Supporting New Moms: A Partner's Guide to Maternal Mental Health
May is Maternal Mental Health Awareness Month, so I wanted to make sure and create space on the blog for education and support related to this topic. As a licensed clinical psychologist, who specializes in treating perinatal mood and anxiety disorders, this month feels like a really important opportunity to share some of the knowledge I have in order to continue to raise awareness, decrease stigma and increase access to effective mental health treatment.
Recently, there have been a lot more open and honest conversations about what pregnancy, motherhood, and parenting can really be like. Gone are the days of over-glamourizing this time of life. And even though the “realities” of parenting are much more exemplified on places like Instagram, those spaces don’t always provide good or accurate information about what to do when the proverbially “sh*t hits the fan”. Well first, let me give a brief introduction about what PMADs are and how you can get help.
Perinatal Mood and Anxiety Disorders, or PMADs are distressing thoughts, feelings and experiences that occur during pregnancy and within the first year postpartum. One of the hardest things about distinguishing between “baby blues” and PMADs is that the signs and symptoms can look and feel very similar. One of the biggest differences to look out for though is how long the symptoms last. If you are experiencing symptoms such as mood changes, irritability, anxiety, tearfulness, and insomnia longer than two to three weeks during pregnancy or postpartum, or they are impacting your functioning, you might have a PMAD. The good news is that PMADs are treatable, and support is available. Treatment might include talk therapy, medication, or, a combination of both. Studies suggest that treatment such at Interpersonal Therapy (IPT), Cognitive Behavioral Therapy (CBT), medication, and unstructured counseling all help in remitting depression in postpartum moms. If you want to learn more about these specific topics related to PMADs check out my previous blog post linked here.
Now that you are a little more familiar with PMADs, what they are, and how to get help, I want to share more about a question I get asked a good amount. Partners often wonder “how do I help my partner with a PMAD?”. Here are five actionable things you can do to begin to support the new mom in your life:
1. Education- Reading this blog is a good start, but it is important to further your knowledge about PMADs if you are thinking of growing your family. This is not meant to scare you, but 1 in 5 women will experience a PMAD during pregnancy or postpartum. Start by becoming familiar with the signs and symptoms of a PMAD. Understand what some of the risk factors are and if you and your partner might have any of those. It is also important to know the difference between the “baby blues”, postpartum depressions, and a psychiatric emergency. As a quick recap, the “baby blues” are normal but drastic changes in your mood right after giving birth lasting for about two weeks. Postpartum depression is more severe, lasts longer than the baby blues, and can often make it hard to care for yourself and baby. Perinatal psychosis occurs in about .1-.2% of the birthing population. The onset is often sudden and usually happens closer to the birth, however, can happen within the first year postpartum. Some signs of postpartum psychosis include strange beliefs, hallucinations, and paranoia. Postpartum psychosis is always a psychiatric emergency. If you notice any of these signs or symptoms, it is important to get help right away.
2. Preparation- You’ve prepped the nursey, packed your hospital bags, and even devised an ideal birth plan. But what about a plan for your mental health? One thing I often work with pregnant clients on is a “mental health birth plan”. Work with your partner on creating a mental health plan. Talk about how you anticipate things going based on previous experiences, risk factors, and desires. Some things I suggest including in your plan would be having easy access to your therapist’s contact information immediately postpartum. If you give birth in a hospital, staff will assess your mental health after birth. If there are concerns, it can be very helpful for them to contact a provider who already knows you. If you’re not in therapy already, start by looking for some therapists who specialize in perinatal mental health or even have some consultation calls before your baby arrives so that if you need more support during postpartum you are already set up. Help your partner by looking up these individuals and possibly even making the first outreach to them.
3. Listen and Validate- It’s natural to jump into problem solving mode when we see someone we care about in pain. Of course, we don’t want to see them suffer, so if we can “fix” it, then they’ll feel better, right? Not always. Problem solving has its place but a good first step is listening and validating. This is especially needed for new moms. Becoming a parent is hard and sometimes you just need someone to hear how hard it is and validate that feeling. We might think that it’s helpful to downplay what a mom is telling us by saying something like “Don’t worry, it’ll get better” or “just remember how lucky you are to have a baby!” but these statements are dismissive and invalidating. Instead, be in it with the person you care about. When they tell you something is hard, they’re overwhelmed, or frustrated, you can say sonneting like “I can see how you feel that way” or “I’m here for you while you feel like this”. Statements like this help to strengthen relationships, help a person feel valued, and, can even foster better emotion regulation.
