Coping – a skill seldom taught

On 30th Oct 2019 By doctorlunnersIn Anxiety, coping, Depression, Doctors, GP, mentalhealth, Mothers, NHSLeave a comment

Today was one of those days. Why do ‘one of those days’ happen? Does one unfortunate blunder happen and someone somewhere decides you’ve now signed up to a day of similar delights? I’m guessing we just notice these delights more. Either way today was one of those days. The highlight was my waving goodbye to 13 years no claims bonus and a wad of maternity pay by reversing into a lovely lady’s car. I then drove to a bodyworks place where the guy did his level best to not judge my lack of knowledge on basic repairs, insurance claims and the registration number or make of my car. One of those gem of conversations where you are fully aware you are doing feminism no favours.

This all got me thinking about how we cope when things are a bit tough and I guess is a follow on from my previous blog on mental health and life-is-tough syndrome. There are a lot of recurring coping strategies that I find come up both in my work and in life in general.

How to cope is never something we are taught, or generally talk about when we are blossoming teens. It’s like filling in a tax return. If we were all taught how to fill in a tax return and how to cope at school I think we’d all be a lot less stressed at the end of January. But no, we have to learn the recorder instead. (Disclosure: I loved playing the recorder).

Obviously how to cope can be a very personal thing, but here goes a stab at what I think are common coping tactics.

Be kind to yourself

So I drove away from the literal car crash earlier and stopped half way up the road to have a cry about how stupid I am. Yes, it wasn’t my finest moment, but it really wasn’t a disaster, accidents happen and could have been a lot worse and all that. Unless you’re a narcissist (google it, I guarantee you’ll know one), we are all generally very quick to find some kind of fault with what we do. Our automatic reactions are too often full of badness, and moreso when we are generally not feeling great and in huge need of some positive response. I think it’s really important to stop the downhill spiral of negative reaction – par example, today I got from I’m stupid to I’m an awful mother very quickly. We all make mistakes, and life is tough, we shouldn’t be so hard of ourselves. It’s cliché but remembering to be kind to yourself can save you a lot of heartache.

Accept that it’s OK to have bad days

When I follow up patients with Depression I try to explain recovery from a bout of low mood doesn’t mean every day will be better than the last. Recovery will have dips, but over time the general trajectory should be up and the dips should be less black hole-ish. I (hopefully) remember to tell people that it’s good to remember this for life after recovery. It is OK to have bad days. It’s OK to have times when you’re not 100% or you’re not ‘on it’ like yesterday. I think we have a tendency to over analyse crappy days and we catastrophise events that really don’t need the drama label. It all causes us unnecessary stress, and that is never helpful.

Accept that OK is good enough sometimes

I think it’s important to be OK with things just being OK. Now I’m exposed to the mothering world, I’ve seen another example of how people find it difficult to not be excelling all the time. I see mothers anguished by the thought of little Johnny not wearing the gillet that matches the particular outfit Aunt Suze got him, and distraught at the prospect of him missing one swimming lesson (meaning he will ofcourse fail to meet every developmental milestone for at least the next 10 years). It is OK if little Johnny doesn’t have matching socks on for nursery. It is OK if he has one meal that isn’t home cooked from your nurturing mother hands. Little Johnny will survive. And I daresay will probably turn out less weird than if we persist in stressing over the constant necessity of waitrose finest in little Johnny’s life.

Pick your battles

Sometimes OK is good enough. Alot of those times when you need to accept ‘good enough’ will be when you are very aware things could be great, but to get to great involves a lot of effort on your behalf. I’m thinking of those classic work situations. You know that improvement could be made, but is it the right battle for you to take on right now? Lots of things in our lives drain our energy without us really thinking about it. Just getting through a normal day for many of us involves a lot of mental baggage and thought processing. It’s right to take on the battles when you think they are important enough, and you have the battery reserve to do it. But fighting every battle will not end well for you.

Make time for the important and the simple things

Imagine you are 80. You are looking back over the lions share of your life. What will you smile at remembering? What will matter to you? What will you be proud of have done? I’m skating close to the cliché again, but I’m reckoning all these things will have something to do with moments with family, close friends and maybe significant career achievements. This evening my daughter wanted to read The Gruffalo. On the 3^rd time of reading, I was DONE with that mouse and his persistent wood strolling. But she wanted it one more time. So we cuddled up and read it a 4^th time. And that made my car crash day good again. Make time for the simple things in life. It’s what makes a life a life and not a daily trudge to the time you can watch Love Island again (Disclosure: I have definitely had days where my highlight has been watching Love Island. Shameless).

