THE EXTENDED VERSION-part 2. My Recovery from mental illness, PMDD, ADHD, burn-out, post-viral fatigue, fibromyalgia & chronic pain

Part 2 of 2; Read first part HERE

Trigger warning: this blog post discusses acute post natal mental health illness and miscarriage

ADHD & bipolar burnout, post-viral fatigue and fibromyalgia

By my early 30s I was overworking, frenetically finishing my degree in nutritional medicine, planning my wedding, and buying our first property all at the same time, (as you do- when you have an impulsive ADHD brain and take on multiple projects) with absolute bundles of energy to withstand this. But you don’t always have the insight you are not entirely well.

My PMDD symptoms went up a notch, no longer only presenting as a very depressive premenstrual mood, I would also feel a crazy rage for 10 days before my period. I didn’t want to feel angry, much of the time I had no reason to be, but my biochemistry would mean I had such a horrible irritable feeling - it was actually visceral. And then after the mist and despair cleared, I would get 2 weeks of feeling great. Looking back, I was at times hypomanic. Super chatty, super confident, and then I would retreat back into my shell, hypersensitive to the hormonal and neurotransmitter fluctuations in my brain. Eventually chronic stress and undiagnosed hypomania (from bipolar) & ADHD impulsivity and hyperactivity, led me to a total crippling burnout.

I ended up succumbing to the flu for the first time in my life in 2007. And regrettably, I didn’t rest sufficiently, still going into the office fighting a virus. As by then I was a nutritionist in a health company doing a trial on a supplement protocol for men with prostate cancer and didn’t want to let anyone down. That period left me broken, eventually spending 6 weeks bedridden with post-viral fatigue. Despite not having the energy to get out of bed, I also developed crippling insomnia and anxiety, and was terrified I wouldn’t get better. I then started to experience crippling pain all over my body (from head to toe), eventually receiving a diagnosis of fibromyalgia.

Basically, my brain’s alarm bells were shot. And my brain and body were no longer been able to withstand the fake energy I had been feeding off for too long. Burnout is very typical in both ADHD and bipolar sufferers for this reason.

Fibromyalgia is a condition whose symptoms include chronic pain, fatigue, and cognitive issues. And it's believed in part to be due to imbalances in the brain and nervous system. Signally in neural pathways that transmit and receive pain have been shown to be altered in brain imaging studies [1] and it can occur due to a result of trauma, stress or a physical insult like a car accident or a virus [2]. But genetics are also involved. I also developed interstitial cystitis- unpleasant nerve pain in my bladder and urethra, which can be misdiagnosed as a UTI, which I no longer experience. Read more here on fibromyalgia in this external article.

Chronic fatigue & fibromyalgia

If you have chronic fatigue or long covid (all involve debilitating fatigue and brain fog) you will know there is little help the NHS can offer and you may be treated like you are just malingering [3], as I was (although I do hope it’s getting better now). There’s also insufficient research and understanding regarding chronic pain syndromes such as migraines, fibromyalgia (widespread pain in nerves and muscles) and interstitial cystitis (IC).

Back then, I was so scared I would never recover, and the anxiety was ratcheting out of control. It’s a vicious circle when you are broken and then become anxious you won’t get better, making recovery so much harder- I developed health anxiety, which is common in my clients. Our brain’s stress response can actually get so maladapted from stress, that we get stuck in huge hypervigilance whereby we feel anxious about everything (irrationally) and it’s totally crippling. It took a lot of time and work on my health to get back some kind of equilibrium.

Eventually with self-care and a host of supplements and measures to calm me down, my energy returned so I could slowly go back to work, which I was so very, very relieved about. And my pain began to subside a little. But what I didn’t know then was that I was sliding ever closer to a severe mental illness. But I would never have guessed in a million years that having my first child would be the catalyst. As worse was yet to come.

Acute post-natal mental health illness

I really longed for a baby despite still living with the chronic pain of fibromyalgia. And my eventual pregnancy with my first son was tough, preceded by distressing miscarriages. (Which I now believe were due to high cortisol, low progesterone, and methylation issues). We also moved house before giving birth and my husband was then made redundant in the midst of all that.

But when I finally gave birth (a traumatic one) to my precious, much longed for son, I felt absolutely elated. This was despite the 2 nights of lost sleep in the early stages of labour at home, then 4 nights on a maternity ward due to my son having jaundice. Noisy and chaotic, with bright lights and alarms going off at all hours, plus howling babies, and over-wrought looking mothers, it wasn’t exactly peaceful. But I had my cherished first baby. Life felt good. Sadly, within days of returning home - once eventually discharged, my mood started oscillating between mania and crippling anxiety and I didn’t sleep for days and days. I was totally besotted with my baby, but I wasn’t at all well.