4. Don’t ask, just do. This tip is a break away from the suggestion of a “honey do list”. Many families function by breaking down tasks and divvying them up. Often times, this role is taken on by the mother. As a new mom though, something like taking stock of all the chores and asking someone else to help with them can be overwhelming. Rather than waiting or asking for your “honey do list”, just start doing things. Take on responsibilities with childcare and household tasks that the new mom in your life normally takes care of. Some examples might be figuring out meals, doing laundry, washing bottles, and, changing diapers. My suggestion is don’t ask what needs to be done, just take a look around and find something you can do.
5. Take care of yourself. You’ve done all the other things on this list and now you’re pretty exhausted yourself! Don’t forget that part of being a supportive partner is making sure you are taking care of yourself. Carve out time for both you and your partner to get some self-care. Come up with a schedule or engage in it together! It is important to note that broad research suggests that dads/non-birthing partners can also experience baby blues or postpartum depression. If you notice symptoms like a depressed mood, low energy, changes in sleep or appetite it could be beneficial to seek professional support like therapy.
Supporting a partner through parenthood and potentially PMADs can be a challenging journey. However, with education, preparation, active listening, proactive assistance, and self-care, it's possible to navigate these times together. If you or your partner are interested in learning more about how therapy can help you on this journey, reach out here. Remember, seeking help is a sign of strength, and in my therapy practice we will work together so you can weather the storm and emerge stronger, more resilient, and connected as a family.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039003/
https://drvvitiello.com/blog/tv2av334ctkiol1ogr6g68jcibo7hp
https://www.webmd.com/depression/postpartum-depression/early-warning-signs-postpartum-depression
https://www.marchofdimes.org/find-support/topics/postpartum/baby-blues-after-pregnancy
The Benefit of Breaks
Now that Thanksgiving break is in the rearview mirror, the countdown to the new year has officially started! During this time of excitement and anticipation, I wanted to take a moment to acknowledge some of the challenges this time of year can bring to our management of stress.
As many of us head toward time off at the end of the year, work deadlines, commitments, and the pressure for us to meet them mounts. Simultaneously, a whirlwind of festivities and obligations at home builds rapidly. As a byproduct of this acceleration of activity, stress can take over.
This time of year can be especially stressful for us with a final push to get work or personal goals done before the break. On top of that, the days are shorter, nights are longer, and we all are faced with reflecting on the year that has passed, while setting sights on what is to come. Burnout, which is described as mental, physical and emotional exhaustion, tends to be at an all time high at this point.
Navigating through this time of year encapsulates the pressure we all face to manage the expectations we have both in life, and for each other, while also underlining the difficulty that can come up when transitioning between items on our complex schedules and routines.
Despite the challenges and stress that are inherent during this busy season, recognizing the benefits of breaks can be crucial to our overall well-being. Giving ourselves “micro breaks” on a regular basis, rather than waiting only for a lengthy break at the end of the day or year, has been shown to reduce stress, improve concentration, and benefit our physical and mental health.
One example of taking micro breaks is by using the “Pomodoro Method”. This is a time management technique that we can use to split up a task we need to complete. The method suggests working on a task for 25 minutes, and then following that period of work up with a short five minute break. It works best if you use that break time intentionally. Do some stretches, have a healthy snack, maybe even meditate for a moment.
We can translate the Pomodoro Method, or “micro breaks”, into our daily lives and find ways to incorporate short breaks throughout our everyday tasks and responsibilities.
Consider these four types of breaks:
Physical: exercise or movement. Try taking a five minute walk or stretch.
Social: connect with friends and family. Give someone a call or send a text. Maybe allow yourself to connect over social media– just be sure to keep an eye on your time!
Mindful: practice a brief guided meditation or breathing exercise.
Creative: engage in a pleasurable activity like a hobby or personal interest.
Beginning to incorporate breaks can feel hard at first, especially if it is not a part of our typical time management or self-care routine. Start by incorporating breaks into your personal and family schedules. Reflect on your responsibilities, and come up with a plan for managing potential stress by incorporating breaks. Try to remind yourself that breaks actually help you to be more productive in the end. Lastly, try practicing these strategies with friends, family, or coworkers.
