Alcohol. Fun, isn’t it, for various reasons. The Christmas holidays are a period of particularly heavy drinking for many of the UK population, so much so that January often feels like one long national hangover. This often combines with the sense of “starting afresh” and the ritual of New Year’s Resolutions and results in a period of abstention. In recent years, it’s become fashionable to swear off alcohol for the whole of January, often (but not always) as part of an overall effort to improve general fitness and lose weight.
But, is this necessary? Or is it possible to have your pint and down it, and lose weight while carrying on indulging in the booze?
On paper, it looks like a big ask. It’s easy to see why people find giving up drinking a bit of a challenge. It has pleasurable effects, it aids social interaction, in the UK at least it’s often expected that you’ll drink at social occasions, and if you’re a regular drinker then you’re brain and body will likely have adapted to expect a regular intake.
But all this comes at a cost to the body. Alcohol is second only to fats in terms of the amount of energy per mass it contains. In plain English, alcohol delivers about 7 calories per gram consumed (fat delivers closer to 9 calories per gram). And that’s just the pure alcohol, the ethanol, in your drink. The stuff around it (the beer, the stout, the cocktail ingredients, the mixers) add substantially more. What’s more, these are “empty” calories. The point of drinking is to get the intoxicating effect, not to nourish the body in some way, so physiologically we’re just pouring pointless calories down our throat.
However, scientific analysis offers some way to potentially “game the system”, and not just lose weight while continuing to drink, but use the effects of alcohol to increase your chances of getting in shape! Here are a few suggestions.
If you stir kale into your shots, it counts as a superfood. Probably. Photograph: Courtesy of Juice Crawl
Pub runs
One of the problems with drinking from a weight-gain perspective is that, as well as pointless calories, it also involves very little physical movement. Sitting down and talking for hours isn’t exactly good cardio. You need to engage in a lot more physical movement if you want to burn off those calories.
So, if you really do fancy a drink, don’t stroll to the local, jog there. In fact, don’t go to your local, pick a pub on the other side of town and jog there instead. Or pick several pubs and sprint from one to the next each time you finish a drink, more of a pub sprint than a pub crawl. This has the added bonus of, at the end of the night, if you arrive at the last pub red-faced, struggling to speak or walk, you’ll fit right in.
You might look at this and decide it’s not worth it just for a drink so opt to stay in. If so, fine. That’s good for your health too. So really, you can’t lose here.
Indulge in impulsivity
One thing alcohol is known to do is make people more impulsive. The complex interaction between alcohol and our brains and genes means our higher-reasoning areas and those that supress impulsivity are often hampered by drink, resulting in us doing and saying things we’d normally shy away from.
You can exploit this effect to improve your health by signing up for fitness classes, marathons, Tough Mudder runs, and things like that. You may have consumed a lot of empty calories but thanks to drink you’re now going to burn those off, and then some.
Obviously, once you sober up, you could just change your mind. It’s harder than you think though, as our brains are reluctant to go back on a decision once it’s made. This is especially true if you made the decision in front of people, who will now think worse of you if you go back on it.
When you wake with a pounding head saying “What the hell did I agree to last night?”, it may well have been good for you in the long run.
Interesting fact – people often look the same after a heavy workout session as they do after a heavy drinking session Photograph: ronstik/Getty Images/iStockphoto
Embrace the anger
One other unpleasant effect of alcohol, which ties in with greater impulsivity, is an increase in irritability and anger. There are many neuropsychological explanations for this; an inability to correctly work out people’s intentions from their behaviour, a drop in ability to plan actions and predict consequences, releasing pre-existing stresses and issues that you usually supress, and so on.
One consequence of increased anger is an increase in “approach” motivation. The brain seems to have two separate motivations systems, approach and avoidance. Things we want to deal with, we’re motivated to approach. Things we are wary or scared of, we’re motivated to avoid. Anger increases the power of the approach system, meaning we “get stuck in” where we otherwise wouldn’t.
So, if you’re drunkenly tempted to pick a fight with the biggest bruiser in the room, go ahead. The realisation of what you’ve done will soon get through your alcohol-infused brain, triggering an adrenaline-rush fight-or-flight response. You’ll have no choice but to get moving to stay ahead of the enraged beast, burning many calories as he chases you with a pool cue.
Blank the workout
Alcohol, at the right doses, can and does disrupt the ability to form new memories. So, if you have a gym session or exercise routine planned, you could dry quickly getting so drunk beforehand your brain can’t form new memories, but you can still complete your workout before passing out from intoxication. When you eventually wake up, you should have no memory of exercising, so will think you still need to do it. Voila; you get to drink and actually double the exercise you partake in.
It’s a delicate balancing act though, to get the timing and intake just right to hit that narrow window of usefulness. So practice is needed, which may well render the whole thing pointless.
Wine is made from grapes. Grapes are a fruit. Fruit is good for you. So, therefore…
You may think all these suggestions fall into the category of “terrible” or maybe even “downright hazardous to health, life and liberty”. And you’d be right.
