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Miscarriage can trigger post-traumatic stress disorder

Miscarriage can trigger post-traumatic stress disorder

Nicole MartinImage copyrightNICOLE MARTIN
Image captionNicole was not part of the trial, but hopes that by sharing her experience she can help support other people who have lost a baby to miscarriage

Women who have recently had a miscarriage are at risk of developing post-traumatic stress disorder, doctors at Imperial College London have said.

At their early pregnancy loss clinic, a third of the women have PTSD symptoms.

Nicole Martin had three miscarriages in a year, her “dark days”.

“Everyone thinks because you’ve already got a child it’s easier. In a lot of respects it definitely is easier than not having a child, but I wanted another child for [my child’s] sake.”

Nicole and her husband, Ben, started trying for their second child just after their first, Eva, had turned one.

“I was 38 years old and fully aware of the risks associated with having children a bit later in life,” she says.

“It took me longer than expected to fall pregnant, and when I did I felt very anxious because many of my friends had suffered at least one miscarriage.”

Nicole and her familyImage copyrightNICOLE MARTIN
Image captionNicole and her family – husband Ben, daughter, Eva, and son, Joseph

Nicole’s story

She was carrying twins, but both died – one at five weeks and the other seven weeks into the pregnancy.

Nicole had to have an operation under general anaesthetic to treat the miscarriage.

Although shell-shocked by the experience, Ben and Nicole continued to try for a baby.

Two months later, Nicole was pregnant, but had another miscarriage at seven weeks.

“The scan showed there was no heartbeat,” she says.

“We had to have medical management this time.

“You get given a tablet which breaks down the lining of your womb and you just get sent home to miscarry.

“It’s really not pleasant.

“It’s your baby, and you have to flush it down the loo.

“It’s horrendous.”

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Pregnancy loss and PTSD

Post-traumatic stress disorder can develop after a very stressful, frightening or distressing event, or a prolonged traumatic experience.

As many as one in four pregnancies is thought to end in a miscarriage – loss of a pregnancy during the first 23 weeks.

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

It is not possible to save the pregnancy. It usually has to be removed using medicine or an operation.

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Her subsequent third miscarriage a few months later left her a nervous wreck.

“I was a mess,” she says.

“Everywhere I went mothers were asking me, ‘When are you going to have another child?’

“I never ask a woman now about whether she’s having babies, or having a second baby, because you never know their story.”

Nicole says she nearly gave up all hope.

Ultrasound scan in pregnancyImage copyright THINKSTOCK

“I found it just unbelievably cruel,” she says.

“I remember phoning my consultant who was great.

“I said, ‘Just tell me what I should do.’

“I really wanted someone from the medical profession to say, ‘Just give up.'”

Instead, the consultant told Nicole to keep trying if she had the emotional strength because there was still a good chance she would be able to have a healthy baby.

Two months later – just after Nicole’s 40th birthday – she was pregnant with her son, Joseph, who is now nearly two years old.

“I still worry a lot, and I’m having cognitive behavioural therapy to help me cope with that,” she says.

“Even though we have two beautiful children, I still feel anxious to this day because I can’t quite believe it’s all over.

“I feel that something’s going to spoil our lovely family unit because it was such a struggle getting there.”

Dr Jessica Farren, who carried out the BMJ Open study on nearly 90 women attending the pregnancy clinic at Imperial College London for a suspected miscarriage or ectopic pregnancy, says although only a minority might have full-blown PTSD, many will suffer from moderate-to-severe anxiety.

“It’s the tip of the iceberg really,” he says.

“There will be a huge number of women who would still benefit from some support. But the NHS isn’t geared up for it.

“Once we’ve looked after these women clinically and discharged them, there’s no real opportunity to check how they are coping emotionally.”

After a healthy pregnancy, all women get screened for depression at their six-week check. But following a miscarriage, there are no routine emotional checks.

Dr Farren and her colleagues are studying more women at their clinic to see if they can better spot those that will need the most support.

In the meantime, they say help is out there if you know where to look.

“There are some really good charities and organisations that can offer counselling, and your GP is a good place to start if you want some help accessing support,” says Dr Farren.

Source: http://www.bbc.com/news/health-37833287

Like Prince Harry, I lost my mother as a child. We need to talk about grief.

Like Prince Harry, I lost my mother as a child. We need to talk about grief.

‘Talking to a child who has lost a parent is particularly difficult, and heartbreaking.’ Photograph: Alastair Grant/AP

by 

My mother died when I was 10. Writing about it after decades of silence, I see now how important it is to discuss bereavement

Death and taxes, as the saying goes, are the only certainties in life. So why then is one of these things still so hard to talk about? Not taxes, that’s just zzzzz, but death. Always death.