Amidst the hustle and bustle of this season, breaks can be increasingly valuable respites as we make our way through the many obligations and pressures we face every day.
For further guidance or support on integrating these strategies, or if you have concerns about your stress management, consider reaching out to myself for a free 15-minute phone consultation to see how therapy can help.
Happy Holidays and Happy New Year!
The Adolescent Mental Health Crisis—Are Teens Really in Crisis?
Overview of teen mental health
If you have watched, listened to, or read the news recently, or perhaps simply live with a teenager then you might have a sense of what is going on with teen mental health. In recent years, we have been alerted about the worsening of teen mental health, and the global pandemic certainly did not help. In fact, many believe that the pandemic is the cause for rising rates in adolescent mental health issues, however, research shows that teens’ mental health was worsening even prior to this.
You might be asking yourself “what do you mean by teen mental health?” and as a follow up to that, you might also wonder, “are teens really in crisis?”. Let me start by answering what we, as mental health professionals, mean when we’re talking about teen mental health.
We specify teen mental health because adolescence is a time of life that is particularly formative, tumultuous, and filled with change. Because of this, and the brain development that is happening at this time of life, the mental health of teenagers is particularly vulnerable. Too often, there is a misconception that mental health is about feeling good all the time. In fact, our wellness-oriented culture would lead you to believe that the absence of emotional suffering is our goal or path towards “achieving” mental health. In fact, though, it’s not! Lisa Damour, PhD. defines mental health as “having the right feelings at the right time and being able to manage those emotions effectively.” This means that rather than feeling happy all the time, we experience a range of emotions, including fear, sadness, worry, and we feel them when it is called for. For example, if you experience a loss or are making a transition in your life, it would be expected that you feel sad or worried about these things and can find adaptive ways of coping with these feelings. Being mentally “unhealthy” might look more like feeling persistently sad or worried in contexts that do not justify those types of emotional reactions or intensity. So when we talk about the trends in teen mental health, this is increasingly the problem we’re finding with our adolescents. The CDC reports that in 2021, 44% of teens indicated feeling persistently sad or hopeless in the past year. In addition to this, reports of around 22% of teens surveyed also seriously considered ending their life. Both of these statistics show significant increases compared to previous years, especially in trends observed from the past 10 to 20 years.
Effect of the pandemic, social media, and academic stress on teens
The COVID-19 pandemic has had a profound impact on teen mental health. Isolation, disrupted routines, increased family discord or abuse and loss of prosocial activities have contributed to increased rates of anxiety and depression among adolescents. In addition, the pandemic also led to increases in screen time as we turned to virtual learning and teens relied more heavily on their phones and social media to connect with peers. Unfortunately, excessive screen time, particularly on social media platforms, has been linked to increased feelings of loneliness, depression, and anxiety among teenagers. Beyond this, the pressure to perform academically, whether in school or in preparation for college admissions, can lead to stress and mental health issues among teens. When surveyed, 61% of teens report that getting good grades is one of their top stressors. To wrap it all up, teens are keenly aware of the ongoing sociopolitical climate, issues around climate change, and their degree of safety and current rates of violence.
Let’s not forget that adolescents are already undergoing a huge renovation and rewiring project as their brains are transforming significantly during this time. Under the most typical circumstances, teens are already vulnerable due to the fact that the emotional part of their brain, the amygdala, is beginning its’ transformation before the rational part of their brain, the prefrontal cortex. Because these areas of the brain are developing at different rates, you’ll know if you spend any time with teens, life can feel like an emotional rollercoaster. I think we can all agree, the circumstances we have all experienced in the past few years has not been the most “typical” and so teens have in some ways doubly suffered. I believe it is due to this combination of factors, at least in part, that we are seeing drastic rises in teen mental health issues.
But…is it a crisis?
So, does this mean that our teens are in crisis? Sort of. The numbers of teens, especially girls and members of the LGBTQ+ community, seem to be at greater risk for mental health issues than in years past. The rates at which depression, anxiety and thoughts of suicide have increased is certainly alarming, and at the same time, not really that surprising. What we can say definitively though is that poor mental health has serious impacts on our youth. Aside from higher rates of diagnosed depression and anxiety, and increased rates of suicidal ideation and attempts, poor mental health impacts teens academic, social, success, and well-being. Research suggests that depressive symptoms are associated with lower grade point averages and linked to higher rates of school dropout. One symptom associated with depression is social isolation and withdrawal which certainly impacts a teenager’s ability to engage in peer related activities and relationships. In addition, some research suggests that teens who experience depression are more likely to have persisting relationship difficulties into adulthood.
