Over the past two decades, we have seen a steady rise in media attention covering Postpartum Depression (PPD). This is partly because the psychiatric community officially recognized PPD as a distinct condition in the mid-90s [i] and partly because of celebrities who have started to talk about their experiences with postpartum depression. And yes, you read that correctly, although there are abundant records of women talking about their experiences with maternal mental illness from the early 1800s to the present, it only started being recognized as a distinct mental illness in the 1990s[ii]. As you might imagine, the result is that the science, the literature and the media reporting are all a bit behind. Luckily, with organizations such as Postpartum Support International (PSI), the science is finally starting to catch up and hopefully, that means the media and our social perceptions of maternal mental health will too.
What is Postpartum Depression?
Postpartum depression is often used as an umbrella term for all maternal mental health conditions, but in reality, there are a number of maternal mental health conditions that are distinct and vary in terms of severity, duration and characterization. All of these conditions tend to get jumbled up together in the media which is confusing for those who have PPD, as well as their loved ones. So, let’s break it down.
The technical term for postpartum depression is a Major Depressive Episode with Peripartum Onset. What that mouthful of jargon basically means is that PPD can be understood as a depressive episode that lasts a minimum of 2 weeks and is characterized by depressed mood, insomnia or hypersomnia, fatigue, feeling worthless, low interest in pleasurable activities and having thoughts of suicide[iii]. If you read my last blog post about the Baby Blues, you might note here that PPD is very different from the Baby Blues. Baby Blues are a normal part of giving birth where most mothers experience a drop in the mood right after giving birth for a short period of time. PPD not only last longer but is more severe. About 15% of new mothers experience PPD as opposed to 85% of mothers who get the Baby Blues[iv][v]. And while this distinction is important, keep in mind that whether you have the Baby Blues or PPD, you can absolutely get treatment, you don’t have to wait and see if it’s severe enough. Every person’s experience is different, and you deserve help. Do yourself a favour and check in with your doctor, midwife and/or therapist to see how they can support you to feel like yourself again.
Men experience PPD too. A growing body of research has shown that roughly 5% of new fathers experience PPD which comes as no surprise because mothers and fathers both endure the many new stressors like lack of sleep, way more responsibilities and demands put of their plate, and feelings of failure and inadequacy often associated with bringing a baby home[vi].
I won’t go too far into the causes of PPD here but if you ever want to talk about them, my door Alongside You is always open.
I’ve spoken to a lot of mothers and fathers who were very confused about the way their PPD presented itself. Interestingly, PPD might look different from what we might think of as a typical episode of depression. A lot of people with PPD have reported either anger or anxiety as their primary symptoms[vii]. Some experience periods of elevated energy and racing thoughts where they’re unable to sleep and can’t stop cleaning. Many also report panic attacks[viii]. While these responses may feel scary at the time, they are normal and can be helped with a number of different therapies that I will get into at the end of this article.
Overcoming Stigmas and Getting Help
Experts agree that PPD is underdiagnosed, primarily because those who endure it often feel too ashamed to seek help. There’s a common misconception that PPD is associated with infanticide which is simply not true. Those over-reported cases of infanticide are not cases of PPD, they are cases of severe psychosis with peripartum onset. Unlike depression, psychosis is characterized by delusions and hallucinations[ix]. And even if a parent does show signs of psychosis with peripartum onset, it is incredibly rare that these delusions will lead to infanticide[x]. I can’t stress enough how rare that is.
New parents are often under a lot of stress and experience intrusive thoughts. When a person’s brain is in an anxious state, it’s common for their mind to go to the worst possible thing they could do (as if you weren’t stressed enough already…). This happens to all of us. Sometimes when I’m driving up the Sea to Sky highway, my brain imagines veering my car off the cliff. Of course, I will never do that, but my brain plays some pretty wild tricks sometimes, just like yours might when you’re under a lot of stress and your baby is still crying.
The main danger with PPD is that the stigmas that result from those sensationalized media stories keep many new parents from reaching out for help. As a result, suicide (not infanticide) is the greatest risk associated with PPD.
What can Help Postpartum Depression
As I mentioned at the start of this blog, science is catching up and we now have many treatments to choose from for PPD. Some find antidepressants helpful, like one woman said, “the me I was used to re-appeared after medication.” Other treatments include infant sleep interventions, massage therapy and relaxation, increasing Omega-3 intake (fish, nuts, seeds, healthy oils), spiritual practices, yoga, bright light therapy and, of course, counselling (individual and couples counselling are both helpful). For most new parents, a combination of any of these above methods works best.
I’ll leave you with a simple and accurate quote from a mother I recently spoke with who had PPD – “Let people help, they want to.”
We’d love to help, if you’ll let us. Give us a call at the office, or contact us through our contact page and we’ll be happy to talk to you about how we might be of help!
Some books that have been helpful to others:
Motherhood May Cause Drowsiness: Mom Stories from the Trenches: A Second Edition Monkey Star Press Anthology (What Is a Mother to Do? Adventures in Motherhood and Mayhem) – by: Lisa Nolan, et al.
