Perinatal mental health services are chronically underfunded and supported here in NZ – and here a Capsule reader who battled Continuous Traumatic Stress Disorder (CTSD) during her pregnancy, bravely shares her experiences, plus what helped her get through the darkest days…
TW: Perinatal Mental Health, Continuous Traumatic Stress Disorder, Suicide
When I was pregnant with my son, I developed CTSD (Continuous Traumatic Stress Disorder), although it would take years for me to find that out. CTSD isn’t explicitly listed in the Diagnostic and Statistical Manual, but I can assure you it’s very real. It’s similar to PTSD (Post-traumatic Stress Disorder) except that CTSD comes from long-term, unrelenting exposure to ongoing trauma that makes it feel impossible to feel safe.
For me it was ‘continuous’ in the sense that I couldn’t avoid the trigger: going to sleep each night. Or, more accurately, not getting to sleep some nights.
How did this come about? When I was maybe three months pregnant, I started waking up in the middle of the night (no one told me this was normal and to roll with it). The more worried I became about sleeping, the harder it was to sleep because I had a flight or freeze response. It was a Catch 22. I developed extreme insomnia and at one point didn’t sleep for five nights at all. Then after that, it was only bits and pieces of sleep, small gaps in the wakefulness.
There are no words to explain the physical and mental torture. I was an animal caught in a trap: the more I struggled, the more trapped I became. In the daytime, I tried to think myself out of it but that made things worse. Especially when I thought ‘how will I cope with a baby?’.
That was the first question someone asked me when I was finally seen at the government-funded Maternal Mental Health service (MMH), when I desperately needed them to focus on the here and now. It took far too long before they saw me.
I later learned that only a tiny percentage of women get seen at MMH. From anecdotal knowledge, you have to have suicidal thoughts. I was getting to that point – not plans, but thoughts.
Pregnancy contained no joy, just terror. Birth was a welcome relief from being alone in my hell. And it’s hard to enjoy a baby when you’re just trying to survive, treading water. Imagine hearing your baby cry just as you’re finally drifting to sleep.
While most people with PTSD have nightmares, being awake in the night was, for me, more frightening than bad dreams. I sometimes dreamt about not being able to get to sleep which, f**k, is a whole new level of messed up.
You start thinking: is this my fault?
It’s not. It’s trauma.
Here are some of the CTSD symptoms that I have experienced:
- Intrusion: Unwanted upsetting memories, nightmares, flashbacks, emotional distress after reminders surrounding the trauma, and physical reactions to reminders.
- Avoidance: Avoiding trauma-related thoughts or feelings and avoiding reminders of the trauma.
- Negative changes in cognition and mood: Inability to remember some details about the trauma, negative thoughts about oneself or the world, distorted feelings like guilt or blame, and loss of interest in activities.
- Reactivity and arousal symptoms: hypervigilance, heightened startle response, and difficulty sleeping.
But diagnosis is secondary in a sense, in that it’s most important to treat whatever someone’s trauma symptoms are.
Thank f**k I could access private treatment. Most people can’t afford ongoing private treatment.
Treatment for trauma isn’t cheap, isn’t easy and isn’t quick, but it’s necessary.
What helped?
I got medication from a psychiatrist (there should be no stigma).
With my psychologist, I did talk therapy, aka psychotherapy, which involves talking to a trained professional about your thoughts, feelings, and behaviours. Sometimes just saying out loud what was happening helped.
I did CBT (Cogivitive Behavioural Therapy), which helps people reframe catastrophic thoughts so the prefrontal cortex gets stronger at calming the amygdala.
And I did EMDR (Eye Movement Desensitization and Reprocessing). EMDR is a form of therapy designed to alleviate the distress associated with traumatic memories or experiences. I was initially sceptical because it includes tapping the body, but the science backs up its efficacy.
My psychologist helped me with something else. It took me years to get up when I couldn’t sleep, and force myself to interrupt the cycle of insomnia by reading a book, doing a guided meditation, getting some fresh air. It might seem simple just to get up, but it’s incredibly difficult when you’re desperately tired and desperately want to go to sleep. But interrupting the cycle is vital.
My message
To encourage women not to come off antidepressants if you become pregnant. To know that it’s normal if you sometimes wake up in the night during pregnancy (if only someone had told me that). To explain just how bad things are to your GP (preferably to a female GP). To push as hard as you can to see MMH.
If they say ‘it will be worth it in the end once the baby arrives’, tell them they literally don’t know that. I said ‘it will never have been worth it’ and that’s still the case, even though my son lights up my world.
The system is in crisis. Too many women are being failed by the public system, including never getting seen at all.
The government urgently needs to fund more and better treatment for mothers and pregnant women experiencing terrible distress. I would say that early prevention will save the public system money down the road, but that’s not true because that help is also incredibly hard to access.
Things need to change.
*If you’re struggling, contact Little Shadow to access counselling or group support
MORE RESOURCES:
- PlunketLine – call 0800 933 922 or text 1737 (24/7)
- Mother’s Helpers 0800 002 717
- Perinatal Anxiety and Depression Aotearoa (PADA) (+64) 04 461 6318
- Post Natal Distress Support Network Trust: 09 8464978 (great Auckland area only)
- 1737, Need to talk? Free call or text 1737 any time for support from a trained counsellor
- Anxiety New Zealand – 0800 ANXIETY (0800 269 4389)
- APP – Action on Postpartum Psychosis – The charity for mums and families affected by postpartum psychosis
