Mum's The Word! The Parenting Podcast - Dr Jorge Palacios on Perinatal Mental Health

Episode Date: July 3, 2022

Ashley is joined by Senior Digital Health Scientist at Silvercloud and perinatal mental health expert Dr Jorge Palacios. In the podcast they offer advice to listener Nadine who has been struggling since the birth of her second child, and they both share their experiences of anxiety and depression as new parents.If you want to ask Ashley a question, get in touch at [e-mail]---A Create Podcast Hosted on Acast. See acast.com/privacy for more information.

I started my day today with an Instagram post about how great motherhood is I was like I've been through poor mental health in that first year I really struggled as you know from listening to my podcast and I was like guys it gets better there is light at the end of the tunnel there is a rainbow and then do you know what happened my son decided to poo in his tent on his lovely little crocheted rug I feel like they really come to test you the worst thing about this poo was that he then started trying to stand in it and I didn't have the wipes near me I honestly didn't know what to do. Tommy was upstairs. So listen to this. This was the emergency WhatsApp message. And you can hear at the end where I started to panic when he was standing in it. Babe, I'm going to need you quickly. I was just shat in the tent. No, no. The panicked cutoff. But I thought it would be a really good chance this week to talk about mental health with an expert, actually a guest who specializes in perinatal

mental health. As you guys will know, I suffered really dark, obtrusive thoughts from about six months onwards. And I know so many of you feel the same, whether it's through pregnancy or at any moment throughout that first year of motherhood. So I am here to say it does get better as a parent. I promise you it does. But for anyone who is either experiencing these dark thoughts or perhaps you know someone who is or you're trying to support your partner, I just thought it would be a really brilliant episode to do, particularly because this week I've been really focused and

determined on dealing with my own sort of long-lasting mental and physical health issues from childbirth. I saw a gynaecologist this week. I have finally booked in a debrief with the hospital to get some clarity on what went wrong. But I'm going to talk about all of that in more detail in a podcast, probably once I've done my debrief. I'll tell you what inspired today's podcast, actually. I got a lovely email from a girl called Nadine. Can I say a girl, a lady, a woman?

It always makes me feel really old when people say, oh, watch the lady. I'm like, I'm a girl. But anyway, Nadine wrote, Hi, Ashley, I hope you're well. I'm loving the podcast. I listen when I'm in the car dropping my girls off at daycare and school. I was wondering if you might be talking with someone soon

who might be able to help with this question. Ever since giving birth to my second, I have found that my anxiety has gone through the roof. I feel like I just can't switch off and my sleep's taken a turn for the worse. Do you have any suggestions on how I can become myself again? I realise is a huge question sending all my love to you now nad so this is what i'm going to do i have a guest like i mentioned specializing in perinatal mental health so perinatal is the time period from the moment you become pregnant and up to a year after giving birth i'm going to try so hard to pronounce his name correctly.

I know how annoying it is when people pronounce his name wrong, particularly after having lived in France and being called Ashley for about a year. He is called Dr. Jorge. That's terrible. No, it wasn't bad. Okay, Dr. Jorge Palacios. He is a senior digital scientist and researcher at Silver Cloud Health. So they are actually the NHS's prime provider of digital therapy.

So they use something called iCBT, which is an internet-based cognitive behavioral therapy to basically deliver a range of programs across the mental health spectrum. They have a specific space of perinatal well-being program to help individuals better manage their mental health during this time. And I'm really excited to talk to him today because he is a thought leader in the field of digital mental health and committed to providing accessible evidence-based mental health solutions to everyone who needs it. And he is a father,

and he has a special interest in maternal mental health. So how did I do with your name, by the way? Welcome, Jorge. Jorge? Yeah, no, very good. I'm so sorry. Very exotic. No, no, no. I love it. I love it. And thanks so much for the intro. It's my pleasure to be on your podcast. I've become a fan. I've started listening to it ever since I knew I was going to be on. My partner and I listened to it, and I love how honest you are about it. I think it's very welcome. And I also think it's a reflection on how society is being more and more honest about things and mental health, right? And especially looking at the other view of paternity and maternity, that it's not just this beautiful, wonderful thing that we grew up to see in the movies.

And even when bad things happen, I remember seeing it on film. I was always in a funny way. It's like, oh, ha ha ha. But then let's get back to how beautiful it is. We both appreciate it. I do have a son. He's one year old. His favorite podcast is not yours.

However, he has one favorite podcast son. He's one year old. His favorite podcast is not yours, however. He has one favorite podcast, and that's the one I host. It's mine. I'm sorry. That's loud. I host a little podcast as well. But you know why that is? It's because he doesn't have a choice in the matter.