Truth is, alcohol isn’t ever really going to be helpful if you’re trying to lose weight and get in shape. That’s just not how our bodies work. But that doesn’t mean you have to cut it out entirely. Each to their own, and many people just cut down and/or increase their physical activity, or some combination of the two. You need to find what works for you.
Of course, this involves navigating the onslaught of “expert” advice and trendy “diets” we are bombarded with at this time of year. It’s enough to drive you to drink.
Dean Burnett ‘s book The Idiot Brain isavailable now in the UK,USA,Canadaand many other countries.
He is appearing at Dry Humour, an alcohol-free comedy night on Friday the 13th in Cardiff, in aide of Alcohol Concern.
Doctors have long warned parents to delay introducing certain foods to babies to decrease the risk of a potential allergic reaction, but a new study suggests that strategy probably doesn’t help.
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By Serena Gordon HealthDay Reporter WEDNESDAY, May 18, 2016 (HealthDay News) — Doctors have long warned parents to delay introducing certain foods to babies to decrease the risk of a potential allergic reaction, but a new study suggests that strategy probably doesn’t help. The study of about 1,400 children found that when babies were given peanuts, eggs or cow’s milk during their first year, they were less likely to become “sensitized” to those common allergy-causing foods. Being sensitized to a food means a child tests positive on a skin test. “That doesn’t necessarily mean a food allergy as such, but it indicates the child is on that pathway,” said the study’s senior author, Dr. Malcolm Sears. The goal is to reduce the risk of sensitization, which also reduces the risk of allergy, said Sears, a professor in the division of respirology at McMaster University in Hamilton, Ontario, Canada. The study’s lead author, Maxwell Tran, said this study, along with other research, “supports the paradigm shift that parents should not hesitate to introduce allergenic foods, especially cow’s milk, peanuts and eggs. This will reduce the likelihood of sensitization.” Tran is a health sciences student at McMaster. Sears reiterated: “Earlier is better. Don’t be afraid to introduce these foods.” But he added that even early introduction of a food doesn’t guarantee a child won’t eventually develop a food allergy. Tran is scheduled to present the study’s findings Wednesday at the American Thoracic Society meeting in San Francisco. Findings presented at meetings are generally viewed as preliminary until published in a peer-reviewed journal. According to Tran, previous guidelines recommended waiting a year before introducing cow’s milk and cow’s milk products, such as cheese, yogurt or ice cream. Doctors recommended delaying eggs until age 2 years, and peanut-containing products until age 3. Since other studies have hinted that earlier introduction of these foods might be beneficial instead of harmful, the researchers behind the new study looked at a sample of children already involved in a large Canadian child development trial. Sears noted that this was not a group of children that would be considered at high risk for allergies. Just over 1,400 youngsters from that study had their skin tested for allergen sensitization at 1 year. Nutrition questionnaires were completed by parents when the kids were 3, 6, 12, 18 and 24 months old, the researchers said. The researchers found that almost half the babies had consumed cow’s milk by 6 months, and the other half had milk by 12 months. Just 4 percent didn’t have milk until they were 1 year old, the study revealed. Only 6 percent of the babies had eggs by 6 months, while 76 percent had them before 12 months. And about 19 percent first had eggs after their first birthday, the study showed. Parents were much more likely to delay peanuts. Only 1 percent of the children had peanuts by 6 months, and 41 percent had peanuts introduced in their diet between 7 and 12 months. Fifty-eight percent of the children were over 1 year of age when they first had peanuts, the study found. The researchers found that early introduction of any of the allergic foods was linked to a lower risk of sensitization for that food. Giving a child egg before age 1 also reduced the odds of sensitization to any of the three tested foods, the study found. Dr. Jennifer Appleyard is chief of allergy and immunology at St. John Hospital and Medical Center in Detroit. She said, “The old train of thought was that the immune system is in flux for the first three years of life, and if exposed during that vulnerable period, food allergies might develop. But some of the old thoughts on how allergies develop and how best to treat them are changing.” She said that parents who followed that advice and waited to give their child these foods didn’t cause any allergies. “So many different things influence allergies… Things we do may affect a health outcome in some way, but it doesn’t completely control how allergies develop,” she said. There’s still a lot of research looking into the development of allergies, Appleyard noted, adding for now, early introduction of foods seems okay. If you come from an allergic family, particularly one with food allergies, Appleyard said it’s best to talk with your doctor about the introduction of common allergy-causing foods.More information Learn more about food allergy from the American College of Allergy, Asthma and Immunology.
I entered the field of mental health social work just a few weeks ago, joining a psychosis team. I had been warned by friends, family, taxi drivers and the media that this area of work is in dire straits and suffering hugely from cuts and poor practice.
After a couple of days, I could confirm that the former is true: swingeing cuts have had a drastic effect. Therapeutic groups and the time practitioners are able to spend with service users are incredibly stretched, and diaries no longer set aside any time for breaks – or, it seems, any time to breathe. However, my observations of current practice contradict the tales of woe.
