As an eating disorder patient, I had been regularly informed of the risk factors of my illness, some of which included amenorrhoea, the absence of menstruation, and a high chance of infertility. However, at the time, pregnancy seemed a far-off ambition, infertility was not visible, it was hidden away, and I was far more concerned and wrapped up with the lure of the eating disorder for this to motivate me into recovery. 

By the age of 27, years out of treatment and at what is considered a “healthy” BMI, my periods still had not returned. I was frustrated and wanted some evidence of my hard work. Despite continued perseverance, I decided to seek medical treatment and visited my GP. I was faced with once again the low probability of becoming pregnant due to my history, and if I did become pregnant, the exhaustive list of complications, such as the high rate of miscarriage, preterm birth, intrauterine growth restriction, labor complications and low birth weight. I was consoled with the possible options of IVF and adoption, yet still yearned for a natural birth. 

Months passed and hope faded. I felt as if I was constantly being encountered with pregnant women, and news of my pregnant friends and family would be tinged with both joy and sadness. However, in November 2019, I began to feel unwell — an upset tummy, I thought, or perhaps gastric flu. When I sent a text my mum one evening that I couldn’t bear the smell of coffee — amongst others — she responded with: Is there a chance you could be pregnant? My husband and I laughed in response: Surely, I could not be pregnant? However, much to our surprise and absolute joy, I discovered I was indeed pregnant. It was a true miracle — confirmed by 7 pregnancy tests (just to be sure)! 

Pregnancy has been transformational both physically and mentally, for once in my life I have felt hungry, eaten according to my desires and pregnancy cravings and revelled in the joy of feeling like a woman, with curves, bigger breasts and a body, which has conceived a child.

Yet, there have of course been challenges along the way. Despite reassuring myself I am nourishing my baby, there is a tug of war between the desire to eat healthily and the eating disorder voice, provoking body image concerns and feeling out of control at my rapidly changing body. Anorexia is ultimately a quest for control, but pregnancy is the most uncontrollable experience.

Stripped of my typical coping eating disorder strategies I have struggled to manage my emotions and hormones, and ultimately pregnancy has been a survival as I count down the weeks. However, I have been encouraged and supported with outstanding personalized care from my midwife and consultant, who have treated me in a non-judgmental manner and my network of amazing friends and family. With this support and the overwhelming desire to nurture the miracle of life growing inside me, I am able to view my body in a new and positive context — healthy, strong and capable. I have started to fall in love with my changing shape and feel a swell of proud of every time I touch my growing abdomen.  

I remember the hours scouring the internet for hope that pregnancy could be a possibility for me and was faced with either a dearth of information or harrowing articles. I want to reassure women who are battling or recovering from an eating disorder that they do not have to be defined by statistics or prognoses, that there is hope and freedom from eating disorders, and pregnancy is possible.  

Some helpful resources for more information include:

• National Eating Disorders Association
• Tommy’s: Together, for every baby

Hidden pain is difficult for anyone to manage without help, especially for those who are young. Nothing in ordinary life naturally prepares us for pain that cannot be expressed. Additionally, the outward world — what your child, teen, or young adult observes — often offers a distortion of what is really going on in the lives of others. Television and movies present unrealistic details, magazines and online media may glamorize extreme ideals and peer behavior, and friendship upheaval exerts tremendous pressure at a time in life when big changes are happening to the body and mind.

You may be the last person to find out your child is struggling. If you have no prior experience with this topic or related mental health training, you may not know how to help.

Self-injury (non-suicidal) may not have one single cause that is easy to understand. Coping skills can help, but the lack of these skills affects behavior and self-confidence adversely. Psychological pain is very different from visible, physical hurt but is just as real. Confusion about mixed emotions and difficulty in understanding how to process them may compound the main issue or issues by causing feelings of loneliness, anger, guilt, self-hatred, or worthlessness. 

First, don’t panic. If you remain calm and offer unconditional love and open communication, you set a model for your child or teen to follow. Let him or her know you are there to help with suggestions that really work. Many resources are available to you and to your child, including your family doctor. 