I knew something was desperately wrong with me, but my brain just couldn’t compute what it was. To be fair to me, I tried and tried to get help from the NHS as I knew something wasn’t right. Two calls, a visit to a local hospital and my doctors’ surgery for some help. But they let me down badly trying to treat me for postnatal depression (I was high, not low) with an antidepressant [4], and not grasping the severity of my symptoms. A sleeping pill would have made a massive difference at this stage. I felt like I had taken an amphetamine, and everything started racing. Like anyone who hasn’t slept for days, eventually I experienced psychosis (delusions from no sleep) and briefly lost connection with reality. Postpartum psychosis is a rarer, extremely serious postnatal mental illness - much more common in those with bipolar.

I remember howling that I was stuck between heaven and hell and wrongly believing that all my family had died in a car crash. It was terrifying. Eventually I was admitted to Lewisham’s secure psychiatric ward and separated from my 10-day-old baby. I felt so distressed and trapped in a small room like a cell with a tiny, barred window, in a tower block with thin corridors and had constant panic attacks. It was hell. I’d like to say the NHS supported me and looked after me. But that was not my experience at all. Neither the very terrifying psych ward I was on (claustrophobic sky rise block with alarms going up every few minutes) nor the dreadful mother and baby unit I ended up in, had any staff who showed me even an ounce of empathy or attention. In fact, I was entirely neglected. This is not to criticise the NHS, but it’s my experience. And in my opinion, the NHS mental health ‘care’ for acute mental health conditions is still in the dark ages, underfunded and for me it was torturous being there. 

I spent 3 very unhappy months in the mother and baby unit. Not helped by my surroundings and being separated from my family and loved ones, I developed extremely dark suicidal thoughts and severe postnatal depression. And because if you have bipolar you know all too well, what goes up, must come down.

I discovered at that time that the mother & baby unit I was in, was within the same hospital grounds, where my’ dad’s mentally ill sister (my aunt) has been in and out of most of her adult life with schizoaffective disorder. I really thought I was destined to be ill forever.

I was prescribed an antipsychotic drug at the beginning of my hellish time in the psychiatric ward, and then 3 months later- the addition of an antidepressant, by then grappling with debilitating depression, worked for me. Although, unsurprisingly after returning home traumatised, I required a lot of therapy to aid my recovery from PTSD from that terrible time.

Shame

But recover I eventually did. I stabilised, from returning home to familiar surroundings, resuming a healthier eating pattern and a mood stabiliser drug. Although, despite my recovery in 2011, I carried great trauma, as well as shame of how I, a knowledgeable health practitioner, had gotten so ill. Was it my fault? I no longer feel this way after having lots of therapy and the healing that time and reflection allows. I know I’m strong to have got through all I have.

I also owe a debt of gratitude to a brilliant charity and their one-to-one peer support - Action on postpartum psychosis, who helped piece me back together and who I highly recommend. Reach out to them here, if you or a loved one, is ill with post-partum psychosis.

Mental health recovery

Since then, with a subsequent diagnosis of bipolar 1, I have made it my mission to learn even more about the brain, chronic stress, trauma, hormones and recovery. It’s literally been my life journey to feel better, and that I love sharing that knowledge and clinical experience, with others who are suffering themselves.

I am beyond delighted to be freed from the debilitating effects of PMDD, discovering through nutrigenomics (hyperlink), I had genetic weaknesses around serotonin production and serotonin sensitivity [5], poor methylation, and a greater need for certain nutrients, which has since entirely rid me from this awful condition 😊.

Unless you have experienced deep depression, anxiety, bipolar, PMDD or other mental health conditions, you can’t begin to understand how debilitating and dreadful they can be. But there are solutions in functional medicine which can have profound benefits. But if people also benefit from antidepressants or any other medication alongside it, then absolutely go for it, integrated medical care is, in my opinion, often the way forward especially for acute conditions.

Lab tests

So happily, after extensive and exhaustive research, further training in nutrigenomic lab testing and a thirst for knowledge, I am now thriving, having learned to calm down my brain and nervous system with personalised diet, supplements and lifestyle hacks. And I’m no longer at the mercy of either ADHD and or the bipolar fake energy (caused by temporarily raised dopamine) and the subsequent burnout and depression that can come with it.

My mental health is very stable, with no PMDD (which I still find a miracle) and I haven’t been ill from bipolar for years. (I still take a mood stabiliser drug but that alone was never enough before). My ADHD is no longer problematic, in the way that I used to be very impulsive or highly distractible or hyperactive, for instance. I have no interstitial cystitis, and largely no fibromyalgia pain, unless I’ve been overdoing it (it’s my body’s well of telling me to rein it in!). This is not to say the answers for your own health puzzle are the same as mine, as each case is as unique as you are.

In perimenopause, but thriving

I am now 49, living my life to the full, coping even with the fluctuating hormones of perimenopause and have had a very busy and successful nutritional health practice for years.

