BBB Moms December Mental Health Tip

 (BBB offers 6-week therapeutic support groups for women experiencing emotional distress during pregnancy or following the birth of their babies: www.beyondthebabyblues.org.)

When you are a new parent, everyday brings its small – and sometimes large – challenges. For many parents, struggling with depression and/or anxiety is an additional difficulty, but one for which there are readily available remedies.

When the beauty of early autumn gives way to later autumn’s earlier evening darkness and hints at the colder days to come, keeping your spirits up and your mood stable can be a struggle. You don’t have to be a mom, dad, or someone who battles generally with his or her mood for this to be the case. Daylight and sunshine can be powerful contributors to positive feelings and outlooks on life for everyone.

Many people have reported significant mood improvement from light boxes – there is even a name for this phenomenon: seasonal affective disorder.

When women come to BBB for one of our groups, one of our first and very strong recommendations is exercise. The benefits of exercise for anyone who is experiencing perinatal mood issues, actually for anyone who is dealing with mood issues, has been documented repeatedly as highly effective and even equaling the effect of anti-depressant medication. This holds true for both depression and anxiety.

So many of the women we see are distressed by the loss of control they feel when they transition to parenthood. Deciding to include a daily walk, whether with or without your baby, regardless of dishes in the sink or clothes in the dryer, puts you back in the “driver’s” seat.

BBB Moms May Mental Health Tip

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Moms' Mental Health Tip of the Month: August 2018

Maternal Instincts - how to learn to trust them

Is a maternal instinct real?  Is it universal?

If so, one would think that it would be easy to figure everything out, right?  But the reality is is that mothers struggle with listening to their instincts and trusting it is easier said than done.  Truthfully, some mothers wonder whether they have the ability to access this instinct, and often feel like their inner voice is silent or nonexistent.  These doubts certainly don’t make us feel inspired or empowered, do they?

In our Beyond the Baby Blues support groups, it is very common for our mothers to have lengthy discussions about how they get too much advice from others - contradictory and often unsolicited-  and how overwhelmed they can become.

The onslaught of advice ranging from professional expertise, parenting books, blogs, and internet sites can be ‘information overload’, capable of stirring strong feelings of inadequacy and incompetence in every mother.  But with women who struggle with heightened anxiety and/or depression during the perinatal period, it can feel particularly stressful and unmanageable, tipping a vulnerable mother into feeling very alone and miserable.

Our group aims to provide the support necessary to help these women access these feelings, and to share them with others in a safe and nonjudgmental environment.  We discuss ways in which to manage and cope with the anxiety, and speak to the need to re-center and listen to their inner voice. We offer encouragement to place less emphasis on outside advice, and more reflection on what they feel is right for themselves and their baby; in other words, the searching for, and nurturing of, that maternal instinct we hear so much about.

With some effort, awareness and a whole bunch of courage, all mothers can learn to trust their maternal instinct more frequently by remembering a few important points: 

- You are the expert - nobody knows your baby/child like you do.
- Pay attention to what might feel wrong, even if you are unsure why it feels wrong.  This is your moral intuition, let it guide you.
- Let go of the inner critic - work on reframing the way you think.
- Let go of expectations of what you ‘should’ be doing, and what others expect what you should be doing.  - --- People are going to judge you anyway, based on their own choices and values, so you might as well behave in a manner that fits and respects your values.
- Be selective with other’s advice - listen to advice from trusted sources.
- Accept your mistakes and bad judgments - there are many different ways to parent, and rarely are there clear answers.  
- Be authentic - if you find yourself struggling over why you can’t ‘get it together’, delve deeply into why...perhaps it doesn’t feel right for you.
- Trust and honor your inner voice...it has much to say about who you are and what is important to you.

BBB Moms March Mental Health Tip

Amongst the most challenging adjustments for a couple after having a baby is the recalibration of expectations that needs to occur for each partner. Whatever the understanding that members of a couple have had about how each of their sets of needs can/should/will be/are/ met within their relationship, introducing an infant into that equation is guaranteed to change that understanding.

And how could it be otherwise? Not only is there a third person now insinuating him or herself into the relationship, but this particular person has absolutely no ability to hold up his/her weight or contribute in any way to the maintenance of that relationship. That little person is managing to use up a lot of the emotional resources that used to be distributed very differently.

So, just how can a relationship adjust to such a major demand?

Right in our own Evanston backyard we have a Northwestern professor and author whose research focuses on marriage, historically and in the current day. Eli Finkel, in addition to being a professor of psychology, management, and organizations at Northwestern’s Kellogg School of Management, is also the director of the Relationship and Motivation Lab. Much of his work looks at how expectations shape relationships and how those expectations have changed, or more importantly for our consideration, how those expectations have increased greatly in recent years.

