Bereavement In Obstetrics – Could Abortion Be Seen As A Bereavement?

 Bereavement In Obstetrics

Bereavement in obstetrics is a difficult topic to cover. Due to recent news about the change to abortion laws in Texas, I think we should think about bereavement in obstetrics in relation to abortion. Although abortion is a choice, it can still come with guilt and grief that need to be processed.

What Is A Miscarriage? 

A bereavement in obstetrics can be anything from a miscarriage to stillbirth. Miscarriages are most likely to happen in the first 3 months of pregnancy and usually happen through no fault of the pregnant person. However, they bring a lot of grief and guilt to the mother, who may feel like it is their fault. Miscarriages can happen later in pregnancy. Any loss up until 24 weeks of pregnancy is considered a miscarriage, and anything after that is considered a stillbirth. 

Complications With Miscarriage

Miscarriage can be extremely challenging physically, as well as mentally. Miscarriages in the first trimester tend to have fewer complications, though it is possible that complications may arise. Sometimes, miscarriages are incomplete. This means that some tissue does not come away and is left in the womb. When this happens, bleeding and cramping can last longer than the expected amount of time. Although incomplete miscarriages can resolve on their own, occasionally further treatment is required to clear the womb. There is also a higher risk of infection. It is possible to have these kinds of complications with abortion as well.

Abortion Laws

Recently, in Texas, abortion laws became very strict. Abortions after 6 weeks of pregnancy are now banned. There is up to a $10,000 reward for people who report illegal abortions. Having an abortion is not an easy choice to make and comes with a lot of guilt. A person may know that they want a child at some point in their life, but at the point in time that they become pregnant, they may be living in difficult circumstances. This can make the decision to have an abortion devastating. For some, contraception fails and they choose abortion because the pregnancy was something that they never wanted to happen. Most people who have abortions feel guilt about their decision, even if it was the right decision for them. Sadly, this law may put a lot of vulnerable people in danger. If someone is desperate for an abortion, they will find a way – and often it will be a higher risk than visiting an abortion clinic.

Bereavement In Obstetrics And Emotional Support

Some might ask if abortion counts as bereavement in obstetrics. I think it’s extremely important that anybody who has experienced a bereavement in obstetrics, including abortion, receive emotional support. I also think it’s important that the benefits of emotional support and possible counseling or therapy be explained to them, as some people might feel that they’re fine as they are. I also think it’s important that there is emotional support provided for both parents. Education on what causes miscarriages, that it isn’t always something in your control, and complications of miscarriages could also really help others in the future. I think that regardless of the fact that abortion is a choice, it still can and should be seen as  bereavement in obstetrics because there is still a huge amount of emotional and physical change that follows. 

Obsessive Compulsive Disorder – Misconceptions About OCD

 What Do You Think OCD Is?

Most people have heard the term ‘OCD’, but the real question is, has it been used in the right context? Many associate ‘OCD’ with traits like being neat, clean, and tidy. While these can come as a part of OCD, they’re not what defines it. OCD stands for obsessive-compulsive disorder – this is shocking for some who use the term on a regular basis, as they might not realize it is an actual anxiety disorder. 

What Is Obsessive-Compulsive Disorder Really?

Obsessive compulsive disorder is an anxiety disorder characterized by distressing intrusive thoughts and the compulsions or rituals that someone may perform to reduce their anxiety around these thoughts. Intrusive thoughts can be relating to the cleanliness or tidiness of a room, but there are many kinds of intrusive thoughts that can come with obsessive-compulsive disorder, not just these. Sometimes obsessive-compulsive disorder affects people in a way that has nothing to do with this. For example, intrusive thoughts can be worrying you might accidentally harm or kill somebody, unpleasant sexual thoughts, anything that you might not necessarily WANT to think, but that just comes into your head. Intrusive thoughts are something that everyone experiences, but not everyone can just dismiss them. To some, they feel extreme guilt or worry around the intrusive thought and they have to check things, count to a certain number, wash their hands a certain number of times in order to rid themselves of the thought. This is only temporary and often the dependence on the compulsions becomes more severe over time.

What Are Compulsions?

Compulsions can be all sorts of things. One that we would be familiar with from TV shows and films would be obsessive cleaning, and checking things are in place. Other compulsions include ‘neutralizing bad thoughts’ by thinking good things to counteract the bad thought, ruminating, hand-washing and many more. One that a lot of people wouldn’t realize is a compulsion is reassurance seeking. This can come through in different ways – checking what people think of something you have said or done, or disguised in a normal conversation which is often guided by the person who needs the reassurance until they find the reassurance they need. Some may say the same things to lots of different people in the form of ‘oversharing’ to get the reassurance they need over and over again. So obsessive-compulsive disorder is not necessarily what the media portrays it as. 

Mental Health Education – What Are We Contributing?