Second, encourage appropriate social networking. People who keep feelings inside often think they are the only ones who have to deal with the issues they face, but assuring them they are not alone helps mitigate the helplessness they might feel and avoid shock reactions that can drive them to deeper silence. Young adults value self-sufficiency and may benefit from individual or group counseling but still need understanding from family members. 

Third, teach healthy coping skills. These are tools everyone should have and know how to use during times of distress. A simple journal can be helpful to begin.

Ask your child to write down things that bother her and then help her identify options. Sometimes, a schedule that is too busy is too stressful. The journal can help her decide if she can relieve some of that stress by dropping some of her activities.

Let her know she can also use the journal to write down her feelings. Seeing her words in print may help her figure out ways to change how she feels about them. Help her list some alternate activities to do when she feels stressed: exercise, listen to music, read a book, practice breathing exercises and more. Sports and hobbies work well, too.  

Fourth, learn together. Warning signs, complications, and ways others have coped are all topics that can be explored together. Discuss what risk factors might be present. According to the Mayo Clinic, mental health and life issues as varied as anxiety, eating disorders, alcohol or drug use, learned behavior from friends who self-injure, sexual abuse, or neglect can contribute as well as experiencing traumatic events or growing up in an unstable home environment. This is just a partial list. The complex picture for one individual may look very different and should be explored with the help of a mental health professional. Though self-injury is not usually a suicide attempt, it can increase the risk of suicide. 

Fifth, encourage your child to reach out to friends who might be using self-injury instead of healthy coping skills. He can be a positive influence and loyal friend to others by sharing what he has learned. Though friends will be treated individually — through psychotherapy such as cognitive behavioral therapy, dialectical behavior therapy, mindfulness-based therapy and possibly medications and hospitalizations — their support for each other can be a valuable way to reinforce success. 

Take care of yourself and consider seeing a counselor of your own. A minister or school counselor can also assist you and will provide resources and confidentiality. These are difficult, heartbreaking issues facing your family. But ongoing help is available. 

Threats and punishments are not usually successful and may drive you and your loved ones apart. Develop your own coping mechanisms to help you work through the emotions you feel. Families can work together to plan relaxed times filled with conversation, artful expression, and fun. Think of what your family enjoys. When these times happen without planning, take time to allow each person to participate. Laughter and just being together can be a great family night around a pizza or two.

Finally, let others in the family know what is going on (as appropriate). Respect your child’s privacy but encourage him or her to gather all the support possible. 

Be as honest as you can. Ask your child what he has heard about an issue and how he feels about it. This gives you a place to start a conversation and the opportunity to correct any misinformation.

Ask questions to make sure he understands and be open to discussion whenever he is. If you do not know the answers to his questions, tell him you will try to find out. And then do so.

Sometimes, as with the worldwide coronavirus situation that’s causing changes to how we live and creating real and serious danger, you may have to help him deal with uncertainty instead of specific answers. That’s okay, too. In fact, it is very important to know how to do this. 

Model a calm approach to dealing with an issue. Use common sense when you make decisions. Follow advice of experts. And seek professional help for you or your child if it is needed. Here are a few sample words to say:

• We are in this together, and my priority is to make sure you are safe.
• How do you feel about that? (Then listen. This can be used anytime.)
• What do you think a good response would be? (Allow input if possible.)
• Here are the actions we need to take.
• We are not alone. Many people are dealing with this.

Talking with you and feeling included can help your child communicate his feelings and feel comforted, no matter the topic. Feeling loved and close to you helps him gain the confidence he needs to face everyday life as well as stressful circumstances or conditions. Older children may find security in helping you research ways to deal with anxiety or steps your family can take to prepare for emergencies. 

These simple ideas can make it easier to get through the tough times.

• Art materials work for any age. Draw or paint along with your child, if they are receptive to that idea, even if you are only painting the house with a big paint brush and a bucket of water with a 3-year-old.
• Encourage journaling. Writing or drawing on a regular basis is a therapeutic way to work through and process many ideas and feelings. 
• Take walks or play outside. Moving can help.
• Use natural materials in your home. Displaying a plant or stones or seashells gives peace whenever you or your child look at them. Let your child examine these and arrange them at will.
• Dough and clay are for more than young children. Search for easy-to-make recipes online.
• Cooking with you teaches about nutrition and provides comfort and life skills.