I spent one day with a mental health support worker, shadowing him on four home visits with service users, and I was touched by the remarkable work he is doing. In the car between visits, we spoke about the value of things like listening, getting fresh air, and working collaboratively with each service user.
I had come across words like “collaborative” and “active listening” time and again in literature and legislation on mental health practice, but had pessimistically assumed that, for the most part, this language served to tick boxes for inspectors.
The support worker valued the time spent with each service user as much as they did with him
Here, I witnessed these things being practised in the truest, most genuine sense. The support worker valued the time spent with each service user as much as they did with him, and I observed them continuously teaching and learning from one another.
This was not in an expensive psychiatric unit or over a £4 coffee, but simply during walks, exploring new areas and the changing seasons, discovering the best places to go. It occurred to me that so much essential work, even administrative obligations, could take place in these settings. Why not?
Understanding of what good practice means is changing, and mental health finally seems to be taking centre stage in public discourse.
Unfortunately, because these changes have taken place in the era of austerity, many ideas about the value of a social approach feel unfeasible in practice. As a result, a return to a medical model is tempting, and can seem like the most time-saving and cost-effective option. However, from what I have seen, expensive medication with often complex side effects, compares poorly with therapeutic support.
Medication is undeniably an important part of recovery for some service users, but the knowledge that they have been prescribed drugs to alter their thoughts automatically places them in a category of “in need”, or in some sense “less human”.
The social work I have observed is therapeutic input at its best. Despite the challenges ahead – inevitable in every job – I am so grateful that the negative attitudes towards the field of mental healthcare are being challenged and contradicted in daily practice. Workers, such as the people I’ve met, are not giving up hope, and as a result, service users are not giving up hope either. This, to me, is the greatest outcome we could wish for.
The Social Life Blog is written by people who work in or use social care services. If you’d like to write for the series, email socialcare@theguardian.com with your ideas.
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In the 1970s, when we were in school, food allergies were rare. But Australian children now have the highest rate of food allergy in the world. Up to one in 10 infants and two in 10 school-aged children have a proven food allergy.
In the 14 years to 2012 there was a 50% increase in hospital visits for anaphylaxis, the most severe allergic reaction. Infants and toddlers accounted for much of this increase.
The most common food allergies are to nine main food proteins: cow’s milk, soy, egg, wheat, peanut, tree nuts, sesame, fish and seafood. Egg and peanut allergies are the most common in infants and toddlers.
New research published today in the Journal of the American Medical Association shows the early introduction of egg (from four to six months) and peanuts (from four to 11 months) is linked to lower rates of egg and peanut allergy.
The researchers analysed the combined results of trials investigating whether food allergens in babies’ diets prevent the development of allergies to these foods. They concluded there was “moderate” certainty that early introduction of egg or peanut was associated with lower risks of egg and peanut allergy.
They also found that early introduction of gluten (wheat) was not associated with an increased risk of coeliac disease.
The researchers used the term “moderate” certainty because the review is based on a mix of studies with different designs and of varying quality. Feeding studies can also be difficult to “blind”; for some studies participants and researchers knew who was given egg or peanut, so were open to some bias.
As a result the authors say more work needs to be done to better understand the precise optimal timing for introducing eggs and peanuts.
Nonetheless, these findings affirm the recently updated Australian infant feeding consensus guidelines. These state that when parents introduce solids – at about six months but not before four months – they should also introduce previously avoided foods such as peanut and egg. This should occur in the baby’s first year of life.
The problem is, there have been so many changes to guidelines over the last few decades that parents are no longer sure what to believe.
In Australia, dietary recommendations aiming to reduce the risk of food allergies began to appear in the early 1990s. They recommended infants avoid certain foods such as egg and peanut. These guidelines were largely based on outcomes of trials focusing on the mother avoiding allergens during pregnancy and while breastfeeding.
In 2008, a number of research projects (including our own) questioned whether these older studies were flawed because they had not adequately adjusted the results to account for the fact that those with a family history of allergies adhere to recommendations better than those without, thus biasing the result.
These new studies accounted for this fact. We found, paradoxically, that earlier introduction of foods such as egg and peanut, at about six months, appeared to protect against food allergy. This has resulted in a complete rethink in our approach to preventing food allergy.
(Note that these findings relate to the prevention of food allergies, not the management, which remains unchanged. Children with food allergies should continue to avoid those foods.)
Based on this research, feeding guidelines began stating that earlier introduction did not increase the risk of food allergy and may indeed be protective.
These recommendations were strengthened this year after research trials tested the effect of eating common allergens (in particular, peanut) in the first year of life compared with completely avoiding them. The guidelines now recommend that exposure to egg, peanut and other foods frequently associated with food allergy should occur in the first year of life to offer protection.
It’s still not clear if this approach alone will prevent the whole food allergy epidemic. Some children will still develop food allergies despite following the feeding guidelines.
We know the tendency to develop allergic disease is inherited but environmental factors, including the microbiome, vitamin D levels, migration effects, the number of siblings and exposure to pets also all appear to play influential roles, as does the presence of early onset eczema. Research trials are investigating the role these factors play in the development of food allergy risk.