When Postpartum Packs a Punch: Fighting Back and Finding Joy – by: Kristina Cowan
Tokens of Affection: Reclaiming Your Marriage After Postpartum Depression 1st Edition -by: Karen Kleiman, Amy Wenzel
The Birth Partner: Everything you Need to Know to Help a Woman through Childbirth – by: Penny Simkin
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) VA: American Psychiatric Association
 Segre, L.S., & Davis, W.N. (2013). Postpartum Depression and Perinatal Mood Disorders in the DSM. Postpartum Support International. Retrieved from www.postpartum.net.
 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). VA: American Psychiatric Association
 Khajehei, M., Doherty, M., & Tilley, M. (2012). Assessment of Postnatal Depression Among Australian Lesbian Mothers During the First Year after Childbirth: A Pilot Study. International Journal of Childbirth Education, 27(4), 49-54
[v] Khajehei, M., Doherty, M., & Tilley, M. (2012). Assessment of Postnatal Depression Among Australian Lesbian Mothers During the First Year after Childbirth: A Pilot Study. International Journal of Childbirth Education, 27(4), 49-54
An interesting piece about “The big myth about teenage anxiety” ran in the New York Times this week, authored by a fairly prominent psychiatrist – which you can find here.
The essence of Dr. Friedman’s editorial is that much of the research showing a rise in teen anxiety is not conclusive, which from a scientific perspective is unsurprising. Many of these studies rely on self-reports, which, though scientifically imperfect, offer an important window into human experience – something we as mental health professionals consider of paramount importance. A better understanding of what we deal with internally and externally on a daily basis (and the meaning we make of it) is essential to better understanding ourselves. Dr. Friedman also encourages readers to remember that phones are not necessarily to blame for anxiety, as much as it may seem that way. He points out that anxiety is normal, and that our brains are quite well-equipped to handle it.
The article is nuanced, and while I would hesitate to back up many of the things Dr. Friedman says, one important distinction he makes is between actual anxiety disorders and day-to-day anxiety and worry – something most teens are virtually guaranteed to experience. Social media and the internet have indeed made the social world more complex for teens to navigate – as many have noted, there is no “escape” from the reach of the internet anymore, and it is more than understandable that teens are often glued to their phones. Teens are under a lot of stress developmentally, socially and physically, and Dr. Friedman is careful to point out that there will and should be plenty of anxiety in teenage life.
The crux of the matter then is not eliminating or avoiding anxiety (avoidance, of course, will actually make the anxiety seem stronger than it is), but focusing on what we can learn to do in the face of anxiety. Teens can learn that anxiety is normal, learn to notice bodily sensations that arise, learn to stay grounded, and even learn to appreciate their anxiety for protecting them.
Many parents are highly distressed when they learn their teen or child is struggling with anxiety, and I would encourage those parents to remember how normal that is. Your job is not to eliminate or protect from that anxiety, but rather to be with your child as far as they will let you, and creating as best you can a space of rest from it. There are many anxiety management techniques that can be learned to reduce day-to-day anxiety, but one of the best things to have is a secure relationship within which you do not need to be anxious. I can’t stress enough the impact of having someone with whom you feel safe to just be you, warts and all.
It’s no secret that I (along with many others here at Alongside You) am a big fan of attachment parenting, an idea propagated by Dr. Gordon Neufeld and brain researcher Daniel Siegel, among many others. I am also a big fan of parents taking care of themselves before they worry too much about taking care of their children, for several reasons. So I should mention that your anxiety about your kids’ anxiety is incredibly valuable: it tells you how important it is to you that your kids are safe and happy. This is wonderful, and you also should get to know that perfectly normal anxiety really well within your own safe relationships, because your kids will use you as a compass point to manage their own anxiety. If you have a good relationship with your anxieties, you will be very much ahead of the game in helping your child or teen with theirs. Normalizing our own experience of anxiety reduces it in our kids, and also shows them that they’re not alone.
Parenting is a tough job, and if you’re reading this, one that I imagine you take seriously. Best of luck, and as always, feel free to ask lots of questions and seek lots of support. If we can be a support to you, please don’t hesitate to contact us. We’re all in this together.
It’s that time of year again; the time of year where summer ends, and kids are going back to school. I find that this time of year brings one of two primary reactions from parents:
“Hallelujah! They’re back in school and I can finally get things done around the house or at work again!”
“Oh no, my babies are gone back to school! Are they going to be ok? How are they going to survive? What if they [insert any number of parental fears here]….”
Sometimes I wonder who has more anxiety during the return to school period – the kids, or the parents? Counselling for children during this time period can be very helpful, as can counselling for parents. What else is helpful as we prepare our kids for school?
One thing that’s clear, both in my personal experience (clinically, and with my own kids) is that our own emotional climate has a great effect on our kids’ emotional well-being as they return to school. If we are feeling anxious, chances are they’re going to pick up on it and join the anxiety party. If we’re calm, they may not join that party, but at least we’ll be in a position to help.
I get it. I hear your fears and anxieties as parents of young children. It’s normal to be anxious about this time of the year. So, what can we do to help our kids during this important transition? I’d like to offer four questions that we can ask our kids to open a conversation with them as they go back to school. I believe this dialogue will not only help their anxiety (which it will), but it will also build up the reservoir of empathy that is so needed, and strengthen your relationship with them.
