Massive (anxiety) attack

So much about pregnancy loss is hidden, particularly early pregnancy loss. The emotional side of loss and the mental health challenges that it brings can be very much a part of that hidden and silent suffering that so many of us experience.

Recently, there’s been greater visibility of the stats about the impact of pregnancy loss on mental health. Tommy’s Miscarriage Matters reported “20% of women who have had a miscarriage will go on to experience clinical PTSD, 16-18% will suffer from anxiety and depression, and the risk of suicide is quadrupled”, but what does that actually mean in reality? What does that look like in everyday life? and how does it impact on a person’s ability to perform daily activities? In essence, what’s it really like living with the impact of pregnancy loss?

I wrote the following about two months ago during a particularly bad anxiety attack and thought that I’d share it here as an example of how pregnancy loss related anxiety manifests itself. I apologise if it’s a bit disjointed but I thought it important to keep it as I wrote it at the time.

As I write this, I’m in the middle of one of the worst anxiety attacks that I’ve had since my last loss in August 2020. If I’m honest, I’ve felt it coming for the last week or so. Struggling to concentrate on one thing at a time, jumping between tasks like a true, elite, Olympic level multi-tasker and my brain whizzing around like one of those Wurlitzer teacups you find at the fair. I tell myself I’m just soooo busy! I am a doer after all. Once I get this, this, this, this, this and this done, I’ll be fine. Sound familiar?

Truth is, this is anxiety bubbling up.

I heard recently that there are three stages to anxiety, pre-anxiety, the anxiety attack itself and post-anxiety. In other words, pre-drinks, main drinks and the inevitable hangover, only less fun.

There are a few events that have happened over the last week or so that may have contributed to this attack. Ava finished school for the summer which means relying on clubs and activities that neither of us are used to and her staying away from me overnight, which due to COVID is something that she’s not done much of over the last 18 months. The dog has decided to go suicidal, attempting to kill herself three times in one day including running into a moving car (she’s fine btw), witnessing a lovely lady nearly drown (she’s also fine, albeit quite shaken up) and it being one year since my last loss. Each of these events on their own may not necessarily bring on an anxiety attack but what all the losses did to me was exacerbate an already embedded fear of losing control or having a lack of control. Ava been away from me and away from my watchful eye is a form of lack of control, the kamikaze dog is a total lack of control, watching a friend almost drown and being powerless to help pushed my big red “OUT OF CONTROL” button and of course the one-year anniversary of my last loss was always bound to bring up a multitude of painful emotions.

Over the last 5 years whilst trying to conceive, when I first saw the positive pregnancy test my initial reaction wasn’t hope or joy, it was sheer terror, so what I did was immediately make a “miscarriage plan”. This plan was what I was going to do when I miscarried. Not if I miscarried, when. You see, anxiety is the brains way of protecting you, I know it doesn’t feel like that, but that’s what it’s doing. My miscarriage plan was my protection, my way of accepting the inevitable early on and planning how I was going to cope with it, again. That way it might not hurt so much. Or at least, that’s what I told myself. The truth is of course, that no matter what I prepared or how many lists I made, it would still hurt like hell regardless.

I tell you about my miscarriage plan because it explains how my brain prepares itself. So, when Ava isn’t with me and someone else is caring for her, my brain goes into disaster management mode. It imagines all my worst fears so that I’m prepared for any eventuality. Due to losing so many babies, my biggest fear is losing Ava so this is what my brain prepares me for. I believe this is termed “intrusive thoughts”, whereby my brain throws random, unsettling and sometimes terrifying thoughts into my consciousness. Even though those thoughts aren’t real, physically they feel as real as they would if they were really happening. My heartbeat increases, fight or flight kicks in, and I must make contact with her as soon as is humanly possible. I’m incapable of doing anything else until I know she’s safe and well. I feel the need to point out that this isn’t a lack of trust in the person caring for her. I wouldn’t let Ava go with anyone that I didn’t trust. This isn’t about the capabilities of that person at all, it’s about me and my fears and the mental health issues that I’m learning to cope with and live with on a daily basis.

When the anxiety comes, I can’t move or concentrate or do anything productive until I know she’s safe and well. I always find myself having an internal battle, like there’s a logical me and a neurotic me inside my head battling it out for supreme dominance. “She’s fine, she’s safe, she’s in good hands” one calmly proclaims. “GET TO HER NOW BEFORE SOMETHING TERRIBLE HAPPENS!” the other rather obnoxiously demands. 