In the meantime, experts agree there appears to be a window of opportunity in the first year of life where exposure to foods such as peanut and egg decreases the risk of allergy to these foods. Diet diversity remains an important part of a healthy diet.
•For the most recent infant feeding guidelines and information about introducing solid foods to infants, visit the Australasian Society of Clinical Immunology and Allergy website
•This article was originally published on The Conversation
A baby was born, took one breath, then left the world again. No amount of the midwife pumping his legs up to his ribcage and back, or poking a finger hard and fast at his chest, would bring him back.
His 17-year-old mother lay in pain on the delivery table as her son was wrapped up in a yellow cloth. There was no time even for her to hold him, as another woman was about to give birth. The midwives quickly changed their bloodied robes and gloves. Because there was no other table, the second woman gave birth lying on the floor.
This time, the baby yelled as soon as she came out. She was healthy. While the midwives moved on to the next urgent case, their small delivery room filling up, she spent her first few minutes screaming on the concrete slab.
Welcome to life in Guinea, baby Katherine.
The situation for newborn babies and their mothers in this west African country is dire. Of every 1,000 babies born in Guinea, 123 die before their fifth birthday. For every 100,000 live births, 724 women die. Guinea has the world’s second-highest rate of female genital mutilation (FGM), after Somalia – 97% of women between 15 and 49 have been cut. Women who have had FGM are twice as likely to haemorrhage during childbirth, and haemorrhage is the leading cause of mothers dying in Africa.
Medicine is in short supply, and health workers’ salaries rely on selling enough of it. This leads to staff shortages; most health centres have one or two health workers when they should have eight.
The Ebola outbreak, which killed more than 2,500 people in Guinea, revealed how little access to medical care rural Guineans had. The health situation has improved slightly post-Ebola, but without donor money, the system would grind to a halt.
“The needs are identified, but the money is just not coming from the government,” says Guy Yogo, Unicef’s deputy representative in Guinea. After Ebola, the government increased its contribution to health from 2.66% to 4.66% of GDP, and has committed to 7% for next year. According to Yogo, however: “The minimum is 11-15% if you really want to have an impact.”
Katherine is one of nearly 5,000 babies officially born each year at Doko health centre in the Kankan region of north-eastern Guinea, but about 2,000 more are born to unregistered mothers who come to the area to search for gold in artisanal mines.
Births take place in one small room, with its single delivery table presided over by two midwives.
“Lots of women come, and there’s nowhere to put them all. They often have their babies on the floor. Better there than next to sick people – at least it’s clean,” says Bernadette Mansaré, a midwife.
Sayon Keita, who is pregnant with her seventh child, is examined by a midwife at a health post near Doko, Siguiri
When there is a moment between deliveries, she lectures the dozen pregnant women waiting outside on the importance of coming in for checkups.
Doko’s midwives have not had any training in 20 years. If they had, they might have known how to give the baby who died mouth to mouth resuscitation or proper compressions. Thousands of babies die from preventable causes each year.
One of the things that the response to Ebola brought was medical supplies, the like of which had not been seen in a generation.
Kondiadou health centre is near Kissidougou, one of the towns to which the UN started regular flights during Ebola. Before, reaching south-east Guinea from the capital involved a bumpy car journey lasting several days. Now, because of the flights, it is easier to get supplies and staff in, although the UN is expected to cancel the flight as soon as the threat of Ebola is completely over.
“It’s the first time we’ve got equipment like this since the centre was built in 1990,” says Therese Soropogui, a community health worker at Kondiadou, as she pulls out standard latex gloves and yellow washing-up ones and explains the difference.
Why do women still die in childbirth?
A small camping stove, some sterilising kit, bandages and a few hundred pairs of gloves have been donated by the Spanish government and Unicef. And a red plastic bucket. It does not take much to save lives in remote Guinea.
“Before, we burned tools in the fire, and that took too long,” Soropogui says. “And if you had two women giving birth at the same time, you had to use our one set of tools for both women, one after the other. That was very difficult. Now we have three or four sets of tools and, at the end, you can sterilise them.”
Not all of the equipment seems to have been used, however, showing up what many see as an endemic problem with the UN’s approach.
“They give out supplies like sweets,” says Yolande Hyjazi, the country director of Jhpiego, an international health organisation. “The UN system is: what the government asks for, they buy, and that’s it. We’ve seen a lot of vacuum extraction equipment, but if you ask the staff about it they say: ‘I don’t know [what it is], the UNFPA [UN population fund] sent it.’ They give equipment without training.”
Even when staff do know how to use it, obstetric equipment does not solve a problem many women have – getting to a clinic.
Harriet Somadouno, a 20-year-old farmer in her third trimester, walked 17km to Kondiadou for a checkup, carrying 10kg of peanuts on her head to sell at the market en route.
“I walked with my friends, but I carried the peanuts myself,” she says. “It took me six hours. I’m going home tonight but I think it’ll be a quicker journey as I sold all the peanuts – perhaps four hours.”