1. How are you feeling about going back to school?
What is your greatest fear, and what are you most excited about? With this question, we’re inviting our children to share their emotional world with us, and at the same time, we’re making it explicit that it’s ok to have fears and it’s ok to be excited. We’re also introducing the idea that it’s possible to have both excitement and fear all at the same time! The psychobabble word for this validation.
By validating their excitement and their fears, we’re helping them feel known, accepted, and heard. This is the very basis of empathy, the greatest antidote to stress and existential anxiety. It’s the greatest tool we have with our children and their fight against their anxiety.
2. How do you feel when you’re in school?
What helps you enjoy the great parts and manage the hard parts? This question helps our child explore how they are doing during the school day when we’re not there. Research out of Yale University shows the importance of helping children have a “mood meter” throughout the day at school. It helps them understand their world as well as regulate their emotions. While specific techniques to manage mood are great, their research shows that simply paying attention to our emotions in a validating environment produces emotional benefits and helps students manage their emotions better in school and at home, all while reducing overall stress.
3. How do you feel during recess and lunch?
What are you looking forward to, and what might be more difficult? This question is a sneaky one. This is how we find out about their relationships at school and how they are doing with their peers. I don’t know about you, but if I ask my kids directly, “How are your relationships with your friends,” I’ll invariably receive an answer along the lines of, “Fine.” Or sometimes it’s, “I don’t know,” and finally, if I’m really lucky, I just get, “Dad! Stop butting in!”
If, however, we ask our kids how they are feeling during the times where they’re interacting socially with their peers, we’ll get a glimpse into their relationships. If they’re connecting well with other students we’ll likely get positive reports; if not, we might hear things like, “I’m bored,” or, “I’m lonely,” or, “I hate lunch.” This provides us with an opportunity to ask further questions, but now with a reason that the child has provided themselves. We can ask, “Wow, I’m sorry to hear you hate lunch and I’m curious what it is about lunch that isn’t going well?”
Sometimes, no matter how we ask, our children may not tell us what’s going on. If that’s the case, we can still get a win. Even if we can’t address that problem directly, at least we can provide empathy. If all else fails, we can still respond with, “Wow, I’m sorry to hear you’re having a tough time at lunch. I’m not sure how I can help, but I’m glad you told me.”
4. How do you feel when you get home?
What do you need after a day at school? This final question gives us a window into what our kids need after a long day of school, and believe me, the school day is long for our kids. Each kid is unique, however, and their needs after a day of school are wide and varied. Some kids need to run, some need a nap, some need a hug, some need…well, we’re not sure what. This is our chance to give our kids the opportunity to tell us what they need so we can help them get their need met.
It also provides us with a unique opportunity to connect in a meaningful way with our kids after their day and show that we’re interested in their world. It keeps us from simply yelling, “Don’t drop your jacket on the floor! Put your bag away! Take your shoes off, etc., etc.,” as our main way of connecting when they get in the door.
As parents, we can’t fix everything for our kids. We can’t solve all of their problems, but in this one question, we can at least begin to learn what they need after school so that we can help meet that need. If we can do this, we’ll help reduce their stress, which has many, many benefits for the kids.
It also has the net benefit that if we reduce their stress, give them opportunities to connect, our time with them will be less stressful, and they may actually be less likely to fling their backpacks across the room in frustration as soon as they open the door after school.
Our greatest job as parents
I hope this article is helpful as we all prepare for next week and the return to school. We all love our kids and we often feel like our job is to fix everything. I want to encourage us to focus on accepting our child’s answers to these questions and not let our own anxiety put us into “make it better mode.” If we fall prey to this, we do the opposite of what our kids need. Our kids need validation and empathy. The great thing is that in order to do this, all we need to do is listen and be with our kids. We don’t have to make it all better, because most of the time, the reality is that we can’t.
Need some help?
Parenting is tough, and this is a tough time of the year for everyone involved. If we can be of any help, please give us a call. This is the time of year is when counselling for children can be extremely helpful. We have a team of counsellors who love working with parents and kids and we’d love to be a resource for you.
What is the difference between a Registered Holistic Nutritionist & a Registered Dietitian?
When I tell people I am a Registered Holistic Nutritionist, I often get asked, “What’s the difference between a Registered Holistic Nutritionist (R.H.N.) and a Registered Dietitian (RD)?” While both healthcare practitioners working in related fields, there are distinct differences as well.
Here at Alongside You, you’ve been familiar with our Registered Dietitian, Annie Tsang. I’ve recently joined the clinic as a Registered Holistic Nutritionist (R.H.N.) and wanted to introduce myself as well as let you know how I can help you achieve your health goals.
Let’s start by explaining the differences between an R.H.N. and an RD.
What is a Registered Holistic Nutritionist?
It is worthwhile to note that there are different nutritionists out there. Each coming from a different school with varying program lengths and certified differently. The term Holistic Nutritionist is an unregulated term.
I graduated from the Canadian School of Natural Nutrition (CSNN) and am certified as a Registered Holistic Nutritionist (R.H.N.) with a Natural Nutrition Diploma. Because I haven’t been to the Institute of Holistic Nutrition (IHN), I will only speak to my experiences as an R.H.N. from CSNN. To complete my program, I completed case studies, did a board exam, and am registered with the CSNNAA (CSNN Alumni Association).