We put it on to get him to sleep. He takes really good naps when we play my podcast. So actually, that's a question for you. I don't know if you know that you've ever used that. Maybe, you know, your voice is soothing to your son, helps him sleep, but you never know. That's interesting, isn't it? I feel like when he hears me, so we do all his naps in the pram,

and I feel like when he hears me, he wakes up straight away. But I wonder if it's something about, I suppose he was probably so used to hearing your voice in the womb. Maybe there's, and I guess a man's voice is much more kind of gravelly and husky. I think my voice is probably a bit irritating. Well, yeah, I don't know. I don't know. I mean, yeah, I mean, I did.

It is true that when he was in his mom's tummy, I was, I was always like singing to him or like, you know, speak to him like that. You know, can't wait to meet you. And I was always in this to him or like, you know, speak to him like that, you know, can't wait to meet you. And I was always in this kind of soothing way. So, yeah, maybe that was cheating a little bit. So, you know, he's used to that. It might be the dulcet tones of your Spanish accent as well. Yeah, I feel like rather than my quite whiny voice. But let's begin with Nadine's message.

So she's saying, obviously, since giving birth to her second, she has found her anxiety has gone through the roof and she can't switch off, her sleep is bad. Do you have any advice for her and how she can feel more herself again? I imagine we're going to cover lots of these talking points, but it'd be great to start with an answer for her. Yeah, I mean, yeah, sure. If you want to start there. I mean, the answer is, Uh-huh. Yeah, I mean, yeah, sure. If you want to start there.

I mean, the answer is there is a way out, of course. And, you know, she's already taken that first step by asking about it, recognizing it, and just sending you that message, right? Because one of the things that I would always recommend is just talking about how you've been feeling. It's just talking about how you've been feeling. Obviously, if it's a trusted person, great. But you can establish a support network or connect with understanding friends, family, and professionals if it comes to that. And that's absolutely fine, of course. So yeah, look, there's a lot of recommendations. I think some of them, Ashley, you've mentioned a lot already, because one of the things around

managing perinatal anxiety aren't that much different when you manage anxiety in general, because, you know, it's a lot of the same kind of symptoms, right? So just in general, recommendations are self-care, making that a priority in your life, and, you know, finding time for yourself and all of that, right? Now, if you do consider therapy or counseling, which is important, you important, reach out, talk to someone. But from that perspective, from the therapeutic perspective, one thing that I'd like to point to is that just as there is a downward spiral into anxiety, and Nadine talks about her second child being the point where she found it a lot worse. So, you know, there's all of these precipitating factors that lead to these negative thoughts and feelings that then influence our behavior and makes you withdraw into this cycle of anxiety, right? It becomes a vicious cycle because the more you think about it, the more your behavior changes and the more you

withdraw. So just as there is that downward spiral, there can be an upward spiral out of it, right? So you have to be aware that these thoughts and feelings influence your behavior in the first place. That's kind of the psychoeducation piece that we like to talk about. And then you need to challenge those thoughts and your feelings by practicing techniques that help you reframe them. That leads to changes in your behavior. And then that reduces eventually the severity of anxiety. So that's kind of the general idea. But I do obviously want to get into the specifics. And as the conversation goes on, you know, there'll be plenty more. more yeah so maybe we just start chatting and then hopefully by the end we've got solid advice for not just Nadine but also everyone else who is feeling like this so out of interest what

led you to an interest in mental health and particularly maternal mental health especially you said that you've you've got son yourself but he's one and I presume that you were in this field before he was even around so where did your interest in this kind of area begin? Well partly it's genetic right so my grandfather my father uncle brother cousins they're all either doctors or psychologists so you know you know, in a way, it was unavoidable, although I tried my best to avoid it. I studied maths and engineering for a while because I really liked data and statistics. And I was like, no, no, no, I'm not going to do this. And then about three years in, I realized that this wasn't enough for me. I always wanted

more of that connection. And I, you know, allowed myself to not be against the idea of doing the same as my dad and my grandfather, etc. So I said, yeah, let's give medicine a try. And so I started studying and I never looked back. I really enjoyed it. Obviously, the scientific part of it, but what I always liked most was the connection that I had with the patients, right? My strongest memories of being a practicing physician are always of this deep connection to patients who then they went out of their way to say thank you, or to say that by talking to you, even like their day had improved. And so I always had that link between the physical and mental health, like really strongly. And then when I started thinking

about a specialty, it was always around, well, something involving mental health and behavioral health, right? But then I kind of veered off and I started doing research. I came to London, I did a master's PhD, and then I started at Silver Cloud. And that's when research into digital mental health became kind of my go-to area, right? And as for the perinatal aspect of it, again, it's just, you know, out of interest. You kind of, you know, it wasn't like a major life event that I had that made me say, okay, this is a particular area. It just was something that I was really interested in. I'd spoken to enough people, spoken to family members and my mom and hearing stories from

