Is your anxiety making you a controlling parent?

"In an uncertain world, we often feel desperate for absolutes. It's the human response to fear."

--Dr. Brene Brown, author of Daring Greatly

I think all parents feel a certain amount of "am I doing this right?!" anxiety. The stakes seem so incredibly high. We don't want to mess our kids up. And lets face it, when it comes to parenting, uncertainty abounds. So, we read pregnancy or parenting books. We ask the mom whose baby is napping what her secret is. We troll blogs or Facebook looking for answers or reassurance. Basically, we just want to know that it'll be ok. That we're doing the right thing for our kids. That we're not being too permissive, or too strict, too controlling or too lax. We're always waiting to feel like we've finally got this parenting thing figured out.

For some, a certain rigidity starts to take hold, as that fear of messing up wraps it's cold tentacles around our hearts. That fear is so uncomfortable, that we start to seek absolutes, clear-cut "must do it this way or else!" methods. As if there were one right way, one trick, one secret to getting kids to nap, or to potty train them or to get them to do their homework. Somehow if we could just figure out that trick, the rest would be so much easier. So in response, we get controlling and rigid, instead of flexible and curious. And guess what results when kids feel controlled? They push back. They whine. And everything feels like more of a battle. Pretty draining, right?

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Angel at school, devil at home?

Does your child behave at school but not at home? Here's your game plan!

I've had a few clients come in lately reporting extreme frustration with their little one. "At school, he's amazing. He's helpful, listens well, and is an all around joy. At home? Completely the opposite! What gives?"

So parents hear glowing reports from teachers and care takers, but find that once they come home or go to pick their child up, things fall apart. And it isn't pretty. Watching your child lose it with no or very, very little obvious provocation can be...heart breaking. Frustrating. Embarassing. Crazy-making. Why is my presence enough to provoke this avalanche of emotion? Why as soon as we walk in the door, does my child lash out at his sibling/kick the dog/not listen to ANYTHING I say? He doesn't do that at school!

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Baby blues or postpartum depression?

t irks me that despite all the hoopla surrounding celebrities who share their experiences with postpartum depression and anxiety, and most recently Chrissy Teigen, journalists still confuse the "baby blues" with postpartum depression and anxiety. (And brava to Ms. Teigen for opening up!)

So let's set the record straight! The key distinguishing factors are when symptoms show up, how long they stick around and how severe they are. 

Symptoms, which may include irritability, tearfulness, fatigue and excessive worry, can be present in both the baby blues and postpartum depression. So I get the confusion on the matter. But, if a parent is experiencing these feelings more than a month or so postpartum, then it isn't the baby blues anymore. The baby blues usually occur within the first week or two after the baby arrives, and most commonly around day 3-5. Hence the saying, "when the milk comes in, the tears aren't far behind."

Despite it feeling like forever in the moment, the baby blues should resolve within a week or two. If they last longer, it isn't the baby blues, it's likely postpartum depression.

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6 tips for dealing with postpartum anxiety

If you think you might have postpartum anxiety or depression, the most important thing to know: it's not your fault. No one wants to feel this way. You're not weak, or a failure, or attention seeking. This is something that happens to one out of seven women and one in ten men. So it's common AND the best news? It's treatable.

So what to do if you feel like you've got postpartum anxiety and you're crawling out of your skin?