“The Canadian School of Natural Nutrition has as its mission the education of the individual in the principles of holistic healthcare and the principles of natural nutrition, to further the well-being of people and the healing of planet Earth.”
As Holistic Nutritionist, I use evidence-based and science-based tools to help guide clients through their health goals and concerns. Recommendations include dietary, lifestyle, and supplementation changes.
Like most holistic health care practitioners, I look at an individual as a whole. That’s why recommendations don’t only include dietary changes. An R.H.N. looks at your complete health history, current diet, and lifestyle habits. We take into account how stressed you are, are you sleeping, are you exercising, etc. Through our intake process, we work with the root cause to identify imbalances in the body and make recommendations based on all of that.
For dietary recommendations, I take a whole foods approach with the belief that natural nutrition is a tool in preventing diseases and bringing the body back into balance.
What is a Registered Dietitian?
Registered Dietitians have regulated professions that register with a provincial dietetic regulatory body.
In BC, most RDs graduate from the UBC Nutrition Program with a Bachelor of Science (BSc) in Food, Nutrition, and Health. In the program, an RD takes courses on nutrition, general science, and agricultural science. In the fourth year of the program, they take a few nutrition courses. RDs use the Canadian Food Guide as a tool to help their clients. The Canadian Food Guide is based solely on science and suggests that everyone’s nutritional requirements are the same. Because they are regulated, they are covered by most healthcare benefits programs.
How can I help you?
As an R.H.N., I can help with:
Chronic pain management
Blood sugar imbalances
Stress and sleep issues
It is important to note that I do not treat, cure, or heal any diseases.
As an R.H.N. and a Certified Yoga Teacher, I blend both modalities in my recommendations to help my clients achieve their health goals. I use my knowledge I can help with 1:1 health coaching, weekly meal planning, and group support sessions.
Are your services covered by my benefits plan?
Currently, holistic nutrition services are covered under some healthcare benefits plans as “Nutritional Counselling”. Companies such as Greenshield and Manulife will cover my services. However, you will need to check your benefits plans to see if nutritional counselling is covered.
Get in touch
Curious what it’s like to work with me? I offer free 15-minute consultations. Call the office at (604) 283-7827 ext. 0 to book your consultation to see how we can work together!
Over the last few years, there has been an increase in mental health visibility in television, movies, and social media. People have been more open about their own experiences with mental illness, and there has been an increase in the representation of suicide and mental health on television and movies. I believe that this is a significant step forward to de-stigmatizing and normalizing mental illness.
One show that tore down barriers and was a big step in suicide representation was “13 Reasons Why”, which was met with controversy and resistance. For those who have not watched the show, it is terrible. I don’t mean terrible as in it was poorly written or the actors weren’t very talented. I am referring to the fact that it is a raw depiction of suicide that captures the intensity and terribleness of taking one’s own life. This television series is a straight-forward, honest, and painful representation of suicide. As mentioned earlier, this television show is deemed by many to be controversial and inappropriate for its target audience. However, it is meant to bring awareness to the factors leading up to suicide in youth, such as bullying, ostracization, or sexual assault. The purpose of this series is to inspire dialogue amongst others so individuals can reach out for help, recognize warning signs of suicide, or be supportive towards others who are struggling.
We are currently in a cultural shift where advocates are working towards the destigmatization of mental illnesses, which also includes discussing suicide openly amongst each other and in our media. Nevertheless, with this shift, there is also apprehension and opposition because it is ingrained in us that we should not be talking about suicide, let alone see it on television. There is a fear that if it is discussed or exposed to others, then we may inspire the idea in someone else and they will be more likely take their life, which is not true.
It is necessary to mention that as our media begins to introduce these topics, there is still a long way to go. More often than not, television shows and films can miss the point when it comes to getting the proper help and support or how to begin the necessary conversation when acknowledging suicide. The mere depiction of suicide in our media is not enough on its own. Therefore, there is a need for more discussion and awareness present in our media regarding mental illness and symptoms, finding support, and accessing resources to be present. We are only at the beginning of the battle of de-stigmatization, and there is a long way to go before we get to where we need to be.
Given that suicide and mental health is a tricky topic to navigate through, it can feel as though there are so many Do’s and Don’t’s when talking to someone about it. If you’re not a mental health professional, it can feel like you’re walking on eggshells trying to have a conversation about suicide with someone else, but that’s okay, it is a tough topic. The best way to talk about suicide and mental illness with someone else is by being open and direct about it. It’s okay to ask someone if they are thinking about, or have thought about suicide because it creates an opportunity for a person to talk about what is going on for them. Additionally, listen to them, respect and validate their feelings, take what they say seriously, and get them the appropriate help and resources that they need (resources and websites are below).
Many of us are entering a new and unknown territory as we learn how to navigate a discussion about these difficult topics and it makes sense that it is met with resistance and uncertainty. However, it is important to note that this is one of the many reasons that we need media like “13 Reasons Why” that will make us cringe and feel uneasy, to bring light to the fact that we may be uncomfortable discussing these topics. What is still sometimes missing in the media, however, is the follow-up conversation needed after these difficult topics.