Overall, the impact of mental health issues during childhood and adolescence can have significant long-term effects, and is associated with lower life satisfaction and quality of life, including both physical and psychological health, in adulthood.
How Can We Help?
If you are still not convinced that teenagers are in “crisis”, I hope you are at least wondering how you might be able to help support the teens in your life. The first thing to do is be aware of the warning signs. While you may not be adept at knowing the nuanced symptoms of anxiety, depression or other mental health disorders, you can pay attention to some of these things:
Changes in school performance or engagement
Excessive worry or anxiety, for example avoiding going to school or seeking constant reassurance.
Frequent or increased defiance or aggression
Withdrawal from things they typically enjoy such as hanging out with friends or watching a TV show.
Changes in appetite, hygiene, or sleep
If you notice some of these changes or behaviors in a teen you know and/or love, here are some ideas on how you can help:
1. Provide a safe and supportive environment for teens. No one wants to see someone they care about in pain or emotional discomfort. What is meant as well-intended support and problem solving is often received as unwelcomed advice from teens. Focus on validating their experience and feelings rather than heading directly towards solving the problem.
2. Learn about mental health resources in their school. Most schools have some type of student support team that likely includes at least one mental health professional such as a school psychologist or counselor. Learn who this person is, what kind of services they provide and how you can work together to support the teen you care about.
3. Sometimes we need more help than supportive friends and family can provide. If changes in the mood or behavior is worsening, intensifying, or persisting more than a couple of weeks, treatment might be the right option for the teen. Help them explore options for treatment through insurance, or use therapy search engines such as Psychology Today, Mental Health Match or Therapy for Black Girls. Sites like Open Path Collective help connect individuals with low fee therapy options.
4. If they are in fact in crisis, (i.e., actively self-harming, making plans to get rid of their things, talking about hurting or killing themselves) seek immediate professional help or emergency services.
Adolescence is tough enough as it is. If you or your teen are interested in learning more or are ready to get support, please feel free to reach out for a 15-minute consultation call I would love to help you!
Feeling Ambivalent?
I recently sat down with a reporter from Today.com to talk about a topic that needs more light shed on it— pregnancy ambivalence. Ambivalence means feeling opposite things or more than one feeling at once. Feeling ambivalent during pregnancy is a common and normal experience, however there is still a good amount of shame and stigma around it. To learn more about pregnancy ambivalence, read about others’ stories, and see what I had to say about it from a psychological perspective, check out the full article linked below.
What is pregnancy ambivalence? It’s a lot more common than people know
It’s 2023 and Dating Sucks!
Okay, let me start off by saying, admittedly, I am not in the dating game. What I can say is that based on what I have heard from friends, clients, and social media, is that dating today sucks. If you are looking for more than just anecdotal information, look at recent Pew Research that suggests nearly 50% of Americans surveyed think dating is harder today than ten years ago. If you are in the midst of finding a love connection or just observing from the outside (like me), you likely feel baffled by the approach to dating these days.
Let’s start with an analysis of the portrayal of dating in reality TV. Turn on your television or any streaming service and you can find a myriad of options to watch others attempt to find love. Some shows tell us that they will help participants find “the one” while others tell us that “love is blind”. The problem with some, if not most of these shows is that for hopeless romantics alike, we are seeing a fantastical version of what being in a relationship really means. They typically include gendered stereotypes, oversexualized engagements, and a cast of characters who are perfectly waxed, dressed, tanned, and made up. Don’t get me wrong—I am a fan of Love Island as much as the next person; however, research shows that individuals who view dating reality shows hold more traditional views on relationships than those who do not watch. Years ago, this might have been fine, but today numerous reports show that traditional dating values are not as widely sought after. Bumble’s recent release of 2023 dating trends shows that about 30% of individuals are reportedly more open to dating outside of their “usual type” and another report tells us that daters are going on less traditional and more authentic dates.
