Postpartum Depression 

Postpartum depression is a type of depression that can occur in women after giving birth. It is a serious condition that requires treatment and can interfere with a woman’s ability to care for herself and her baby.

Symptoms of postpartum depression can include:

•   Persistent feelings of sadness, hopelessness, or emptiness
•   Loss of interest in activities that used to be enjoyable
•   Difficulty bonding with or caring for the baby
•   Changes in appetite or sleep patterns
•   Difficulty concentrating or making decisions
•   Fatigue or low energy
•   Feelings of worthlessness or guilt
•   Thoughts of death or suicide

It is important to note that these symptoms can also occur as a normal part of the “baby blues,” which is a temporary and milder form of depression that affects many women after giving birth. However, if these symptoms persist or worsen, it is important to seek help from a healthcare provider or mental health professional to determine the best treatment plan.

There are several methods of recovery from postpartum depression, including:

1.   Therapy: Therapy, such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), can help individuals understand and change negative thought patterns and behaviors that contribute to their depression.
2.   Medication: Antidepressant medication can be effective in reducing symptoms of depression. It is important to work with a healthcare provider to determine the most appropriate medication and dosage.
3.   Support: Receiving support from family, friends, and other new mothers can be helpful in coping with the challenges of motherhood and managing postpartum depression. Joining a support group can also be beneficial.
4.   Self-care: Taking care of oneself is important for recovery from postpartum depression. This may include getting enough rest, eating a healthy diet, exercising regularly, and finding time for activities that bring joy and relaxation.

Postpartum depression is a common and treatable condition, and that with proper treatment, it is possible to fully recover and enjoy motherhood.  Do not hesitate to reach out for help if you or someone you know is experiencing postpartum depression.

Claudia Coxx, MSW, LMSW

248-860-2024 ext 505

 Ccoxx@marshpsychologygroup.com

How To Feel Your Feelings

One of the basic foundations of most therapy work is to have awareness of one’s emotions as they come up. But this awareness can often be focused on our thoughts about the emotion instead of feeling it. For example, if someone has anxiety about an upcoming social event, they might have the thought ‘I am anxious about this event.’ 

They might even be able to observe the specific thoughts they are having about the event: picturing the worst that could happen, anticipating discomfort, thinking of ways to avoid the event, etc.

While this is important awareness to have, it enforces the idea that our feelings are something we THINK and ignores the physical experience of feeling them. 

Feelings and the Body

Our emotions do not just exist in our brains, they are experienced in our bodies. 

While this person is focused on thoughts about their anxiety, they will likely have less awareness of the physical sensations their body is experiencing. For example, anxiety could cause faster breathing, sweating, fluttering in the stomach, heart racing, or shaking.

Even if we know these are physical symptoms of anxiety, we usually do not take the time to fully experience the sensations in the moment. In fact, many of us avoid attuning to our physical experience of emotions because we want to avoid discomfort. But avoiding the physical feelings works against us because it does not allow the emotions to be processed fully, and they will last longer as a result. 

By developing the skill of experiencing and connecting with how our emotions feel in the body, we can become better able to allow them to come and go as they are meant to.

A Step by Step Guide to Feeling Your Feelings

1. Find a quiet place to sit or lay with your eyes closed. Take some deep breaths to start to get more in touch with your physical awareness.
2. Think of an event that triggered an emotion for you. Start with something small that is not too intense or uncomfortable. 
3. Allow the feeling to come up and focus your attention on the physical sensations, where you feel this emotion in your body. 
4. Describe the sensations (‘my heart is racing, there is a heavy pressure in my gut, etc.’)
5. Your brain will want to start thinking thoughts about the event – keep bringing your awareness back to your physical experience. 
6. Keep breathing into the sensations and allow them to be.
7. Observe how things shift and the sensations change – and trust they will leave. 
8. Notice that you got through this process and tolerated the feeling!

Developing this awareness through practice will allow you to be able to eventually tune in to your physical sensations in the moment when you are triggered. This will help in processing and releasing your emotions, as well as better informing you in how to communicate your feelings and needs to others.

Sometimes previous experiences, such as trauma, cause one to become even more disconnected from the awareness of their body, which will make it difficult to access physical sensations. If for any reason you find this practice too challenging to do on your own, working with a mental health professional can help guide you in becoming more attuned to your body in a safe way.