Finkel points out (in his new book, The All or Nothing Marriage: How the Best Marriages Work) that couples have come to expect that their partners, in addition to loving them, will help them achieve self-actualization, to grow as an individual, and to become better versions of themselves. If this is what has been expected, if not verbalized, just think how disappointed partners are going to feel if now, after introducing a baby into the family, their standards have been lowered to comparing who has changed the most diapers today or who got the most sleep?

Lurking behind those small resentments is probably the larger concern that the deeper and more significant ways in which each partner has come to expect the other to support him or her has been irreparably compromised. Introducing a more flexible and more widely distributed set of expectations as well as a temporarily lowered bar for couple satisfaction can help the relationship to stabilize and grow. Finkel points out that little gestures of enthusiasm and appreciation for each other can carry tremendous power. He suggests that savoring the little stuff in a way that might not seem self-evident can enhance emotional pleasure during this difficult transitional time; and that recognizing that this relationship maybe cannot meet every last need can lead couples to broaden their social networks to include meaningful time with friends and family members, not just as a couple but as individuals as well.

BBB Moms May Mental Health Tip

Well, I have to be honest. There was a big part of me that thought that just because I wrote about the COVID-19 pandemic last month did not mean that I would be writing about it again this month. Yet here we are, and I sure was wrong. Unless you escape to Netflix etc. or a good novel, or a children’s television show, what else is there going on in the world? We are surrounded by and inundated by - news, updates, alerts, press conferences, Zoom meetings – all pertaining to this health crisis. Discussions of it are inescapable. And some of them are very important.

As the medical and scientific communities learn more about this virus, it’s important for us all to be able to distill which of that information can pertain to our lives and extend our ability to keep ourselves and our families safe and well. So really, we can only avoid so much of all of this without missing out on vital information.

So then, what can we do to balance this highly stressful information with something more benign and hopeful? At a time when everyone, and I do mean EVERYONE, is feeling pretty powerless, pretty small, pretty vulnerable, and pretty anxious, what can we do for ourselves? I have no magic; there is no magic; but there are some tried and true measures to decrease the stress we are all feeling:

Breathe; Meditate; Sing; Dance; Cook; Bake; Garden; Take a hot bath; Take a walk and look at the blooms all around you; Be very silly with your baby and kids; Do some of the things you always told yourself you would do if you ever had the time – if you have the time now.

Now is the time to think about what is really important to you, what your dearest values are, and what you have some control over. And, as terribly hard as it is, don’t be part of the problem.

Stay home unless you are exercising in your neighborhood or buying food. Wear a mask. Wash your hands. Express gratitude to those who are working to save lives and to bring you food to eat and supplies to enable you to stay home.

If you are amongst those who are caring in any way for the rest of us, thank you so very much.

If you think it would be helpful to have some individual or group support. We’ve got you covered. You can reach BBB at beyondthebabyblues@gmail.com and The Moms Line at 866-364-6667.

BBB Moms June Mental Health Tip

One of the lessons I have learned from the many women we have worked with in our BBB groups is that we, as women, are much better at feeling and displaying empathy for other women than we are for ourselves.

In our groups, every member has the opportunity each week to share how she has been feeling, what struggles she continues to experience, and the progress she is making toward feeling more like herself again.

Often a group member will describe a difficult relationship, a work conflict, or concerns about her baby, as well as the difficult emotions engendered by these situations - followed quickly by negative, self-judgmental thoughts. Other group members will respond with expressions of concern and understanding that are clearly heartfelt and without any hint of judgment. Yet these same group members, when they speak about their own situations, are also quick to be critical of themselves for their own struggles.

We call this the double whammy: not only are they experiencing unsettling feelings, they also are blaming themselves for experiencing these feelings.

I don’t think this response is atypical for women.

It is often much easier for us to be kind and understanding of others than it is for us to direct those feelings toward ourselves. We need to learn to practice our own version of that old proverb: (emotional) charity begins at home!

BBB Moms September Mental Health Tip

Women with newborns and infants often wonder how to assess the feelings they are experiencing and the thoughts they are having.

They are uncertain about what’s “normal” and typical and what might be cause for concern. Especially if a woman’s expectation has been that that the transformation from person to parent and parent-of-one to parent-of-two would be instantaneous and seamless, she might not be prepared for such thoughts and feelings as:

This is definitely not what I expected. Nobody told me it would be this hard. I feel like I have lost my sense of self/independence/locus of control. I used to be so efficient/competent – now I feel successful if I can fit a shower into my day. I love my baby but if he/she had arrived in a box, I might mark it “return to sender” and hurry to the post office.

All of the preceding is normal and typical, especially if you have a baby who is still waking up a number of times each night and has not yet figured out that napping is good for everyone!

Or you have a baby with some eating/nursing/gastric issues, which many, many babies do.

Here is what is less typical and possibly indicative of some depression or anxiety:

frequent and/or uncontrollable bouts of (maternal) crying; intense sadness and/or anxiety; frightening intrusive thoughts; difficulty connecting emotionally with your baby even if you are able to provide adequate physical care; having difficulty providing your baby with adequate physical care; wishing to or actually avoiding interacting with your baby; having trouble sleeping at night even when your baby is sleeping; thoughts of self-harm, a plan to harm yourself or your baby.