My eldest is 13 and I went on to have another son- 10, without getting ill again afterwards, despite being given extremely unfavourable’ odds by my former perinatal psychiatrist (75 percent chance likelihood due to my genetic loading). I play competitive netball at least twice a week after fearing I would remain bedridden or very fatigued, and the team I captain won the league last few seasons. And although I wouldn’t wish what I went through on anyone, it has given me strength, true gratitude for what is important in life. Plus, deep compassion and understanding for those who suffer with mental illness, hormonal dysfunction, burnout - and its associated conditions, like migraine, fibromyalgia, IC and chronic fatigue syndrome.  I know I’m strong and have overcome a lot and that the genetic susceptibility and the traumatic events that occurred were out of my control.

My life’s purpose. And the power of hope

So, if you are struggling, or are a parent of a child who is suffering, I hear you, I understand and I am here for you. I never found the guidance or support I needed, so spent most of my life trying to solve my distressing health problems. In the end, I had to work it out for myself, and now I can use that knowledge to help others and it’s a true privilege. I am also proud of my level of expertise I have in the field of brain health, mental health, hormonal balance, and gut health. I have seen hundreds of clients over my 18 years in practice. And I can also liaise with your GP and/or psychiatrist to provide multi-disciplinary care.

 If you are feeling suicidal, I strongly advise you to urgently contact Samaritans here. Also please share how you feel with a friend or a relative you trust, and urgently speak to your GP and a trained counsellor. I promise you are a worthy, and you are loved. If you are having a tough time, better times are ahead. I promise. And now being able to help people get there (alongside other professionals where needed) truly is my life’s purpose and passion.

Any comments or questions please feel free to ask below.

RESEARCH

Some underlying causes of PMDD in the research

If you want to learn more about some underlying causes for PMDD, which I have researched, please read on.

Genetics are definitely known to be at play, research has found a link with the gene that codes for the serotonergic 5HT1A receptor [5] [7] and genetic variants of the oestrogen receptor alpha gene (ESR1) [6]. Sex hormones affect mood far more in PMDD sufferers via the impact on serotonin levels, especially in the luteal phase than in typical women. [7] They also can have low GABA (a calming neurotransmitters) or lowered sensitivity to GABA receptors as they metabolise progesterone to a metabolite that can inhibit this calming neurotransmitter, and a heightened sensitivity to glutamate (an excitatory neurotransmitter) in the luteal phase. Progesterone should soothe your brain and increase GABA, the neurotransmitter of calm but doesn’t. [8] As well the HPA axis dysregulation due to chronic stress which is common in mood disorders, there has been shown to be lowered cortisol and beta endorphins [9]

For those interested, some of the health imbalances I suffered from

Here are a few of the imbalances which determining (often via lab testing), then rectifying, led to my health recovery. Results can sometimes be quite quick and truly dramatic, although each case is unique: -

Blood sugar imbalances, low levels of certain essential fats, pyroluria (higher need for vitamin B6 and zinc under chronic stress), food intolerances, gut lining hyperpermeability and gut bacteria dysbiosis. Nickel toxicity. Neuroinflammation from HPA axis dysfunction, unfavourable genes around serotonin and dopamine, higher than usual requirements for methyl folate, methyl B12, vitamin b6 and choline for methylation issues. And hormone imbalances (oestrogen dominance and raised DHEA).

I have been a great guinea pig so I can help others!!

REFERENCES

1.Neural imaging in fibromyalgia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492865/

2.Stress causing symptoms of fibromyalgia https://pubmed.ncbi.nlm.nih.gov/22110948/

3.The misogynism in fibromyalgia diagnoses https://link.springer.com/article/10.1007/s10067-021-05888-0

4.Patel R.,1 Reiss. P,1 Shetty. H,2 Broadbent. M,2 Stewart. R,3 McGuire.P,1 and Taylor.M. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open. 2015; 5(12). [PubMed] -link that to here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679886/

5.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]

6.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]

7.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]

8.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]

9.Young EA, Korszun A. The hypothalamic-pituitary-gonadal axis in mood disorders. Endocrinol Metab Clin North Am. 2002 Mar;31(1):63-78. [PubMed]

10.Brain glial cells in fibromyalgia https://pubmed.ncbi.nlm.nih.gov/30223011/

RESOURCES

To learn more about premenstrual dysphoric disorder (PMDD)

https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/

For support for PMDD- see https://iapmd.org/

To learn more and get support for bipolar - https://www.bipolaruk.org

To learn more about postpartum psychosis- https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/postpartum-psychosis/

For support for postpartum psychosis from this brilliant charity, including one to one peer support-https://www.app-network.org/

DISCLAIMER

If you have questions about any medical matter, consult your doctor or other professional healthcare provider without delay.