Somadouno, exhausted after her walk, barely seemed to take in the information given by the nurse.
One scheme to help women involves what looks like a giant old-fashioned pram, which is attached as a sidecar to a motorbike. Spain has given 15 of them to health centres in Guinea.
Mamady Berete doubles up as Doko health centre’s broken bones specialist and the moto-ambulance driver. Dressed in high-vis from head to toe, he bumps up and down bush tracks and through enormous puddles, picking up pregnant women, strapping them in his sidecar and taking them to Doko.
The giant pram turns heads, but brings fresh problems, such as how to pay for petrol or maintenance.
“We have someone here who can fix it but, if a tyre breaks, we have to send to Conakry for a new one. It’s a bit difficult,” Berete says.
On his trips to the villages, Berete spreads the word about the health centre and encourages more people to use it.
Mamady Berete heads off to collect a pregnant woman from a remote outpost and bring her to the Doko health centre
Trust in Guinea’s health system was in short supply during Ebola, when clinics closed their doors, doctors and nurses died, and infected people seemed to disappear into hospitals never to return.
“People were afraid of our health centre – they said if you came here you’d catch Ebola. So people avoided coming,” says Berete. Because nobody came, salaries could not be paid, so the clinic had to shut, leading to even less trust in the service.
According to Yogo, the lack of working health systems meant the death toll from “collateral” diseases and health complications outpaced that of Ebola.
“More people died from malaria, diarrhoea and in childbirth than of Ebola,” he says. “The country did not have enough ambulances. They were all used for Ebola patients – nobody else.”
Now, people are trying to take advantage of the supplies and attention that Ebola brought, and keep people coming through the doors so staff can afford to keep those doors open.
Berete and his colleagues are succeeding: several health centres, including Doko, are recording pregnant women coming in greater numbers than before Ebola.
Somadouno, who left school aged nine and had her first child at 16, plans to repeat her gruelling 17km journey to give birth.
“I gave birth to my first child here and, because it went well, I’m coming back for this one,” she says. “My mother-in-law will come with me, but we’ll be on foot then too. My plan is to try to catch it early.”
Magda, a 29-year-old software developer, regularly fends off questions about when she will have her first child. Coming from a close-knit family and having been with her boyfriend for a decade, the topic is brought up regularly. But Magda grimaces in response, only to be told: “Don’t leave it too late.”
For Magda, the question of when she wants to have a child is complex. There is a serious history of depression and psychosis in her family on both sides. In fact, her mother was sectioned for a long time after giving birth to her.
“I’m not just concerned about passing on mental health problems to any child I might have, I also have serious concerns about the risk to my own wellbeing from having a baby,” she says.
She also worries about the kind of treatment she might receive if she were to have problems. “I’m acutely aware of how awful the mental health support can be in the NHS. I have witnessed failing after failing in the care of my mother. If I speak to a GP about my concerns, will they care and offer advice? If I did decide to have a baby, would they make sure I’m looked after through pregnancy and beyond?”
This is just one of the individual stories sent to the Guardian as part of a project inviting people to discuss the often taboo topic of mental health and pregnancy.
Between 10 and 20% of women in the UK develop a mental illness during pregnancy or within the first year after having a baby. This costs the NHS around £8bn for each annual birth cohort. Conditions range from postnatal depression to obsessive compulsive disorder and psychosis.
It’s not just women either: one in eight first-time fathers suffer from depression while their partner is pregnant, according to a survey by scientists at McGill University in Canada.
Despite this, new NHS England figures show less than 15% of areas currently provide recommended services for mothers with mental health issues, and more than 40% provide no service at all. In almost half of the UK, pregnant women and new mothers do not have access to specialist perinatal mental health services – with even less specific support in place for men.
It’s an issue the government has pledged to address, with £365m allocated for specialist perinatal mental health services over the next five years, the the first tranche of which has just been made available.
So, why is help desperately needed and what sort of experiences do people have? Here are our readers’ stories.
The decision to have a child
For some, like Magda, the challenge begins before pregnancy – many women and men experiencing mental health problems worry about their children developing similar conditions. They also worry about how their condition could affect their ability to be a parent.
A lot of times my days are coping minute to minute. I don’t know if that puts me in a good position to raise a child
Daniel Stusiak, 37, from Aberdeen, South Dakota,has type-two bipolar disorder. In the audio recording above, he explains how his mental health problems influenced his decision not to have children.
When it comes to having children I have two thoughts. One, genetically I don’t like the idea of gambling and seeing whether I pass it on… Second, should that child not have to deal with that, they will have to deal with me as their father and a lot of times my days are coping minute to minute. I don’t know if that puts me in a good position to raise a child in the best way.
The medication question
A lot of women also have to weigh up whether or not they are prepared to come off their medication to have a child. While some drugs are considered relatively safe the evidence is not conclusive, and some have been linked to health problems in babies.
But those who come off any medication are at risk of getting ill again: for example, seven out of every 10 women who stop antidepressants in early pregnancy become unwell again.