Sometimes, “play” or “chores” spark serious conversation, but these times are usually a safe outlet for feelings to be expressed and released. Children need that as much as adults do, but allow it to happen naturally. Never force a child to talk or complete these activities. Don’t forget about board games, toys, cards, and crafts. Laughter and appropriate humor can ease tension, too.

Set a routine and keep it going as much as you can to create a feeling of normalcy but show your child how to handle sudden, unavoidable changes and temperamental upsets. If you need guidance on these topics, check books or online resources. Many parents share what works for them in online groups or in comments below parenting articles. There are many choices for pleasurable reading for all ages. Search for “free digital books” for the age and category that you want.

And, keep self-care practices going for you as well as your children. Drink water. Eat healthy food. Exercise. These things help tremendously with health, anxiety, stamina and strength. Have confidence in your parenting skills. You know your child best and how he or she might react. Adjust and adapt any suggestions you find to your unique situation. 

If there’s one thing we can learn from the younger members of our families, it’s that life goes on in full, rich, and exciting ways. It may not feel like this is true sometimes, but we only have to take one step, one breath, one day at a time.

A young adult woman just graduated from university and gets her first job. She comes down with a stomach bug and her mom calls her boss for her to tell her she can’t come into work. 

A high school student shares that her teacher gave her less than an A on her assignment and her parents request a meeting at the school and demand to know why. 

A preteen girl found out she has a project due in four days along with another assignment and she forgot. She is distraught and her mother offers to do the entire project for her. 

A 2-year-old child is excited for her birthday because it is going to be an extravagant event with pony rides, jumping castles and princesses. Her parents couldn’t really afford all that, but everyone is doing it, so they said that they had to. 

A child was just born and her parents vowed to love her and give her the life of her dreams. They hovered over her day and night from the time she was little, right through into adulthood. Now they sit dumbfounded why their daughter who they bent over backward for, did everything for, smothered her in love and helped her out of every life troubling situation, can’t hold down a job, is late for every appointment, still asks for money for food, has relationship issues, mental health issues, is overwhelmed with anxiety and sitting in a counselor’s office. 

Hyper Parenting, also known as Helicopter Parenting, is harmful and psychologically damaging, yet it has been encouraged and expected in society for the last few decades. There is this idea that good parenting is being overly involved, practicing micromanagement, and giving your children everything that they want and need, despite the visible long-term effects it can have. Knowing the repercussions doesn’t deter parents from engaging in these harmful behaviors that are hurting their children and that is concerning. 

Since parents are often caught up in the competition factor of who has their child in the most activities, the best schools, and the most prestigious art programs, it undermines the seriousness of the side effects of these parenting choices. This thought of noble, dutiful parenting, giving your children the best, being overly involved and coddling them, is said to be creating anxiety-fueled teens and young adults who are ill equipped to function as an adult in a healthy and independent way.  

The actions and behaviors of parents that coddle and hover over their children are something that has been widely accepted and encouraged. You are considered a wonderful parent if you have your child registered for an impressive preschool when they are first born. You are admired for your wonderful contribution to your child’s experiences when you throw a lavish birthday for their first party with all the bells and whistles. 

With new information that is becoming available on the effects of Hyper Parenting, we know that in the near future there could potentially be a shift in the perspectives of parenting whereas, perhaps, it will no longer be seen as the epitome of good parenting. Parents are now being invited into orientations at universities to address the issues of Hyper Parenting their children and how this is hindering their academic and life experiences (Hyper Parents & Coddled Kids, 2013). Hyper parenting has created a mental health crisis in post-secondary education institutions that are perplexing and scary. 

Hyper Parenting first originated from an academic model that believed that more care and attention would ensure success. It was part of a suggested solution to help struggling kids in school. In a way, it was placing blame on parents and created this guilt-ridden parenting sub-sector that perpetuated the hyper parenting culture. So how does a parent be a loving and mindfully present parent with the pressures of society to go above and beyond, without harming their children? I struggled with this answer for a long time. I fell into the role of hyper parenting and began to see the detrimental effects it was having and I would like to think that I caught myself in time before inflicting too much harm. I had to learn balance. I not only had to stop worrying about what other people thought, but also let my child know that I believed they were fully equipped to do things for themselves. We do a disservice to our children when we do everything for them. With the intention of being helpful, we are sending the message that we don’t believe they are capable. 