her and about how she felt after a couple of incidents that she had before I was born, when I was born. So it was always there. It was just an area that I took more interest in as well. But, you know, like I said, perinatal anxiety, perinatal depression isn't that much different from anxiety and depression that you read in general. It just happens to be around that perinatal period, which you said perfectly well what it was. was. And it's related to being pregnant, becoming a mother, that matricence that I know you talk about a lot, which by the way, I did look up patricence because I was like, is that also a thing for dads? Just like matricence starts, you know, the point of the biological conception and then the growth and pregnancy itself. Patricence is kind of when the baby's born and you hold that baby in your arms for the first time as a dad. There is a biology to that

as well. Testosterone levels change and et cetera. But anyway. No, this is really interesting. It's something I'd love to ask you actually, because we talk a lot about the mom's mental health. And particularly, you know, for me, before I became became a mom my understanding was that it was just hormones you know your hormones run over the place you might get depressed because of your hormones your hormones especially when you finish breastfeeding your hormones and they are obviously all perfectly valid things i i actually found it was more the total life change like this mattress sense like nobody can quite prepare you for the psychological changes but how how does it affect fathers both from a professional perspective and obviously as a father yourself like can it affect dads and is there a sort of practice sense because

i think we forget about that and from my own personal experience i'd say tom's role was also to kind of protect me and my fragile state of mind which i suppose is quite a big burden for someone to have it is it is no i mean you've already touched on a couple of things there and thanks for asking i know i'm kind of crashing the mom's the word is a dad here so i really appreciate from dads you know i do like to be honest in person about this because I think it's important because you said it right. Like the advice I, I give every dad that's about to, you know, or every future dad is like your one job is to make sure that she's happy and okay. And she has everything she needs, right? That's your, that is your one job, but also look, look out for yourself because if you're not okay, then there's that domino effect and she's not going to be 100% and then the baby is ultimately affected, right?

The good part of it and of the patricence is yes, when you hold that baby, it's magical. It's amazing. You know, like as soon as I saw him, yes, there were tears. It was just tears that also relief of, oh, my God, he's actually here. It's an actual person that just came out of also of relief of, oh my God, he's actually here. It's an actual person that just came out of my partner's body. Right. And for me, it was like, I have delivered a lot of babies as a doctor. I delivered many, many babies when I was rotating an OBGYN. So it was like, oh my God, now this is happening to me and I'm going to bring this one home. And it was,

you know, a lot of that. And then the reality kicks in just like, you know, as a mom and for a dad, I think there is a lot of loneliness there. And I was hearing the podcast that you did recently, actually on loneliness. And I thought that was really insightful. And for me, the last time that I felt truly lonely was as a dad, because I felt that, you know, everybody's asking me how she's doing, how's the mom, how's the baby, but really no one asks, how's the dad doing, or very few people, or it's kind of offhand. And that's fine. That's absolutely fine. But it does make you feel, oh God, like who can I talk to? And who can I open up to? So there was a moment where, yeah, I just felt that downward spiral a little bit. And then I couldn't talk to anyone about it until, you know, saw some friends and they asked me, hey, how's it going? And instead of just going, yeah, you know, like wild, having a baby, I went, you know what, it's been really, really tough. And I felt really, really alone. And you know, like my voice broke and it was like, and so they could see, they could see it, right? look, we're here. Come talk to me. Hey, let's grab a coffee whenever you have a chance and all of that stuff. Because that's the other thing that most of our friends don't have kids yet, or they're starting to, right? So, you know, you make new friends as a parent, and I don't know if that

happened to you, but then you try and find people who are going through the same thing. Exactly right. Someone who you can really connect with and say and they go oh yeah yeah it's the same thing happened to me that's a lot of what being a dad is like I think and I'm sure I'm not saying anything new to a lot of people listening I think it's interesting and a good reminder to ask dads how they are because you're right yes the the mom goes through a lot physically that the dad doesn't but it must be really hard. And I actually, when you were saying this, recall kind of repeated conversations with my brother-in-law.

