It can be difficult to know what to say or do when someone has experienced a loss. It is a delicate subject to approach since we do not want to say the wrong thing or come off as intruding or prying towards someone who is grieving. We don’t want to add to anyone’s pain, so sometimes we go back and forth between being present and supportive, to taking a step back and giving a person their space to cope. Both of these can be beneficial for the other person, but our uncertainty about how to respond can make us feel unhelpful or that we are adding to their pain. When it comes to offering support, however, being present and available to help or spending time with them can be healing.
What else can we do to be supportive during this difficult time? Here are a few practical ideas of how to help a friend or family member who is grieving:
Know what “normal” grief is and how to respond – check out my last article for a primer
Know that there is no one right way to grieve, every response and emotion is valid; people who are grieving may feel relief, guilt, anger, emptiness, sadness, etc. These emotions may be intense or extreme or they may be more mild. Be prepared for any reaction, and know that the reaction isn’t about you, it’s a response to pain.
There is no timeline or linear process to grief; each grief process is unique. People will cope in whatever way feels right for them and will take as long as they need.
Expressing support
Be empathetic by acknowledging the bereaved individual’s feelings (e.g. I can’t imagine how difficult this must be for you). Showing acceptance and support of their emotions, whether it’s anger, sadness, or otherwise, can provide a safe space for the person to experience their emotions openly.
Give them space to tell their story. The person may want to discuss the details of their loss repeatedly or in detail as a way to come to terms with what has happened.
Reach out to the person who is grieving whether it be through a phone call or an in-person visit. Remember them as time goes on and check in. Many times, people respond immediately and then support fades quickly.
Avoid saying things like: “Everything happens for a reason”, “They’re in a better place”, “At least…”, “It’s time to move on”, “I know how you feel”, “You can always have another child/get another job/get remarried”, “Time heals all wounds.” Avoid finding a silver lining to the loss or trying to fix what’s happened.
Instead, say things like: “I’m here for you.”, “I don’t know what to say, but I care.”, “I’ll call you/visit in a few days.”, “What can I do?”, “I can’t imagine what you must be going through.”
Saying nothing and just listen. It’s okay to listen or just be present with the other person. Sometimes there’s nothing at all that we can And certainly, whatever we say is unlikely to make the situation better.
Providing practical support can be very helpful, such as offering to:
Help with arrangements related to the loss, such as funeral arrangements, packing, finding a new place to live, etc.
Complete household chores or run errands
Cook or drop off meals in non-reusable containers so they don’t have to worry about washing your dishes and getting them back to you
Watch their children or pets if needed, giving them time for themselves
Help with insurance or other paperwork
Answer or make phones calls or for them
Take them out for a meal or a movie
Watch for signs of depressed feelings or complicated grief
We’ll take as long as we need to cope with our loss, but we do need to eventually come to terms with what has happened. Over time, we’ll adjust to a new normal and be able to move forward. However, sometimes we don’t move on and get stuck, which is called complicated grief which involves:
Being unable to move on from the loss
Being unable to carry out daily routines
Isolating ourselves
Having feelings of intense loneliness, numbness, or sorrow
Wishing to be dead with the loved one who has passed
Depression can also occur and is often a part of complicated grief. The challenge with depression and complicated grief is they can be hard to tease apart, and often co-exist. Both can come in waves, or be constant companions.
If you’re noticing a complexity in the grief of a loved one, or signs of depression, then it’s best to encourage your loved one to seek out mental health support such as counselling. This can provide a space for emotions and thoughts related to the loss to be processed and allow for healing to occur. It can also provide an invaluable resource for depression and trauma screening by experienced professionals who can direct care most appropriately.
A loss isn’t something that can be fixed or repaired; it is something that has to be lived with. The pain cannot be taken away, so instead, we can help others by sitting with them in their pain. It is okay not to know what to say or how to help; if we can show up, listen, and be present, then that’s enough, and is valuable!
Neurofeedback is one of the most amazing technologies at our disposal for so many reasons. It’s an invaluable tool for overall resilience, cognitive flexibility, mental health management, sleep enhancement, and so much more. One of the most common questions I get, however, is how on earth does it work? I’m going to do my best to explain it here for you!