It’s all so overwhelming that there’s nothing to be done sometimes but cry and cry and cry some more. I’ve cried on and off now for two days, I think this is the hangover stage, for sure.

People bang on about self-care (including me), but it really is so so important. Over the last two days I’ve baked, exercised with the lovely Joe Wicks, walked with the dog (without her trying to kill herself thankfully), meditated, reached out to my Wild Sea Women community, had lots of hugs from my wonderful husband and am now sitting down to write this, which I find rather therapeutic. Thankfully, work have been understanding and have given me the time to do this.

I know this will pass but I also know that it will likely come back again, maybe not as powerful next time, maybe not for as long, maybe more powerful, maybe for longer. There’s just no way of knowing really. All I can do is keep up my self-care and trust in the journey, easier said than done of course, but this is lifelong work, there is no silver bullet.

As always, I’ve written this in the hope that someone feeling the same way might read it and realise that they’re not alone. I’ve also written this in the hope that it gives a glimpse into the hidden and silent world of a person dealing with pregnancy loss and “parenting after loss” related anxiety. How many people show up to work or show up in their lives hiding their true emotions, hiding their anxiety from the world for fear of not being understood? Maybe the person you sit next to today or the person you bump into in the street is hiding a silent, unseen emotional burden such as I’ve described. I hope that by putting this out into the world it might mean that one more person who didn’t previously understand, can now show more empathy, and feel able to reach out to others in their time of need.

Following this episode, I spent a week with terrible stomach issues, at the time I thought I had food poisoning, but in hindsight this may have been a physical reaction to my emotional state. I’m a great believer that the gut holds a significant level of intelligence based on our emotions and that our brain and gut are inextricably linked. There are a lot of positives in this, namely that the gut can be used as a barometer to the state of our mental health which can give a unique insight into our emotional wellbeing before we’re even aware of it. I work hard on raising my awareness of my internal world so that I can continue to improve my ability to notice the signs and put things in place to support myself as much as possible.

Over the last few years, I’ve been experimenting with breathing and movement to help my physical and emotional health. Here are a few of the activities and exercises that I’ve been using:

·        Diaphragmatic breathing, AKA abdominal breathing, is the act of breathing into our diaphragm as opposed to breathing into our chest which is a much shallower breath and is linked to our fight or flight response. This leaflet from Guy’s and St. Thomas’ NHS Trust gives a useful description of the benefits of diaphragmatic breathing and provides an exercise that you can try.

·        Kundalini Yoga uses diaphragmatic breathing in its breathing techniques. I’ve found that Kundalini Yoga not only reduces stress but also supports digestion.

·        This is a breathing exercise that I use regularly, first thing in the morning and whenever I need it throughout the day. It can also be done anywhere as it’s very discreet. Take a deep breath in through the nose and out through the mouth and simply think about the sensation of the breath, take a second deep breath in through the nose and out through the mouth and then relax the muscles in our face and shoulders. Finally, take a third deep breath in through the nose and out through the mouth and ask yourself “what do I need right now?”. Usually, the first answer that comes to you is the right one. You can also change that last question to whatever works best for you.  

·        Generally, our reaction is to push away discomfort and distract ourselves from pain, but if you can be curious and lean into the discomfort there may be little gems of learning to be found. I know this is far more difficult than I’m making it sound, it takes patience and practice over time but the more you can learn about yourself the better you’ll be at identifying your triggers and supporting your mental health on a regular basis.

·        When the discomfort comes, I try to have the following conversation in my head “I see you, where are you coming from? what are you trying to tell me? Sometimes, that little voice gives me an answer, and sometimes it doesn’t, but that’s ok. Like I said, it’s a practice, sometimes it works and sometimes it doesn’t but it’s a worthwhile exercise regardless.

·        Another thing you can do is to keep a journal of your emotions and reactions. Carry a little notebook with you or record it on your phone, when you feel that discomfort write down what you feel, where you feel it in your body, what your reaction is to it. This is a nice way to recognise and notice your emotions. In the future, you’ll also be able to look back over it and see how far you’ve come on your journey.

·        It almost sounds too easy, but the simple act of noticing is so powerful and, in my experience, has the ability over time to heal from the inside out.

Good luck on your journey.