Hyperemesis Gravidarum: Is it all in our heads?

How many times have you heard this:

“You’d feel a lot better if you would adjust your attitude.”  “You should be more positive.”  “That Molly. She’s so excitable isn’t she.”  “Maybe you should see a tharapist?”  “You’re not sick.  You’re pregnant.”  “You’re weak.”  “You’re hysterical.”  “You’re doing this to yourself.”

From doctors. From nurses. From the lady taking your vitals in the hospital. From a friend. From a relative. From your spouse?

It’s all in our heads.  We’re doing this to ourselves.  It’s our fault we’re so sick.

Over and over and over.

Some HGers aren’t lucky enough to have a support system.  They suffer and suffer believing to their core that what they are experiencing isn’t real.  They blame themselves when they miscarry.  They feel the agony of guilt when they have to terminate the pregnancy that they were so excited for just to save their own lives.  If they’re like the woman a few years back at one of my local hospitals, they die.  It’s their own fault.  If they hadn’t been so weak, so fragile, so excitable.

A new study has come out: Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study.

Apparently, according to the abstract, HG is a relatively common medical problem among pregnant women.  Well, gosh.  I certainly learned something today.  I wasn’t aware that it’s common for pregnant women to require PICC lines, constant IV hydration, high doses of multiple medications, and bed rest.  I wasn’t aware either that it’s relatively common for pregnant women to become so dehydrated that they begin to halucinate, to vomit until their esophagi tear and they start to vomit blood, to become so malnourished that they lose their babies, for their kidneys to fail, to die.

I didn’t realize any of that was relatively common.

After looking quite a large sample size of 142 patients and observing whether or not there were mental health issues prior to the pregnancy, these psychiatrists conclude:

The results of the present study suggest that mood and anxiety disorders, and personality disturbances are frequently observed among women with HG and that there is a potential relationship between these psychiatric disorders and HG during pregnancy.

Pardon my skepticism, but this has been done before.  It was a crock then and it’s a crock now.

Look, I get that they’re saying that HG isn’t caused by mental illness. Of course not. This is all couched in the language of statistics.  But how many of us have had doctors who told us to just suck it up before sending us on our way with admonitions to take some ginger and eat some crackers?  How many of you have nearly died because of it?  I know at least one of you personally who has had this happen.  I know it nearly happened to me when I was pregnant with Cricket.  I remember that Friday night when they suddenly went from, “Molly, you’re in really bad shape. We need to get you on TPN,” to “There’s nothing wrong with you. You need to go home.” (Of course I seemed fine at that point! I’d been on IV fluids, a potassium drip, and IV zofran and nexium for 3 days!)

Oh sure.  Plenty of us who have HG are depressed and anxious.  Who wouldn’t be after what we’ve been through?  HG causes mental illness and depression.  The researchers got it the wrong way round.

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15 thoughts on “Hyperemesis Gravidarum: Is it all in our heads?

  1. It is a shame this stupid argument has come around AGAIN. WHat you said is right though certainly in my case it caused the depression and anxiety, never had it untill I had 2 months being completely bed ridden and then 5 months of struggling to balance work and HG (which ended disastrously).

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    1. I remember trying to balance work and HG when I was pregnant with the Grasshopper. Yeah. That ended disastrously for me, too. Thank goodness I wasn’t fired, but it was a near thing.

      HG definitely causes depression and anxiety. I know I’ll never be the same.

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  2. Oh my goodness. I just stumbled across your blog and this article hit such a nerve I had to comment. I don’t think my symptoms during pregnancy were severe enough to be called HG, but it was BAD. I couldn’t imagine it being worse, and I have such a heart for women who go through what you describe. I had to shoulder all those comments, too. Family who told me I just had to stop “thinking about it”, patronizing nurses and, unfortunately, a husband who seems to remember my pregnancies as being so unpleasant because he had to “deal with” me. I made it through two pregnancies to deliver two healthy, beautiful children and I feel blessed. But, sometimes I still feel a little heart broken thinking about the large family I’d dreamed of. Thank you for a great post. The way the medical community deals with this is inexcusable. Because they have been unable to find an answer, they pass the blame to us. Months of debilitating nausea & fatigue that steal dreams and alter life forever would cause the strongest person to become anxious and depressed.

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    1. I hurt for the large family I’ll never have, too. Blaming the mother is so easy. It starts from the moment you get pregnant and continues until the day her kids are grown and she passes away. I’ll shoulder a lot of guilt (hello! raised in the South!), but I refuse to tolerate someone blaming me or any other mom for HG.

