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Jane

Age at interview: 38
Brief Outline: Jane felt unwell in 2009 when her children were 2 & 4, and was admitted to hospital but discharged shortly after. In 2010, age 36, she was readmitted and had 7 and later another 12 sessions of ECT. Now she is recovering, has had a 3rd child and is finding support from yoga and church, and has more confidence in herself as a mother.
Background: Jane is a mental health worker and lives with her husband and three children. She describes her ethnic background as White British.

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Jane first noticed that she was becoming unwell in July 2009. She became worried about making small decisions and about the development of her children. Her colleagues also noticed that she was ill as she had hidden under her desk at work. Jane says that as a mother she became paranoid about child abuse and worried that her actions were somehow causing accidents. Her GPs notes state that she was prescribed venlaflaxin (an antidepressant) and an antipsychotic (olanzapine). Jane had a friend who was a psychiatric nurse who helped get her a referral to an Early intervention Team.

After this time, Jane finds it difficult to remember exactly what happened. She went into hospital voluntarily as she didn’t want be ‘sectioned’. As she had done social work training, she was aware of the process. She can remember seeing the ECT suite when she first came in and that she had ECT during her second stay on the ward. Life on the ward wasn’t always nice, and Jane thinks that it is a shame adult psychiatric wards aren’t more like mother and baby psychiatric units. 

She was prescribed an antidepressant called lofepramine and an antipsychotic called aripiprazole. During her second admission to hospital, just after childbirth, she was given ECT due to concerns about her deteriorating relationship with her children. She had 7 ECT treatments, but then changed consultants, and her ECT was stopped for a time. Because of this, time elapsed between treatments and when she resumed having ECT she had to have 19 sessions of ECT overall. Jane remembers once having had ECT as an outpatient in the morning and then actually competing in a “Mum’s race” at her child’s school in the afternoon. 

Jane can remember she had ECT twice a week and described it as a ‘still point in a turning world’. Staff took great care of her throughout the process. Jane waited in the anteroom, went through to the main room, had a general anaesthetic and then came around in the recovery room. After treatment she would have a bit of a ‘woozy day’, which she said she quite liked. Jane started to get better and went to stay in a cabin in the woods with her family and can remember feeling better.

Jane isn’t sure that antidepressants alleviated her anxiety but made her gain weight; and she felt that antipsychotics slowed her down. Despite feeling that nobody knows exactly how ECT works, she felt that ECT helped her recover. She also feels that psychotherapy helped her in a constructive way. Since having ECT, Jane has thought a lot about her relationship to her parents, her upbringing, her approach to faith, the amount of physical affection she was given as a child and in turn how physically affectionate she is to her own children. Jane told her consultant that if she became ill after the birth of her child that she wanted ECT to be considered very quickly as she would rather have ECT than ‘mess around’ with medication. Jane thinks people don’t know enough about ECT and only hear about it from the film “One Flew Over the Cuckoo’s nest”. She also thinks health professionals should still maximise the opportunity for people to make a choice about their treatment, however ill they may seem. The information needs to be broken down into very small, manageable chunks.

Overall Jane struggles to remember periods of time when she was very depressed, for example in her teenage years. However, she found ECT only affected her short-term memory, temporarily and not her longer-term memory. 

Now she finds support from a yoga group and an open house organisation. She has more faith in her instincts as a mother now and trusts her own judgement more.
 

Later in life when Jane had severe mental health problems, she realised she had experienced abnormal levels of anxiety as a child.

Later in life when Jane had severe mental health problems, she realised she had experienced abnormal levels of anxiety as a child.

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So I realise that I was quite a fearful child. And I used to remember that I used to have dreams of like pillows suffocating me, and I thought this normal because I’d always had them, but actually that’s got quite a lot to do with sort of fear and depression. 

And I used to have something that I call the dreads and I think those came back when I was really ill, but you know, when you’re a child everything’s normal. So I didn’t know that was abnormal and not ideal. So therefore, it is not surprising that I then felt that I’d been damned by God, because that was really the image that I had of God and I didn’t trust him at all. So that was very much part of my anxiety, was that somehow, and it was actually a very protective factor. It stopped me killing myself, because I was utterly convinced if I killed myself I would go to hell, and I didn’t know how I would ever get better or not go to hell but I didn’t want to die, because I thought that would be what would happen to me, and my husband was aware of that particular bit of psychosis but he didn’t try to dispel that feeling at all, because obviously he could see that it was protective and it was what was keeping me alive so…
 

For Jane there was a period when she became increasingly anxious about small decisions. She thought she was well but all she could think of was the worst possible scenarios.

For Jane there was a period when she became increasingly anxious about small decisions. She thought she was well but all she could think of was the worst possible scenarios.

