Trigger warning of reference to suicidal thoughts, as well as miscarriages, premenstrual dysphoric disorder (PMDD), mental illness (post-partum psychosis), bipolar
Hello. You may have seen that it’s World Suicide Prevention Week. I don’t normally share private information such as this, but given my unique experiences and recovery, I decided it was important to tell this story of hope. It relates to my hospitalisation for an acute psychiatric illness in 2010 after the birth of my first son. The reasons for the build up to it and how it has informed my clinical practice.
I also want to reduce the shame and stigma of mental illness.
For more info on some of these conditions referred to in this blog, go to the bottom where there is further info.
Premenstrual dysphoric disorder (PMDD) and ADHD
You see, I’ve always been vulnerable to poor mental health, having had PMDD – as 5- 8% of women do, since I was aged 14. This led to crippling symptoms of irritability, depression & social withdrawal for up to 10 days before menstruation, despite otherwise being a bubbly, happy person. Sadly, it had been dismissed as trivial by doctors. I was also recently diagnosed with ADHD (and the 2 conditions are more likely to co-exist). More on ADHD in this blog- here.
It is believed that PMDD isn’t the result of a hormone imbalance, but a hypersensitivity in the brain to hormone fluctuations. These changes have effects on our brain chemicals such as serotonin, making us more vulnerable to more severe premenstrual symptoms. [1, 2, 3, 4]
Also, my genes weren’t on my side. My dad has been hospitalised twice for bipolar depression. And his sister, has had her life blighted by schizophrenia, as did my gran (their mum).
But the environment pulls the trigger, and it didn’t help that my diet as a child was a typical 70’s diet of ultra processed foods. I’d also had a lot of childhood trauma, which primes your developing nervous system to be more reactive, causing more dysregulation as an adult.
Build up to an acute medical emergency and a pattern of BOOM then BUST
In my late 20’s, I’d been really delighted that my emerging interest in nutrition, whilst working in travel, had finally resolved the gut issues, irregular periods (PCOS) & weight gain I’d struggled with. They had started because of a hedonistic party lifestyle during my university days. So, I decided to retrain and embarked on my second university degree.
Fast forward 3 years - I was starting up my new clinical practice, finishing my dissertation for my degree in nutrition, renovating our former flat. Plus, planning my wedding and working part-time as a consultant for a supplement company.
Clearly, I’d put myself under too much pressure. But I was feeling invincible from what I now know was a heightened mood from undiagnosed conditions- I had mild hypomania, plus ADHD impulsivity and hyperactivity. This eventually led me to a total crippling burnout, as my elevated brain chemicals and adrenaline were disguising the fact I was burning through my energy and nutrient reserves. Burnout is more common in those with ADHD.
That winter of 2007, after a wonderful wedding, I’d gotten ill with the flu aged now 33. And instead of bouncing back from a virus like I usually did, I was ill in bed, I’d totally crashed and couldn’t recover. This culminated in my being bed-bound for 6 weeks with post-viral fatigue - utter exhaustion and I developed as a consequence dire mental health.
I was terrified that I wouldn’t recover my energy, that I’d failed as a newly qualified health practitioner, getting terrible insomnia and health anxiety. And eventually to my horror, I woke up one day with chronic pain all over my body. Despite eventually returning to work, I was not well.
Chronic stress and vulnerable genetics had destabilised all my body systems including my HPA axis [5} and literally rewired my brain and nervous system.
Diagnosis of fibromyalgia
It was awful being diagnosed with fibromyalgia which has no cure. (Fibromyalgia is also more common from ADHD burnout). The brain and central nervous system get revved up into a heightened state of pain from chronic stress, trauma and neuroinflammation [6]. And unfortunately, the pain can also spread. So, I also ended up with interstitial cystitis (bladder pain syndrome) - chronic pain in the bladder and urethra). Basically, my brain’s alarm bells were shot.
But as the brain is a dynamic organ, the good news is that it can indeed be rewired.
Pregnancy
We wanted a family, and I was devastated when I then had a few miscarriages (I will do a blog on that soon) adding further to my growing anxiety and physical and emotional pain. I couldn’t compute how my world had imploded.
We therefore decided to take a break from trying for a baby and even put an offer on a house (the home in South-East London, where we still live).