  • Tell people. Talk to your care providers. Talk to your partner. If they're not supportive -- and unfortunately, given the stories my clients tell me about their doctors meeting their concerns with a shrug they might not be terribly helpful!--then don't give up. Help is out there. Ask around for therapists that are trained and specialized in helping postpartum families. The Postpartum Resource Center of NY has lists of qualified providers organized by county (www.postpartumny.org) and is a good place to start. Postpartum Support International (www.postpartum.net) is also an excellent resource. Ask the therapist what their qualifications are and what kind of therapy they practice. An evidence-based therapist will employ cognitive behavioral therapy, and provide warm, empathic care. If you don't feel like you click with a therapist on the phone, move on to someone else. A qualified therapist should also be able to help direct you to providers who can prescribe medication (ie a reproductive psychiatrist) if needed.
  • Take care of yourself. The old saw about putting your own oxygen mask on before helping anyone else holds true. If you're burning out, you can't help anyone else, let alone take care of a baby. So, eat properly, get a shower in, go outside, rest, ask for help with the other tasks of daily living. There's no shame in asking for and receiving help at this time-- you've got an excellent reason when you've got a baby.  Everyone wants to help new parents, but few know how. Tell them exactly what you need.
  • Calm down. If you're getting physiologically activated by your anxious thoughts (heart racing, tense muscles, shallow breathing) you're sending your body the signal that this is an emergency. Your body then goes into "fight or flight." At that point your rational side shuts down because you've declared there's a dangerous threat to you or your loved ones--when this is usually just not the case. So if you feel you're about to spiral and you're starting to react physically, stop and breathe deeply. I teach clients to breathe in for 3 counts and out for 5, which allows them to focus on the counting instead of the worrying thoughts. Focus on where the anxiety is being held in your body and send your breath there, easing the tension. Developing a meditation practice can also be extremely helpful.
  • Wink at your anxiety. This is a strategy that at first blush might seem a bit counter-intuitive.  Bear with me.  We all get anxious. You're not alone in feeling worried about things, and yet for those caught in the grip of a pervasive sense of doom, the worry takes over. Most people will instinctively try to fight against the anxiety, stuffing it down, ignoring it. And this can be a strategy that works in the short term, but the anxiety never really goes away. If instead, you acknowledge it, wink at it over there, say hello to it and even thank it for trying to protect you unnecessarily, you can pivot to more balanced thoughts more easily.
  • Avoid triggers. Now isn't the time to be watching violent TV shows or to be glued to the latest disaster stories in the news. This won't be forever, but create a blackout of triggering sources: Facebook, the news, etc. Don't feed the beast.
  • Get information. Karen Kleiman's book, Dropping the Baby and Other Scary Thoughts, can be a real life saver and provides excellent information about Postpartum Anxiety and OCD. The blog site www.postpartumprogress.com is also a great resource for those experiencing postpartum anxiety and/or depression.

Bottom line? Don't go it alone. Help is out there and there is no time to waste.

Signs you may have Postpartum Anxiety or why can't I get these crazy thoughts out of my head?

If you say "postpartum," to most people, then next thought that pops into their head is "depression." In some ways this is great: word is getting out that PPD is common and treatable and not anyone's fault. And yet, many parents don't present with symptoms that we consider common to depression. Instead they are experiencing postpartum anxiety, which I've got to say is incredibly common, and waaay underdiagnosed. Ever hear something like this: "Oh, you're just a first time mom, it's normal to be worrying about the baby"? Well it's common but not normal to be constantly ruminating that something terrible is going to happen, or to be staring at the baby monitor all night to see if the baby is still breathing when you're desperately tired and need to sleep. So people who need help aren't getting it. Let's change that.

When we think of postpartum depression, perhaps we have visions of moms with crying spells, diving into a carton of Ben and Jerry's. While there are moms (and dads!) who present with these types of symptoms, there are an awful lot that do not. How do moms and dads with postpartum anxiety feel? Here are some of the signs of postpartum anxiety--note that you may not have all of these symptoms:

  • Angry. Irritated. Agitated. Nothing anyone does is right, including you.
  • Constantly waiting for the other shoe to drop. Unable to relax. A sense of dread and foreboding.
  • Having the same scary thoughts about something terrible happening, and doing everything you can to keep it together while "dying on the inside," as one client recently told me.
  • Scared to be alone with the baby.
  • Difficulty falling and staying asleep despite feeling exhausted.
  • Having the sense that there's always something you should be doing--laundry, cleaning, thank you notes, etc.
  • Feeling crazy and scared that you'll never feel normal again.
  • Zooming off into the future on a tide of pessimistic or negative "what ifs."

Wait, so that's anxiety? Yup. Often, well meaning partners and friends will have the sense that something is wrong but can't really put a finger on what it is. They just know that their loved one is on edge or very controlling and that they are on the receiving end of a lot of irritable or even angry comments. It's easy for both partners to feel helpless and hopeless. And yet...and you knew where I was going with this...there is hope. Postpartum anxiety is truly treatable. Using a mix of cognitive behavioral therapy and supportive techniques, you can absolutely feel better and shrug off that oppressive sense that something bad is going to happen.  There's no reason to "white-knuckle" it.

Next up, what you can do about postpartum anxiety.

What's your parenting super power?

Parenting in New York City can often seem like a competitive sport. Is it the same where you are? Maybe this is just a Brooklyn or Manhattan postpartum parenting phenomenon. But, I suspect it's a bit more global! There's always someone at the playground or school yard mentioning how early their kid walked, talked or slept through the night. The choices to work or not, opt for a nanny versus group childcare, stay in the city or split for the suburbs can make it feel like no matter what we do, we're not making the best choice. The pressure to get it right for the sake of our kids is extreme. And what a price to pay for both us and our kids: stressed families where nothing is ever good enough. We feel like we're always behind-- working really hard scurrying on the hamster wheel but never feeling like we're doing anything well. Sound familiar?

