Anxiety

Why Should I Worry?

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Anyone else singing the song from the old Disney movie “ Oliver and Company?” Just me? OK, then let’s move on….

Worry. It’s kind of part of the human condition. If you care about anything or anyone in your life you will at some point worry about it or them. The problem is, that sometimes this worry gets in the way of our functioning. It takes us away from being present in this moment because we are still worrying about the last moment or how to face the next.

So is worrying just…bad? The answer is no. We have actually been “gifted” the ability to feel anxious or worried as part of our adaptive functioning to promote our survival. Our flags go up and we do things in order to ensure our safety. That’s a good thing, right? Not always, because sometimes people worry on overdrive, worrying about things that have nothing to do with safety, or things that can’t be controlled, or that they have little influence over. So, then what?

What I will frequently coach clients on is pulling what is useful or productive from their worry. So for example, we worry about our kid’s safety. OK, let’s make that worry productive. Go ahead and tell them to hold your hand or look both ways when they cross the street, buckle their seat belts in the car, and teach them not to speak with strangers, etc. All these things are good things. I encourage clients to respond to the worry in useful ways as long as it doesn’t interfere with their (or in this case, their child’s) functioning. Although it may help to ensure your or your kiddo’s safety, never leaving the house really isn’t an option, because that impacts the overall functioning of everyone involved.

But because anxiety and worry can be a real jerk sometimes it will always remind you of the “what ifs”. The elements you can’t control. This is the worry where there is nothing productive to pull from it. So what do you do with that? The answer is: you learn to let it go.

The sad truth is, somewhere today someone is worrying about something bad happening. They are overcome with the worry. Maybe it is even incapacitating them in some way. And, then the bad thing still happens. The worry did absolutely NOTHING to affect the outcome of what the person was worrying about. It only robbed them of any joy or experience of being present leading up to the event. The worry served no purpose but to make that person feel like garbage. The outcome may remain the same, but in letting go, the person has a better overall quality of life.

So, Elsa style (man I’m on a Disney kick today) we need to let go of that residual worry, which is easier said then done. So stay tuned, because my next blog post will include some tips/tricks on how to do just that. And as always, feel free to reach out with any questions you may have.

Dropping the Baby and Other Scary Thoughts: Book Review and Comparison

As I may have mentioned before, I hate to read. However, it comes with the territory of the work that I do that I need to read and provide quality book recommendations to my clients. I knew that I needed to put books by therapist, author and PMAD pro Karen Kleiman and co-author Amy Wenzel at the top of my list. Based on what I’ve read so far, I can say with confidence that ANYTHING with Karen Kleiman as an author/co-author is going to be a valuable read (Yes I am fangirling here…she’s amazing and I want to be her when I grow up!) A few months ago I did a review on “Good Moms have Scary Thoughts” which you can read HERE, but I wanted to go back to the OG of books on scary thoughts, which is why the subject of this review is “Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood”.

Compared to “Good Moms” this book offers a much more in depth understanding of what exactly scary thoughts are, what causes them, and approaches on how to gain relief. The book is divided in three sections titled “What’s going on”, “Clinical Concerns”, and “Breaking the Cycle of Scary Thoughts”.

Section One differentiates between typical presentations of new mom worry, anxiety, and scary thoughts. It details the different types of scary thoughts that mothers have and includes examples and personal accounts from real women who share their own experiences. The authors do a really good job of normalizing some of these experiences for new parents. They also share some of the “why” behind the scary thoughts, which is very important to many mothers to help with externalizing symptoms and helping ease some of the blame moms place on themselves for having them in the first place. I think it’s important to note that at the end of each chapter they offer a “Take Home Point” for both mothers and clinicians. This was very helpful especially since there is so much good information it’s useful to boil it down to the most valuable information.

Section Two starts with helping mothers recognize when they need additional help/support in addressing their scary anxious thoughts. The different types of Perinatal Mood and Anxiety Disorders (PMADs) are discussed and “really scary thoughts” including suicidal thoughts and psychotic symptoms are also addressed. There is a chapter on barriers to relief and a chapter on screening. I think that these chapters speak a little more to the clinicians reading the book, however are valuable to mothers in order to predict potential obstacles and promote self-advocacy in their treatment.

Finally Section Three really gets at the meat and potatoes of how to get relief. The authors give ideas that are easy to implement and practice in order to begin experience change as well as a whole chapter on Cognitive Behavioral Interventions. This is Amy Wenzel’s chapter to really shine as she’s an expert in utilizing this approach with the perinatal population and co-authored a book with Karen Kleiman on this topic (and HEY I’ve shockingly already read it and it’s awesome! Check it out below!) They continue the section by discussing professional options like therapy and/or medication when self-help just isn’t moving the needle for readers as well as offer a chapter on enlisting help from the supports available to moms.

I would say the best chapter in the book is entitled “Your Personal Treatment Plan” which helps readers create an action plan of how to take all the information presented in the book and implement it. I think this is a great way to put everything in the book together. This is especially helpful for a new mom who is most likely sleep deprived and reading in a disjointed way making it difficult to remember what you read in chapter one by the time you get to chapter 11!

Compared to “Good Moms Have Scary Thoughts” this book is a little more “book-y” in that it’s longer and presented in a typical fashion, whereas “Good Moms” has a more relaxed approach to presenting information. I have a hard time imagining the moms I work with in their most anxious or depressed state sitting down to read this type of book. For that reason I am more likely to recommend “Good Moms” first. I say that while also recognizing that the moms I interact with are typically in significant distress which is why they are coming to me in the first place and a reader dealing with less intensive symptoms may do just fine with this book. I also want to acknowledge that I am also saying that as a non-reader and for someone who reading comes more naturally to, it may bring great comfort to sit and read a book of this nature. This book is a little pricey although I feel the info in it is of great worth. “Good Moms” is much more inexpensive which makes it giftable as a baby shower or new mom present.