 About Us

At Mental Health TV, we provide mental health education to the general public, as well as medical students, or professionals looking for CPD. We believe mental health education is extremely important for those dealing with mental health problems, but also a key to becoming more aware of when there really is a problem. Mental Health TV was founded by Dr Andrew Macaulay, MD, MSc., MRCPsych. He has been a practising Psychiatrist for over 30 years and is passionate about mental health education.

Our Programmes

We make lots of different programmes, ranging from Insights on Depression, to The Medicated Misadventures of Sarah Tonin. The Medicated Misadventures of Sarah Tonin is an animated short series that we are working on to show how serotonin, adrenaline, noradrenaline and dopamine work together to affect our moods. The aim of this programme is to provide mental health education to a broad audience and simply explain the way these neurotransmitters can work. This will help with awareness on how SSRI anti-depressants work as well.

The Medicated Misadventures Of Sarah Tonin

What we are aiming to achieve with this programme is mental health education that is eye-catching and interesting. Many sources of mental health education, while good, are in the familiar format of talking heads. We decided to change serotonin into a character called Sarah and demonstrate simply what her tasks were when it came to regulating mood. The catecholamines (noradrenaline, adrenaline, and dopamine), we turned into cats named Nora, Addy and Dopey. They all live in the brain of a 20-something party animal. Nora is fitness obsessed and keeps the body ready to move, Addy is always on the watch for things that make Mac anxious, and Dopey encourages Mac to do the things that he enjoys – though this isn’t always helpful. Sarah sends messages to the nerve cells every day, but if she slacks, Mac’s mood can dip as things go out of balance. The second episode will demonstrate the function of SSRI anti-depressants. This is important, as there are a lot of misconceptions about anti-depressants and sometimes this prevents people from seeking treatment for their mental health problems.

Matters Of The Mind

Matters of the Mind is a YouTube series that we regularly update. It’s bite-size mental health education, covering a variety of topics, with our most recent one being caffeine and mental health. We’ve also covered schizophrenia, bipolar disorder, obsessive compulsive disorder, trichotillomania and more. These are short and snappy, in the hope they can appeal to a broader audience. 

Stress And Depression In The Workplace – How Can It Be Tackled?

What Are Symptoms Of Stress And Depression?

Stress is something that all of us experience. It is normal to go through stressful times in our lives. However, too much stress can affect mental and physical health in a negative way. Stress can cause someone to experience mood swings, agitation, the feeling of being overwhelmed, difficulty relaxing, low self-esteem and feelings of worthlessness. These are just the emotional symptoms of stress. Physical symptoms include fatigue, tension headaches, IBS symptoms, muscle tension, palpitations, difficulty sleeping, lack of libido and more. It can make it hard for somebody to concentrate, and they might be less organised than usual. Having listed just some of the symptoms of stress, it’s easy to see why it is in an employer’s best interests to tackle stress in the workplace. Symptoms of chronic stress and depression do overlap. Depression affects motivation, sleep, appetite, anxiety levels, and more. Too much stress can lead to depression.

How Can We Reduce Stress And Depression In The Workplace?

It’s important for employers to be approachable about these issues, so that they can try and make a difference. This isn’t always the case, but many large companies do have policies in place to help employees who are stressed or struggling with mental health problems. Many will be able to try and negotiate more comfortable hours or ask what can be done to reduce stress during every day tasks. However, sometimes these changes are not made, or if they are, they aren’t enough. In this case, employees should be allowed the time that they need to visit their doctor and see if there could be further treatment for their stress. Sometimes the stressors come from outside the workplace and make it difficult for employees to work, with examples being divorce or bereavement. In these times, employees should be given the time they need to recover or navigate their stressful situation. When they wish to return to work, they should have a return to work interview to discuss how to make coming back to work as smooth for them as possible. The focus should always be on the employee, and not the effect that it has on the workplace here. Employees struggling with stress, depression, or both, may also feel a lot of guilt about a lack of productivity in the workplace. It’s important that they are made to feel supported and not worse.

 

Bereavement in Obstetrics - Reaching Out To Anyone Struggling

Miscarriage

Miscarriages are very common, and most women will experience at least one miscarriage in their lifetime. There are all sorts of reasons that miscarriages happen, and some are still unknown to us. However, knowing it is a common occurrence is not a comfort to those who experience it. A is still a bereavement, and people going through this should be offered the same kind of support that other grieving people are offered.

 Empathy

It's important to try and show empathy to anybody experiencing loss. All too often, a person experiencing a miscarriage will be expected to 'just get on with it'. This is unhelpful and does not help the person to process their grief. Sometimes, this lack of empathy is even seen coming from doctors, which is the worst place for it. In our programme, 'Bereavement in Obstetrics', we explore the best way for medical professionals to approach treatment for a person who is having a miscarriage. 