The pressures of parenting are not new. There have long been ideas about what constitutes a good parent. There isn’t a perfect way to parent and every family is unique with their own values, experiences, and needs. Being mindful of the emerging information on how being overly involved can cause harm is by no means a way to shame, blame or judge. It is an opportunity to reflect a little more on how we are guiding our children towards or away from becoming resilient, capable, and independent adults. 

After getting home from school yesterday, I reminded my children, as per usual, to wash their hands, but this time I stressed,  “for at least 20 seconds because we need to be extra vigilant against getting the coronavirus.” My generally cool-as-a-cucumber son immediately replied, “I don’t want to hear about that anymore!”

While we are all adjusting to social distancing and self-quarantining as adults, do we realize how this may be creating anxiety in our children? It was my son’s abrupt response that made me pause and reflect about how other children are coping with the unpredictability of the pandemic. I realized that while I limit the amount of news my children watch, they must have been inundated with information all week as their teachers diligently shared information about the pandemic while encouraging hygienic behavior in the classroom. And now their school was closing for at least two weeks! There would be a disruption in their day and simply missing their friends that would induce anxious feelings that they may struggle to articulate. 

According to a study from the Journal of Developmental and Behavioral Pediatrics, anxiety is a major public health concern for children and experiences filled with uncertainty can increase their vulnerability to feelings of stress and even to mental health problems. With the recent announcement of a state of emergency due to coronavirus, parents and caregivers have to figure out ways to strategically communicate reassurance to our children even when we do not know the outcomes from the health threat. This is more difficult than making sure your home has enough toilet tissue! 

While chaos ensues around us, what should we do be saying and doing to help to calm our children’s feelings of uncertainty? How do we keep our children relaxed when even play-dates are temporarily discouraged because of social distancing? 

Besides urging them to wash their hands there are other healthy behaviors that should be encouraged as healthy habits: 

1. Building and strengthening immunity by
   • Drinking a lot of water and good nutrition (especially fruits and vegetables with high Vitamin C content) 
   • Getting enough sleep. Depending on their age, children still need 10-11 hours of sleep each night, but with busy schedules with extra-curricular activities, getting to bed at a reasonable time can be a difficult feat. Plus, there is  painful cycle between sleep deprivation and anxiety.
   • Playing outdoors, which allows for more social distance while having fun and reduces their screen time. 
   • Practicing calming techniques — singing, praying, meditating, and laughing together. 
2. Keep a schedule of activities for your children. In addition to what teachers are preparing for your children there are educational resources that are free during this period. Remember to schedule family play time and share the schedule with them so they know what they will be doing. There will be temptation to approach this moment like summer vacation, but it is imperative that children retain some form of routine so they can return to the school day with ease. 
3. Stay informed. 
   • Go through the CDC checklist together. 
   • Watch videos from PBS or this cartoon from NPR for entertaining, while educational tools, that explain the science behind COVID-19. 
   • Increase Learning about geography by looking at an interactive global map about the pandemic. (But use good judgement with this, as it could overwhelm them!)
4. Do not be wasteful. This is an opportunity for children to understand that during this period, things may be limited. Be mindful of how much toilet tissue you use; don’t eat all the snacks in one day!
5. Share your feelings with each other and talk about how this experience is building our resilience. Respect their need for a mental break when they do not want to talk about the pandemic.
6. Practice gratitude and encourage patience with each other. 
7. Be kind. Do not participate in scornful behaviors to those who may be ill. 
8. Remind your children that staying healthy not only reduces their risk of contracting coronavirus but it can also prevent the spread of the virus, particularly to the elderly, like their grandparents, and those who have chronic illnesses. 
9. Take time for yourself — self-care remains essential during this emergency — practice the healthy behavior you’re teaching your kids.