-Laura Gross, LMSW

Laura Gross is a Clinical Therapist with Marsh Psychology Group

You can contact her at:

(248)860-2024

lgross@marshpsychologygroup.com

Source: Emily McDowell, @emilyonlife

Women and Depression: Ways to Feel Better

Reach out for social support:

Getting support from people who care about you plays an essential role in overcoming depression

Ask for the help and support you need and share what you’re going through with the people you love and trust. You may have neglected your most important relationships, but they can get you through this rough time.

How to reach out for support:

Look for support from people who make you feel safe and cared for. The person you talk to doesn’t have to be able to fix you; they just need to be a good listener—someone who’ll listen attentively and compassionately without judging you.

Make facetime a priority. Phone calls, social media, and texting are great ways to stay in touch, but they don’t replace in-person quality time. The simple act of talking to someone face to face about how you feel can play a big role in relieving depression and keeping it away.

Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed it feels more comfortable to retreat into your shell- but being around other people will make you feel less depressed.

Find ways to support others. It’s nice to receive support, but research shows you get an even bigger mood boost from providing support yourself. So, find ways to help others: volunteer, or  help a friend.

Join a support group for depression. Being with others dealing with depression can go a long way in reducing your sense of isolation.

Support your health

In order to overcome depression, you must do things that relax and energize you. This includes following a healthy lifestyle, learning how to better manage stress, setting boundaries on what you’re able to do, and scheduling fun activities into your day.

Aim for eight hours of sleep. Depression often involves sleep problems, whether you’re sleeping too little or too much, your mood suffers.

Keep stress in check. Not only does stress prolong and worsen depression, but it can also trigger it. Figure out all the things in your life that stress you out, such as work overload, money problems, or unsupportive relationships, and find ways to manage the stress so you feel more in control. 

Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Do things you enjoy (or used to). While you can’t force yourself to have fun or experience pleasure, you can push yourself to do things, even when you don’t feel like it. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to, the park, the beach, or the ballpark.

Come up with a list of things that you can do for a quick mood boost. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even if you’re feeling well.

1. Spend some time in nature.
2. List what you like about yourself.
3. Read a good book.
4. Watch a funny movie or TV show.
5. Take a long, hot bath.
6. Take care of a few small tasks.
7. Play with a pet.
8. Talk to friends or family face-to-face.
9. Listen to music.

Get up and get moving

When you’re depressed, just getting out of bed can seem overwhelming, let alone working out! But exercise is a powerful depression fighter—and one of the most important tools for depression recovery.

Studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue. A 30-minute walk each day will give you a much-needed boost. And if you can’t manage 30 minutes, three 10-minute bursts of movement throughout the day are just as effective.

Your fatigue will improve if you stick with it. Starting to exercise can be difficult when you’re depressed and feeling exhausted. But research shows that your energy levels will improve if you keep with it. Exercise will help you to feel energized and less fatigued.

Find exercises that are continuous and rhythmic. The most benefits for depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.

Add a mindfulness element, especially if your depression is rooted in unresolved trauma or fed by obsessive, negative thoughts.

Eat a healthy, depression-fighting diet

What you eat has a direct impact on the way you feel. Some women find dietary modifications, nutritional supplements and herbal remedies can help aid in the relief of depression symptoms. These include:

Cutting back on salt, unhealthy fats, caffeine, sugar/refined carbs, and alcohol.

Not skipping meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.

Boosting your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To increase your intake, eat more citrus fruit, leafy greens, beans, chicken, and eggs. Vitamin B-6 along with calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit women suffering from PMDD.

Eating foods with Omega-3 fatty acids. Omega-3 fatty acids play an essential role in stabilizing mood. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, sardines, and tuna, or vegetarian options such as seaweed, flaxseed, and walnuts.

Making sure you’re getting enough iron. Low iron levels can produce common depression symptoms like irritability, fatigue, and difficulty concentrating. Iron rich foods to add to your diet include red meat, beans, leafy greens and dried fruit.

Get a daily dose of sunlight

Sunlight can help boost serotonin levels and improve your mood. Aim for at least 15 minutes of sunlight a day. 

Take a walk on your lunch break, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or spend time gardening.

• Increase the amount of natural light in your home and workplace by opening blinds and drapes and sitting near windows.
• If you live somewhere with little winter sunshine, try using a light therapy box.