'Lockdown Babies' And Social Media

The pandemic over the last year has meant that social media has been a very popular form of communication between families and friends. It also meant that many people were out of work and fending off boredom at home. People were posting more about their personal lives to their Facebook, Twitter, Instagram and other websites. For those who at the time were struggling with infertility or miscarriage, this will have been difficult. Most people do post about their family lives on social media, and there is nothing wrong with this. However, to someone struggling with infertility, their feeds might have been full of pregnancy scans and announcements. These are easier to avoid when you are working full-time and have other things to do, but during the pandemic and various lockdowns, it would have been harder to avoid for a lot of people. Somebody going through a miscarriage would be seeing the journey that they themselves were expecting to make. It can be hard for someone to feel happy for others who announce they're expecting when they are struggling or unable to live that dream themselves. This can have a big impact on their mental health.

 

Feelings of Failure

Feelings of failure are a huge part of low self-esteem, anxiety and depression. Many people struggling with infertility and recurring miscarriages have a feeling of failure associated with this. Most people would agree that you have not 'failed' if you have a miscarriage or struggle to conceive, but for the person going through it, especially if it is their dream to have children, it is harder to believe. Be mindful of this. 

Mental Health Education - How Can It Be Improved?

 Why do we need more mental health education?

The world has become a lot more understanding of mental health problems, thanks to many efforts to raise awareness and also research that has been gathered over the years. However, there is still more work to do. The stigma that comes with mental health problems still survives. Misconceptions about mental health problems thrive in various forms of media, with people misusing terms regularly. Some examples are when people use the term 'OCD' to mean that they like things to be clean, and when people describe the weather as 'Bipolar'. Many people think that schizophrenia means to have multiple personalities, when in fact this is known as Dissociative Identity Disorder. Some symptoms of schizophrenia are hallucinations, delusions, and paranoia. However, schizophrenia affects everyone who has it differently. Many also think schizophrenia makes people violent, which more often than not, isn't actually the case.

 

What do we need to know more about?

We've all seen plenty of information on the basics of anxiety and depression. I think these are the easiest topics to cover, because the symptoms of both are things that many people can relate to, so they're easier to understand. Having said this, there is still a stigma around both anxiety and depression, so more content in that direction doesn't hurt. It would be good, however, to cover topics that are often portrayed incorrectly, such as Obsessive Compulsive Disorder, Bipolar Disorder, Schizophrenia, Eating Disorders, and Emotionally Unstable Personality Disorder. Other topics that could be explored are ADHD, Autism, and other conditions that may have an effect on anxiety levels and self-esteem.

What formats can we take advantage of to educate?

The internet is a huge resource for education, and along with this, social media sites and apps. Full documentaries can be uploaded to YouTube and Vimeo, while more 'out of the box' creative, bite-sized pieces of information can be spread through apps like TikTok, and Instagram Reels. While full length and short documentaries are very informative for those going out of their way to seek the information, the TikTok and Instagram Reels format suits shorter attention spans.

 

What is most helpful?

There really is no 'right' answer to this question. The best thing that anybody can do to raise awareness about mental health problems is to try and understand others' experiences, and if they're comfortable, share their own. Professionals in the psychiatric field can help by speaking out about the things that they have learned. Everybody can challenge misconceptions when they see them. 

 

Stress And Depression In The Workplace - Working From Home

Stress and Depression in the Workplace

Stress and depression in the workplace is a common issue, especially during the pandemic. The employees that can have moved to work from home, while others may feel anxious going out to work, but not have many choices in the matter. Although lockdown restrictions in the UK are being lifted gradually, many people continue to work from home.

 Working From Home

COVID-19 has forced many to work in a completely different way. Having an office job may mean you can work from home, but there is no ‘water-cooler conversation, and routine falls apart over time when you no longer need to commute. Suddenly, you’re working in your pyjamas, sitting on your sofa with a coffee and a blanket. While this is cosy, over time it can ruin your idea of what relaxation is. Working on the sofa, a place where you might usually relax, suddenly makes it seem like a less relaxing place to be. It is the same if you have a desktop computer to work from in your bedroom.

 Correct Work Set-Up

Employers may send their employees to work from home with computers, desks, and desk chairs from the office. This is great for making sure that your employees have a decent work set-up so that they can prevent RSI. However, not everybody has enough space to set up a desk and desktop computer. This can lead to not-so-good set-ups and an increase in the risk of repetitive strain injury and back problems. Courses can be sent out so that everybody knows how they are supposed to sit, but really there is no way to make sure that your employees have the correct setup all of the time.

 Repetitive Strain Injury

Back, shoulder and other repetitive strain pain can cause stress in the workplace. Not being able to relax in spare time can also cause stress. When the workplace is suddenly your home, you might struggle to know when to stop work. It might be hard to feel motivated to start work as well. Being overly productive or counter productive can have an effect on emotional well-being.

 Empathy

It’s important for employers to regularly check on their employees during this time and show kindness and understanding to those who are struggling with any changes that may have been made. It might be good to set up regular group meetings (online) in order to keep the team spirit alive. Encourage them to speak up if they’re struggling, and see what changes you could make to improve their situation.