Eventually I fell pregnant again, in pain from head to toe, I was very scared I’d lose this baby. Our house move got badly delayed to around the due date and my husband also lost his job in the pregnancy, so it was very fraught time, giving birth and moving within 3 days of each other.
Birth and severe mental illness
I was so relieved to finally hold the child I had longed for—especially after a very difficult birth. I ended up having to be in hospital on a shared ward for 3 more nights with my tiny baby boy, where I barely slept.
When I finally came home, I was totally euphoric for the first few days. But very soon my brain started racing to the point and I could not sleep a wink, and I knew something was badly off. Despite contacting the NHS multiple times to say I wasn’t well; they didn’t take me seriously. By the tenth night after my baby’s birth, I cracked. Seriously sleep-deprived and my hormones massively out of whack, I became delirious, believing my whole family had all been killed in a car crash. Looking back, I had full blown mania (a symptom of bipolar) which led to the relatively rare but very serious postnatal illness. This happens in around 1:100 births, known as post-partum psychosis.
Dramatic hormonal shifts from birth, stress and bipolar can be a trigger in those genetically susceptible, like myself.
The darkest time of my entire life
Hysterically upset, I called an ambulance for help, but instead, whilst in A&E, I ended up getting sectioned, without my knowledge.
I woke up the next morning in a mixed, locked psychiatric ward, separated from my newborn son in Lewisham hospital’s claustrophobic and crumbling tower block - with low ceilings, long corridors and tiny barred windows. They had given me strong medication that night and I had finally actually slept. Waking up, I was so relieved that it had all been a crazy time and that mercifully I had imagined their deaths. And could return to my sweet, new-born baby.
I was initially advised I could go home with daily visits from a mental health team. But, when they checked my medical notes, I learnt the horrifying news that I was under section. For ten long days, I couldn’t see my son, was trapped, traumatised beyond belief with constant panic attacks.
Eventually I was moved to a mother & baby when a place finally became available, but I received very little care or help, as many of the staff were temps. No one explained either that from a high I would have a dramatic low, I was too ill to work out what had happened to me. I was crippled with desperate anxiety and debilitating depression. Plus, I was separated from my husband (bar visiting time) for 3 long months.
I couldn’t even watch television or read to distract myself …. I didn’t have the concentration span to do so. I also became instiutionalised, so would get sensory overload whenever I was finally allowed out for small visits home, weeks later. Therefore, developing horrible agoraphobia, whereby my brain & nervous system would go into full on 'freeze mode' (instead of just fight or flight). I was utterly broken.
I was convinced I would never recover, given my family history of schizophrenia, schizoaffective disorder, bipolar and clinical depression.
… What I’m trying to say is that this was the darkest, most terrifying time of my life.
I planned my suicide in secret. I didn’t think I would ever be anything close to who I had been. And how would I ever be a good mother.
But there is always a light at the end of the tunnel.
I begged for antidepressants; alongside the anti-psychotic they’d prescribed (that I was on for a year). But eventually, with the combination of meds, finally going home and therapy, things improved. I am certainly not against mental health medication—sometimes we desperately need it. Many of my clients have been prescribed them and I work alongside psychiatric medication, where required.
Like many women (not all) who have had post-partum psychosis, I also had to face I had bipolar, which I was devastated by, fearing a scary future as my time in hospital had also caused PTSD. Plus, I was still enduring PMDD and pain.
On a mission. Functional medicine & recovery
So, I made it my life journey to study Functional medicine and regain good quality of life with root cause medicine. I scoured journals, studied more and learnt everything I could about the brain & nervous system and the health imbalances I had. I also learned everything I could about nutrigenomics and testing helped me understand how my unique genetics increased my specific needs for certain nutrients. I then chose to specialise in some of these areas as once I’d tackled them successfully in myself, as the Brain Health Nutritionist. See https://www.instagram.com/thebrainhealthnutritionist/
Now, as a result in September 2024 (14 years on), life is much better than I could ever have imagined. I don’t have symptoms of PMDD, I'm not in chronic pain. And my mental health has been stable for years... I am flourishing, even in Perimenopause, aged 49, and with a busy, successful practice and with ADHD.
I went on to have a second child without any issues (having been told my odds for another PPP episode was between 50-75 % likely) and my boys have a happy, healthy mum.
BUT, I'll never forget how close I came to giving up …
….. The point of sharing this is to also remind you that we can never truly understand
the pain of someone having suicidal thoughts. It’s not that they want to leave their
loved ones; it’s that they’re enduring an agony that feels unbearable, with no escape.