To my understanding the book is currently being revised and updated but there was nothing in this book I felt was dated or irrelevant. All in all in my opinion this book is another winner by these authors, and I would highly recommend it to both clinicians and moms.

If you are interested in reading either of these titles click on the following links to purchase through Amazon. And as always, feel free to reach out through my contact page to get more info on this or any other topic relating to reproductive and maternal mental health.







Good Moms Have Scary Thoughts: A book review

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Remember that song by Usher, “These are my confessions”??? Well here is my confession, it’s quite shocking…..I HATE TO READ. I really do. Even though I love to learn and find tremendous value in reading, I just don’t care for it (and don’t try and convince me to try audio books, because I just can’t absorb the information the same way in audio format!). But when this book by my hero, social worker and postpartum expert Karen Kleiman came out, I had to suck it up, purchase the book and dive in.

First a word about scary thoughts:

Most if not all new mothers will experience scary thoughts regarding the safety of their baby. These thoughts can be intrusive, vivid, and even violent at times, hence the name “scary thoughts”. These thoughts DO NOT mean that the mother is at risk of hurting her baby or herself. In fact, the distress caused by these thoughts, although quite unpleasant is a good sign to a therapist that the mother will not act on them. Unfortunately, moms are often terrified to share that they experience these thoughts for fear of being judged as “crazy” or even having their baby taken away.

The book is a great resource to provide education about these scary thoughts, normalize the experience and reduce the stigma around them. It is written in a lighthearted way with comics style illustrations depicting the types of secret scary thoughts moms experience while caring for their baby and in their everyday interactions.

In addition to the illustrations, the opposing pages have valuable information about what the thoughts mean, affirmations for moms, and even action steps for how to manage that particular thought or subject matter. The chapters address the different types of thoughts moms can have including general thoughts about motherhood, safety, the transition to parenthood, unsolicited advice from others, comparison, breastfeeding and much more.

Just because scary thoughts are common, what typically needs to be addressed in treatment is the distress that they cause. The book does a good job helping moms understand when and how to get help. The back of the book also has resources to access including helpful websites, how to find a trained therapist, and additional reading.

What I like about the book is that the information is delivered in small "bites”, which are much easier to digest, not just for a non-reader like me but certainly for a busy and overwhelmed new mom. The information, while covering a serious topic is presented with a lighthearted tone which helps it to be accessible to everyone who reads it. The book rings in at about twelve bucks and change on Amazon which comes in way under some of Kleiman’s other works.

I highly recommend this book for any mom. I think it would make a great baby shower or new mom gift. I’m a big fan of the adage “an ounce of prevention if worth a pound of cure”, so if a mom read this book before she experienced any scary or anxious thoughts she may be less likely to be blindsided by them and more likely to talk about them or reach out for help. I also think the book can be a tremendous resource for the partners, family, and others who support new moms.

If you or someone you know are having scary thoughts that are causing a lot of distress or interference in their life. It may be time to get some help. Feel free to reach out to me on the “Contact Me” page for more information.

And click here to order your copy of “Good Moms Have Scary Thoughts”.

Postpartum Depression: NOT Just the Baby Blues

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Having a baby is hard. Whether it’s your first or your fifth, the transition after bringing baby home can be challenging at best. And although that transition can come with a lot of emotional fluctuations, frequently referred to as the “baby blues”, Postpartum Depression is a whole other animal.

Frequently, when sitting across from a new mother in my office they share about their efforts to reach out for help. Maybe it’s to a family member, friend or medical provider (OB, Midwife or Primary Care Physician). What boggles my mind is how often they are told that what they are experiencing is “normal”. While unfortunately Perinatal Mood and Anxiety Disorders (PMADs) such as depression, anxiety, OCD, PTSD or bi-polar is very common affecting approximately 20% of mothers (and 10% of fathers and non-gestational parents) it is NOT normal.

I would like to share what differentiates the baby blues from a PMAD so in the event you or someone you care about is affected you will know when it’s time to reach out and get the right kind of help to feel better faster.

Baby Blues:

  • Transient mood shifts throughout the day marked by tearfulness or irritability

  • First 2 to 3 weeks (at most)

  • Influenced significantly by hormonal shifts and sleep deprivation

  • Does not significantly affect functioning

  • Affects 70-80% of new mothers

  • Not a mental health condition

  • Resolves itself over time

PMAD (Postpartum Depression or Anxiety):

  • Excessive sadness or worry most of the day for most days

  • Extends past the first couple of weeks

  • Impacts functioning for example, inability to sleep (even when baby sleeps), decreased appetite, unable to concentrate, decreased enjoyment in things

  • Scary, vivid and intrusive thoughts about harm coming to baby (both intentional or accidental)

  • Disconnection from or excessive clinginess to baby

  • Feelings of guilt, shame, inadequacy, worthlessness and/or hopelessness (“Bad mother”)

  • Low or no motivation to complete even simple tasks

  • Just not feeling like yourself

  • Does not get better over time

If you or someone you know are experiencing the symptoms of a PMAD it is imperative you reach out to a medical or mental health provider to get the appropriate help. Prognosis for recovery is much better the quicker the symptoms are recognized and appropriately treated. If your provider tells you it’s “normal”, and just take a walk or get some more sleep and you still feel like something is just not right, keep reaching out until someone listens! A wonderful resource is the Postpartum Support International helpline at 1-800-944-4773. You can speak with someone who can get you connected with providers in your area that can get you the support you need.

If you are local to Syracuse or the Central New York area and think you may be suffering from Postpartum Depression, feel free to reach out to me through my website or call me at 315-552-0180. You are not alone and you can get better with help!