Harriet, 32, Stoke-on-Trent
Giving birth was much more painful and difficult than I ever imagined it would be
I have been told that I may need medication for life to treat my anxiety and depression. When I decided to have a baby, my main fear was that the drugs would be dangerous and I’d have to come off them. I was scared of falling ill, which had happened when I came off medication before – when I was at my worst I had extreme panic attacks about 10 times a day.
My dad, who is a doctor, assured me that citalopram is generally considered OK during pregnancy. But babies born to depressed mothers can have worse growth and general health.
I talked to my husband and I decided it was safer for me to stay on the drugs. However, I still found the pregnancy very stressful. I worried constantly about miscarrying. I was offered a reassurance scan but it made me more stressed because they noticed a slight abnormality in the baby’s brain. It turned out to be nothing, but I completely broke down. I could not function for weeks and struggled with the rest of the pregnancy.
Since the birth my mental health has improved. I love being a mum and my daughter makes me very happy. Giving birth was much more painful and difficult than I ever imagined it would be. Afterwards, you wake up to a life and a body that you don’t recognise. It’s not great for your self-esteem. I put on a huge amount of weight but the pain was definitely worth it.”
Mandy, 36, north-west England
I have borderline personality disorder and a social anxiety disorder. I stopped taking my medication (Escitalopram) when I was pregnant because I was worried about the health of my baby. Some doctors thought it was better I stay on the drug, while others disagreed, and because of this varying advice I stopped. However, coming off it caused me a lot of problems. I started self-harming, for example, and worried about everything. I ended up hiding in my house, which meant I couldn’t go back to work. With borderline personality disorder I can go very quickly from being level-headed to mentally unstable. Being pregnant made it harder to cope with this. I didn’t feel like my body was my own. I couldn’t harm myself physically to rid my mind of distressing thoughts.
I was referred to a mental health assessment team and put back on medication on a low dosage. I had one visit with the assessment team but found the nurse dismissive and unhelpful. They didn’t realise I’d had past mental health problems and were treating me as if I had just turned up with thoughts of harming myself. Once I explained to them that I presented before pregnancy I hoped they’d adjust their attitude towards me, perhaps offer more contact, but they didn’t.
I coped throughout the pregnancy mainly thanks to my husband and my GP, who I could talk more openly with, but I wish there had been more support from the assessment team.
Hannah from Yorkshire experienced anxiety before pregnancy, but chose to come off medication to treat this in order to have a child. Listen to her story below.
Antenatal
Postnatal depression is often reported on, but less attention is given to mental health issues during pregnancy. While it’s normal for women to experience “baby blues” as a result of hormonal changes, for a large number this is much more extreme. In fact, it is estimated that 7% to 20% percent of pregnant women are affected by what is known as antenatal depression, which if untreated can lead to postnatal depression after the birth.
Women and men can also experience a great deal of anxiety during pregnancy – it is thought that more than one in 10 women struggle with symptoms of anxiety while carrying a child.
I started to have horrible thoughts about my baby – thinking I had made a terrible mistake and wanted to get rid of it
Ariana, 25, London
I have never experienced mental health issues other than while I was pregnant. When I was around eight weeks, I started to feel upset. The baby hadn’t been planned, but I was ecstatic at first. However, depression soon took over. As the weeks went on it got worse – I hated people talking about the pregnancy and wanted to pretend it wasn’t happening. I started to have horrible thoughts about my baby – thinking I had made a terrible mistake and wanted to get rid of it. Bizarrely, I also decided that when the baby was born, I would swap it with another child in the hospital, and at least then they wouldn’t be my responsibility any more.
Fortunately by the time I was heavily pregnant, I didn’t feel negatively any more. I only felt sad that this thinking had ruined my early pregnancy for me. I now have a huge amount of sympathy for anyone who experiences depression.
After having my son, I stayed up all night on the maternity ward just watching him. I remember thinking he was the best thing that had ever happened to me, and I still do now. He is three years old.
Postnatal depression is widely recognised, but there is less said about depression during pregnancy. I might have sought help if people talked about it more.
Leila experienced anxiety and depression during her pregnancy, having never had mental health problems before. You can hear about her experience in this recording.
I finally admitted to myself that I was seriously ill after weeks of considering throwing myself under the train
I finally admitted to myself that I was seriously ill after weeks of considering throwing myself under the train on my way to work, followed by weeks of not being able to get out of bed. I lacked the motivation to do anything: get dressed, wash my hair, let alone make any preparation for a new baby. There is a hormonal trigger to perinatal depression and the more the pregnancy progresses the greater the influence of hormones.
Miscarriages
There are no official government statistics held on women who miscarry (they are only collated for women admitted to hospital), but the pregnancy charity Tommy’s says around one in every four women with a BMI of over 30 will miscarry a child.
The effects of this last longer than you might imagine: a study in 2011 found that the depression and anxiety experienced by many women after a miscarriage can continue for years, even after the birth of a healthy child. Men are also affected, although perhaps differently. One British study of 323 men found that although they displayed less “active grief” than their female partners, they were more vulnerable to feelings of despair and difficulty in coping eight weeks following the loss.