If you are feeling that despair from poor mental health, there is hope. No matter how dark the world feels right now. Please stay with us. You are not alone.
I am so fortunate now to have such a rewarding career, specialising (amongst other areas) in helping others with their mental health, brain function, hormones and with conditions such as PMDD, ADHD, burnout, chronic pain and many more. I’ll never take that for granted.
Sending lots of love,
Kirsten
READ FURTHER BELOW IF YOU WOULD LIKE FURTHER RESOURCES AND REFERENCES.
RESOURCES & REFERENCES
What is fibromyalgia
Fibromyalgia is a condition with symptoms that include chronic pain, fatigue, and cognitive issues. And it's believed in part to be due to chemical imbalances and neuroinflammation in the brain and nervous system, especially in the brain’s glial cells [7]. The brain’s neural pathways can become entrenched in patterns of pain perception and response, leading to a cycle of heightened pain sensations and emotional distress.
Signally in neural pathways that transmit and receive pain have been shown to be altered in brain imaging studies [8]. It can occur due to a result of trauma, stress or a physical insult like a car accident or a virus . But genetics are also involved and like bipolar below it can run in families.
What is post-partum psychosis (PPP) - & link with bipolar
Around 1-2 women in every 1000 giving birth experience post-partum psychosis (PPP).
Approximately 30% of women with bipolar disorder who give birth experience some form of PPP.
Postpartum psychosis (PP) is a serious, rare mental illness, which some women, like me, may be more genetically susceptible to. But it can also happen to women who have had no personal history or family history of mental illness. It begins suddenly in the days and weeks after having a baby and is not to be confused with post-natal depression. Symptoms include hallucinations and delusions, often with mania or confusion and can include depression and anxiety. It can get worse very quickly and should always be treated as a medical emergency. Currently there is sadly a lack of mother & baby units.
What is bipolar
Bipolar is a mental illness with clear changes in mood, energy, and activity levels. These moods range from periods of feeling extremely “up,” elated, irritable, or energized behaviour (known as manic episodes) and periods of being very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.
Where to find help & further info
Please if in need reach out to Mind Charity and to Samaritans Charity.
If you have PMDD- visit IAMPD https://iapmd.org/
For support with PPP Action on Postpartum Psychosis – an amazing charity that personally helped me so much in the year after hospitalisation.
If you have bipolar (which a lot of women who have had postpartum psychosis end up being diagnosed with), seek out Bipolar UK.
REFERENCES
1.Eriksson O, Wall A, Marteinsdottir I, Agren H, Hartvig P, Blomqvist G, Långström B, Naessén T. Mood changes correlate to changes in brain serotonin precursor trapping in women with premenstrual dysphoria. Psychiatry Res. 2006 Mar 31;146(2):107-16. [PubMed] [Reference list]
2.Dhingra V, Magnay JL, O'Brien PM, Chapman G, Fryer AA, Ismail KM. Serotonin receptor 1A C (-1019)G polymorphism associated with premenstrual dysphoric disorder. Obstet Gynecol. 2007 Oct;110(4):788-92. [PubMed]
3.Batra NA, Seres-Mailo J, Hanstock C, Seres P, Khudabux J, Bellavance F, Baker G, Allen P, Tibbo P, Hui E, Le Melledo JM. Proton magnetic resonance spectroscopy measurement of brain glutamate levels in premenstrual dysphoric disorder. Biol Psychiatry. 2008 Jun 15;63(12):1178-84. [PubMed]
4.Huo L, Straub RE, Roca C, Schmidt PJ, Shi K, Vakkalanka R, Weinberger DR, Rubinow DR. Risk for premenstrual dysphoric disorder is associated with genetic variation in ESR1, the estrogen receptor alpha gene. Biol Psychiatry. 2007 Oct 15;62(8):925-33. [PMC free article] [PubMed]
5.Young EA, Korszun A. The hypothalamic-pituitary-gonadal axis in mood disorders. Endocrinol Metab Clin North Am. 2002 Mar;31(1):63-78. [PubMed]
6.Stress causing symptoms of fibromyalgia https://pubmed.ncbi.nlm.nih.gov/22110948/
7.Brain glial cells in fibromyalgia https://pubmed.ncbi.nlm.nih.gov/30223011/
8.Neural imaging in fibromyalgia
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