Grief and mental health: it’s complicated, what can help?

I haven’t really spoken much about my mental health after Luna died. I did write something else (click here) about it quite a while ago now and with everything going on lately around the world, I thought it might be worth talking about again. I have to say, I’m very reticent to put grief and mental health/illness together in a sentence. Of course, people can and do (I did) have depression and/or anxiety as a result of grief, but grief is not a mental illness. I sometimes worry that people are too quick to prescribe pills (or ‘concerned’ friends/family push for it) for what is a natural process to the death of someone you love. That said, I’m not opposed to taking medication. Prolonged periods of depression or escalating anxiety that’s having a detrimental impact on my life may be causes where medication can be helpful, with other measures in place as well.

After Luna died, I was in shock. The proceeding days and weeks were spent trying to come to grips with my reality: that I had given birth to a dead baby and I ‘decided’ to take that path. My feelings took me by surprise. Thank goodness for Sally, our bereavement midwife, we would have been completely lost without her. She was the tether back to earth, letting me know that all the feelings and emotions I was experiencing were completely normal and ok. We gradually figured out that yes, we did want a funeral for Luna and we eventually figured out how to do this. But after the funeral, that’s when the grief really got to work on my mental health.

My anxiety was already high. It was an extremely stressful and traumatic time. From the time we learned of Luna’s condition, right through to delivering her. What doesn’t get spoken about very much is the toll grief takes on your body. I hurt all over. Our mind and body are not separate entities, and we are not separate from them/it. What I mean is that the mindbody is not just some vehicle for us, it also is us (I also believe we are more than it – but that’s a spiritual conversation for another day). Every cell in my body was grieving, my bones were grieving, deep in my marrow. My entire self was grieving. At this point I had also had a few panic attacks and I was suffering from what I called waking nightmares. Very vivid, violent daydreams of something terrible happening to Benjamin. I would imagine our walk to his nursery, where we had to cross a very busy road and picture him on his scooter, not stopping at the lights and a car/bus/lorry come speeding round the corner…I don’t want to write the rest, you get the idea. It was horrendous. I felt so powerless and at the mercy of my imagination. We had by this time also started seeing a counsellor, Charlie and I together, once a month. It was a relief to be able to talk about my anxiety, panic attacks and intrusive thoughts/images with her. For Charlie, it was helpful for him to hear what he could do for me when I was in the middle of an attack. I was also still being seen by Sally, about once a week. But things continued to be difficult, I can’t imagine what it would have been like if I/we didn’t have anyone to talk to about it, how much worse it would have been. Then, one morning, I woke up in sheer agony. I cried out in pain. I couldn’t get out of bed on my own. It was like my body said ‘No’. Charlie just said, ‘That’s it, you must go to the doctor and I’m coming with you’. He was gentle about it. He was concerned. He had lost his daughter and now his wife seemed to be falling apart at the seams. Post Traumatic Stress Disorder (PTSD) had been mentioned in our monthly counselling sessions, Charlie was now very worried.

We went to the GP. She was lovely, thank god. I blurted out everything, I mentioned the possibility of PTSD. She just sat and listened, then asked, ‘what do you feel should be done?’ I realised that I was worried that she would want to prescribe medication and I realised that I didn’t want pills, not yet anyway. I told her that I believed all of this was a part of my natural grieving process. That it wasn’t surprising that I was experiencing everything that I was, given not just what had happen to Luna, but what I had experienced in my past (both of my parents are also dead and I’ve had several miscarriages). I wanted to feel…everything, but I was terrified too. I felt it was the only thing I could do to demonstrate my love for Luna…which may sound like I wanted to suffer and maybe I did. It was all I thought I had left of her and I wanted everything she had to offer. I didn’t want to numb out, I wanted to feel the pain and I wanted others to witness my pain. Perhaps my pain was also an expression of my guilt, which there was a lot of. Maybe it was a way to offset it in some way, like paying a penance. I mean this in a deep, unconscious way, not a religious one. A way for my mindbody to express what my psyche felt. To my surprise, my GP agreed. We talked about what I had in place: couples counselling once a month and weekly midwife appointments. I was also journaling a lot. She suggested referring me for Cognitive Behavioural Therapy (CBT) sessions and this would put me on a path towards being assessed for PTSD. I don’t understand why they couldn’t just assess me then and there, but I didn’t push it either. I think if I felt suicidal, it would have changed things. I was asked, and although I was in extreme pain, I wasn’t feeling that death was my only option and I was able to hold on to the fact that Benjamin needed me. Even if I did feel like a useless mum at the time. I suppose I was still hopeful, somehow. The GP also asked me to make another appointment to see her again in two week’s time, to check in. We agreed that we would continue to review the need for medication.

