Archive for the ‘Articles’ Category

For New Moms: When You’re “Just Not Yourself”

April 26th, 2012

Being a new mother should be a joyous time in your life. But what if you’re not feeling like yourself after having a baby? About 10-15% or of new moms experience postpartum depression, which can begin any time during the first year after childbirth. Depression is a treatable illness that causes feelings of sadness, indifference, and/or anxiety.

Postpartum depression (PPD) is different from the “baby blues.” A majority of new mothers experience the “baby blues,” a period of sadness that isn’t debilitating and passes quickly. Symptoms of the “baby blues” include tearfulness, irritability, restlessness, and anxiety. But when symptoms of sadness, irritability or anxiety continue for more than two weeks or make it difficult to care for your baby, there is more going on and it’s time to reach out for help.

Symptoms of PPD include:

  • Fatigue or lethargy
  • Feeling sad, hopeless, helpless, or worthless
  • Trouble sleeping/sleeping too much
  • Loss of appetite/increased appetite
  • Difficulty concentrating/confusion
  • Crying for no apparent reason
  • Lack of interest in the baby
  • Fear of harming the baby or oneself

    • Symptoms can vary in severity, but persistent depression often causes new moms feel isolated, guilty, or ashamed.

    You should tell your doctor if you have several of these symptoms for more than two weeks; if you have thoughts of suicide or thoughts of harming your child; depressed feelings are getting worse; or you are having trouble caring for your baby or yourself.

    Depression is an illness. It is not a sign of weakness or of being a bad mother. It can be treated successfully, and getting help is the best thing you can do for your baby.

    Risk Factors for PPD

    Any new mom can develop PPD. Its causes may include hormonal and other physical changes, sleep disturbance, emotional adjustments and chronic stress. However, women are at increased risk of depression if they have a personal or family history of depression, if they are have experienced particularly stressful life events such as significant losses, a high-risk pregnancy or traumatic birth, or if they don’t have adequate support from family and friends.

    Other Postpartum Conditions:

    Postpartum Anxiety and Obsessive Compulsive Disorder
    Many new moms experience anxiety rather than sadness after giving birth. Anxiety, panic attacks, irrational fears or intrusive thoughts, or images can be associated with Postpartum Anxiety or Obsessive Compulsive Disorder. Symptoms of a panic attack can include a racing heartbeat, unusual physical symptoms, a sense of impending doom, the feeling that you are dying, dizziness or nausea.

    Posttraumatic Stress Disorder after Childbirth
    New mothers can also develop post-traumatic stress disorder (PTSD) following a traumatic childbirth experience. PTSD involves reexperiencing the trauma through flashbacks or nightmares, having difficulty sleeping, and feeling detached or estranged from friends and loved ones.

    Postpartum Psychosis
    Postpartum psychosis is extremely rare but also very serious. It affects only two out of every 1,000 new moms. The symptoms are severe and may include insomnia, agitation, hallucinations, and extreme paranoia or suspiciousness. Postpartum psychosis is a serious medical emergency and requires immediate attention.

    Treatment for Postpartum Disorders is Effective

    If you believe you are suffering from a postpartum disorder, the first step is to talk to your doctor or mental health provider.

    You should be evaluated by your doctor to rule out a medical cause that can contribute to depression.

    Psychotherapy, medication or a combination of the two may be needed to get you back to feeling like yourself. But you must continue treatment even after you begin to feel better, because discontinuing treatment too soon can cause symptoms to recur.

    The support of family and friends is also instrumental to your recovery. In addition, joining a support group for postpartum disorders can help overcome feelings of isolation, increase coping skills and provide social support.

    Getting help is the most important step you can take for yourself and your baby. Untreated maternal depression is associated with developmental delays in babies, as well as potentially serious emotional consequences for your growing child.

    How Partners Can Help

    New moms suffering from Pospartum Depression and Anxiety need the support of their partner, as well as friends and family. Help with baby care and household responsibilities, provide an ear to listen or a shoulder to cry on, and be patient and understanding with her struggles. And make sure she gets help.