I've seen both professionally and personally that the moms and dads who are most at home in their own skins, most confident in their parenting choices and just less preoccupied about attaining some unreachable goal of perfection, all share a secret. They know that they will never be "that mom" or "that dad."

You know "those parents," right? The ones who are PTA president, grow their own organic food, pack gourmet lunches for their children and spouse, maintain an impeccable apartment, have some awesome work from home gig, and always look fabulous? Well, the rest of us could take some lessons from those that are okay with being good enough. Why? Because those folks know that they have their own super powers in other areas; that they don't have to excel in every single aspect of parenting and life, because it's just not possible. They know they can't be perfect and they are okay with that. And these are moms and dads that absolutely shine as parents. Maybe they know that they are awesome ticklers and all-around great organizers of games and family activities. Or that they remember and share family stories so that their child will pass the family lore on one day. Or that they always know where the lost teddy bear is. What ever it is, they know that we all excel in some areas and not in others. Yes, even "that mom" and "that dad" have room for improvement. And I suspect they're paying quite a price to maintain the aura of perfection. So why not focus on what we're great at as parents and people?

After all, do our kids notice or care that we are knocking ourselves out, sweating the small, unimportant stuff? Nope! Would they prefer to cherish memories of us as calm and happy to be around them? Absolutely!

So, what's your super power?

WHAT'S THE DIFFERENCE BETWEEN COACHING AND THERAPY?

I get asked pretty often-- "what's the difference between coaching and therapy?"

Well for starters, therapy focuses on you and oftentimes addresses symptoms such as depression or anxiety. As a parent, when you aren't feeling like yourself, it can have real ramifications for the rest of the family. It is key to take the time to get relief, both for your sake and for your family's. I urge parents to incorporate counseling, meditation, exercise and slowing down to help address the emotions that are interfering in your day-to-day. For some folks, a session or two is all it takes to "right the ship." For others with more long standing symptoms (eg, "I've always been a worrier,"), it may take a bit longer to shift those thoughts and feelings. But it can be done! In therapy, I use a combination of Cognitive Behavioral Therapy (CBT) and supportive therapies, with a strong focus on self care and self regulation. CBT has a fairly intuitive underlying concept, namely that your thoughts affect your feelings and behaviors. Helping clients examine their negative, distorted thoughts using a more balanced and realistic lens can make a huge difference both as a person and a parent. 

While in parenting coaching we certainly look at how you are doing, the main focus is on improving the relationship with your child. As a parent, I know how easy it is to get overwhelmed and having some outside help can really help shift the negative dynamics at play at home. The peaceful parenting approach is practical, and it works. There are three main ideas. The first is the need to regulate yourself as a parent. So, stopping yourself from yelling, pausing to breathe and not reacting as if the situation is an emergency is key. The next and most important piece is fostering connection. We truly cannot force our kids to comply--instead we have to use the power of our relationship. This means taking the time to connect and build a warm, loving relationship so that our child will not want to endanger that connection, and will instead, follow our guidance. The last part, is to coach and not to control our kids. Studies have shown that spanking and time outs are truly ineffective as means of guidance. When children misbehave, it's actually a sign that there is something wrong physically (hunger, fatigue) or within the relationship, but not with the child. Mind you, this is not permissive parenting, where anything goes and the child has the run of the house. On the contrary, the idea is to maintain limits but use empathy to see your child's point of view. 

So would you like to work on you or on your relationship with your child? In some cases, I even offer a bit of both coaching and therapy, which can be a good option as well. I am happy to speak and offer additional guidance on which option is best for you.

 

Connect to the Parenting Tribe in Your 'Hood

Ok, you're pregnant, or have a young child. And maybe you're the first --or last!--among your friends to have a baby. If, so you're not alone. It's extremely common never to have experienced life with baby close up...before one pops into your own life. Once you have a baby it can feel like you've landed on a different planet-- one that your childless friends just can't relate to. That can be very isolating, as your other childless friends and family may not get what it's like for you. And even seasoned parents forget what it's like during the zombie first months with a baby. (We block it out!)