Challenge negative thinking

Depression puts a negative spin on everything, including the way you see yourself and your expectations for the future. When these types of thoughts overwhelm you, it’s important to remember that this is a symptom of your depression and these irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic.

Women also tend to ruminate when we’re depressed, perhaps spending hours trying to figure out why we’re feeling this way. However, rumination can maintain depression or even make it worse.

     Once you identify the destructive thought patterns that contribute to your depression, you can start to challenge them with questions such as:

• “What’s the evidence that this thought is true? Not true?”
• “What would I tell a friend who had this thought?”
• “Is there another way of looking at the situation or an alternate explanation?”
• “How might I look at this situation if I didn’t have depression?”

Get professional help if needed

If you don’t benefit sufficiently from behavioral tools, seek help from a mental health professional.

Therapy. Talk therapy is an extremely effective treatment for depression. It can provide you with the skills and insight to relieve depression symptoms and help prevent depression from coming back. One of the most important things to consider when choosing a therapist is your connection with this person. The right therapist will be a caring and supportive partner in your depression treatment and recovery.

Medication. Antidepressant medication may help relieve some symptoms of depression in women, but it won’t cure the root cause of depression. 

If you feel you could benefit from further support and counseling consider finding a qualified therapist you trust who can help you manage your mental health.

Carol Van Kampen, LMSW

Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com

cvankampen@marshpsychologygroup.com

https://marshpsychologygroup.com/carol-van-kampen-lmsw/

The Amygdala Answer: How understanding the origin of your anxiety will lead to the best solution

We usually assume all anxiety has a similar biological process, but anxiety can come from two different places in the brain. 

The Cortex

If anxiety is caused by our thoughts, it originates in the cortex. For example, if you are preparing for a big presentation and you start to think about all the things that could go wrong, you will likely begin to feel anxious about it. Those thoughts come from the cortex, which activates the amygdala, and then the amygdala responds by releasing an anxious response in the body.

The Amygdala

However, when anxious feelings come on suddenly before we are cognitively aware of the cause, that anxiety originates in the amygdala (without the cortex being involved). This type of response is the body’s way of protecting itself from perceived danger when there is no time to wait for our thoughts to recognize there is a problem. For example, if you heard a car horn just before being in a car accident, your amygdala might have learned to associate the sound of a horn with danger. If this happens, the amygdala will initiate an immediate anxiety response every time it hears a car horn. Only after the body has responded in this way will your thoughts catch up to apply reason and determine if the horn is a sign of danger or not. The amygdala has activated a response aimed at protecting the body, without you having cognitive awareness until after it happens. 

Responding to Amygdala Anxiety

Knowing what area of the brain is causing our anxiety is the key to understanding how to best address it. If our anxiety is coming directly from the amygdala, then the cortex (and conscious thought), are not involved. So, it would not be effective to try to use our thoughts to change this type of response. With amygdala-based anxiety, the best thing we can do is work on exposure. Finding ways to expose ourselves to the trigger that causes this type of anxiety will over time teach our bodies that the situation is safe. The amygdala learns from experience, so the more we experience a perceived threat without a negative outcome, the less likely it will continue to cause an anxiety response.

Responding to Cortex Anxiety

With cortex-based anxiety, the most effective approaches address our thoughts directly. Cognitive restructuring refers to the process of identifying thoughts that cause anxiety and replacing them with helpful thoughts. Thanks to neuroplasticity, each time we do this we are creating new pathways in the brain that will help to prevent an anxious response in the future. Different problematic thought patterns contribute to anxiety, such as expecting the worst, jumping to conclusions, judging yourself unfairly, making ‘should’ statements, and perfectionism. Using these thought patterns as a guide, you can identify specific thoughts you have that lead to anxiety, and then develop coping thoughts to replace the unhelpful thoughts. For example, if you frequently think ‘I need to do this without making any mistakes’ (perfectionism) it might lead to feeling anxiety about completing the task, and possibly prevent you from doing it. A more helpful coping thought to use in its place could be ‘I am learning, it is safe for me to make mistakes.’

Anxiety is a complex issue, and this is a very brief overview of how understanding where it originates in the brain can help inform the proper intervention. These processes would best be navigated with the help of a mental health professional trained in the treatment of anxiety. 