    Partners also need to take care of themselves. Having a new baby is hard for partners too. And if the mother is depressed, you are dealing with two major stressors. Partners can also suffer from Postpartum Depression, a often undiagnosed problem.

    How to help a partner suffering from a postpartum disorder:

  • Encourage her to talk about how she is feeling. Listen without judging her. Instead of trying to fix the problems, just be there for her to lean on.
  • Offer help around the house. Chip in with the housework and childcare responsibilities. Don’t wait for her to ask!
  • Make sure she takes time for herself. Rest and relaxation are important. Encourage her to take breaks, hire a babysitter, or schedule some date nights.
  • Be patient if she’s not ready for sex. Depression affects sex drive, so it may be a while before she’s in the mood. Offer her physical affection, but don’t push if she’s not ready for sex. She will recover in time!
  • Go for walks with her. Getting exercise and sunshine can make a big dent in depression, but it’s hard to get motivated when you’re depressed. Help her by making walks a daily ritual for the two of you.

    • If you’re not sure if you have PPD, complete the Edinburgh Postnatal Depression Scale. It is a fairly accurate way of determine if your symptoms are normal or may require treatment.

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    Posted in Anxiety, Articles, Attachment, Baby Care, Depression, Postpartum | 1 Comment »

    Coping with Anxiety Using Mindfulness

    March 30th, 2012

    You know the feeling when it starts: an unpleasant burning in your chest or abdomen, a feeling of cold on the back of your neck, tingling in your arms, or tightness in the back of your throat. Anxiety is a physical phenomenon. Many of us are unaware of the specific physical sensations associated with our anxiety, but it sends a signal to our brain that we are in danger. On its own, anxiety tends to pass quickly and without much ado. It is the way we attribute meaning to the sensations in our body that causes anxiety to feel unbearable and to stick around. We interpret our anxiety as being “out of control.” We look to our environment for signals that we really are in danger, either physically or emotionally. And we beat ourselves up for feeling anxious, telling ourselves “What is wrong with me?” “Why can’t I feel calm?” And even worse, “I can’t tolerate feeling this way.”

    But in reality, we can tolerate anxiety. By tolerating it and observing its physical manifestations, we rob it of its power over us. And over time, anxiety will diminish if we refuse to escalate it by letting it take over our thoughts.

    Mindfulness is one of the most powerful tools for coping with and transforming anxiety. While it may feel like WE ARE anxious, bringing awareness to our body and choosing to focus on the specific physical sensations we are experiencing allows us to see that we are the observer of anxiety, not its victim. We can choose to halt self-defeating thoughts by returning awareness to our body and reminding ourselves “Anxiety cannot hurt me. It is only a feeling, and it is temporary. I am in control of myself. I can choose to be aware of the anxiety without letting it take over my thoughts.”

    Practice doing mindfulness exercises such as this one when you are not feeling particularly anxious, as a way of being ready for anxiety when it comes. Learning to focus your full attention on your body rather than your thoughts takes some practice, but only five minutes a day can make a huge difference in reducing anxiety and helping you cope with it when it comes.

    Anxiety is often associated with depression, even if the depression is not severe. Taking steps to address negative patterns of thinking, grieving losses, and learning to take better care of ourselves physically and emotionally is another important step in dealing with anxiety. If you need help to learn to identify and challenge negative thoughts, work through with past trauma or loss, or learn to improve your self-care and relationships, finding a therapist you trust is a great place to start.

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    Posted in Anxiety, Articles, Depression, Mindfulness, Self Care for Parents | Comments Off

    Antidepressants: Yay or Nay?

    August 23rd, 2011

    For individuals who have struggled with depression, the decision of whether to try, or later to stay on antidepressant medication is often a difficult one. Some people swear they will never try an antidepressant, until or unless their depression becomes so debilitating that there seems to be no other option. For others, the promise of relief is so attractive that they jump into the decision to take antidepressants, but then they struggle with the question of whether the medication is a lifelong sentence.