In the next few weeks, I got assessed for the CBT sessions. It was group sessions, which I was not happy about. It just peaked my anxiety too much to be in a room full of strangers, with all kinds of reasons for being there. I had a panic attack during my second session there and had to leave. From then on, they offered me one to one sessions (I’d gone up another peg on the way to being assessed for PTSD in the process). To be honest, I don’t think the CBT really did anything for me, but that doesn’t mean I don’t think anyone else should try them…and they were helpful, just not in the way I expected them to be. By this time I had a good understanding of what was triggering me and why. I had started doing mindfulness meditation, which was slowly making a difference and dialling down my central nervous system and making me aware of how I was feeling on a day to day, moment by moment basis. What the private CBT sessions did was give me another listening ear to talk to. I think the sessions were weekly, so I had yet another counsellor listening to me rant and rave, or cry, or laugh hysterically, whatever. By the time I came to the end of that 10 weeks block of sessions, things were a little calmer. What I did learn, was the importance of staying with a panic attack. Not to run away, which was my default. In the middle of an attack, it felt like I was going to die, so I just wanted to run. If my panic attack was to do with Benjamin, which often it was, it made me feel really horrible as a mother. I should be staying to protect him if I thought there was a threat, right? Well, I just wanted to run and hide and not feel it. Which made things worse. Also, apparently if your brain is perceiving a threat that isn’t really there, but you continue to run away, you are just reinforcing the idea that there really is a threat. Basically, the best thing you can do is stay with it, breath through it, feel deeply uncomfortable and ride it out.

My sessions came to an end. I had been back to see my GP several times throughout, just as check in’s. It was yet another person to talk/vent to and be heard. No drugs were ever prescribed. We sold our flat in this time and were in the process of moving house, always a stressful thing and I was anxious about leaving our home that was connected to Luna. We talked about all this stuff, over and over and over again. Me and Charlie. Me, Charlie and Sally (midwife). Me, Charlie and the couples counsellor. Me and the GP. By the end of that summer, I felt more calm. I was ready to stop seeing Sally. I’d been seeing her pretty much every week since the end of January, it was now September. The mindfulness meditation had helped me to slow myself down, it also gave me insights into how I was feeling. I could sense when I was having a good day or a not so good day and then I could try to be kinder to myself in response. I stopped working. This was a huge thing and it can’t be understated how much this had an impact on how I coped. I had been working all through Luna’s diagnosis and birth/death. I had my panic attack in the group CBT session and realised I needed to stop working, or else I may end up being hospitalised. I was lucky that we could afford to do this. There were some financial repercussions, but it was worth it. In truth, I’ve still not gone back to full capacity, we’re 3.5 years on now.

I want to give something useful to other people who may be in a similar boat as I was. What helped me come back?

Mindfulness meditation and breathing exercises.

It was really hard to do at the beginning, but with persistence and patience, it made a difference. I did it every day, several times a day. It is still something I rely on, especially my breath work. I’m more tuned into what my breathing is doing, when I’m holding my breath. Being able to pause for a few seconds to take a few deep, cleansing breaths, is simple and it works.

Nature.

It’s my church. I need to look up at the sky. Watch and listen to birds. Hug a tree. Stumble across beauty and the divine in a ladybird. Water is deeply spiritual for me. I dream about it often. The type of water dreamt is very insightful into what emotions are bubbling, gurgling under the surface.