So, bam...here you are. Baby? Check! Friends? Not so much. In a city teeming with parents pushing strollers, it's strangely easy to feel isolated. But stopping a random mom and asking "Can you be my mommy friend? Please!?" isn't necessary. Finding your parenting tribe is easier than you think. In New York City and especially in Brooklyn, each neighborhood has a parenting listserv where parents right in your area post questions, sell baby stuff, list baby classes and set up play dates. These listservs are super resources and are a great place to start to get connected to the parenting world. Below is a link to a list of most of the local NYC listservs, but if you don't see your neighborhood represented, go to groups.yahoo.com and search out your own neighborhood to see if there is a group nearby. Chances are good that you'll find one.

http://www.parkslopeparents.com/Local-Organizations/other-parenting-groups.html

 

New dads have it rough

New fathers have it pretty rough. The baby and mother get all the attention, leading to feelings of abandonment and possibly resentment of the new interloper. Subtly or overtly, many moms and grandmothers shunt aside new fathers as they swoop in to take care of baby, leaving dad feeling feckless and incompetent.  On top of it, the pressure to provide for a child hits home. Combine these feelings with a lack of sleep and a steep new fatherhood learning curve, and you have a recipe for turbulence. 

While the occurrence of Postpartum Depression (PPD) and anxiety in new moms is fairly well known and discussed -- though still mostly undiagnosed-- PPD can occur in new dads as well. Some studies report that one in ten new fathers experience PPD! Surprised? Unfortunately, the vast majority of new fathers get neither diagnosed nor help for their symptoms.

The symptoms of PPD can look different in men and women, with men often becoming withdrawn, perhaps distancing themselves by working longer than necessary hours at work, or by exhibiting greater irritability and lashing out in anger. Women more frequently have symptoms of anxiety, insomnia, bouts of crying, a sense of helplessness and of feeling overwhelmed. In either case, the ramifications for a new family can be severe and troubling if left unaddressed.

During the transition from pregnancy to new parenthood, many fathers feel that  they have to be "the strong one" to support their partners through the difficult physical and emotional adjustment period that comes with giving birth. Unfortunately, new fathers often neglect their own well being in the process. 

So what can be done if you are a new father who doesn't feel like yourself and may be depressed? Here are four suggestions:

  1. Check in regularly with your partner. Share what it's been like during this time. Sometimes just getting the feelings off your chest can be a huge relief. Make a point of taking at least a few minutes every day to talk. Send texts or emails when you're apart during the day. Don't stop communicating.
  2. Reach out to other new dads through meet ups, support groups or friends that are new parents. Commiserating with other guys can really help to avoid feeling isolated and it's helpful to know that you are not alone. There are parenting listservs in most neighborhoods in New York City, check out groups.yahoo.com to search for one in your area. 
  3. Take care of your needs. Rest, exercise, and eat well. You are no good to anyone if you are tired and burned out.
  4. Finally, consider getting professional help if your symptoms don't seem to be getting better after a few weeks. Talking over your experiences and feelings with someone neutral can make a big difference and can help you enjoy this time as a new family.

Will I Ever Be in the Mood Again?

Sex After Baby: Will I Ever Be In The Mood Again?

First published in Parents and the City

Olivia Bergeron, LCSW

I see many new moms in my therapy practice here in New York City.  From the Verrazano to the Whitestone, what do they all have in common? Pretty much without exception, for new moms sex takes a backseat. Between the almost hourly feedings and the turmoil of adjusting to a new role as parents, who has time for a shower, let alone lovemaking? If you add the baby blues, or even postpartum depression (PPD) into the mix, sex can drop down a notch below scrubbing out the garbage cans on a new mom’s priority list. 

Of course, many women who aren’t depressed also experience a nosedive in desire following birth. While I don’t believe that New Yorkers are any different from women around the country in this regard, I suspect that this sudden bottoming out of our sex drive hits women here pretty hard. We are used to being in control, at the top of our game, sexy and sexual and now…fuggedaboudit. Lack of libido combined with the physical and hormonal changes that having a baby brings, can bring even the most active pre-baby sex lives to a screeching halt. Leaking breasts, excess weight and spit-up do not make for a very sexy feeling mama.

Incidentally, one of the most common symptoms of depression is decreased sex drive. So if your sex drive has plummeted, take some time to consider whether you might also be facing PPD. One in seven new mothers experience postpartum depression and one in five experience emotional difficulties beyond the baby blues. So if you are in this boat, please know that you are not alone and help is available in the form of support groups, therapy and even medication, if necessary.

Whether or not depression is playing a role in the lack of libido, the physical and life changes involved in having a baby can be incredibly isolating. Partners often report “missing” each other and their former sex lives. Sex can create intimacy and boost mood: great benefits for all involved. For women with a young child, lovemaking—the whole gamut from nonsexual touching to sex—can provide a welcome bridge back to their partners.