My sister gave birth at a similar time to me, and my brother-in-law keeps saying, it's really hard with my friends because they don't have kids. And I kind of just always, I'm like, oh, yeah, it's hard, isn't it? And I don't really say, how does that make you feel? Or are you lonely? how how is it going and it's made me think to remember a little bit about the dads as well especially when a lot of your friends don't have children yeah and you know the other thing is that and I've talked to a number of people on this as well it's that men really have a hard time

opening up and talking about their mental health in general so not only you don't have many friends who are dads but it's just not something that you generally talk about yeah it's it's hard it's hard to find that space how can someone ask a guy how he's doing in a way that might encourage them to open up because it's quite hard imagine if i was said to you that but how are to open up? Because it's quite hard. Imagine if I was said to you that, but how are you doing mentally? I mean, it's not, you know what I mean? It's a bit like you get defensive, don't you? Like, get out of my brain, I'm fine. Yeah, yeah, yeah, I know, I know. It's an excellent question. How do you even approach it,

right? I think, because, you know, the other thing is, look, you have to just listen and make yourself available because it's not easy for a lot of people to open up and you can't really force it. But I think by sometimes approaching it from a different angle, asking questions that aren't so upfront about, hey, so mental health, are you depressed? Are you anxious? But hey, yeah, it's stressing, right? Like, so how have you been handling it? Or have you ever noticed any changes like are you doing things differently or like try and see if it's starting to affect their behavior slightly or mentioning something like i've noticed you you know you're not as joyful as you were or like maybe you you're not enjoying this as much like is everything okay this kind of thing what are some of the signs

to indicate somebody might be experiencing perinatal anxiety? I presume perinatal can count for the dad and the mom, can it? Yeah, exactly. Yeah, yeah, yeah. I mean, it is, research has shown more common in women, about 15 to 25%, but in men, it's quite common too, and more common in that period than in general. So anyway, again, some of the signs, yeah. So look, I've always, whenever someone asks me about anxiety and depression

and how to define it, I always say, look, it's a collection of symptoms, right? I could ask 10 different people whether they're experts or they're not, and they'd give me different kinds of symptoms. So they're not that different from anxiety. So it's feeling tense, unable to relax, fearing worst case scenario, obviously tied to your baby. And then the somatic symptoms of feeling slowed down or that things are speeding up, you know, having butterflies in your stomach, this kind of thing. Sleep, although, you know, obviously lack of sleep is a given when you become a person how do you

tell the difference right i feel like anything to do with mental health especially now you have these viral reels on instagram or tiktok or whatever and they're always like to be happy just get more sleep and i was like i can't get more sleep i know i know i know so every time i read an article that okay we've determined that eight hours sleep is what you need in order to live longer and healthier. I'm like, come on. Obviously, obviously someone who's not a parent wrote this, right? It's impossible. So yeah, I mean, some, some will blend into that. But you know, some of these things around anxiety, such as thinking about a bad experience over and over again, or even more extreme feelings of depersonalization so that you're kind of disconnected for your mind and body.

So all of those things have to do with anxiety and they shouldn't be taken for granted. People with anxiety then tend to have these coping mechanisms around trying to reduce it. So, for example, looking for a temporary fix. So, you know, imagine someone rereading a book over and over and over again about managing birth or becoming a parent, you know, like not satisfied with reading it once or twice or three times or asking constantly for advice from everyone. And then the other one is avoidance and avoidance can manifest itself in many ways. So maybe you don't leave your baby with anyone, not even your mom or your sister who just had a baby, even though they're experienced because, you know, you're just too anxious

to leave your baby with someone else. Or maybe you don't let anyone else do the everyday tasks because maybe they do it wrong or things like that. So those are, I think, things to look out for in yourself. And then just feeling that you are a different version to yourself. I know that you have to take into account the stress that comes from being a parent, but thinking that, no, no, no, I mean, you should be handling this in a different way. It's always good to at least stop and ask yourself that question, is there something more that I should be dealing with?

Welcome to Paranormal Activity with me, Yvette Fielding, a brand new podcast bringing together people's real ghost, extraterrestrial and paranormal stories, as well as getting some inside details from those who study the supernatural. I'll be listening through your paranormal stories every week and try to understand them, as well as chatting about my own encounters with an occasional paranormal investigator too. You can find us wherever you get your podcasts from, including Apple Podcasts, Spotify and Acast. Just search for Paranormal Activity with Yvette Fielding. Do you know what's really interesting to me?