As inevitable as dying may be, talking about mortality remains taboo. How strange this is when it affects us all – not just our own deaths of course, but those of our loved ones, as shown by Prince Harry’s recent admission that he regrets not talking sooner about how his mother’s death affected him.

Harry was 12 when Diana, Princess of Wales, died. At 31, he was hosting an event at Kensington Palace for the mental health charity Heads Together when he admitted that he only began opening up about her sudden death three years ago. That’s a lot of years of sweeping a defining life event under the carpet.

I was 10 when my mother, Jane, died in 1985. And it has taken me all this time to open up about it. Last year, I wrote a piece for the Guardian’s A Moment that Changed Me series about her death. I had recently started a new relationship, and my boyfriend asked me what had happened. I realised I had never really talked about it before, and that I needed to.

The piece struck a chord. In the first few days alone it had more than 225,000 views online. I had comments from readers all over the world – and not just in the comments thread beneath the piece, but from strangers who tracked me down via social media.

Even now, a year later, people I know vaguely come up to me and say they have read the piece, and that they were moved, or that they too have been bereaved. Maybe it was their father, their sister or their friend – but they have been bereft, broken and lost, and they too have rebuilt themselves, and their lives. The message is clear – this is a universal feeling.

And even if you have never been bereaved, have rarely contemplated your own mortality or that of your nearest and dearest, talking about death can be liberating. An old school friend got in touch after I wrote the article. To think that I was going through all of that at school, she said. She didn’t have an inkling. How could she? My new life had begun and I was not to look back on my old one. This was the message that resonated throughout the rest of my childhood.

After my mother’s death, I was looked after by a friend of hers, who had three older children – two were young adults, aged 20 and 18. They didn’t understand how a 10-year-old could be grieving. On the first Mother’s Day that rolled around – less than four months after she died – they pressured me into giving my new foster mother a card. “She’s done a lot for you,” they said. How could I possibly say this woman wasn’t my mother? That I had but one mother, and that she was dead. I was a shy child. I kept my mouth shut and handed over a card. They did not mean to be cruel. They were protective of their own mother. And I am sure they genuinely did not know how I was feeling, or think to talk to me about it.

I understand. Talking to a child who has lost a parent is particularly difficult, and heartbreaking. But bereaved children are not rare. The charity Child Bereavement UK estimates that 23,600 parents of children under 18 die every year, and that one in 29 children has lost a parent or a sibling – that’s one child in every class.

There’s a mistaken idea that children forget, and that they adapt. Yes children can be resilient and adaptable – as can adults. But children grieve. We need to acknowledge this, and learn how to talk about death.

It has taken me 30 years to realise that my story isn’t over – and that talking about my mother’s death doesn’t mean I am stuck in the past, but that I am moving forward. I have started writing about her more, and about the multifaceted aspects of bereavement. And because of this opening up, not only have strangers been in touch, but also people who knew my mother. I have even met some of them – a moving, strange and surreal experience. So I will continue to talk about death, to open up, to throw off my Britishness, because it feels right. And you should too.

Adele speaks about her postnatal depression after the birth of her son Angelo

Adele speaks about her postnatal depression after the birth of her son Angelo

Adele has opened up about her battle with postnatal depression after the birth of her son, Angelo.

FROM THE TOPICLIFE

The singer told Vanity Fair magazine that she felt, at the time, like she had made “the worst decision” of her life.

The 28-year old goes on to say that she “loves her son more than anything” but admits she really struggled adjusting to motherhood.

“I was obsessed with my child. I felt very inadequate,” she says.

Adele

Angelo is now four and Adele’s only child with partner Simon Konecki.

He advised her to talk to other mothers about her concerns. She says she refused at first but the depression “lifted” once she confided in a friend who had a child and realised she wasn’t alone.

She goes on to say that taking an afternoon a week to herself improved the situation.

“A friend of mine said, ‘Really? Don’t you feel bad?’ I said, ‘I do, but not as bad as I’d feel if I didn’t do it.’ It makes you a better mum if you give yourself a better time.”

The interview comes as Adele reaches the end of her 10-month tour to mark her album 25. She admits she still feels uncomfortable spending time away from her son.

“I’m enjoying touring, but at times I feel guilty because I’m doing this massive tour, and even though my son is with me all the time, on certain nights I can’t put him to bed.

“I never feel guilty when I’m not working,” she adds.

“You’re constantly trying to make up for stuff when you’re a mum. I don’t mind, because of the love I feel for him.”

The singer also spoke of how her stage fright is so bad that she may never tour again.

“I’d still like to make records, but I’d be fine if I never heard [the applause] again. I’m on tour simply to see everyone who’s been so supportive.”