    To Take Antidepressants or Not to Take Antidepressants

    There are no easy answers to this question (as is true for most important ones!). Studies show that individuals suffering from moderate to severe depression have better odds of recovery with a combination of therapy and antidepressants. However, for some people, changes in diet, additional exercise, and better strategies for coping with stress can work just as well. For debilitating depression, medication can often help to lift a person up enough to be able to meaningfully participate in therapy. But depression generally happens for a reason, and often changes in thinking patterns, relationships or career are necessary for a person to have more happiness and fulfillment in their life. Medication alone may not make these changes happen. Does relying on antidepressants to make life more bearable reduce the motivation to make needed life changes that will improve the quality of one’s life? The answer to that question may be different for every individual, and is something that can be explored in therapy.

    Side Effects

    Some individuals find great relief on antidepressants, and don’t have any bothersome side effects. But others experience weight gain, sexual side effects or other unwanted secondary effects from these drugs. Sometimes, switching medication can resolve these issues, but in some cases the antidepressants that work for the individual are the same ones that cause other problems. That is a common reason why some people consider going off medication and try to manage their depression in other ways.

    Never Go Off Antidepressants Without Consulting Your Doctor

    A reminder here is important; never go off antidepressant medication suddenly, or without the supervision of the prescribing doctor. Some of these drugs require an extended period of weaning to avoid serious withdrawal symptoms. And an important factor to consider is the possibility that if you wean off your antidepressant medication, the same medication may not work for you as well in the future. That is one factor that you need to weigh with your health provider when making this decision.

    Issues Raised by Weaning Off Antidepressants

    Individuals that decide in consultation with their doctor to wean off antidepressants face a whole other set of challenges. The fear of a relapse of depression can be the most difficult part. Coping with the symptoms of withdrawal can be challenging, and often brings up these fears. Also, people who go off antidepressant medication may find themselves more vulnerable to feelings of sadness, irritation, anger and stress than they are used to. Learning coping strategies for these emotions is very important. A really bad day can create a lot of anxiety that the depression may be returning, even if the emotions involved are normal and healthy. Therapy can be an helpful place for reality-testing in terms of what is healthy and what is a signal that depression may be returning.

    The thoughts and feelings around the decision to go on or off of antidepressant medication can be confusing. Therapy and consultation with your medical provider to sort through the questions and concerns raised by antidepressants is a good place to start.

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    Letting Go of Parent Guilt

    August 22nd, 2010

    There is no guilt quite like the guilt of a parent. We feel so uniquely responsible for the care of our children. Every lapse in our parenting weighs on us.

    Throughout life there are always reasons to feel guilty: the call we forgot to return or the birthday card we forgot to send, or the time we snapped at our partner for no good reason. But when we feel we have failed with our child, this guilt weighs even heavier on our minds.

    Guilt is an emotion with a conscience — it helps us try to do our best, and it reminds us of what is important to us. But too much guilt can rob us of enjoyment. And as a parent, there is so much to feel guilty about! If we dote on our child, there’s the house, friends, partner or even job to feel guilty about, and if we try to meet our other obligations, it is easy to feel that you have failed as a parent. It’s a Catch-22!

    I wonder sometimes if our parents felt as guilty as we do, or if it is unique to our generation to expect so much from ourselves. And guilt in itself is purposeless. It doesn’t help anyone, but only makes it more difficult to do our best.

    When you are feeling guilty, it is important to look at this feeling from some emotional distance, seeing it objectively instead of being its victim. Decide whether your sense of guilt is justified. Sometimes sharing your feelings with a fellow parent can help you sort out what is legitimate and what is perfectionism.

    When you feel that you have truly let someone down, it is important to do what you can to make it right. Apologize to the friend you neglected, or the partner or child you yelled at. Try to learn from your guilt to change your priorities and do things differently. Then let the guilt go.

    When the guilt is baseless, or unavoidable, like when you feel guilty for a feeling you have, or because you cannot do more than you are capable of, then you need to practice using your “interior parent” to counter those feelings.

    If you had a beloved friend who told you she felt terrible because the baby cried while she was on a much-needed outing with her partner, what would you tell her? Probably you would reassure her that she is a wonderful mother, and that she must nurture herself and her relationship in order to be the best mother she can be. You would tell her she has nothing to feel guilty about, and you would also empathize with her pain. This is the role you must also play with yourself.