Be present

Mindfulness. One of those things you’ll have heard of, maybe given a go, decided you felt no better after it so went back to worrying about Little Johnny’s gillet. I went through a phase of trying to do some mindfulness practice regularly. But then busy-ness happens and things fall by the wayside. Like flossing. Flossing and mindfulness, both definitely on the wayside list when things are busy.

But I try to take one thing from mindfulness – I try to be present when I’m doing important things. Like being with my 4 month old. We are sharing a moment where he’s finding the squeaky giraffe-cow type rattle hilarious. I try to enjoy being in that moment rather than let my mind wander to the pile of poop stained leggings from my potty training toddler, or to the grand total of fridge contents standing at one onion and a questionable stick of celery. Yes, both of these things have happened in the last week. I am too aware that being present (including literally) for all the moments you’d like to be isn’t reality, but even when we are super busy doing this once a day should still be achieveable. Being present means you can actually experience (and therefore live) moments, rather than floating from one tesco shop to the next.

Make time to do the things you enjoy

One of the symptoms of Depression is losing interest in things you used to love. I always find this symptom very sad. Feeling like the joy has been taken from you is pretty terrible. One thing we advise patients suffering with this to do is try to keep doing the things they used to love. Because one day it’ll start coming good again. And, although Depression and struggling a bit are very, very different, I do think that too many of us let the things we enjoy go by the wayside. Another thing to add to that wayside list. What we enjoy tends to come bottom of the priority list, because of the very nature of it – it’s what we enjoy, so we see it as an indulgence that we can’t possibly flirt with now we are adults and have responsibilities like not crashing a car. But making time for things you enjoy is hugely important. Again going back to the when-you’re-80 – you’re probably not going to remember that Saturday you dusted the house particularly well. But you may remember making time to read one of the classics. Making time for yourself does not make you selfish. It makes you more robust. It makes you less likely to hit rock bottom.

Be honest

This is a real bugbear for me in this age of social media and my-life-is-so-tremendous posts. Don’t be that person. That person is rarely genuinely happy with themselves, and for some reason gets a kick out of persistent my-life-is-better-than-yours statuses. All these do is make people who feel vulnerable feel worse, and make you (as in the perpetrator of these status irritants) strive to achieve the next ‘like’, as if your very existence needs to be validated by some chuff you’ve befriended online but you see on the 5^th of never. I’m not saying don’t ever share goodness, but constant updates is not good for anyone involved. No-one is ever constantly that happy. Same applies for when you catch up with friends. I know I have a tendency to want to portray the beacon of coping motherhood, but it would be more cathartic for me if I was more open about honest. Goes back to the blog on mental health and talking more. Being honest when we talk. That’s key.

Don’t isolate yourself

The honesty with friends thing leads quite nicely into this nugget. Don’t isolate yourself. Again, withdrawing from social times is a common symptoms of Depression. And again I think we can all take something from this. How many times have you had some get together planned but decided 2 hours before that it’s dark and raining and you cannot to bothered to leave the well-bedded corner of your sofa to catch up with Gazza? We’ve all done it. But how many times have you forced yourself out and rolled in from that night out proud of yourself for making the giant leap out of the comfy corner? Many, many times. I’m not suggesting you say yes to every social event (also in my opinion not a healthy thing to do), but it’s important to stay connected, see your friends and family. We rarely feel worse for being round true friends. But we can definitely feel better for it.

Radiators versus Drains

I can’t remember where I first heard it but I wish everyone knew this analogy. Some people are radiators and others are drains. Radiators are those people who shine with positivity. Drains are those people who seem to leave you feeling like all the colour of the world has been sucked out. We spend far too long worrying about supporting the drains. We worry that we have to remain faithful to that person no matter what the cost to ourselves or our mental health. Being around a drain does nothing for any of us. It’s important to choose to spend time with the people who are healthy for us and our mental health. Drains can pull you down their plug hole of coping despair.