Looking ahead to new material Adele reveals that she thinks she “will never write songs as good as the ones that are on 21”, admitting “I was completely off my face” while writing the second album.

She says the success of tracks like Someone Like You were largely down to drinking two bottles of wine a night and chain-smoking on a regular basis.

“A drunk tongue is an honest one,” she said. “I’m not as indulgent as I was then, and I don’t have time to fall apart like I did then.”

If you want help or advice on depression, visit BBC Advice.

Fear of Choking Phobia – Pseudodysphagia

Fear of Choking Phobia – Pseudodysphagia

What is Pseudodysphagia?

Patients with Pseudodysphagia complaint about the inability to swallow but they do not have any physical symptoms to account for their condition. The word Pseudodysphagia comes from GreekPhagophobia where “phagein” means eating and “phobos” means deep dread, aversion or fear. Other names for this phobia include sitophobiawhere sito is Greek for food.choking-woman-mf

Pseudodysphagia is an unnatural and irrational fear of choking or swallowing that causes a person to believe s/he will become ill or die if one tries to eat solid foods. The nature of difficulty these patients face when it comes to swallowing varies depending on the level of their fear: some people can only eat very small pieces of well lubricated foods, while others are afraid of drinking liquids or swallowing pills or tablets. Naturally, there is substantial loss of weight in this phobia and it is a debilitating condition that can interfere with one’s day-to-day life.

What are the causes of fear of choking phobia?

As with most specific phobias, Pseudodysphagia also begins with a negative experience related to swallowing food. As a child, the phobic might have choked, vomited or had an “embarrassing response” after swallowing certain types of foods. The brain then creates the same response as a defensive mechanism each time one is confronted with the thought of eating. For example, a patient recalls choking (as a child) on a quarter after it got lodged in his throat. He lost consciousness and turned blue and recalls fearing eating solid foods like steaks, meats, capsules, pills (anything hard or chewy) after the incident.

Psychiatrists also believe that most people with the extreme fear of choking are usually anxious or suffering from other psychiatric disorders like depression, Hypochondriasis, Agoraphobia or have a general predisposition to panic attacks.

The fear of choking is also often listed in conjunction with Globus sensation-(a condition that comes and goes wherein the patient feels there is a lump in his throat that prevents him from eating). However, the two conditions are different; Globus sensation is more common and occurs when patients are typically suffering from ear-nose-throat infections that cause them to fear they might choke or vomit after eating.

fear-of-eating-e1467807625589Symptoms of Pseudodysphagia

Psychogenic Dysphagia leads to many psychological symptoms, the most important one being inefficient ordisorganized swallowing. Other symptoms of the fear of choking include:

  1. Avoidance of food, especially swallowing pills, tablets, hard and chewy foods
  2. Abnormal oral behavior is also seen including deviant tongue movements, feeling the throat pressure, and complaint of globus sensation.
  3. Malnutrition and weight loss are common side effects of this phobia
  4. General difficulties in breathing, swallowing and other issues like elevated heart rate, feeling dizzy, having fearful thoughts of dying, passing out or embarrassing oneself in front of others are common symptoms of Pseudodysphagia.
  5. Nightmares about choking on candy, peanuts or indelible objects also tend to keep these patients awake at night.
  6. Some refuse to eat in front of others thinking that swallowing makes “unpleasant noises”.

Needless to say, this phobia is a debilitating condition that affects the normal life of the patients.

Source: http://www.fearof.net/fear-of-choking-phobia-pseudodysphagia/

Lets hear from Maddie:

 

The Hidden World of Mental Illness

The Hidden World of Mental Illness

By Everyday Health Guest Contributor

Ruston headshotBy Delaney Ruston, MD, Special to Everyday Health

When I was young, my dad would come to my high school campus, yelling out my name. I remember feeling shame and embarrassment. I would crouch down in my desk hoping someone would get him to leave before my friends would see him, but they always did.

My dad had schizophrenia. His dream was to be a professor, but when he was an English graduate student at the University of California at Berkeley, his illness got so bad that he could not finish the program. Dad was often off treatment and in a state of psychosis. During these times, he would look all over for me, saying how only I could save him.

Things escalated when I was in medical school. I remember the first time dad suddenly appeared at my doorstep, 400 miles from where he was living. I was shocked that he had just appeared like that, and sadly not shocked by how disheveled, irrational, and desperate he looked…I was used to that. I took him into the Stanford ER where I was a student, happy that I would be able to get him care, but that did not happen. Dad returned several times, and eventually I realized that to finish my medical training, I would have to disconnect from him. I moved and unlisted my new phone number.

When I became a doctor for the underserved, I kept seeing families torn apart. I discovered this was happening not because of the illnesses, but because getting loved ones the right services and treatments was so difficult. This reality, I realized, was so rarely discussed.

