it is a long process and almost like there's kind of not

going to be this point where I...

or it doesn't, maybe I'm not there yet.

I don't know, like my daughter's two in April.

But I don't feel like I could say "I'm 100% recovered" or there has been a

point where I could say "It's gone now."

It feels like something that I will manage on a long term.

Perhaps kind of the rest of my life.

I mean, I'm already worrying about menopause.

I think, "God!", if this is what this has been like, I can't kind of face that!"

Menopause is a massive ballache!

(laughs).

It's one of those things that's only just being talked about now, but Oh God.

How our mums, and their mums generations and stuff, how they just coped with

it all and didn't even mention?

I mean, me and my friends, we're all about the hot flushes and

the sweaty hugs of solidarity!

Yeah.

Yeah, You know, in my research and reading around perinatal mental health,

there's a word for the journey into motherhood and it's called Matrescence,

and it has a lot of similarities to adolescence and to the menopause.

That they are these kind of distinct periods of a woman's life.

Obviously not everybody has children.

But even kind of going through that 'being of a childbearing age' and either

deciding not to have children, trying to have children or having children has this

huge impact on who you are as a person.

And actually is this life stage that comes with it it is a lot of

difficulty and a lot of challenge and I think those conversations are

so important because actually what do we understand about these things?

So we think that motherhood is about having a baby, but there's

so much more to it than that.

And menopause is more than your period stopping, there's

so much more to it than that.

But there's so much missing in education or conversation.

And this is why podcasts like this is so important, because they bring

the realities of what it's going to be like, you know, to either expecting

Mums, but also to people going through it, that they're not the only ones.

And there is kind of light on the other side.

Actually there is a life the other side of these dark times, where

you can experience joy in it.

And it can be a positive thing.

But even knowing that you're not alone and that you are not

going crazy, that these are actually parts of the illness and

established parts of the illness and you know that it isn't something

that you've brought upon yourself.

There's almost a script,t isn't there like a PND script?

Yeah!

It's like if say, "I'm going crazy, I'm losing my mind.

I can't do this.

I'm a failure as a mum.

Like I'll never be okay.

I'll never be alright."

I mean, all of these things, they're things that kind of probably every

mum has thought at some point, but if they're happening a lot, then

they could absolutely be an indicator that you are struggling with P.N.D.

(Postnatal Depression) and to talk to somebody and get some help.

You know, and actually in services like mine, but others that exist,

you don't have to have a diagnosis of postnatal depression to seek help.

You can contact a therapist to say, "I want to talk to somebody.

I kind of want to make sense of my experience."

And that's okay, you can do that without.

Absolutely.

Several women I know have sort of come forward to me, since I started the podcast

and were saying "I was never diagnosed."

They would almost feel shameful that, you know, "Oh, I wasn't really

P.N.D., because I was never diagnosed."

And it doesn't matter, you know, if you struggled or you felt a sense

of loss or a sense of grief...

you know, everybody's experience is legitimate and valid.

And everybody's experience is different.

Yeah - there's not a blood test!

There's not a kind of conclusive test where they'll go, "We'll prick

your finger, we'll take some blood.

Yes, you've got P.N.D.; no you don't."

There's diagnostic criteria that describe a collection of symptoms.

And if you have experienced that, then it's possible that you've

experienced postnatal depression.

Some people like those labels and some people don't.

You don't need them to be deserving of support and of

treatment - you can have that without.

That's a very good point you've made there.

Our conversation over both these episodes has just been so inspiring.

You've been such a fabulous guest and so much wisdom and also bravery

in talking about your story.

Thank you so much for having me as a guest.

I've enjoyed it so much.

I think it's wonderful what you're doing.

You know I love listening to the podcast myself, so I was very

excited when you invited me on.

So thank you.

Aw, thank you so much - thank you!

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