Because like I kind of touched on earlier, I thought that postnatal depression, let's say, was all about the hormone imbalance. postnatal depression let's say was all about the hormone imbalance and obviously I well not obviously but when I had ALF and I felt this rush of love and adrenaline and I just felt amazing and it was like the best thing in the world and why didn't I have children earlier and have five of them and then I think it was more the realization that it was permanent and the constant responsibility and you know you don't get weekends or lie-ins or you know when you're ill you don't just get to lie in bed and be ill and for me it was that realization and I I still wonder like was I depressed or is a lot of the first year just shit? And I think if somebody had just, I know it's very easy to say,

I wish someone had said this, but equally we also say, people need to stop being negative and let me experience it. But I think like you touched on at the beginning, there's this Hollywood idea of motherhood and also this kind of really two-dimensional idea of postnatal recovery. You'll be back to normal in six weeks. you'll either want to bounce back or you won't and you'll be body accepting whatever it is but for me i was like why didn't no one just tell me it was shit and i i felt like it was going to be permanently shit so i was like what have i done

this is awful and i think that's where my dark thoughts came in because I was like the guilt of loving this child so much, but also feeling like I wish this had never happened because it's forever and what a permanent mistake. And now I'm coming out the other side where I'm like, this is amazing. The first year, it gets better. It gets so joyful. The more they can give back, I'll see 18 months now. And I'm like, that's when the thoughts they can give back i'll see 18 months now and i'm like that's when the thoughts came in let's do it again whereas six months ago i was like this this should never have happened to me and it's interesting isn't it that no one ever really says it's just shit yeah yeah no so i mean you touched on a lot of things so well first let me say that julian my my son he's 19 months so very very similar to you so i think i can empathize a lot of things. So, well, first, let me say that Julian, my son, he's 19 months.

So very, very similar to you. So I think I can empathize a lot with not only when they were born, but the pregnancy, which was right around lockdown. And, you know, wasn't that just such a weird time? I mean, the first ultrasound we went to, I couldn't go in because of lockdown. And that was really tough for us, for her, for me, just waiting outside. But like the city was empty, completely empty. And so he was born at St. Thomas, right? So she came out and she had like that first ultrasound that confirmed everything was okay. But like everything was empty.

So, you know, it was like that scene from 28 Days Later where, you know, the citizen. So we did a little video, right? And, you know, at the end of the video, she was like calling up the ultrasound. Well, I used that video to tell people online that we were pregnant because it was a nice surprise because I said, oh, let me show you how crazy the city is. So, you know, empty. And so they were looking at the video going, yeah, no, man, like this. And then suddenly at the end, the ultrasound and they went, oh my God. So we at least took something out of that. It's been a weird time. I want to say something you said about hormones. And I think I just want to say that that's as a doctor. And I remember reading and studying, right? Those books about the embryonic stage and reading all of that. There were a lot of sections that said, we don't know enough about this. There's probably a

combination of hormones and things like that. So I was like, wow, there's a lot that we don't know around pregnancy and what it does to a woman's body. But the problem with you hearing as well, oh, it's hormones, is that it can be dismissive, right? Because if people attributed that to that and society does then women feel that oh it's just the hormones and everything will be back to normal exactly how you said but it's the language that we use because you know no one's saying to a father oh it's just your hormones don't worry about it they're like oh god you feel shit yeah right and it must be something because you just said there was something about a testosterone drop or something so there is actually there is actually hormones yeah of course yeah yeah we exactly like we go through biological changes too depression anxiety are also tied to physical

things and stress and you know there's there's hormones that are released etc but that doesn't i mean yeah obviously things happen in your body but what matters is how you feel and how that makes you react and behave. And that's the thing that you want to tackle. And that's why psychology is such an important field. And that's why we use these techniques to feel shit. And I mean, yeah, that's, that's true. There's a lot of awareness around perinatal, like postpartum depression, you know, and people talk about it and, you know, be aware of it and call, call the midwife. Right. But anxiety, I think is just as important. It's very intertwined and really like no one really talks about perinatal anxiety, at least. I mean, we didn't hear it in our NCT classes or in the PMP club. So it's not really talked about that much. So yeah, definitely there's still room to raise awareness, right?

What would be your tips on managing perinatal anxiety or how better to manage it? Because I'm someone that suffered from anxiety actually for as long as I can really remember in my life. And I feel like I can manage it. But even now, I feel physically anxious. But I wouldn't say any more so with children. How do you manage perinatal anxiety? Top tips. It's always a question that I feel like I answer it slightly different each time.

But there are some that I always go back to. So, look, I mean, one is very important. It's to don't feel shame, right? Don't feel ashamed. So if you feel overwhelmed and you can't cope, it's okay. But that means that it's okay to feel like that. But it's also okay to seek help because your struggles are in others too. We always take care of our physical problems.

If something hurts, like you take a pill or you do something about it, you go to a doctor. But like we should treat our mental problems exactly the same. We need to fix them because there's an adage that says there's no health without mental health. And, you know, I live by that. Speak up and don't feel overwhelmed. The other thing I'd say is I heard this from someone I interviewed for a podcast who was a user of one of our programs, a perinatal program. And it was really insightful to hear her story.