Matt Allen, 38, from Brighton, shares his story of how miscarriage affected his mental health below.
Looking back on it it would have been better for me to have someone to talk to [after the miscarriage] and maybe drop the stigma that men have to be strong and carry everyone around them, because something like losing a child does affect us just as much emotionally.
Kaye, Manchester
I’m pregnant for the second time. My husband and I lost our first child when I had a miscarriage in my first trimester. It’s not something you get over. People around you think that it’s all about getting pregnant, but the waiting for the arrival of a healthy baby now is worse than any treatment. I suffer from crippling anxiety – crying at random times, waking up from nightmares. I can’t talk about being pregnant and am still trying to hide it at almost 20 weeks.
I wish that I could be offered some counselling. My partner and I received no support whatsoever from the NHS after the D&C [a surgical procedure often performed after a first-trimester miscarriage]. Only now, from reading the Miscarriage Association’s literature am I beginning to understand that the anxiety we are going through is common.
A viability scan should also be offered on the NHS at seven to eight weeks as a standard. This can really help to reassure new parents. I do think the NHS should have different support in place for people where this is a Pal (pregnancy after loss), and that includes silent miscarriages. Friends from abroad are often shocked at how few scans we get in the UK and that the chance to hear the baby’s heartbeat at midwife appointments isn’t standardised across the country.
Postnatal
Postnatal depression is an illness that affects between 10 to 15 in every 100 women having a baby. It can start within one or two months of giving birth. It’s also something that hits men too: studies predict about one dad in 10 has postnatal depression. Traditionally, the mother’s mental health gets more attention, but recognition of the dad’s mental health is increasing.
Alice, Midlands
I had my daughter a few years ago and read all the information I could get my hands on. After a difficult birth I eventually delivered my baby. I was exhausted (it took 48 hours in total) and shell-shocked. We stayed in hospital for a few days while trying to get my daughter to breastfeed. I was struggling so much with this that I refused to have any visitors as I didn’t want anyone to think I couldn’t cope. In the end I gave up so that we could all just go home. Luckily bottle feeding didn’t affect bonding with my baby.
However, my partner didn’t cope well at all. From seeing me in so much pain and out of control, he tried to take on far too much so that I could recover. His mental health spiralled as a result to the point where he couldn’t look at our baby. He couldn’t handle her crying and one day I found him crouched in a corner rocking. I got him to see a counsellor and the doctor advised that he would recover better if he moved out for a while. He went to live with his parents and we would visit, but he couldn’t cope with the guilt of leaving us.
Eventually we got through it and he was able to move back home with us. Unfortunately we didn’t make it as a couple; the strain was too much. Looking back I wish we’d have had more support in trying to deal with his depression but even though this was a few years ago, there was very little awareness about male postnatal depression and a lot of shame attached to it. I wish I could have helped more.
Emma, Manchester
I’d already had a baby and enjoyed being a mum, so when I fell pregnant again I never expected to experience postnatal depression.It was four months before I plucked up the courage to go and see the doctor. I kept telling myself to keep going, and that I could be a perfect mum like the ones you see plastered all over social media. Now I realise that it’s not real. To me, during the dark days that perfect picture wasn’t my life but boy did I try to achieve it. I was really struggling and I told no one. Admitting weakness was like putting my hand up and saying: “Look at me, the bad mum over here.”
The day I told my sister and my mum I was at my wits’ end. I cried the whole time. I paced the length of my house for half an hour before I finally made the call to my family. After that I went to the doctor. I thought he was going to laugh and tell me to just get on with it like every other mum, but he didn’t. He told me that this would be the last time I would feel this way and that every day, from today, I would start to feel better. Most importantly he made me realise for the first time in four months that I wasn’t a failing mother-of-two. I’d managed to keep my head above water through one of the most challenging times of my life.
We discussed options and I agreed that I would take tablets for depression and anxiety – it was time to give my body a little helping hand. He made me see some things are out of my control and postnatal depression can happen to anyone.
Psychosis
One of the most severe forms of illness seen in psychiatry are postpartum psychoses. In rare but tragic cases it can lead to women taking their own lives.It’s thought that postpartum psychosis affects women in every 1-2 of 1,000 births. It’s more likely to affect women who have had it before (or have a relative who has) or have a serious mental health condition, such as bipolar disorder or schizophrenia.
Lisa Abramson, who suffered from postpartum depression after the birth of her daughter
Lisa Abramson, from San Francisco, experienced severe mental health difficulties after giving birth to her first child. She talks about postnatal psychosis in the audio recording below.
Leila, interviewed above, also experienced psychosis after pregnancy – as well as antenatal depression and anxiety. She talks about this below.
