“My Story”
I (Attia) discussed the following with perinatal lead nurse Eileen Kinsella and together we have written the account of my journey with post-natal depression.
How it all began
For the last few months of my pregnancy I knew that I didn’t feel right. I didn’t sleep at all. I did tell professionals who said it was normal to experience insomnia in late pregnancy so I thought it must be okay. My head was full of thoughts about Allah. I wasn’t looking forward to having my baby.
On the day my baby was born (07/04/2016) I knew that I did not feel well. I didn’t know what was wrong with me but I knew the world had changed. I looked out of the hospital window and could see everything was different. The colours had changed, and nothing was familiar. Everything was spooky. There was a dark cloud on top. It was a world I had to get out of.
Half an hour after giving birth my Uncle telephoned me from Bradford. He said he knew I wasn’t well and had been to see a Mufti, who is like a Muslim priest scholar about me. The Mufti wrote my name together with my parents’ names and could see from that that I was not well. He told my uncle that I was lost, didn’t know who I was, had something wrong in my head and needed to hurry up and get better because I had a baby to look after. This was how I felt. He gave my uncle prayers for me to say. I begged my uncle to hurry up and visit me because I was desperate for the prayers. I had to stay in hospital, on Trinity Ward for 3 days. As soon as I got home my uncle visited me. He gave me the prayers in my bedroom. I read them straight away and then rubbed them on my forehead and then burnt them.
I still couldn’t sleep and my Mum did most of the childcare. For the first 2 weeks after my baby was born I did not sleep at all. I didn’t feel tired but I knew it was not normal to not sleep. I can't remember much about those 2 weeks. I still find gifts that must have been given to the baby but I cannot remember who gave them. When family and friends visited I went upstairs and lay on the bed or looked out of the window. I couldn’t relax and didn’t want to spend time with anyone, I was having strange thoughts in my head. The words God and Allah kept appearing in my head. I didn’t know why. I phoned the GP on Monday 18th April asking for sleeping pills. I thought that if I could sleep then the thoughts would go and I would be back to normal. The GP said she wanted to see me before she gave me the pills. I felt annoyed about this. Why couldn’t I just have the medication? On Tuesday 19th April my Father and I went to see the GP. The GP was concerned about me and wanted to refer me to the perinatal mental health team. I was really shocked and started to cry. I thought mental people were literally mental, walking about talking to themselves and beating
people up. I said I’d rather die than see a mental health nurse. I couldn’t believe that the GP was serious. I didn’t know anything about mental health problems but did know that I wasn’t mental.
The GP gave me Fluoxetine because she said I was depressed. I didn’t take them for the next few months because I knew I wasn’t depressed.
I did get the sleeping tablets which I took.
Perinatal team note:
A referral was received from the GP on Wednesday 20th. The referral appeared urgent. Dr Gandhi was with us as it was a Wednesday and telephoned the patient to assess the urgency of the situation. A plan was agreed for Eileen (Perinatal CPN) to visit the following day.
When I received a phone call from a psychiatrist I was wondering why these people are ringing me; I’m not mental. I felt like they were following me about. He told me somebody would visit me at home the next day. My Mum was pleased because she had been really worried me. I thought that everyone was wrong and wasting their time and that everyone else had gone mad.
The next morning Eileen visited from the perinatal team. I was able to tell her how I had been feeling. I didn’t feel any attachment towards my baby. I didn’t feel that she was mine. My Mum was doing all the care anyway. I felt as if she was the Mum rather than the Grandmother. I was spending all the time preoccupied with thoughts of Allah. They were always in my head. I was anxious all the time and thought I was going mad. I woke at night and the first thought was not about my baby but about Allah which then brought on a panic attack. My Mum slept in the same bed as me because she was so worried about me. The sleeping tablets hadn’t really been helping. Eileen thought I needed Diazepam in the evening. Evenings were really bad. I couldn’t settle and felt agitated. Eileen visited again in the afternoon after speaking to my GP. My Dad went and collected a further prescription for Diazepam and the sleeping tablet was changed to Temazepam. We talked about ways to manage my anxiety but I was sure that something physical was wrong like a brain tumour so I didn’t see what good talking about anxiety and depression would do. Eileen told me about post natal depression but I definitely didn’t have that.
Over the next few weeks I slept a bit better but didn’t really feel much better. I told Eileen that I had been taking Fluoxetine but I hadn’t. Some people had told me that if I took Fluoxetine then I would kill my baby and do crazy things. They said they believed I was physically unwell due to low iron following a lot of blood loss and that I would be better if I took an iron supplement.
I went to see the Mufti twice more and got more prayers from him.
I stopped washing. My hair became matted. I refused to get out of bed. I lost interest in praying. I had always been a devout Muslim and prayed 5 times a day but now felt angry. I was saying all the proper prayers but not getting any better so I stopped praying. I had no interest in my baby or anything else. I had always been a really happy and chatty person and couldn’t understand what was happening to me. I told my cousin that I had a brick in my head. She said I was depressed but I knew I wasn’t. I went on Google and asked what did it mean to have a brick in your head and the answer was depression. I thought that can’t be right.