I thought she was really brave in sharing it. But, you know, she said a lot of really nice things. And one was that she learned not to compare herself to others, because one thing that she found was that when she had this anxiety, like she wouldn't even find herself able to look at how amazing her friends' lives were. And especially on social media, right? Like people post about pregnancy, most everybody, like you're unique or, you know, one of the exceptions, but most people, or most of your friends on Instagram, it's like this perfect shot of them and the baby and everything looks amazing and everyone's happy. And you take 50 pictures of your baby and you post the one where they're smiling, not the one where they're like, like, like if you compare yourself to others, you're always going to lose out because the comparison is unfair.

out because the comparison is unfair. So don't compare yourself to others. Compare yourself to yourself, to past versions of yourself, where you were different on a high. And if it's not acceptable, if you're in a place which doesn't feel like yourself, then reach out and do something about it. And then more practical, there's something about dividing your worries and acknowledging them. So one of the things with our worries is some of them are hypothetical, right? So, you know, if this, what if this happens? What if this goes wrong? So the way to cope with that is by shifting your focus.

So focus on just, you know, go outside and focus on the breeze or on the trees or on a park because anxiety comes quickly, right? Like you get this thought in your head. So shift your focus, listen to some music, smell, taste, whatever. But then the practical ones, which are worries that are practical that could happen. So for example, that you're worried that you won't be ready for the delivery, actively problem solve. So. So, for example, that you're worried that you won't be ready for the delivery. Actively problem solve. So convert it into a practical problem that you can solve, right? So, okay, if you worry that you're not going to be ready, put together a list of everything that you need so that you make sure that you are ready, right?

So simple things like that. So I think those are some of the tips. And look, I mean, just in general about anxiety, and I'm someone who even before going on this podcast, like I was anxious, I wanted to do a good job, right? And my mouth is driving now. I always, like when I present or whatever, I always feel when I feel that, oh, maybe I didn't do such a good job. I always know that the reality is always much kinder than what you make it out to be, right? So other people will say, look, it's not what you think. And that's just something that you want to continuously go back to. It's like, yes, anxiety is a thing,

it happens. It's very common, but the reality is always kinder. So it's kind of those, those kind of mantras are good. It's so funny, isn't it? As humans, we are very good at romanticizing the past and fantasizing or catastrophizing about the future. And we're not very good at being in that present, are we? Because also I sometimes look back at pictures and videos of Alf now, and it does seem like a highlight reel. Oh, he's so cute. And why didn't

I just enjoy it but then at the time I was like because it's not enjoyable it's really really not enjoyable like I've gone from being this person that traveled the world and DJ to singing songs on repeat to a guy that can't even smile back at me or you know he's just dribbling in front of me and I feel like if I could go back and probably if i ever decide to have another child or i'm able to have another child i think i will allow myself to just be in the present a little bit more to be like yeah it actually is shit at the moment but i do know it's not forever and yes i can't sleep and i can't make time for my friends and i'm missing deadlines or whatever it might be but i know it i know it isn't forever so I'm just going to try and enjoy those little cuddles before they can

walk and then suddenly they're shitting in your tent or you know whatever it might be yeah yeah no I was just going to say that um again like I really empathize one of the things is it's just funny isn't it that you know you have such a tough day and it's long and everything goes wrong but at the end of the day you're looking at pictures and you go, oh, man, that's isn't he beautiful or isn't he so special? So we're always romanticizing, even for the same day. Like, you know, you just spent a really long day. You're as tired as ever. Wishing for them to go to bed.

Yeah, exactly. And then, yeah, like, look, I mean, iPhones send these like memories of the past and they create these amazing videos that you're then sharing with your family members. So it's really not fair. But no, you're right. I mean, it is about staying in the present. And on the singing, let me share a little anecdote. I sing to him a lot too. And I sing the same song. I try to sing the same songs to him every night although sometimes he goes no no and I'm like a jukebox right okay well what about this one he goes no no until he finds one that he likes but I've been singing Hey Jude to him a lot and the other day like he started singing back a couple of the words like of the song and I was trying to keep it together but I couldn't I had to stop I was like this is too much I've started going to Alf you gotta fight for your right and then he goes but then he can't say the t so he just goes and it is so nice isn't it when they start to yeah yeah it's amazing it's and then it's random points

in the song are getting hey Jude it's a part of the middle that goes upon your shoulder. And he goes, upon your shoulder. And I went, what? Oh, it's so cute. So, yeah, yeah. I mean, it is those little moments and they do make it worth it. And it's not, you know, look, I think the shit moments will always be in between. Like I have a cousin who has a teenager and he became a dad when he was 19. So very different experience. And he's like the