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Ok, well I think I’d say that the relevant time with me becoming ill was around July 2009. I’d become increasingly anxious about kind of any decisions that I had to make, like we were going camping with some friends up in [name of town] and we had to go by car, although we don’t own a car and I was really anxious about driving and about what to take and things that I’d normally be fine about, I was really fretting about. 

And I’d also become quite anxious about the children’s development and how I was with them and the way that I was bringing them up and things like that. So that was all, I was extremely anxious about that.

And then we went, the crucial time that sort of triggered the fact that I was ill happened just after I’d been sent home ill from work, so they’d noticed that something was up, when I was hiding under a desk and saying that I needed to go to sleep [small laugh]. So they said, “You’re not right. You need to go home.” So I was sort of signed off from that point.

Anyway we then went camping to a festival. I don’t know why we went. It was crazy to have gone, but we did [laughs]. I think I was just like, well I’m not ill, so we have to go with life as normal, because I was utterly convinced I wasn’t ill and there we were with some friends who, she was, just found out that she was pregnant and she had to tell us because she kept being sick, so, and they had two small boys. So I became convinced that my daughter was sexually abusing the boys. So I didn’t want to leave them alone with her and all that sort of thing. And then also was convinced that we were going to cause the Mum to have a miscarriage because we were like demanding so much of her, as she was doing all the cooking and things like that. 

So when I said that to [name of husband], when I got home, I said, “She will have a miscarriage and then you will know that I was right about everything.”

That was when, I think that could have been when he called the doctor initially or called a second time and certainly spoke to a friend of mine and said, “Look she’s really lost it completely.” 
 

Jane’s friend was a community psychiatric nurse who noticed that Jane was very unwell. She made sure Jane was seen by an “Early Intervention Team” and became her advocate.

Jane’s friend was a community psychiatric nurse who noticed that Jane was very unwell. She made sure Jane was seen by an “Early Intervention Team” and became her advocate.

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That was when, I think that could have been when he called the doctor initially or called a second time and certainly spoke to a friend of mine and said, “Look she’s really lost it completely.” This particular friend of mine who was a CPN herself, a community psychiatric nurse, contacted the doctor and said that she thought I should be referred to the early intervention psychosis team. The doctor was very loathe to do that, wasn’t really interested. I got referred to the… crisis team and they saw me and then discharged me back to the GP, despite the fact that I really was very ill. 

So thanks to the persistence of my friend I got referred to the early intervention psychosis team. And I was, like I was kind of a bit of exception because they work with people up to the age of 35 and I was actually 35, so they could work with me, but it was a little bit, they were clearly going to work with me beyond the age of 35, because they work with people for up to three years. But I think thanks to my friend’s advocacy and she wrote directly to them and stuff, they did take me on. 
 

Jane managed to compete in a school sports day event in the afternoon after having had ECT in the morning. But she says she felt dissociated from reality.

Jane managed to compete in a school sports day event in the afternoon after having had ECT in the morning. But she says she felt dissociated from reality.

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During the time that I was having it, a friend of mine would come down to the hospital and we’d go running together and I certainly on some days ran with her after having ECT [laughs] and I certainly went at the school, because I’m quite, what’s the word? Competitive. And they had the school sports then. They had the mums race and I did quite well a couple of years before, so I ran in the Mum’s race having had ECT and almost won but I kind of tried to lunge myself over the finishing line so that I could beat the person next to me and fell over unsurprisingly, as I’d had ECT earlier in the day [laughs]. So I didn’t win. But it was incredible what I could manage to do afterwards. Because I think I was so dissociated from what was going on that I just kind of did whatever I liked. 
 

While Jane couldn’t see how antidepressants had benefitted her, antipsychotics had “balanced [her] out”. However they did also make her put on weight, which she said isn’t good for your mental health.

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While Jane couldn’t see how antidepressants had benefitted her, antipsychotics had “balanced [her] out”. However they did also make her put on weight, which she said isn’t good for your mental health.

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Well, I don’t really know what it’s done. I think, personally I can’t see, I can’t very obviously see how the antidepressants benefited me. I mean I ended up not depressed but I think I was working through a lot of things and that was making me not be depressed. I can see that the antipsychotics slowed me down when I needed to be slowed down, because like I was in psychosis and I was just all over the place. But it slowed me down and made me put on weight and that’s not good for your mental health anyway. And then once I got put onto a different antipsychotic, I guess it kind of balanced me out. It would certainly be the antipsychotic that had obviously played a more important role than the antidepressants. 
 

Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it.Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it

Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it.Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it

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But I think it was probably, I needed to be on them but it’s been psychotherapy that’s helped me in a sort of more constructive way, and it would be useful if there were ways of being able to access that through the NHS, like through the, the doctors prescriptions for leisure, a model like that, or where you could sort of have a subsidised psychotherapy, because its only available to people that have got enough money or find a psychotherapist on a sliding scale that they can then afford. And, you know, it’s very inequitable really.
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