–Laura Gross, LMSW

Laura Gross is a Clinical Therapist with Marsh Psychology Group

You can contact her at:

(248)860-2024

lgross@marshpsychologygroup.com

Pittman, Catherine M., and Elizabeth M. Karle. Rewire Your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic, & Worry. Echo Point Books & Media, 2019. 

An Introduction to Dialectical Behavior Therapy: 1. Mindfulness

Dialectical Behavior Therapy (DBT) is an evidenced-based type of psychotherapy developed to help individuals manage emotions and symptoms of mental illness. It includes four different modules that will be explained in a series starting with Mindfulness in this article.

Mindfulness has become a buzz word in recent years, and for good reason. Being mindful is increasingly challenging as our lives become more focused on technology, and most of us are running on auto-pilot to manage our packed schedules. Mindfulness is simply paying attention to the present without judgment, being aware of what is happening in your mind, in your body, and in your surroundings. It is easy enough to see how detached we can become from the present when we think of an activity like driving. Do you have full awareness of your actions every time you use your blinker or look in the mirror? Something we tend to do so often becomes automatic, to the point we might not even fully remember getting from one point to another!

While this lack of awareness has become the norm, it can cause problems with our mental health. When we go through the motions without checking in with ourselves to notice how we are feeling and responding to things, we become ungrounded and detached from ourselves and our experiences.

Learning to become more mindful in our everyday lives is a process that takes time, but even starting with small practices can help. Mindfulness is the foundation for being able to improve our emotional experience and mental health.

DBT teaches the following ideas for mindfulness:

Here are some ways to build mindfulness skills:

If you feel you need more guidance to incorporate mindfulness skills and improve your mental health, a licensed mental health professional can help.

-Laura Gross, LMSW

Marsh Psychology Group

248-860-2024

Linehan, M. M. (2014). DBT Skills Training Handouts and Worksheets. New York: Guildford Press

It is incredibly common to struggle with the process of setting and accomplishing goals.  And due to this difficult process, many of us end up feeling defeated or as if we have some sort of character flaw.  This way of thinking can not only keep us from practicing goal setting but can have negative impacts on our overall self-esteem.  The process of setting and accomplishing goals is a vital component to our overall mental health and emotional wellbeing; therefore, it is extremely important that we do not abandon the practice of goal setting and goal accomplishment.

Below are some tips to assist you in successfully setting and accomplishing your goals:

1. Keep your goals simple and specific.  Many of us set goals that are simply too large and/or not clearly defined.  This can lead us to feel overwhelmed and/or inadequate if we do not accomplish our goal, when in reality the goal as we defined it was just not feasible. Examples include the following:

2. Make sure your goals are realistic. Identify potential barriers to accomplishing your identified goals and modify your goals accordingly.  For example, if you set a goal to go to sleep each night at 10 pm but you have a favorite show conflicting with that time, consider altering your chosen bedtime for that evening, or recording the show to watch it at a time not conflicting with your chosen bedtime.

3. Identify and challenge “all-or-nothing” thinking. “All-or-nothing” thinking is a pattern of thinking in “extremes” or “absolutes.”  When we apply this inaccurate and often-negative method of thinking to goal setting, we can become very easily frustrated or feel as if we have failed.  It is therefore vital that we are able to identify and challenge “all-or-nothing” thinking as it applies to goal setting and completion.  The following is an example of “all-or-nothing” thinking in relation to goal setting and completion:

4. Set up cues or prompts to remind you of your goal and/or to assist in making your goal more attainable. An example of this would be keeping a pair of walking shoes near your door if your goal is to begin an outdoor walking regimen.

1. Be mindful of your self-talk.  It is not easy to develop a new habit.  It is not easy to set goals and accomplish them.  Be kind to yourself.  Remind yourself that this is a new process, and it is completely normal to struggle when we are learning something new.  If you find it hard to be compassionate with yourself, think of what you might say to a close friend or even to a child who is learning a new skill and/or attempting to develop a new habit.

1. Provide yourself with positive reinforcement for accomplishing your goals.  As stated above, this is not an easy process.  Reward yourself for setting and accomplishing a goal.  This is a way to show yourself encouragement and compassion, and it is also a technique to make habits you are trying to develop more likely to continue.

If you are finding any of the concepts and/or techniques described in this blog particularly difficult, it may be helpful to seek the guidance of a mental health professional.

-Sierra Shapiro, MS, LPC