This is a time for kindness and thoughtfulness for the community around us. To all the parents and caregivers, enjoy your children during this time off. Answer their questions with patience and encourage their curiosity. Above all, stay hopeful, we will get through this together. 

And you find yourself seething with rage. Or you’re heartbroken or devastated. Or you feel a profound sense of shame.

Your heart is beating faster and faster. Your palms are clammy. Your face feels hot. Your ears are burning. You feel incredibly uncomfortable. And you want to leap out of your body.

It can be hard to know how to handle your emotions when they’re so intense. After all, most of us weren’t taught this skill. But thankfully, it is a skill that you can learn—regardless of your age or past experience.

For insight, we turned to Lisa M. Schab, LCSW, a licensed clinical social worker and author of 18 self-help books and workbooks, including her newest book Put Your Feelings Here:  A Creative DBT Journal for Teens with Intense Emotions. Below, Schab shared several actionable strategies for managing any intense emotion in the moment.

Take one conscious breath. Simply taking a single deep breath can help to relax “the muscles and begins to dissipate the stress chemicals that just shot out,” said Schab. It also delivers oxygen to your brain, she said. “This helps us to think clearly so we can make healthy, rational choices about how to proceed.”

Practice these four steps. Schab regularly teaches the below “feeling plan” to her clients.

• Name your feeling. Be very specific here. I’m feeling angry. I’m really disappointed. I’m worried. I’m embarrassed. I feel humiliated and ashamed.
• Accept this feeling. Tell yourself that it’s OK to feel whatever emotion arises. “We have a right to experience all of our feelings,” Schab said.
• Express this feeling safely. This means making sure you’re not hurting yourself or anyone else. You might talk or write about this feeling. You might draw, run, sing, dance, or play the piano.
• Care for yourself. What do you need in the moment? You might need to cry, take a walk, watch a silly video, or crawl under the covers, she said. Of course, the particular strategy will depend on where you are and how much time you have, but either way, you can find something healthy to soothe yourself with.

Target the trigger thought. First, identify the thought that sparked your intense emotion. According to Schab, these are common ones: “Oh no, I can’t handle this!” “This is terrible!” “This is unbearable.” “This is so unfair.” “This is the worst thing that could happen!”

Next, identify what you’d like to do with this thought. You might question it, decide to let it go, or revise it so it’s more accurate, she said. For example, instead of repeatedly telling yourself, “This is unbearable,” you’d say: “Wow, this is SO hard. But I will get through it,” or “I hate what just happened! I’ll take a break for a minute, calm down, and then figure out what to do.”

STOPP. According to Schab, this is another helpful acronym for managing intense emotions in the moment:

• “Stop whatever you’re doing or saying right now.”
• “Take a breath.” A single “breath can help stop the emotional ‘revving up’ cycle and begin the ‘calming down’ cycle.”
• Observe what’s happening. You might directly ask yourself: “What is going on here?” Schab said. This helps you gain a bit of distance from your emotion.
• “Pause and take a second breath,” which further promotes the relaxation response.
• “Proceed wisely.” “Once we’ve lowered the intensity of our emotion by stopping, taking a breath, and observing, we then have a better chance of deciding how to proceed in a rational way.” According to Schab, we can think of proceeding wisely as “proceeding from ‘Wise Mind,’” which is a technique from dialectical behavior therapy. (Here’s a helpful mindfulness meditation to access Wise Mind.)

When we’re experiencing intense emotions, it can feel like we have no choice but to explode. It feels inevitable.

But, as Schab said, “We’re not victims of our emotions.” We can learn to regulate the storm, she said. And, while it does take practice and can feel tough, remember that the starting point is a single slow breath. And remember that the more you practice, the easier and more natural this process will become, and the better you’ll feel.

I’ve been there. I know how it feels to dread hearing your alarm clock go off in the morning signaling that it’s time to get on with the day. It’s not a good feeling especially when you know you have to get up. If you are a mom, you can agree that if you don’t get up the entire house is in jeopardy.