Okay, so most of us, much to our chagrin, are not going to end up on a reality match making TV show. So, what alternative do we have in our ever-evolving technological world—online dating and dating apps of course! Research shows that more than half of never married adults are on a dating app. Moreover, about one in five adults aged 18 to 29 who are partnered report finding their love match through online dating. Even though many of us utilize online dating and apps, it does not come without out its challenges. Issues around safety, accuracy of physical appearance, and even cost of apps arise. Dating apps are reportedly “lagging behind” in safety measures leaving their users vulnerable. One study showed that over 1,200 women reported sexual assault by an individual they met through a dating app. Additionally, research shows that most people’s decision to swipe left of right is based on someone’s attractiveness and race. That’s not a major problem though since online daters can and do alter, edit, and curate the perfect yet not always accurate presentation of themselves. Finally, it’s no surprise that dating apps have capitalized on lonely hearts alike and are raising the price to find love. Listen to the podcast, The Price of Dating Apps on The Journal to get a sense of how dating apps are becoming more exclusive, and daters are paying to find “better” matches.
Why Dating Sucks from a Psychologists Perspective:
If you are not convinced already, I am going to share a few more reasons, from a psychological perspective of why I believe dating kind of sucks.
Dating is being treated like a game:
The combination of dating shows where you win money and features of dating apps are making it apparent that dating is a game. A study even showed that college students described dating apps as “fun, a joke, and game-like” (Hanson, 2020). The problem with this is that being in relationship with another person is not a game. Whether you are dating to find a committed relationship or a current companion, you are entering into some form of a relationship. When you treat a relationship as a game aspects like competitiveness, strategy, and jest show up. Treating dating as a game could even lead to manipulation and malintent. Being in a relationship is all about reciprocity. Reciprocity in a relationship means mutual engagement and exchange. Unlike a game where generally one person “wins”, reciprocity allows for both parties to benefit. For all these reasons dating can’t possibly work when it is a game.
Vulnerability and Authenticity Are Not Being Valued:
In today’s world we have so many options: what to order on Uber Eats, where to go on a trip, and now, who to date. No longer are the days of meeting someone at your local bar or at work. Instead, we turn to the world wide web and the options are endless. As you can imagine and with the previously mentioned data, online daters who are quite literally sharing themselves with the world may be less inclined to show up authentically. Of course, an online profile is only just a window into a person. Not only this, but one article states: “It is extremely eye-opening that people are willing to make decision about whether or not they would like to get to know another human being, in less than a second and based solely on the other person’s looks”. How much room are we leaving for vulnerability or authenticity when we are making split second decisions based on looks? We are closing ourselves off to the option of engaging in an authentic and vulnerable relationship. Vulnerability does not mean being an open book. Instead, vulnerability in a relationship means an honest exchange of thoughts, feelings, and experiences. Dating today focuses on the surface stuff. Although we can disclose aspects of ourselves on a dating app, it is hard to get to know someone authentically. Dating and romantic relationships cannot exist without vulnerability and authenticity.
We Still Have Our Own Healing to Do:
Last and maybe most importantly, your dating life sucks because you still have your own healing to do. Yeah—I’m sorry to be the bearer of this news, but dating doesn’t just suck because of technology, reality TV, or even the pandemic. Dating might suck… because of you. Now, I am not saying that people cannot date or be in relationships while simultaneously working on themselves. What I am suggesting though, is that if relationships are about reciprocity, vulnerability, and authenticity, we have to know how to engage in these things. For some of us, our previous experiences, personality characteristics and even family upbringing can make that hard. Luckily, we can make an active choice to work on this by building skills, self-awareness and trust. One way to do this might be through going to therapy. In therapy, you will have a safe space to explore and get to know yourself and your patterns of behavior better. In fact, therapy can be a lot like dating and relationships. It can take time to find a therapist who you like and is the right fit. You might even have to try a few out or “date” before you find “the one”. The therapeutic relationship as I describe it to my clients, is a microcosm of your real-world relationships. In this way, therapy can also provide an opportunity to “try out” communication, boundaries, and trust, in a non-judgmental environment. All of these things being vital to a healthy relationship.
If you’re dating life sucks, and you are ready to give that a change, please feel free to reach out for a 15-minute consultation call. I would love to help you prepare yourself to find love!
References:
Hanson, K. R. (2020). Becoming A (gendered) dating app user: An analysis of how heterosexual college students navigate deception and interactional ambiguity on dating apps. Sexuality & Culture, 25(1), 75–92. https://doi.org/10.1007/s12119-020-09758-w
https://nypost.com/2022/11/23/new-dating-trends-revealed-in-bumbles-2023-annual-report/
https://www.theknot.com/content/dating-trends