If this second set of thoughts/feelings characterizes what’s going on for you, there is help out there.

Tell your obstetrical care provider.

Tell your partner.

Go online to postpartum.net and learn more about perinatal mood and anxiety.

CALL the MOMS Line at 866-364-6667, at ANY time of night or day.

There, you can speak with a perinatal mental health professional who can help you better understand how you are feeling and make some recommendations as to what will help you feel and do better.

Then, they will send you the names of some therapists in your area who take your insurance and maybe refer you to a support group at a wonderful program called Beyond the Baby Blues!

There is help out there and you will feel better when you get it. 

BBB Moms April Mental Health Tip

There is only one topic on all of our minds right now. You have doubtless read and heard just about everything that can be said about COVID-19, none of which brings any of us much comfort.

Let’s focus instead on you and what you are likely feeling. I’m going to take a guess that your predominant emotional state is that of anxiety.

Increased anxiety.

No matter how solid or stable or at peace you felt before all this began, it is very unlikely that as a parent, a partner, and a human being you can escape the burden of uncertainty and concern about your own and your family’s health.

If you were experiencing essentially no anxiety before, you have at least some now. If you were already struggling with low level anxiety, you may have at least moderate anxiety now. If you had moderate anxiety before, you may have considerable anxiety now.

This is unavoidable.

This is normal and to be expected. This situation has no precedents. None of us has a script for how to get through it.

Now you need to be clever because you need to find some physical and emotional space in which you can engage in activities that will lessen your anxiety so that it is manageable and bearable.

You need to be clever because you probably don’t have much physical space or unoccupied time in which to engage in soothing activities.

Might you have your own version of a “lovey” that you can put there and use to create some comfort? A favorite scent?

It is completely reasonable to turn your bathroom, or a corner of your bedroom, or a hallway, into a sanctuary where you can meditate for five minutes or even one minute.

Where you can just close your eyes for a moment.

Where you can indulge in the most relaxing fantasies you can call up.

Where you can take child’s pose and just remain there for a few minutes.

Maybe you can take a warm bath in the evening. Maybe you can watch the most escapist of programs you can find once some reasonable peace descends upon your home. Maybe you can skype or facetime with family or friends and revel in the fact that if this had happened twenty-five years ago, you couldn’t do that.

Most importantly, do not personalize your anxiety right now. It is not a reflection upon you. It just is. And for a while at least, it is not reasonable to expect it to go away.

I am including here a personal essay written by a woman who is pregnant and due in September with her first baby. Although her particular situation will certainly differ from your own, her thoughts and feelings will ring bells for many of you.

Many years from now, my son will ask me what it was like to live through the time of COVID-19. “It was a scary time. Especially because we didn’t know how or when it would end”, I will tell him. “I also didn’t know how it would affect you, because you were growing in my belly then”.

Scary is right. Along with anxiety and fear provoking, and lonely. I suffered from anxiety long before I became pregnant. But I was able to manage it with exercise, meditation, occasional visits to the therapist, and my friends.

Little did I know how significant my relationships with friends and patients (I am a physical therapist in an outpatient clinic) were until they were no longer reliably and regularly in my life.

When you spend 40 hours a week talking with 2 patients an hour and your 6 co-workers in an open and small clinic, and enjoy all of that, you are a very satisfied extrovert.

Take that extrovert, and stick her in an apartment with a husband who has to work more than 40 hours a week from home, and eliminate her physical contact with any other human, and she becomes very isolated.

So the anxiety and fear grow unchecked.

It has been difficult to motivate myself to be more active. There are so many options of exercises classes online that I find myself not choosing any. I am trying to continue running 2-3 times a week outside when it is not raining or too cold. I introduced meditation and self-help workbooks back into my life, and I try to call friends almost every day.

But I realized that what motivates me right now is the desire to be happy. Small things that used to make me happy don’t exist much anymore.

A smile from a stranger on the street doesn’t exist as I am physically trying to run away from everyone while walking my dog.

The weather is reflecting everyone’s emotions, and it rains almost every other day; vitamin D isn’t making its way into me naturally. Being able to physically help another human being by fixing their body or listening to their hardships is gone.

For now, I am finding my happiness in mental stimulation; I am doing crosswords, and jigsaw puzzles, and reading.

This is just the beginning of my COVID-19 story. As the weather gets warmer, and my thoughts shift, I hope that my motivation to engage in or learn other activities, skills, and crafts will grow. I will find other sources of happiness and different ways to manifest my extroversion.

Because I have to, for my son.

What is BBB doing? We are offering our groups on Zoom. We are going to reach out to former group members and offer a Zoom session.

We are going to respond to the emails and calls we receive and work to be there for our community of young mothers and their families.