I completely lost touch with reality and was convinced my phone was communicating with me in code
I started to get hyper-manic and the effect that had, in terms of behaviour, meant that I would be wide awake all night. My mind would be racing and I was really driven to do things, for example I would reorganise the kitchen cupboard at 3am to 4am in the morning. I also wrote lists compulsively and used hand gestures, which I don’t normally do … then after that I became psychotic. I completely lost touch with reality and was convinced my phone was communicating with me in code. I thought it might be my father who had died three years previously. I thought I would just will with my mind ordering a pizza and it would be delivered to the door.
Post-traumatic stress disorder
Research is limited but estimates of post-traumatic stress disorder (PTSD) after delivery tend to be around 1-2% in high-income countries. One study in Sweden put the rate of postnatal PTSD at 2% in the first year after birth. While some women experience it after a particularly traumatic birth (with medical difficulties), others have PTSD from the birth process itself.
A spokesperson for the Birth Trauma Association said: “The help on offer for women is very patchy and generally poor. Individual health visitors and midwives may help but waiting lists are long – up to a year – and almost no one gets on a list for cognitive behaviour therapy or other treatment unless they have been symptomatic for at least 12 weeks.”
Bill, Staffordshire
My wife and I experienced the stillbirth of our first child, Andrew. It was very sudden, my wife noticed a lack of movement and we went to hospital. We saw a classic scan, but this time with no heartbeat. I carry the image with me to this day. The following days and weeks were traumatic. We were told that the chances of a future successful pregnancy were higher if my wife delivered Andrew naturally, so labour was induced gently. We then went to a dedicated maternity suite (where we were handled with exceptional care and attention by all staff). The delivery was normal, except that Andrew was not alive.
Following the stillbirth, I experienced post-traumatic stress disorder for which I have since received cognitive behavioural therapy. I had flash-backs of the traumatic delivery and the events immediately before and after, including my son’s funeral. I also suffered from an intense anxiety as we went through four more pregnancies – two ended in miscarriage and two ended inthe births of two wonderful boys. We constantly wondered about miscarriage, stillbirth and the chances of a good outcome. The mental health problems affected my work – I was constantly on high alert.
On the whole the NHS was marvellous. Their care when we lost Andrew was excellent in the circumstances. My wife got support during the pregnancies and for the way in which the stillbirth affected her. However, there was less attention on the father. I was not prepared mentally for the immense impact that this would have on me.
On the whole the NHS was marvellous. Their care when we lost Andrew was excellent in the circumstances
Emma, Midlands
I had a traumatic first birth and my baby was in neonatal care, which left me struggling with what I know now to be PTSD and perinatal anxiety. I didn’t understand what was happening, so tried to carry on as normal. I became pregnant again 14 months later by accident and really suffered. I believed I would die, writing letters to all my family and counting down the days until I would leave this world. I had awful anxiety, flashbacks and was terrified all the time. I didn’t trust healthcare professionals, hated going to the hospital for appointments and didn’t know who I could approach for help. I became a shell, empty and full of fear.
I wish that my traumatic birth had been acknowledged and that I had been asked how I was coping in my next pregnancy. I wish that there had been counselling, more information around having a difficult birth. I wish I’d just been asked how I was, not physically but mentally. I wish there had been continuity of care so that I had someone I trusted care for me. It took me 15 years to get a correct diagnosis after the second birth and even then there was no specialist treatment support available.
Obsessive compulsive disorder
It’s thought to affect 2-4% of all new mothers, but – until recently – has received relatively little research attention. Some women develop obsessive compulsive disorder (OCD) for the first time either during pregnancy or shortly afterwards, while others find it makes a pre-exisitng condition worse. This is partly down to the fact that pregnancy is a time of increased stress, with most women becoming concerned about protecting their baby. It is a time of major physical change, which can cause difficulties.
It’s not just down to hormones, however, and some fathers also experience postnatal OCD because of their feeling of responsibility to protect their new baby.
May, Birmingham
I was diagnosed with OCD following the birth of my first child. I was experiencing intrusive thoughts about my son coming to harm (and that I might actually be the one to harm him). I have suffered from recurrent depressive episodes throughout my life.This and the severe anxiety I was experiencing led me to spend a lot of my maternity leave sitting at home, waiting for something terrible to happen.
My midwife noticed during my pregnancy that I was feeling anxious and referred me to a mental health clinic at the local women’s hospital. I continued to attend there after my pregnancy and, as things spiralled out of control, I was prescribed antidepressants and given a place in a group therapy session. I was admitted to hospital – in a dedicated mother and baby unit – for two months as things failed to improve.
The care I received was wonderful – I cannot fault it at all. I had never imagined that I might be suffering from OCD, and once I had my diagnosis and began cognitive behavioural therapy, the depressive episodes in the past began to make sense. I was treated with utter respect and kindness both as an outpatient and an inpatient, and have since been able to return to work. I feel very lucky that I had access to this service, and that it was so close to home. I know that this isn’t the case for most women.
•Some names have been changed.
• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here
FRIDAY, April 23 (HealthDay News) — Brandy Pitman suffers from a lifelong allergy to cats, enduring regular bouts of congestion, sneezing, and watery eyes. 