Exercise.

Gentle stuff for me. Yoga. Swimming. Walking. But some exertion is good at times too. A run (I shuffle-jog really) or a challenging walk (like the one I did in the Alps, which had awe inspiring nature with it) are very nourishing.

Massage.

I started booking in regular myofascial release massages with a truly gifted and lovely woman. We hold grief in our bodies, especially in our hips and thighs. Everything else I was doing was helping, but the massages were a way of connecting a little deeper and helping to move energy along. It is also deeply healing to be touched. We need this as humans – it connects us back to our bodies.

Being heard.

I had so many outlets of different types of people, mostly in professional capacities, but some very good friends as well (and, of course, Charlie), who were capable of holding the space and just listening. This was key. I needed people I felt safe with to be able to say all the bat shit crazy stuff that was rolling around in my head, along with the deeply painful/hurtful things, but also all the expressions of love I have for Luna. In fact, as soon as I went to the GP, was deeply heard by her, my physical pain began to fade away. Finding trusted people to be able to say how you are truly feeling and what is happening for you is so important.

Time.

I can’t stress this one enough. Time and the compassion to give it to myself. I was fortunate to be able to stop work, not everyone can do this. That’s ok, just know that it may take you a bit more time, and you may need to guard your ‘off’ time more religiously. I took a lot of naps. Actually, this is still one of my top self-care things to do. There is no set amount of time grief takes to move through us. Surrendering to what it has to do and for however long it takes is probably one of the most difficult, painful things to accept. Mine’s still moving through, it’s just intense for shorter periods of time and the space between is longer.

Could drugs have helped me? Yes, probably. Should I have taken them? Hmmm, difficult question. They may have eased my pain a bit quicker, but I still would have had to do all the things above, especially give voice to my feelings. I do feel leaning into my anxiety, fear, pain without the use of medication gave me a clear sense of where my edges were. I was working at what I felt was the limit of myself. But it’s funny, when you do this, you adapt. You accommodate. You grow. I wouldn’t hesitate to take medication if I felt I was about to shatter under the strain, or, if my GP, therapist or Charlie thought I was in need. I would listen to those I trust. But they can only know my limits if I take the risk and share openly with them what my true feelings and thoughts are. Which so far, has kept the need for meds at bay.

I worry that in this time of Covid 19, plenty of women and families have been left hanging, with little to no ongoing bereavement care (and let’s face it, this was a hit or miss thing even before Covid). However, just because you are not being followed up properly, don’t take this to mean you don’t matter and your loss doesn’t matter. You may need to take some of the initiative to pick up the phone, or send an email. If you can’t do it, find a trusted friend or family member who is willing to do it for you and let them. If one person doesn’t respond, don’t give up on finding someone who does. There are organisations out there that can help. Don’t ignore your body. It is there to tell you what you need. Sensations and physical pain are signals. You are not crazy or silly or stupid for feeling what you do, but you do need to tell someone. Trust me.

When I did finally get the follow up call to see if I was still experiencing PTSD symptoms, I was surprised to hear myself saying, ‘actually, I have been feeling much better’. I remember asking if the symptoms can just ‘go away’. Apparently, yes, PTSD can resolve itself. With time, self-compassion, being heard…and whatever else may work for you. I was so relieved. They could also come back and this pandemic has been testing my resilience and my ‘edges’ again. I’ve had to up my self-care and be more aware. Yoga more regularly, swimming (both in the pool and in the river), spending time in nature, massages, taking naps whenever needed and possible. But most importantly, telling Charlie. This was the one thing where I felt an almost immediate sense of relief. As soon as I said that I was feeling frightened and anxious, I suddenly didn’t feel them so much anymore. Never suffer in silence.

Here are some organisations that can help:

Child Bereavement UK

Miscarriage Association

Cruse

Antenatal Results and Choices

SANDS

Mind

Petals

BACP

UKCP

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