Here’s some advice and motivation to get your day started:

Go to Bed Early

If you’re a night owl, you may enjoy staying up late and even work better at night. But when you have kids, a job, a spouse that you take care of, you probably need to get some rest. It’s tempting to stay up past midnight to get some “quiet time”, but maybe you should get the kids to bed earlier so you can get that quiet time. It may take a while for your body to adjust, but eventually you’ll get used to going to bed at normal hours.

Take a Break

If it’s been a while since you have taken a vacation or a day off, you may be due for some time off. I know that it may be difficult for you if you have to work to get the bills paid. But at some point, if you’re drained from the constant busyness of life, you should try planning a small vacation. We all need a break sometimes, it’s okay. Consider asking your boss about taking a mental health day. If you’re married, talk to your spouse about taking a getaway together or by yourself. It may be the breath of fresh air you need.

Call in the Grandparents

If your parents live nearby or can afford to take a trip to visit you, invite them over. Most parents would love a chance to visit and get a chance to see their grandchildren if they could. Even if it’s a short trip, they can give you the break that you need. Having your parents around as support for you and your family can lift a huge burden off your shoulders. It may allow you to feel refreshed and regain focus and energy. 

Check Your Diet

Our diet plays a big part in why we feel the way that we do. When we always go for the donut instead of the smoothie for breakfast in the mornings, it’ll eventually catch up to us. Our bodies need proper nutrients to give us energy to get through our day. When we don’t drink enough water, eat mostly fast food, sweets and starchy foods then our bodies may begin feeling a little sluggish. Our bodies can get drained more quickly than usual. 

Take some time to reflect on what you have been eating for the past week or two. That may be a reason you’ve been feeling more tired than usual.

Include Fun Stuff in Your Day

Without enjoyment, our days can feel flat, leaving us with nothing to look forward to. Do yourself justice and pencil in a little bit of excitement in your day. If you like to read, pick up that novel. If you’re more adventurous, go on a small excursion after work on a Friday afternoon. Plan a movie night in the middle of the week with your family and pop some popcorn. Whatever you do, make sure it’s something you look forward to and enjoy.

Go Talk to the Pros

If you’ve tried everything and nothing works, you might want to go see a therapist. They are trained professionals and can help if you think you really have a serious issue. It’s a scary thing to go talk to a complete stranger that says they can help you. But if you have exhausted all your options, then it may be time to reach out to a professional. 

If you or someone you know battles depression, know that you are not alone. There are treatment options, support communities and resources available for you or your loved one. 

If you or someone you know are in an immediate crisis, get help by calling the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or visit The International Association for Suicide Prevention to be connected to a trained counselor at a crisis center nearby.

Having a baby is a wonderfully happy time, right? For many women, it certainly is, but estimates show that 1 in 5 women who give birth will suffer from some type of perinatal mental illness, such as depression, anxiety, OCD or psychosis. Chances are, this includes someone you know. In today’s podcast, Dr. Katayune Kaeni, a psychologist who specializes in perinatal mental health and a sufferer herself, discusses these often confusing and debilitating disorders, particularly postpartum psychosis, a more rare and severe form of perinatal mental illness.

Who is at risk? What does perinatal psychosis look like? And what is the treatment? Join us as we discuss an often misunderstood disorder.

SUBSCRIBE & REVIEW

Guest information for ‘Dr. Kat- Postpartum Psychosis’ Podcast Episode

Katayune Kaeni, Psy.D., PMH-C, is a psychologist in private practice specializing in perinatal mental health. She was drawn to this specialty after going through Postpartum Depression, Postpartum Anxiety and Postpartum OCD with her first child.

Dr. Kat is involved with Postpartum Support International as a subject matter expert for PSI’s certification exam development, helped develop advanced training curriculum for PSI and is a board member and Chair of Education, Training and Certification. She also works with her local community to provide training and education about perinatal mental health.  

Dr. Kat is the creator and host of Mom & Mind Podcast, which focuses on perinatal mental health and wellness. Through interviews with experts and people sharing personal stories of healing, the podcast raises the volume on issues to give information, reduce stigma and support families in the transition to parenthood.

About The Psych Central Podcast Host

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com.

Computer Generated Transcript for ‘Dr. Kat- Postpartum Psychosis’ Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard.