So once Dad began receiving consistent care and I wanted to reconnect with him, I decided to bring my camera along. I hoped that documenting this could help spark a dialogue on what many families were dealing with in our country. And quite honestly, having the camera with me gave me a sense of purpose that helped me face things I didn’t want to face.

One of those things was my guilt. I hated myself for having disconnected from Dad. One day during filming, Dad said to me, “You did not invite me to your graduation from medical school. You did not invite me to your wedding. What does an invitation look like?” You could see his pain and you could see my pain. It was a really hard moment to expose, but so many people told me that seeing that exchange somehow motivated them to come forward with difficulties they experienced around mental illness in their families.

Inspiring Story Sharing

When the film, “Unlisted: A Story of Schizophrenia,” was released in communities throughout the nation and on PBS, I was amazed by the number of people who told me how seeing the film inspired them to talk more openly about mental illness, and that through these discussions they were learning how to better access mental health care or pass on such information to others. The whole goal of my film was being realized – and I was hooked to share more stories.

It was during the launch of “Unlisted” that I learned something that stunned me and would lead to the next stories – 450 million people in the world are living with some type of mental health problem. It stunned me on two fronts: first, the magnitude of the problem; and second, how rarely we hear about mental illness in different countries. What obstacles did families face abroad?

I began looking for mental health stories when work or family life took me abroad. What I found by filming in China, South Africa, India, and France is that when it comes to experiences of mental illness, we are much more similar than different. This reality was in stark contrast to the few stories that ever make it to the press – that somehow mental illness is culturally defined and thus so different globally.

Why do I say that we are much more similar? Take stigma, very much present in all the countries I visited. Imagine, for example, the challenge of getting an Indian family to participate when they had not even revealed the truth about their daughter’s schizophrenia within their own extended family. They had spent many years telling the rest of the family that their daughter was home studying, and that’s why she couldn’t come to any of the family activities and family engagements.

I also discovered the similar challenges pertaining to mental health care access. The extent of these challenges frankly overwhelmed me when I went to India and South Africa. In these countries, upwards of 80 percent of people do not receive mental health care that could improve their lives.

With the release of the resultant film, “Hidden Pictures: A Personal Journey Into Global Mental Health,” I have happily witnessed what I experienced with “Unlisted” – the power of a film to get people to open up, share stories, and work towards getting needed mental health care to individuals and to families. A highlight occurred on World Mental Health Day on October 10, when 140 organizations across the globe joined me in screening “Hidden Pictures” and held in-person and online discussion events.

HIDDEN PICTURES- Trailer from Delaney Ruston on Vimeo.

An Exciting Juncture

I have been making films on mental health topics for a decade now, and in that time I have seen an increasing level of discussions, internationally and nationally, around improving mental health care. Globally, for example, the 194 member countries of the World Health Organization (WHO) recently pledged to increase efforts to improve mental health care in their countries. I was honored to be asked to screen stories from “Hidden Pictures” at the WHO’s launch event for this historic moment.

Nationally, the number of awareness campaigns that have started is truly impressive. For example, in “Hidden Pictures,” I filmed politician Patrick Kennedy andactress Glenn Close, who spoke frankly about their family struggles and their determination to fight stigma.

ImageBannerWithWebsite (2)Most exciting is the large-scale collaborations between committed organizations that have begun. In November 2013, I was invited to share stories with a talented group of mental health experts, patients, and caregivers at the Connect 4 Mental Health Community Collaboration Summit, part of the new Connect 4 Mental Health nationwide initiative. Led by the National Alliance on Mental Illness (NAMI) and the National Council for Behavioral Health, working together with Otsuka America Pharmaceutical, Inc. and Lundbeck, the campaign is bringing together industry, advocacy, and communities throughout the United States to work together and inspire widespread discourse to improve access to care around serious mental illness. I know firsthand that getting the right access to services and treatments for those with serious mental illness can be such a challenge, and this initiative seeks to empower leaders from both the mental health community and other community-focused organizations – such as emergency services, law enforcement, and public housing – to recognize how unaddressed serious mental illness may be connected to other local challenges they face.

I was able to reconnect with my dad in a truly meaningful way because he was finally receiving adequate treatment, supportive housing, and much more. I think that is the story that is told time and time again – when that level of support is there, families can thrive. Sharing our stories, I have learned, is how each of us can help families find the support they deserve.

Delaney Ruston, MD, lives in Seattle, Wash. For information about her award-winning films, “Hidden Pictures: A Personal Journey Into Global Mental Health”and “Unlisted: A Story of Schizophrenia,” visit www.hiddenpicturesfilm.com

 

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