I had always dreamed of visiting Dubai but now knew it was too late because everything outside was different and it wouldn’t look the same. I remembered that I used to always look forward to coming home after a day at work but now as I looked outside at the street I grew up in it did not look familiar and I did not feel at peace in my home and didn’t think I ever would ever feel peace and belonging again.
12th May
Today I felt physically weak. People noticed I had lost weight. Spending most of my days in the living room preoccupied with thoughts of Allah/God. I wished each day could be Judgement Day so that this world would end and maybe the next would be better. When I tell my Mum this she got upset. I can’t concentrate on anything except my thoughts. I’m so tired. Speak to baby when my Mum brings her to me. I am convinced that I will start living again when the thoughts have gone. Every day I sit alone with the thoughts waiting for them to go. I tell Eileen I am taking my Fluoxetine but I am scared to take it in case it makes me hurt my baby.
26th May
Finally admit that I have not been taking my Fluoxetine. I promised to take it from today. Eileen spoke to my Mum who although she does not speak English understands a lot. Mum will make sure I take it. I don’t feel as if my head is attached to my body therefore do not see the point in swallowing. I am still not eating much. Mum is really worried but nothing has a taste. Can’t remember when I last brushed my teeth. I'm still feeling very weak and I agree to see GP regarding my physical health. I rated mood as 2/10 today. I was prescribed Antibiotics and iron by my GP.
My relationship with my Dad got really bad. We used to be soul mates but he doesn’t seem to understand what I’m going through. Mum used to care for him but now cares for me and my baby. He has stopped talking to me. I think he is embarrassed about my depression.
15th June
I had an Out Patient Appointment with Dr Gandhi. My Mum came to the appointment in the children’s centre with me. Dr Gandhi spoke to her in Urdu which was really good for her. She was able to tell Dr Gandhi everything that she has been worried about. The Fluoxetine was increased to 40mgs.
20Th June
Eileen came to visit and I said my mood was 3/10. Mood is a little bit better. Maybe the tablets are helping? I was enjoying the occasional bit of food.
24th June
I woke up at midnight with thoughts that I might throw my baby down the stairs or deliberately hurt her. I can’t believe the thoughts they are really strong. I know I don’t want to hurt her but can’t get rid of the thoughts. I wake Mum to tell her and she is really upset and tearful. I phone Eileen and leave a message on her phone. The next day Eileen comes to see us. Although Mum can’t speak English she joins us anyway and is very upset and scared. I tell Eileen that I had been reading about women with post natal depression and some of them had had thoughts about harming their baby. After a long chat I felt reassured that because I had read this I had then become preoccupied with this thought. We were reassured that it was a thought and I wasn’t going to do it. Dr Gandhi phoned and talked to my Mum who had been really worried. She wouldn’t leave me alone with my baby for a long time after this.
30th June
Mood 7/10.I was feeling much better. Beginning to think that maybe I do have post natal depression. My Dad agreed to join me and Eileen for a chat. I had asked Eileen to explain to Dad about what I had been going through. My Dad really understood and I was able to open up and tell him a lot of what I had been feeling. We all talked for a long time. We discussed mental illness and Dad shared a few stories that men who attend the Mosque had experienced.
Throughout July and August I have been only getting better and stronger. I have been able to go out with my baby independently. I have visited family in Bradford, Leeds and London. I’ve also almost completed an Art Therapy group run by Family Action which I have loved. It’s been really nice meeting other Mums.
What went well?
I am now so grateful that I was referred to the perinatal mental health team. I don’t know how I would’ve got better on my own. I have read lots about mental illnesses and would not hesitate to talk to other Muslim people or anybody about it. In our culture we do not really talk about mental health as there is a stigma about it but I am happy to tell everyone. Look what happened to me and look at me now!! Talking about this now makes me realise how ill I was and I didn’t know it.
In the past I have had what I now know were intrusive thoughts. I used to think I was just going mad. If this happens in the future I will just shake it off.
Perinatal team note:
The timely response from the team proved to be very beneficial. Two visits were made the day after receiving the referral.
As we received the referral on a Wednesday Dr Gandhi was at the children’s centre for our referral meeting and telephoned the family as he is able to speak Urdu and felt this may have been useful.
Dr Gandhi being able to speak Urdu was really helpful especially when talking to the family in particular Mum.
The engagement with our service was really good despite the lack of insight and the different/conflicting advice she received from a wide range of people.
What could improve?
I don’t feel that anything could have been improved and neither does my Mum.
Perinatal team note:
A psychologist in the team would have been beneficial in providing the psychological care.
Difficulties and solutions?
Now that I am better I wonder if I would have admitted to having strange thoughts in late pregnancy if somebody had asked. Maybe a questionnaire asking about my mental health might have helped me admit it. Maybe more questions about sleep would help. I know people don’t sleep when they have a baby but I imagine they must get some whereas I really don’t think I had any.
Perinatal team note:
It might be useful for professionals to have more understanding about different cultures to be more aware of what people know about mental illness and when to seek help?
Key messages for the Governing Body to hear
My family, especially me and my Mum are so glad that this service was available to us
Perinatal team note:
It was a privilege to work with this young lady and her family. Her health visitor was also very supportive and we coordinated a few joint visits and had close communication throughout.