Get outdoors

I want to make this my last point. Just recently prescribing the outdoors has become a thing in Scotland. Whilst I think it’s pretty ridiculous we’ve got to the point where ‘the outdoors’ needs to be on a prescription for some people to get outside, it really does show how disconnected we are with the world around us – and how appreciating nature can help our mental health, and help us cope better. Being outside offers so much, yet so many of us will consistently choose to spend our time shuffled away indoors. Next time you feel like you can’t cope try going for a 10 minute walk. I bet there will be a part of you that feels better for it.

Final thoughts

Today I tried to tick off a lot of these coping gems, and now I sit here and realise I don’t feel so bad. It’s still a bad day, but I’m OK with it being a bad day, and that makes it better.

So go easy on yourself, be honest about how you’re doing, see your radiator friends and family and make time for yourself and the simple things in life. You’ll cope with losing your no claims better and your 80 year old self will thank you for it.

Formula and breastfeeding – the minefield

On 14th Oct 201920th Oct 2019 By doctorlunnersIn Breastfeeding, Doctors, Formula feeding, GP, Healthcare, Mothers1 Comment

6-8 weeks after a baby is born, mum and baby will have a check with their GP. I’m a GP and I’ve done many of these now. One of the questions we ask is how the baby is fed. I must admit I now have that sinking feeling asking the question, because alot of mothers who use formula milk will look at me with a sense of shame as they admit their feeding method. Now I am a mother and I sit of the other side of the desk, and I’m ashamed to admit I feel a sense of guilt having given my eldest some formula milk.

How have we got to a state where a mother feels they need to hide the way they give milk to their child? So we give formula – and we are judged for ‘failing’ our child. We breastfeed our child – and we get judged for getting a boob out in public. We express breastmilk and give in a bottle – and I’ve known people to be judged for giving a bottle to a baby and not offering the cuddles that a breast brings. We can’t win.

Education and informed choice

Some women don’t want to breastfeed. That is obviously completely ok – although I would argue it’s ok if that woman has had a chance to weigh up all the information on feeding for herself. This brings me to my first main point – lack of education. Education to women, mothers, men, children, society. Did anyone ever have a lesson on feeding a baby at school? When do we ever learn about it? Most of us will just hear about our mum’s journey, hear about some horror stories and have an NCT session on feeding. There is a raft of literature on both breast and formula feeding. Yes, you can read a summary from some – hopefully legit – website, but it’s a really complex issue that I honestly think needs much more face to face education. For everyone.

Breastfeeding support

Then there are many women who want to breastfeed but for a large number of reasons can’t. I personally very much feel for these women now I have personal experience of how shockingly hard breastfeeding can be. I have survived stretches of 7 night 12 hour shifts working in some of the busiest A&Es, but trying to breastfeed stands out as the hardest thing I’ve ever done. It completely broke me. My baby, Nina, would nibble off so much skin and tissue she significantly changed the shape of my nipple in the early days – yes, so much of the ouch. I recall one evening curled up in the corner of the lounge, crying with a whole array of emotions from guilt through to failure as I desperately tried to google someone who could help me breastfeed my child. And I’m a GP! I should know where to get the help! But I didn’t. How embarrassing, yes, but if I didn’t know, what about those who don’t happen to work in healthcare? I had the confidence to drive back to hospital, to an environment I know well, and ask for the specialist breastcare help from the ward, but would all women? In the end I managed to breastfeed my firstborn with expressed breastmilk for the large majority of her first 6 weeks, until, with the exceptional help of a health visitor, I was able to overcome the enormous number of issues to be able to directly breastfeed.

This brings me to my second main point – support. Women need support from day 1 of having their baby. All healthcare professionals try their best. My midwives have by and large been super, but they weren’t breastfeeding specialists. If someone had come to see me as a GP prior to my personal experience, my knowledge and advice I would have given on the topic would have been pretty limited. We need to be better as healthcare professionals at getting mothers the help from the word GO with breastfeeding. Day 7 is too late to offer help. I cannot stress this enough. Figures show most people have – quite understandably – thrown in the towel by then. We need professional help offered on Day 1.