worst bit is when they're teenagers, but leave me. You hate them. You hate them. You want them out of the house. So I was like, oh my God. So yeah, I mean, look, you always have those moments, but you'll always have the amazing moments too. It's just, yeah, how it is. But you wouldn't want it any other way. Like you're not going to send Alfie back I'm not going to send him back there's no way I would have liked to for a few months sorry I actually forgot to collect the receipt but I'm here to return it it's just not what I expected or yeah or hey like wasn't this a rental thing maybe I can like I'll rent him out again in a couple of months just let me do the lions for one week oh the lions actually when I heard you say that's probably the thing I'd want

back first you know a Sunday where I could lie in until 11. It's like that triggering thing when people it's a Friday and people are like oh I'm so tired I can't wait to switch off at the weekend and you're like fuck yeah yeah yeah Yeah, yeah, yeah, yeah. No, the weekends are not what they used to be. They're like, oh, hopefully you get to rest this weekend. And I'm like, do you know that I've got a toddler at home? Like, at what point will I be resting? If anything, the weekends are harder because he's not a nursery.

Yeah, I went on a holiday recently. We went to Menorca and someone asked, how was your holiday? And I'm like, you know what? It's not a holiday. It's a trip. Holidays don't exist anymore. Like, you think I was lounging at the beach for three hours reading a book? No.

I was running after him, making sure he wasn't eating the sand. You mentioned earlier that you've worked, obviously, delivering babies. And obviously, you are an expert in maternal mental health. Was your own experience of parenthood anything like you imagined and and experiencing the labor obviously as a doctor who's not being an active doctor in that moment were you tempted to be like lads move over all ladies move over i've got this or were you just like wow this is this is not at all i i wasn't i didn't even have time for that for two reasons one is that the labor was really,

really hard for my partner. Her water broke and then, you know, she didn't get anesthesia for a while and she was in a lot of pain and I was just trying to manage that. And then when she, we finally went down to the delivery room and the midwife's there and they said, look, the baby's on its way. Let's just go for it. Like she took over incredibly like military style, but she took over. And the first thing she said to me was like, right, you sit down or like you just support there. And then, you know, that's it. Let me take her. And I was like, no, yeah, yeah, fine. I'm not going to suggest a thing, you know, I'm sure she can handle it. And then the second reason was I was like holding my partner by the hand and she just started this is very

this seems like a film but like just shouting at me you know abuse right you're not doing this right you're not doing this right and then I just started to I love sports I was like very like hey come on you've got this like you're almost in the goal and all that and she's like what what like shut up right I don't I don't need So in the end, she ended up relegating me to the feet and the legs so that I could give her a massage, like a thigh massage. And then she started going, he's not doing it right. Can you just tell him he's not doing it right? And the midwife turned to me and said, just stand there quietly. In the end, I was just just like you know whispering go come on come on come on and then starting to see the head and then it went back in a couple of times and i was like oh my

god oh my god so it was just a completely different experience to when i was there and doing the shouting and the supporting because you know it was me actually receiving the baby completely different completely different so funny i remember tommy saying it's all right you're nearly there nearly there not long and i was like shut up i'm not trying to think about how long it might take i just want to like deal with it now and yeah i i got him to do the tens machine to press it every time i had a contraction which by the way was what wonders for me oh yeah that's great yeah i was like stop trying to encourage me yeah yeah no it's really hard as a dad to do anything right and that's fine but like believe me i tried i mean well the other thing is that because it was saint thomas so we had a room and it was beautiful the beautiful view

in the house of parliament big bend the river and when we came in i was like oh like look at that isn't this great like where he's gonna be born and she's like i was like, oh, like, look at that. Isn't this great? Like where he's going to be born. And she's like, I was like, expletive, expletive. The last thing I care about is the view. And I'm like taking a quick picture. Okay. It's just, I just want to, she'll appreciate it later. But yeah, no, I mean, it's like, yeah, that's two different worlds right there that then unite when the baby's born, which is nice.

What about obviously being an expert in maternal mental health and managing your partner's mental health, if indeed she did experience anything with her mental health, did you find that you could kind of put your professional hat on and offer support? A little bit, yeah, without expressively saying it, but, you know, definitely calling on those things when we had really tough times. Again, it was lockdown. Most of our family is in Mexico and, you know, we did feel quite isolated. So it was quite a challenge for both of us. It was a trial by fire for sure. So there were a couple of moments of sheer panic. It's like, ah, I can't do this anymore. And so just as I, in those moments, had put my professional hat on and talked her through it and all that stuff, she did the same for me a couple of times. And one of the things I've learned, too, by talking to people who have used our programs and who have been patient themselves is that the techniques that you learn for perinatal anxiety,