Clinical Director’s Note:
When this TV show came out there was a lot of controversy. In fact, in conversation with many of the leaders of the local mental health resources we even considered creating media titled, “13 Reasons Why Not,” because much of the response to the show seemed to be that the show glorified suicide, or certainly did not provide any of the needed conversations to follow up on this important topic.
Whatever our views are of this new sort of media and its’ appropriateness, it’s a reminder of the importance of having open, honest conversations with youth around suicide and mental health.
It’s a difficult conversation to have, and there are many local resources to help, including Alongside You. If we can be of help please let us know. Here’s a list of other resources in the community as well as larger resources across Canada and North America:
Today is the anniversary of the best decision I’ve ever made. This sounds cheesy, perhaps, but it also happens to be true. Fifteen years ago, I married Meg, and it’s been a wild ride ever since. Depending on how you recount history, our story either started in grade 5 or when I was 16. I went to school with her twin sister when I was in grade 5, and I remember when she came into our class for the first time to deliver a message to her sister. Now, you have to understand, I was in no way, shape, or form smooth at that age (many would argue that never changed). But, I distinctly remember turning to my friend and saying, “Wow, she could come back more often.”
Fast forward to when I was sixteen and started working at a summer camp. I walked along the boardwalk and low and behold, there was a beautiful girl that I recognized. I walked up to her and asked her, “Do I know you from somewhere?” She, thinking I was feeding her a line, literally got up and ran away. Now, I’m not using the word “literally” in the new-school hipster way, I actually mean she literally got up, moved her feet at a rapid pace, and in the opposite direction. Great start to a relationship.
Needless to say, it took a few years of work to get her to stop running away and to actually consider that I might be marriageable material. But, when I was 20 and she was 21, I asked her to marry me and, as they say, the rest is history.
As I was trying to fall asleep last night, my mind kept circling the question, over and over, “How is it that our relationship has lasted, and gotten infinitely better over time?” See, it hasn’t been easy. We got married young, and in our first year of marriage we went kamikaze with school, work, and other activities and didn’t see each other a whole lot (I definitely do not recommend this approach…). We are quite different people in many ways, and we often don’t see things the same way. And now, we’re business partners full time. Our recipe for success isn’t so simple! I also realize that we’re still in our infancy in our relationship at 15 years in – my parents will be celebrating 48 years of marriage this year, something I aspire to. So, this article isn’t definitive, because we have a long way to go!
I can’t write nearly as much as I wish I could hear, so I’ll save some for a later article. Here are three things that have been helpful to me in our marriage, and I hope will be helpful to you in your relationships.
If you know you’re wrong, admit it. If you know you’re right, shut up.
A very close family friend wrote this on the wedding card he gave us on our wedding day. I didn’t realize that this was a quote from Ogden Nash at the time, but it’s always stuck with me. Anyone who knows me knows that I love a good argument, and I’m pretty opinionated. I don’t expect everyone to agree with me, but if we’re arguing, I’m going to try to win the argument.
This is not a recipe for success in marriage. If it’s simply an intellectual argument it might be ok. If the argument is about something you’ve done wrong, arguing that you were right is not going to help things. Similarly, if you know you’re right it may not be your best course of action to beat this over the head of your partner. Chances are they know you’re right (even if they don’t want to admit it), and forcing the issue will just breed resentment.
Accept influence from your partner.
This one does not come naturally to me, at all. I’m not even sure why because I often say, and I sincerely believe, that I married up. It would only make perfect sense for me to accept Meg’s influence as a matter of course, but for some reason, it’s still challenging for me. There’s still a little birdie on my shoulder that, when I’m under stress, tells me that accepting influence is admitting defeat. Let me assure you, it’s not.
Accepting influence from your partner means that we shift from a focus on me and instead, focus on we in the relationship. John and Julie Gottman refer to this as the we-ness of the relationship and it’s something they measure in their research i. If you’re a research geek like me, feel free to have a read of this article that highlights how John Gottman has shown that relationships are far more successful when men accept the influence of their partner. It’s important for women to do this too, but the research seems to show that most women are already pretty good at it.
69% of conflict in relationships is due to perpetual problems.
This fact can either be encouraging or be discouraging depending on how you look at it. This statistic comes from John Gottman’s research and it’s been replicated. Perpetual problems are the issues that come up in the relationship over and over again. These problems are due to fundamental personality differences or lifestyle needs and are not going to be solved. These problems simply need to be managed. The conflict stems from the idea that we can change these things, rather than accepting them and managing them.
Part of me finds this frustrating. My brain and my passion drive me toward creating positive change and my superhero complex leads me to believe I can solve all of life’s problems if given enough time. When I’m stuck in this mode, I get frustrated and wonder why, after 15 years, we stumble through the same issues and I haven’t figured out how to solve them yet.
My more reasonable, rational self-finds this encouraging. I find it encouraging that after 15 years of struggling with the same issues, we still have a great marriage. We haven’t given up. We haven’t grown resentful. Somehow, even though we can’t change it, we find a way through it together. Over, and over, and over again.
We’re not perfect, even after 15 years of working at it
I didn’t want this article to come across as Andrew’s guide to having the perfect marriage that he has with his wife, and I hope it doesn’t come across that way. We’re not perfect, and we regularly screw it up. But when we do, we work hard at it.