Need for the right kind of feeding chats

There has now been some move towards not being up-in-your-face about breastfeeding. Healthcare professionals are not now allowed to be seen to over-pressure mothers to breastfeed. I totally get it. Infact, I definitely get this having now been personally exposed to the breastfeeding world. For some reason you can get the mothers that I term the breastfeeding police – those mothers who will judge you as their hobby for your despicable choice of giving your child something other than a boob. Interestingly I’ve seen the same mothers been totally fine having their kid exposed to or engage in other arguably unhealthy activity. Which links in with these annoying pesks not actually being interested in the health benefits breastfeeding may confer – they are interested in rubbing it in your face. I mean, how old are we?!

But women still need the information. We should be given this and processing it much, much earlier (like years earlier in my opinion) than when you’re holding your newborn. And then on the flipside healthcare professionals don’t like harping on about the amazingness of formula. So what you end up getting is something similar to what I got an a session put on for expectant mums nearby – none of the healthcare professionals talked about any feeding. One of them did try in fairness, but they were quickly shut down by a colleague. How ridiculous.

Feeding – a balanced view?

I was originally spurred on to write this blog by an article I saw in in the BMJ (British Medical Journal, kind of a big thing in the doctor world). Earlier this year the BMJ pulled all advertising of formula milk citing the negative impact it’s had on the breastfeeding world. They took alot of backlash for doing this as you can probably imagine. This month BMJ published an article on the impact of formula on the environment. I get it, we are (quite rightly) now in the day and age that any and all manufacturers of anything that has an unacceptable carbon footprint need calling out. But publish an article without giving a balanced view? Breastfeeding has an environmental impact! If you express breastmilk, you will usually do so now with a machine, and have to express into a bottle and store in a freezer with plastic bags. Even if you admirably exclusively breastfeed with no expressing, you eat TONS more food – that has an environmental impact. The article in my opinion was published by the BMJ in an attempt to justify their stance taken against formula milk. Even a renowned medical journal fails to give us all the information we need to be able to make our own minds up about milk for our babies.

How we choose to feed our baby has somehow become a hugely contentious minefield of an issue. And it absolutely should not and need not be. So much judging, so much negativity, so much misunderstanding, lack of kindness, lack of support. And a woman is exposed to all of this just as she’s pushed out a watermelon or had the pleasure of being sliced open on a chopping board.

Judging needs to stop.

Everyone needs better education. Women need better support – however they choose to feed their baby.

doctor lunners in a nutshell

On 13th Oct 201916th Oct 2019 By doctorlunnersIn Doctors, GP, Healthcare, Mothers, zerotohero1 Comment

I’m Hannah, hi! Thanks so much for reading this, or anything quite frankly because life is so busy it’s hard to find time to go for a wee before it’s getting pretty critical.

So yes, thanks. I’m a GP, mum, and lover of outdoors and sun and food. Man I love food. Very easy to say you’re going to watch the waistline but actually when 4pm comes round all you want is 1kg of cadbury, and nothing else will do. Nothing. And so the daily cycle of food shame starts.

I started writing this blog whilst on maternity leave with my second kiddy, James. He’s got classic second child syndrome and seems pretty happy with being left on a playmat for extended periods of time whilst I write about wee and cadburys and suchlike.

I probably started writing because I was talking at my husband, Chris, too much for his liking and so one evening he suggested I blog about all my excellent thoughts. And so my blog was born, and he now gets evenings of a free pass at playing that playstation game, you know the one where all they ever seem to do is ride a horse from A to B. Red Dead Redemption? What an appealing title. Anyway, win, win. Happy marriage.

So here in my blog you’ll be find my musings and amusements. I think it’s healthy for all of us to notice more in life, and think about stuff in whatever way we think is helpful for us. I’ll probably focus more on things I know about, like healthcare, being a doctor, a parent, a mother, the outdoors. But who knows to be honest, let’s not limit ourselves to a few categories. Aiming to get one more follower to add to my husband by october 2020. Dream big.

It would be nice if I could quote Oscar Wilde off the cuff, but english literature was never a strong point, so here’s one from Greenday –

So why are you alone wasting your time? You could be with me wasting your time! May I waste your time too? – Sassafras Roots, Greenday, reliably informed c.1994. Now I feel old. Oh, and look it’s nearly 4pm, cue the cadburys.

Doctor Lunners

Category: Mothers