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From depression to rashes, Dr Zoe answers your health problems

NEW parents have a habit of putting themselves last, which is understandable when you have a tiny little baby to look after.

But you still have to remember to take care of yourself.

Dr Zoe Williams answers some common questions sent in by readers

Dr Zoe Williams answers some common questions sent in by readersCredit: The Sun

And that’s true whatever your age and whatever your circumstances – baby or no baby.

I’m here to help you do just that, so any health query you’ve got, send it my way and I’ll help if I can.

For now, here’s this week’s reader’s questions.

Q: I HAVE a small rash on my face, which is mottled under the skin. It’s been there for months. Could it be from antidepressant medication Paroxetine?

A: A rash of this nature could be caused by a number of things. Skin rashes can be triggered by things that are in direct contact with the skin, such as fabrics, cosmetics, chemicals, etc.

But they can also be a manifestation of systemic disease, infection, poor circulation or things that have been consumed, including new types of medication.

A full assessment of the skin involves taking a medical history, including any new medication that you may have started, and also assessing the skin by examining it.

Examination of the skin is not just looking at the skin but also feeling the skin, as the changes in texture can also give clues as to what the cause might be.

My advice to anybody who has unusual rashes lasting more than a few weeks, or getting worse, is to make a face-to-face appointment with your GP.

If there is quite a long wait for a face-to-face appointment, then you can send in an E-consult in the meantime with some photographs.

When taking photographs of the skin it’s always best to do this in natural light, so you could stand facing a window and take a photograph with the light from outside shining on to the skin.

It’s always useful to take photographs of any rashes that come and go, because sometimes when I see patients they are describing a rash that has settled at the time of seeing them.

Q: CAN breastfeeding cause teeth problems? I have recurring decay and wisdom tooth issues.

A: Some people are more susceptible to dental issues while pregnant or breastfeeding.

It is a myth that calcium and other nutrients are removed from the teeth and bones of mum as the baby grows.

Actually, most dental changes that happen during pregnancy are caused by hormone changes in the body.

High levels of the hormone progesterone create more acid in the mouth during pregnancy, which can lead to gingivitis. Symptoms include red, swollen gums that bleed during brushing or flossing.

Tooth decay is another risk during pregnancy — especially if you suffer from sickness — and breastfeeding.

Serious tooth decay can lead to cavities or even tooth loss.

My top three tips for pregnant people and for those who are breastfeeding are:

1) Ensure that you maintain excellent dental hygiene.

It’s easy to let these things slip when a new arrival comes along who is all consuming, but it’s important to brush twice a day and floss daily — and also to drink plenty of water.

Avoid having lemon or lime in water, except for with meals, as the acid can affect the tooth enamel.

So drink plain water, or flavour with cucumber, mint or rosemary, for something a little different.

2) It is incredibly important to ensure you are getting sufficient calcium in your diet — your needs increase during pregnancy and while breastfeeding.

This is especially important if you are somebody who does not consume dairy products, for either ethical or intolerance reasons.

In this case, it would be best to take a calcium supplement to make sure you are getting sufficient amounts.

Most pregnancy multivitamins contain calcium.

Cow’s milk remains the most nutritious type of milk for those who are able to have dairy.

If choosing a plant-based milk, check that it is fortified with calcium, and ideally iodine too, and that it is not sweetened with added sugar.

3) In the UK, dental care is free for all pregnant people and for the first year after the child is born.

So make sure you take advantage of this opportunity and get your teeth checked regularly.

My advice would be to ensure you have a dental appointment during the couple of months before your child turns one.

Any treatment that has commenced prior to the child being one year old can be completed without charge.

How do I know if I’m bipolar?

Q: I HAVE suffered with depression on and off for most of my adult life and I’m currently taking 20mg of Citalopram daily.

I have also had cognitive behavioural therapy (CBT), but not found it very useful.

A few people have asked me about bipolar as my moods can be very up and down. It’s never occurred to me before, but how would I go about ruling it out, or getting a diagnosis?

It would be nice to have an explanation for my quirkiness!

A: It is really great that mental health is talked about much more openly now than in the past, and I hope that this progress continues, as we still have a long way to go.

However, severe mental illness is still not talked about any-where near enough, and people who are suffering with conditions like bipolar disorder, schizophrenia and severe depression can often feel forgotten about and unseen.

Bipolar is a severe mental health condition that affects approximately one in 50 people in the UK. The majority of individuals with bipolar experience alternating episodes of mania and depression.

Some examples of behaviour that people may have in a manic episode include talking too fast, not needing much sleep, having uncontrollable rapid thoughts, feeling over-confident and over- important, acting impulsively, over-spending, being sexually promis-cuous and using poor judgment.

Bipolar can often go undiagnosed for a long time, so it’s important to speak to your GP and let them know if you suspect that you might have the condition. It’s important to get a diagnosis and the right treatment, as this can be an extremely difficult condition to live with otherwise. In fact, Bipolar UK’s website states that the condition increases an individual’s risk of suicide by up to 20 times.

To prepare for your GP appointment I would advise keeping a mood diary. There is a good one at bipolaruk.org along with a range of useful resources.