Relationships are difficult. My marriage is by far the most difficult thing I’ve had to work on, and I can say without reservation, that I’ve had more work to do on myself than my partner has. She’s better at this than I am, she’s more of a natural, and Gottman’s research seems to support this.
What their research also shows, however, is that if I continue to work on this, and continue to accept Meg’s influence, my doing so is one of the most powerful forces to effect positive change in our relationship – and that’s what I’m going to work on for the next 50 years, God willing.
I love you Meg. Thank you for working on this with me and teaching me every day.
[i] It’s ok to laugh at this. Every time I go to one of their training and they use this word, I laugh. Part of maturity is accepting that we laugh at immature things. Or something like that.
If you’re looking for some summer reading that will improve your relationships, check out this book by John Gottman. It’s a great primer for some of the principles that make relationships last!
“This week’s blog is written by one of our volunteers, Sarah Vaughan-Jones. Sarah is entering her last year of her Psychology degree at UBC this fall and is helping out around the clinic as she learns more about the field of psychology.”
Relationships can be challenging. They don’t come along easily and require constant attention to sustain them. At different stages in our lives, they can be more difficult with the other challenges that life throws at you. Being in a relationship, and having a romantic partner can play an especially large role in our health outcomes. Whether it is a budding relationship in high school, or a 30-year marriage, having a partner can certainly impact our health. Let’s take a look at a few of the ways this can happen throughout our lifespan.
As we reach our later teens, major changes happen in our day to day lives. Many of you are heading off to college or joining the workforce. It is probably the first time many of you have lived on your own, with less direct guidance or support from your parents. You may find that you are ripped out of your comfort zone and put in a new environment, where you may not know anyone! This can be lonely and stressful!
With your newfound freedom, you might explore new things such as drugs and alcohol, experimenting with sex, and others. Often, these are in an effort to develop and form relationships with others, including romantic partners. How might relationships affect this? Research has found that young adults in a relationship may have less mental and physical health problems when compared to single college students, as they may engage in less risky behaviour (Braithwaite et. al, 2010). Sometimes we experiment with risky behaviours as we look to expand our social network. Alternately, being in a relationship might encourage us to be healthier. In the people studies, exercise, smoking habits and eating habits were more likely to improve due to being in a relationship with a partner (Nichols, 2017). Couples can receive the emotional support and comfort that they may be missing from home, benefiting their wellbeing.
Life continues to change once we’re in early adulthood. Relationships can quickly become a more important part of our lives. Many feel stress and pressure from society to find a relationship, as it’s a common time for marriage, moving in together or having children. Whereas a few years ago it was all new and experimentation, now the pressure is on – people may be expecting you to be in a relationship as you get older. It can be tricky to balance; you’re trying to find security in a job and search for a partner at the same time as dealing with whatever other life challenges come your way!
In this stage of life, research suggests that women will have better mental health outcomes, while men will have better physical health, when in a happy, committed relationship (Nichols, 2017). A married man’s health was similar to that of a non-smoker, with regular blood pressure and BMI levels (Loving & Slatcher 2013, p.8). Happy couples also have a decreased mortality risk, decreased the risk of cardiovascular disease, and decreased cancer-related mortality.
On the other hand, when in a relationship, conflict can arise between career and love. With a common goal of being financially stable, this can mean more time at work, which can strain and cause stress in relationships. This kind of stress has been linked to future cardiovascular problems (Nichols, 2017). Research suggests that adults who are able to maintain a good balance between many demanding situations have the ability to adapt to demanding environments better than others, which helps form a greater identity (Cao, 2013, p.7).
If this is you, you might feel trapped in a cycle of doubt, as it can be hard to find a solution and how to balance a relationship with work and other commitments. What you might find interesting is that being in a relationship can help with coping; that is, the relationship becomes a strength in coping. They call this “dyadic coping” and it can be beneficial for many couples. Dyadic coping focuses on how couples can cope together to decrease their stress. They can prepare for future stressors, and plan on how to deal with them together. This can increase an individual’s support for their partner, and improve trust and intimacy with one another, improving each other’s mental health (Landis et. al 2014, as cited in Umberson & Montez, 2010).
Long-term marriages and relationships can also have a significant impact on our health. Whether you are new parents or retiring, relationships still have a substantial influence on your health.
Research is finding that that long-term relationship satisfaction is different between men and women. Men that engage in problem-solving and stress management, are predicted to have the healthiest relationships (Pietromonaco et. al, 2013). It seems as though focusing on problem-solving and stress management in relationships may allow men to be rational and calm under stress, which may place less of a negative stress on their body.
Some of the research highlights that health outcomes for women improved when they were intentional about paying attention to their personal satisfaction and this led to better relationship happiness overall (Pietromonaco et. al, 2013).
What about children? Having a child can be an important part of a relationship. Research has found that during pregnancy, women that receive support from their partner had reduced anxiety during and after pregnancy. It can be a stressful time for many couples, and having support can be not only healthy for the mother, but also the child. Reducing parental anxiety levels can also improve the infant’s behaviour and development for the better (Pietromonaco et. al, 2013). Parents who are calm and less stressed during, and after pregnancy may have less distressed children.