    Listen to your own thoughts, and when they are self-defeating or judgmental, respond to yourself the way you would to a loved one — being a good parent to yourself is part of being a good, loving and joyful parent to your children.

    Posted in Articles, Postpartum, Self Care for Parents | Comments Off

    Feeling Clueless? Reading Your Baby’s Cues

    July 25th, 2010

    By Meri Hanson Levy, MA, MFTI

    People have a physiological reaction to the sound of a baby crying. Our hearts pound, our blood pressure rises, and we start to sweat. This reaction causes most of us to try to stop the crying, regardless of how tired, irritable, or hungry we might be ourselves. And that’s a good thing. It’s how our babies learn to trust that their needs will be met and that the world is a safe place.

    But sometimes (often!) new parents wonder what the baby is trying to say? What does the baby need? We run around randomly, trying different remedies: jiggling the baby, rocking the baby, changing her diaper, offering a breast or the bottle, or a pacifier. And sometimes the baby still cries. We desperately want to eliminate the cause of the crying, and we become frustrated, angry or guilty when we fail.

    I faced this situation with my first child, Benjamin. I never knew what he wanted. He seemed to be constantly fussing, and I was never very good at calming him (and I did not feel calm myself). My second child, Elijah, always wanted to eat, so it was easier to consistently meet his needs. But I had not really improved my ability to read a baby’s signals.

    With my third child, Emma, I hoped and prayed she would never (or rarely) cry, so I wouldn’t feel quite so inadequate again. But in the meantime, I picked up a copy of Secrets of the Baby Whisperer by Tracy Hogg. I had heard her on a talk show, and she claimed she get babies to sleep through the night, on their own, without letting them cry. This was a secret I wanted in on.

    What I got from the book was very different from what I expected. The book is not for everyone. The author is not an advocate of “attachment parenting,” for example. But regardless of your parenting philosophy, The Baby Whisperer has a lot of good information about caring for your baby in a respectful way. She focuses on honoring your baby’s individuality, understanding how babies communicate, and learning how to meet their individual needs.

    The book prompted me to stop when Emma began to cry, and to really listen and observe her, rather than jumping in and trying to “rescue” her without knowing what she was asking for. When I figured out what she was saying to me, I was in a much better position to meet her needs.

    Here are some of the body language cues discussed in the book that I have found helpful:

    Tiredness:

    • Yawning;
    • Moving head from side to side;
    • Flailing, uncoordinated arms, clawing at face;
    • Strong, uncoordinated kicking;
    • Bloodshot eyes.

      • Overstimulation/overtiredness, same as above, plus:

    • Turns away from objects and faces;
    • “Seven-mile stare.”

      • Hunger:

    • Turning head to one side and craning neck back with an open mouth;
    • Bringing hands to mouth, trying to suck them;
    • Pursing lips;
    • Curling tongue at sides.

      • Coldness:

    • Quivering bottom lip;
    • Extremities turning bluish;
    • Mottled skin;
    • Goose pimples;

      • Pain/gas:

    • Silent screaming, then gasp and audible wail
    • Grimacing, often scrunched up face
    • Arms shaking, slight tremor
    • Rigid torso
    • Legs pulled up to chest

    What I discovered, from observing Emma more closely and choosing how to respond to her body language and cries, is that frequently what I used to interpret as hunger or gas was in fact tiredness or overstimulation. What happens if you feed a tired baby who isn’t hungry is that frequently she may get gas and be overtired and more difficult to put to sleep.

    The goal is not to stop all crying. Babies cry to express themselves, and even a “perfect” parent, if such a thing existed, couldn’t prevent all crying. Nor should you, necessarily; your baby may benefit from having a chance occasionally to self-soothe, which is an important skill as your baby grows older. For subsequent children, this skill is learned by necessity because parents can’t always respond immediately. But by learning to read your baby’s cues, you can avoid some frustration for yourself and have the confidence to know you are doing the best you can for your baby.

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    Posted in Articles, Attachment, Baby Care, Feeding Your Baby, Infant/Toddler Sleep, Postpartum | 1 Comment »