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  3. You would not believe some of the things I have read in research over the past few days (I’m busy putting together a HG book for UK sufferers with help from a UK based charity to help support them and have access to the research they need to provide to their GPs as some of our treatment protocols are different to yours). The book also contains lots of experiential stories and it’s shocking to see how even though there are some really strong research studies out there to show that treatment needs to be given as early as possible, in reality women are still being treated so poorly. Only in retrospect do I realise that I should have been admitted and when my GP said that despite being dehydrated (and she could physically see this) I was okay because I had no ketones she was wrong (and that the only reason I didn’t have ketones was most likely because the 400-500ml of liquid I’d managed to force down for well over a week at that point was a sports drink and most likely helped with the extra bits they put in them). Looking back I can see that even though I was nowhere near as severely sick as many women are, I was still very sick and needed help. And I remember finding your blog and thinking, “someone understands!” and you were the one who gave me the confidence to go back to my doctor at 21 weeks, still unable to eat and barely able to get out of bed for more than a couple of hours a day and living on about 900ml of liquid a day and say, “this isn’t normal, you have to see that!” If I hadn’t found your blog I’d have probably gone through my entire pregnancy without help. In fact it was because I was so used to drs fobbing me off that my Obstetric Cholestasis wasn’t detected until 37 weeks despite having had symptoms for almost 2 months at that point. I just hadn’t thought to mention it to anyone.

    Sorry, didn’t mean to offload all that. It’s a bad day for me. My husband and I decided recently we can’t face another pregnancy. Not just because of the HG (there are other health factors at play) but HG was a massive factor in our decision. And seeing research like this coming up just makes me so mad. Thank you for speaking out about it xx

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    1. How completely ridiculous of your doctor! Being dehydrated is life-threatening for mom and baby! Just because your body wasn’t consuming fat stores to fuel itself (and thereby spilling ketones) doesn’t mean a patient is not in a really dangerous position!

      I’m so humbled to hear you say that I helped you. While I hate HG with everything I have, I’m so thankful for the sisterhood of HG survivors that springs up in its wake.

      I’m definitely looking forward to reading your book!

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  4. I threw up every day, sometimes multiple times a day, through week 32 in my first pregnancy. Thankfully, I never experienced anyone telling me anything as horrible as “You’re fine, it’s in your head,” or “Suck it up.” I cannot even begin to imagine telling a woman suffering in this way that she’s somehow causing it or that there isn’t a problem. My doctor was concerned but mildly dismissive, her comment was simply, “Every pregnancy is different.” Despite her dismissiveness, she still prescribed me zofran to help combat the nauseau. It helped some but did not erase the issue completely.

    Thankfully, despite my nausea and vomitting, I also managed to keep enough down to continue to gain weight at a healthy pace, and not become dehydrated, so I didn’t need to be hospitalized.

    The sheer awfulness of it certainly dulled some of the happy from being pregnant. I was happy and excited, yes, but I didn’t feel all cute and happy like many of my pregnant friends appeared to bel. Rather I was exhausted and reeking of vomit most days; resentful of other pregnant women who seemed to be able to eat anything they wanted without fear of throwing it up. Definitely did not make me the perkiest of pregnant women.

    Now I’m pregnant with my second. The horror of the first pregnancy has totally affected my level of excitement for this second pregnancy. I feel horribly guilty for not being as excited about this pregnancy as I was the first. I feel like a bad mother and worry the baby will somehow sense my lack of excitement- I KNOW its an irrational train of thought. I KNOW its not a lack of excitement to have a second, its the fear of being sick for 8 months. But mentally, I am already exhausted just thinking about what lies in wait for the months ahead. Its a horrible mentall seesaw.

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    1. Congrats on being pregnant again, and condolences for the possibility of an HG pregnancy. I hope, hope, hope that you will be one of the very lucky few who do not get HG a second time around. If you haven’t already, I strongly recommend putting together an HG protocol. From the sounds of it, you were undertreated your first time around. Check out the info I have on my protocol page. There might be something in there to help you this time around. Best of luck and keep us posted!

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  5. I just happened upon your blog and I am stunned to find out that there is a name for what I went through for 5 pregnancies! I love my children Lord knows I do, but I can completely see how HG is directly connected to mental health. I do not feel as though I have the connection with my first 4 children as I should because I was so ridiculously ill and it was so hard to get them here. I felt like I was dying! Morning sickness the entire 9 months for 24 hrs a day? Not one doctor could tell me what was wrong. My youngest child was born with brain bleeds and she did not take anything by mouth for the first year of her life and I truly believe that this has something to do with me being so sick. It was agonizing. I am still astonished that there is a name for this …WOW

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    1. Hi Anita. I’m so sorry to hear you had HG. There is definitely a name for it and it’s not our imagination. I’m so saddened to hear that you didn’t have medical support and even sadder to hear that the lack of support caused such serious illness with your daughter.

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    1. I’m sorry it has taken me so long to respond to your comment. My HG-related posts are still very popular. Right now though, I tend to avoid them. It’s very painful for me to remember what I went through. I am sure that someday I will be able to participate more in the HG community again, but it is just too difficult.

      I am glad you found my blog and I hope you are able to get useful information from those older posts. I wish you all the best for your pregnancy.

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      1. No worries! I completely understand. HG is so traumatic…I totally understand not wanting to dwell on those memories. Thank you for the well wishes. I just read your post about breastfeeding and love all the suggestions!

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