Later on in life, as we age, more and more health problems may arise, including chronic diseases. Having a partner as a support system can have great effects on health outcomes. Cancer patients reported feeling more intimacy in the days in which their spouses supported them. What’s interesting is that giving support, not just receiving support can also be beneficial to our health. Supporting a spouse showed lower mortality rates for the supporting partner (Brown et. al, 2009, as cited in Pietromonaco et. al, 2013).
What can we take from this? Although relationships require effort to find, grow and maintain, they may be very beneficial to our health in the long run. With the curve balls life can throw in your direction, it can be very beneficial to have the support of a partner, at any time in your life. But of course, there is always an alternative to this. Others in your life such as close friends and family can also provide a similar support for you in times of need, or anytime at all! For any question, feel free to contact us!
It is not uncommon to feel worried or stressed in our everyday lives. Occasionally we find ourselves taking on too much and feeling unsure if we can do it all. Other times we may dread going to work, meetings, or social events. However, at what point does every day worry or stress become anxiety?
Everyday stress and worry tend to be more contextual; meaning, you can compartmentalize whatever is going on for you, it is manageable, or it can be a motivating factor to get tasks done. Anxiety, however, can be exhausting, depressing, and ever-present no matter how hard you try not to let it bother you.
Anxiety is sneaky and can work its way into our lives in different ways. Some of us may have constant and high levels of worry about nothing specific, while others may only fear social events because they’re concerned about offending someone, being judged, or embarrassing themselves. Sometimes we might worry about leaving our home even if it’s to go shopping, go out for a meal, or run errands.
It can also feel very different for everyone. I have had people describe it like a drowning sensation that never really goes away, or feeling unable to concentrate on whatever is in front of them because they are so in their head. Some people may feel anxiety in their body through frequent headaches or stomachaches, or other physiological symptoms. It is difficult to generalize what anxiety feels like since it affects people in a wide variety of ways.
Nevertheless, there are a few questions to ask yourself if you are still not sure if anxiety has snuck into your lifei:
Have I had panic attacks and worried about having more?
Do I have trouble sleeping or concentrating because I am worried about something? Or because my mind won’t shut off?
Do I go out of my way to avoid objects or situations that make me anxious?
Do I feel anxious about things more often and more intensely than others around me?
Am I fearful about being embarrassed in public?
Do I get headaches, stomach aches, or other bodily sensations from feeling anxious?
If you find yourself relating to any of these questions, then don’t worry (just kidding!) but really, you’re not alone. Anxiety is the most common mental health difficulty that people live with. It affects 12% of British Columbian’s which works out to approximately 1 in 8 peopleii. Contrary to what we may think, however, it does not need to be “cured.” In fact, it should be embraced! Now you’re probably wondering, “Why the heck do I want to embrace something that causes me so much distress?” Embracing anxiety can be helpful for recognizing your emotions and triggers to feeling anxious and overwhelmed so you can develop a toolbox of coping mechanisms and skills to handle anxiety as it comes up in your life.
How can counselling help?
It can feel cathartic and be relieving to express your worries and fears to someone who can relate. Additionally, counsellors can help you to figure out how to develop a toolbox of skills to embrace anxiety! Tools vary from person to person, but some can include meditation, relaxation and breathing techniques, cognitive behavioural therapy, worksheets, art therapy, the list is endless! There is no “one-size-fits-all” approach to living with anxiety, living with it depends on you as a person and how you want to embrace it. If you are not sure about counselling and/or would still like to learn about embracing anxiety, then take a look at the resources below or give us a call!
Alannah McIntee is the one of two new interns at Alongside You. Studying at Adler University she has a keen interest in working with kids and we’re excited to have her on board!
One of the questions we get a lot is what are some of the specific Dialectical Behaviour Therapy (DBT) techniques that we teach clients? I think this is a great question and one that we can answer through some blog posts, so here’s the first one – I hope you like it!
Mindfulness is the at the core of dialectical behaviour therapy – it’s the foundation, if you will, that everything else is built upon. Mindfulness is the practice of being present in the moment, without judgement and without attachment to it. It sounds simple, but it is often very difficult for us to practice in our daily lives.
What are the goals of mindfulness, with respect to DBT, you might wonder? According to Dr. Marsha Linehan, the goals are threefold:
Reduce suffering and increase happiness
Increase control of your mind
Experience reality as it is
The mindfulness skills learned through engaging in dialectical behaviour therapy help clients create their own mindfulness practice. A mindfulness practice involves incorporating different skills into a routine practice that is woven into our lives as a foundation for doing life. This can involve any or all of the skills, meditation, contemplation, and mindful movement.
There are three core mindfulness skills in dialectical behaviour therapy and I want to introduce one of my favourites because it’s one of the ones I’ve found most helpful: Wise Mind.
The Wild Mind
You won’t find this terminology in any DBT books, but it’s what I call the dance between the two extreme states of our minds: logic vs. emotion. In DBT terms, we’d call the two polar opposites Reasonable Mind and Emotion Mind.
Often, we tend toward one or the other especially when we’re under stress. Those of us who are more naturally prone to logic will rely on this part of our mind to make everything rational, logical, and pragmatic at the cost of ignoring emotional content. Others more naturally drawn to emotion will rely on this part of the mind to make everything about mood, feelings, and impulses to do or say things.
As you can probably tell, both of these approaches are likely to create problems because they focus on one area at the cost of ignoring the other. So, what’s the alternative?