you can apply to other parts of your life, like relationships and relationship anxiety, and like the same kind of techniques help in that. And generally speaking, if you're in a relationship where you share a lot, like what one person learns, you both learn. And so that really helped too. So, and look and look she's she's a psychologist she specializes in addictions but yeah she she she knows so i can't bs her right like she knows when i'm being more professional more personal and we just try and balance it out but hey you know sometimes you just gotta survive the day right don't we know that so what exactly is silver cloud health like and also if anyone that is thinking that their perinatal mental health is suffering

how can how can the the is it an app or a platform how can it help individuals manage their mental health during the perinatal period yeah i mean it is it's a platform it's not an app that anyone can download we provide it via the nhs and highT services. So, you know, you'd have to go through your GP. The particular program for perinatal is called Space for Perinatal Wellbeing. And it includes a lot of those psychoeducational techniques that I mentioned. But it's gotten, look, it's gotten great, great results. People have talked often about how it helped them through it. In general, these are the sort of programs that SilverCloud offer, depression, anxiety, stress, things like that. But yeah, they're provided through the NHS and IAP services. So you'd go to your GP and say, I feel anxious or depressed or whatever it might be. And then they'd refer you to a night service or something like that. And then, yeah, they'd recommend that program. Well, thank you so much for your insight.

And I have to say for Nadine, one silly thing, I find sometimes it's the silly things that stay in my head. But when she says her sleep's taken a turn for the worst, I remember when I was about eight years old, I was at boarding school and I couldn't sleep one night and I was getting so upset. And weirdly, we had dorm captains who were girls just a few years older than us so you know they would kind of be in charge of the room so she must have been 11 or 12 I think she must have been 12 and I remember going up to her saying Juliet I can't sleep I'm so stressed and she just said to me

it's so silly because I'm not particularly religious, but she said, don't worry. In the Bible, God doesn't say you need to sleep. He says you need to rest. So just rest. And it's such a silly thing, but it's stuck with me ever since because when I can't sleep and my mind's racing, I think, don't worry about the sleep. Like, don't look at the time and then calculate how much sleep you're going to have. It doesn't matter. Just rest. And then I find it helps me sort of stay in the present a

little bit and just rest so hopefully that's a silly bit of advice from a 12 year old girl yeah no i mean you just did what i what i said earlier which was shift your focus so it's perfect it's not silly at all hopefully nadine will will be pleased with the answer i hope so i i think it's been really helpful for everyone so thank you so much for your time and obviously all your work with maternal mental health and good luck with the next chapters of parenthood i'm sure like you said there's going to be lots of highs and lows but yeah until we get to the teenage years i'm sure it can't be shitter what we went through so no the first, definitely the first year is the toughest.

I think so. I think so. Because you're right, they do start to give back and that's what really matters. So yeah, no, I mean, good luck to you too. We'll be following you and listening back. Alfie's a lucky, lucky guy.

Oh, thank you. Thank you so much. I loved that conversation. Hopefully it helps lots of you, either with your own personal experiences or with maybe people around you who you think might be experiencing it but before I go we actually got a voice note I always get very very excited when we get a voice note on the old whatsapp so please keep them coming in this one I think it's anonymous but I'm just going to play it now so you can listen to it here. Hi, Ashley.

I just wanted to send a quick message. I hope a voice note's okay. Say thanks for the episodes on your podcast. I've been listening to them over the last few months. I have an almost 14-month-old, and it's been really refreshing just to hear an honest chat about motherhood. But I've just listened to your episode with Marianne Levy, and it was a fantastic episode. Oh, my God, you touched on so many things that resonate with me I've definitely found it a lot harder becoming a mum than I thought I would

having been somebody who's always wanted kids I have pre-ordered her book on audible as I don't manage to read a physical book with the baby so we listen to them on walks and I am so excited to read it but yeah I just want to say thank you again for having such open and honest conversations with people it's really helped me while struggling myself with my mental health and just being with my mom in general but yeah thank you so much and I can't wait to listen to more episodes I loved that voice note thank you so so much a for listening but also for getting in touch and i agree i absolutely loved the podcast episode with marianne and i've also ordered her book after the episode that we did so it's called don't forget to scream unspoken truths about motherhood i like the idea of listening to

it as an audio book i don't know why i hadn't thought of that but if you would like to get in touch on whatsapp the voice messages are obviously free you can do it like that lovely lady did anonymously if you want the number is 075-999-27537 and i can't tell you how nice it is by the way to hear positive feedback especially on a podcast because obviously you record it there's no audience there's no clapping you know it's not like an old school tv show or there's no booing or anything so it's really nice to know how many people engage and relate so thank you so much and thank you for listening to mum's the word parenting podcast if you do enjoy the podcast then don't forget to hit the subscribe and follow button so you never miss an episode and i'll be back same time same place next week