Dynamic Neurofeedback Training
The type of neurofeedback training that we use here at Alongside You is called dynamic neurofeedback. What this means is that our neurofeedback system constantly monitors the brain using electroencephalography (EEG) and provides feedback to train your brain. To put this into perspective, our system monitors the brain 256 times per second. That’s a lot of feedback!
The feedback happens through video and audio sources. During neurofeedback training, you’ll be watching a computer screen that displays a variety of moving images and listening to an audio soundtrack. The neurofeedback system monitors your brain activity through EEG, and when it senses that your brain activity on the various wavelengths is outside of the optimal range for your brain, it interrupts the video and audio signals briefly. Because this interruption is tied to your specific brain activity, your brain knows to connect the dots. This allows your brain to know what it is doing at that point in time, and adjust accordingly.
I Still Don’t Get How It Works Andrew!
Let me explain a little bit more then! One of our misconceptions is that because our brain is constantly working, it must know what it’s doing at all times. This is unfortunately not the case. It’s like when I grew around 6 inches in one year, I kept walking into door frames because I didn’t realize where my shoulders were in 3-D space! What our brain is able to do, however, is adjust itself for optimal health if it has the information it needs. Neurofeedback training is what helps provide the necessary information for the brain to change itself.
Imagine you’re driving. Anyone who has driven for any length of time knows that the mind wanders sometimes. Every once in a while, we’ll wander too far to the right and our right tires will go over the shoulder, and we’ll feel a rub strip or gravel under the tires, and hear a noise that signals to us that we are over the shoulder. What happens next is automatic – we naturally move over to the left a little bit. We generally don’t even need to think about it, we just do it. This is analogous to what happens with our brain during neurofeedback training. The interruptions in the audio and video signal to the brain where it is on the wavelengths. The brain uses this information and adjusts itself accordingly. Over time, this training helps the brain stay within the optimal range on the various wavelengths on an ongoing basis.
How Long Does Neurofeedback Training Take?
This is the million-dollar question! It’s also an understandable one. We all want to know how long something is going to take. It’s really no different than wanting to know how long counselling is going to take. Unfortunately, the answer may not be any more gratifying than the answer to how long counselling is going to take: it depends.
Here’s the truth – it depends because every brain is different. It’s also challenging to predict because dynamic neurofeedback training is not a specific treatment for a specific symptom, it is a whole-brain training aimed at helping the entire brain function better. Because of this, we can’t claim that neurofeedback will cure your anxiety, depression, or otherwise. What we can say, however, is that by helping your brain to function better, symptoms that exist because your brain is not functioning at its best are likely to improve. What I can say, is that this has definitely been my experience in working with clients with neurofeedback. Symptoms of concern do improve, our ability to manage any remaining symptoms gets better, and we become more flexible and resilient, but it takes time.
It may be helpful to think of neurofeedback training as gym training for your brain. When we go to the gym, we don’t see much improvement after one workout. We see improvement over a series of workouts, and over a consistent effort to train. How fast each of us builds muscle, and get in shape depends on a whole lot of variables, so in the same way, we can’t predict how long it’s going to take for you to build the muscles you want and get in the shape you’re looking for. What we do know, however, is that if you train consistently over time, you’ll build muscle, and you’ll get in better shape.
How Do You Know It Works?
This is a great question. Monitoring brain changes can be challenging, but here’s how we do it. Before you start, we use a variety of tracking tools to track the symptoms you have concerns about, and over the course of the sessions, we repeat these tracking tools to look at improvements. In addition, we check in with you each session to see how things are going and what you’re noticing. The true indication of whether it’s helping is the answer to a very simple question: “How do you feel now versus how you felt before we started?” Sometimes it’s hard to notice the shifts, and this is where we can also help you monitor by asking the right questions to pick up on shifts.
I have noticed significant positive results in my clients who have done neurofeedback training. In fact, it’s uncanny how positive it has been. I hope this article has helped explain a bit more about neurofeedback, how it works, and how it might be helpful. If you have any more questions, give us a call and we’d be happy to answer them!