The Wise Mind
The concept of Wise Mind within the framework of mindfulness involves combining the two minds, Reasonable Mind and Emotion Mind into a new framework – Wise Mind. Wise Mind balances the Reasonable Mind and Emotion Mind and allows us to follow a middle path.
Another description of Wise Mind is something we often call wisdom. In this case, it’s the wisdom within each of us that combines both our more rational, reasonable mind with the emotion-focused part to create a full picture. This focus allows us to see, and value both reason and emotion, bringing the left and right brains together as one.
I was just remarking to a client that someone once described wisdom to me this way:
“Knowledge is knowing that a tomato is a fruit. Wisdom is not putting it in a fruit salad.”
Apparently, this quote came from Miles Kingston, a journalist and musician, and what I like is that it helps explain the difference between wisdom and knowledge. In our case, knowledge is what each of our minds is telling us – our reasonable and our emotion mind. Wisdom is knowing how to combine that information and knowing what to do with it – our Wise Mind.
How Can I Get Started Using Wise Mind?
Mindfulness takes practice, as does listening to Wise Mind. Here’s an example exercise that you can try right now to see if you can listen to your inner wisdom using Wise Mind. It’s taken from the Mindfulness Handouts in the DBT Skills Training Manual from Dr. Marsha Linehan:
Asking is this Wise mind?
Breathing in, ask yourself, “Is this (action, thought, plan, etc.) Wise Mind?”
Breathing out, listen for the answer.
Listen, but do not give yourself the answer. Do not tell yourself the answer; listen for it.
Continue asking on each in-breath for some time. If no answer comes, try again another time.
This may not come naturally to you at first, in fact, it probably won’t. Repeat this exercise and see if you can allow yourself to enter a mindful space where you can notice what your Reasonable Mind and Emotion Mind are telling you, and then listen to your Wise Mind to see how you can trust your inner wisdom and operate out of an effective, mindful place in your decisions.
The transition into parenthood can be a time full of tender and beautiful moments, and it can also be a time of immense difficulty. On social media, we see a lot of those beautiful moments, but we don’t typically see the difficult ones. Many parents are then caught off guard and may even feel isolated and ashamed for the difficulties and alterations in their own mental health that can come with childbirth. While conversations about the beauty are important, it’s also crucial to talk about the difficulties.
About 85% of mothers experience the Baby Blues, which is a period after giving birth where mothers and some fathers experience profound sadness and anxiety. Baby Blues typically lasts 2 weeks to one month as women’s hormone levels slowly return to their baseline. These perinatal hormonal imbalances can often affect a woman’s ability to respond to stress for a variety of biological reasons. On top of the physiological changes, there’s also an unimaginable number of new stressors that new parents may have never dealt with before.
Imagine if you were a lawyer for several decades, you were great at your job and thought of yourself as competent. All of a sudden, you were then thrown into a job as a chef at a high-level restaurant and everyone immediately expected you to know exactly what you were doing and to perform perfectly and instinctually. You may have read some books on cooking, but you find the high paced kitchen overwhelming and can’t always remember what you read when stressful situations arise, yet you feel ashamed for not immediately knowing how to adjust to this completely new career. That seems like a pretty unreasonable expectation for others to put on you and for you to put on yourself. Presumably, you would need a period of someone showing you how to do the job, you’d need support from your partner and friends with the stress of taking on a new career and you’d need time to eventually allow your own personality and creativity to catch up with the learning curve.
It’s not difficult to understand the need for a time of transition in a drastic career change, and yet, we as a society ignore this need for most parents new, especially women; we assume that parenthood and bonding with a new baby just come naturally and easily. In reality, new parents are often overwhelmed by the anxiety of not knowing what their baby needs at first and they need time to learn. Breastfeeding may be incredibly difficult and your baby might never take to it. Contrary to popular opinion on social media, that is okay! Fed is best, any way you can make that happen makes you a superhero whether it’s breastfeeding or formula.
During this transition, relationships may also become strained. Partners often need to re-establish new roles now as co-parents which can take time and can be challenging at first. Some co-parents may find themselves pulling away from each other due to the stress of not sleeping, having less alone time and trying to figure out this new role. This relationship strain can be a particularly harmful consequence because new parents really need support, especially during the period of baby blues.
How can counselling help the Baby Blues?
Relationship counselling can be really helpful during the perinatal period. During pregnancy, new parents can prepare for their shifting roles through the counselling process and determine how to best support each other when their new family member comes along. It can also be helpful to seek/continue relationship counselling after the baby is born for the same reasons.
Similarly, mothers and fathers can also benefit from individual counselling, where they can learn to draw on their personal strengths to develop coping methods and better understand what their emotions are telling them. These skills derived in counselling can help new parents to best support themselves, their partners and their new baby as they embark on this new life transition that is both wonderful and stressful.
It is important to remember the phrase, “it takes a village to raise a child.” You don’t have to do all of this on your own and there is so much strength in reaching for help.
This post has been about the Baby Blues, which is different from postpartum depression in terms of length and severity. My next post will address postpartum depression, what to look for and how to find help.
Marcia Moitoso is the one of two new interns at Alongside You. Studying at Adler University she has a keen interest in reproductive mental health and we’re excited to have her on board!