So how do you jump start romance when on a desirability scale of one to ten, you feel minus five? Here are seven tips to fan the flames and get your sex life back on track:

1.    Have patience with each other. If you’ve been avoiding sex or just haven’t felt like it for a few weeks or even months, give yourself time following the birth of your child to get back to a semblance of normalcy. In the meantime…

2.    Keep up the non-sexual touching. We all need to be touched and held. Touch can convey warmth and intimacy even if we don’t feel up to having sex.

3.    Let each other know you find one another desirable. Telling your partner that you find them sexy and attractive (despite the spit up stains) can boost self confidence and provide reassurance that you haven’t forgotten each other.

4.    Slow down. It may take more time and effort now to get into a frame a mind where you are able to tune out thoughts about baby and tune into your own sexual desires. Take the time to turn each other on.

5.    Romance each other. Nothing sets the mood like a thoughtful gesture, a sexy text message or the old standby, wine and roses. We all need to be wooed, especially during this period of transition.

6.    Listen. Physical changes after birth may bring about differences in sexual needs and wants. Speak up about your needs and listen to your partner’s.

7.    Be “selfish.” Date nights may seem a distant memory, but taking couple time is essential to being good parents. Carve out time here and there to get away, talk and reconnect.

8. Get help. If it seems like nothing is working and you are concerned about rekindling your libido, seek out a qualified therapist to help work through your feelings.

Each couple is different and there is no magic formula that will work for all.  However, maintaining honest communication and making time for intimacy can go a long way towards reestablishing a fulfilling love life as new parents.

Postpartum Depression: The Silent Epidemic

Postpartum Depression: The Silent Epidemic

First published in A Child Grows In Brooklyn

Did you know that one in seven mothers experience postpartum depression, but that most suffer in silence, never seeking help or support?  Despite the number of celebrities such as Brooke Shields, Gwyneth Paltrow, and Bryce Dallas Howard who have spoken publicly about their bouts with PPD, many women still think it’s shameful to feel down after the birth of a child. Not so.

PPD should not be confused with the “baby blues.” While a woman may experience a short period of tearfulness, irritability, and frustration soon after giving birth, the baby blues do not interfere with a mom’s ability to care for her baby or herself. PPD, on the other hand, can be severe. Women suffering from PPD typically report feeling hopeless, angry, worthless, guilty, and/or anxious starting around 4-6 weeks postpartum. Some women may experience panic attacks or become obsessive about such things as germs or the baby’s health. The condition can become so intense that it interferes with a woman’s desire and ability to bond with her baby. A good rule of thumb is if a mom is not feeling herself by the time of her six week postpartum check-up, then it’s time to get help.

Because of mom’s central role in the life of her child and family, PPD can have unfortunate consequences. Not only is mom’s ability to function at home and work compromised, babies with depressed mothers have been shown to have diminished cognitive development and are more prone to forming an insecure attachment to their mothers.  As they get older, the children of depressed mothers may have language delays, behavior problems, and social impairments.

No one knows for sure what causes PPD, but there are some environmental and genetic predictors for postpartum depression, including a poor support system, marital conflict, a personal or family history of depression, a colicky or difficult baby, financial difficulties, closely spaced births and a traumatic birth experience.

While PPD is common and debilitating, the good news is that it is very treatable, particularly when caught in its early stages.  If you think you or a loved one may have PPD, the first thing to do is to rule out physical causes by getting a thorough medical check-up.  Thyroid dysfunction and anemia can sometimes mimic the symptoms of PPD.  Next, get help.  Therapy, combined with medication if necessary, has been proven extremely effective in treating PPD. Look for practitioners who specialize in treating PPD and who understand the unique needs of new moms.

In addition, rally all the support you can. Ask your friends, family, or neighbors for assistance. Make things easier on yourself by hiring help, if possible. A doula, for example, can offer support, comfort, and a hand around the house. Avoid isolation by seeking out PPD-related support groups and blogs.  And lastly, take time to care for yourself: go outside, do some gentle exercise, and rest. By accepting your condition and seeking the proper help, you will be able to be the mom you want to be, sooner rather than later.

 

Links to information:

The Postpartum Stress Center (postpartumstress.com),

Postpartum Support International (postpartum.net),

Postpartum Resource Center of New York (postpartumny.org)

Postpartum Progress, A Survivor’s Blog (postpartumprogress.com)

 

- See more at: http://www.achildgrows.com/the-silent-epidemic-postpartum-depression/#sthash.kCJK6qbi.dpuf