Grief is a normal emotional process that happens when adjusting to a loss or change. It happens not only when someone has died, but also after things like a job loss, the ending of a relationship, or while anticipating a future loss. Grief is a complex process that has no concrete roadmap, but there are some common factors that influence the process we go through. Some of these factors are:
Our relationship with the individual who is gone
The circumstances surrounding the loss
Our current coping mechanisms and how past emotional distress has been handled
The availability of support networks while we grieve
(Living Through Loss, 2017)
No matter what we are grieving, it is difficult, painful, and exhausting.
Part of the difficulty in grief, as I alluded to above, is that the roadmap isn’t clear. What we do know, however, is that there’s no right or wrong way to grieve. It is okay to feel relief, emptiness, or nothing at all when coping with a loss. It’s also okay to cry, feel physically exhausted, be angry, or struggle with feelings of guilt. Grief is a process that is unique to each person and so our bodies and our minds will respond as best they can in whatever way they feel is best for us to move on; in other words, they do the best they can at the time, with what they have to work with.
Sometimes the timeline of grief can be a challenge. Often, we expect ourselves, or even others expect us to move through the grieving process more quickly than we’re able to. It’s important to know that it’s okay to take as long or as little time as we need to move forward. Given the popularity of the five stages of grief (denial, anger, bargaining, depression, and acceptance), many people believe that they need to go through these five stages linearly to move forward (Living Through Loss, 2017). That may be the case for some people, but it is not for everyone. As mentioned above, people experience a wide range of emotions and experience grief in different ways so their grieving process may not always be forward moving. Sometimes we get stuck, sometimes we go backwards, or sometimes we’re all over the place and have a mix of good days and bad days, which sometimes ends up looking like a mess.
How do we manage while all of this is happening? With how intense and exhausting grief can be, it is vital that we take care of ourselves. Often, we’re so overwhelmed we can’t even think of how to take care of ourselves. Here are some suggestions for ways you can practice self-care while going through the grieving process:
Avoid drugs and alcohol since they may make you feel worse
Avoid isolating yourself and find support from a friend or counsellor
Get lots of rest. Grieving is exhausting, so you will likely be more tired than usual
Drink lots of water and try to eat the best you can, and try to avoid sugar and caffeine
Exercise, even if it’s only going for a walk around the neighbourhood
Give yourself time and permission to mourn as often as needed
Do things that make you feel good such as journaling, art, listening to music, reading
Be kind to yourself. You’re doing the best you can
(Living Through Loss, 2017)
After some time, we will adjust to our losses. It’s hard work and takes time, but eventually, we can come to terms with what has happened, grieve and mourn our loss, and move forward. However, some people find themselves stuck. This experience has been described as something called Complicated Grief. Some of the signs of complicated grief are:
Being unable to move on
Being unable to carry out everyday routines
Isolating yourself
Feeling intense loneliness or numbness
Feeling extreme sorrow, pain, or depression
Feeling that life has no purpose
Ruminating or experiencing intrusive thoughts about your loss
Wishing you died with your loved one
(HealthLinkBC, 2017)
If you notice that you or someone you care about are experiencing any of these symptoms, then may be time to seek out professional help such as counselling. Therapy can give you a space to talk about your loss and help you to work through your thoughts, feelings, and memories relating to your experience. Counselling can also help to identify and work through any potential trauma relating to the loss and helping you to adjust to this change.
I hope this article has been helpful if you’re experiencing grief and loss. We’ve all been there, and some of us are there right now with you. If you could use some help as you walk through this journey of grief, we would love to talk to you. Please give us a call or contact us anytime, we’re here.
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
References:
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) VA: American Psychiatric Association
[1] Segre, L.S., & Davis, W.N. (2013). Postpartum Depression and Perinatal Mood Disorders in the DSM. Postpartum Support International. Retrieved from www.postpartum.net.
[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). VA: American Psychiatric Association
[1] 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
[i] American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) VA: American Psychiatric Association
[ii] Segre, L.S., & Davis, W.N. (2013). Postpartum Depression and Perinatal Mood Disorders in the DSM. Postpartum Support International. Retrieved from www.postpartum.net.
[iii] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). VA: American Psychiatric Association
[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
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!
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!