Gabe Howard: Welcome, everyone, to this week’s episode of the Psych Central Podcast. Calling into the show today, we have Dr. Katayune Kaeni. She is the host of the Mom & Mind podcast, which focuses on perinatal mental health and wellness. Dr. Kat, welcome to the show.

Katayune Kaeni, Psy.D.: Thank you so much for having me. Glad to be here.

Gabe Howard: Well, I’m always excited to have a fellow podcaster because you know what we go through.

Katayune Kaeni, Psy.D.: Yeah, right. Yeah. It’s a thing.

Gabe Howard: It really, really is. Now, today, we’re going to discuss postpartum psychosis. And you were drawn to this specialty after you yourself went through postpartum depression, postpartum anxiety and postpartum OCD after the birth of your first child.

Katayune Kaeni, Psy.D.: Correct. Yes. There’s a lot of things that can happen in the postpartum period. I’m here to talk about one of the more severe conditions.

Gabe Howard: In the interest of full disclosure, I’m a 43 year old male. I’ve never been pregnant and I do not have children. I’m really, really entry level when it comes to understanding what postpartum anything is. So thank you so much for helping to educate people like myself. It really is an important topic.

Katayune Kaeni, Psy.D.: Yeah, it’s absolutely important and a lot of people have that same feeling. I don’t know anything about it. It seems like this weird thing that happens to other people. And chances are, you know, somebody who has suffered through some form of perinatal mental health condition, even if they don’t talk about it, which is very common, a lot of people don’t talk about it because there is so much shame around kind of not feeling well or not feeling yourself even during pregnancy or postpartum. There’s all these ideas out there that it’s this wonderful magical time and hopefully it is. But for a lot of people, it isn’t.

Gabe Howard: That’s one of the things that came up while I was trying to do research for the show so that I could talk somewhat authoritatively on this subject. I was shocked at how many times I Googled postpartum psychosis or postpartum anything, and the articles that came up were, Am I a bad mother? Am I a bad parent? Am I harming my child?

Katayune Kaeni, Psy.D.: Right, yeah.

Gabe Howard: That really kind of spoke to me like in a visceral way, this idea that you also have the illness and there’s all this stigma and shame surrounding it. Is that what you found working as a therapist?

Katayune Kaeni, Psy.D.: Oh, absolutely. I hear those comments all of the time. I feel like a bad mom. I’m not good enough for my child. Feeling the shame and the blame and confusion around why do I even feel bad? We are just not educated on what can happen. I think it’s a great disservice to everybody who goes through any kind of perinatal mental health condition because they’re mostly blindsided by it. Right? You’re like here I’m supposed to be having the best time of my life. This is like what my body is supposed to do, quote unquote. And here I am feeling like a failure.

Gabe Howard: And just to be clear, none of this is true. You are an excellent parent. This is just sort of the illness and society’s misunderstanding of the illness taking hold in an unexpected way.

Katayune Kaeni, Psy.D.: Oh, for sure. This is a very treatable and very temporary condition. If you get the right help and if you get it as soon as you know, even if you’re getting it a little bit later down the road, you still can feel better. And there’s not a huge impact throughout the life course of you or your child. However, again, in the more severe cases that are not treated, there are some long term effects. And I know that might sound really scary to people. So I want to dispel the myth that if you have a condition, you’re going to be like messing up your kid in some way. Like I said, this is very treatable. And also, when it’s very, very severe, there can be really life-threatening consequences.

Gabe Howard: So let’s talk about postpartum psychosis. What is the definition of postpartum psychosis?

Katayune Kaeni, Psy.D.: Typically, a postpartum psychosis is very rare. One to two out of every one thousand deliveries, and it is not postpartum depression or postpartum anxiety. The onset of these symptoms are usually in the first two weeks, but certainly can show up a little bit later. There’s a really rapid onset meaning symptoms start quickly and it is characterized by the mind is kind of going off on its own, in part because of hormonal changes, in part because of your own mental health history and in part because of sleep deprivation. So people who are experiencing postpartum psychosis are having rapid mood swings. They are potentially having delusions or strange beliefs about themselves or their child or people around them. They may be having hallucinations. Feeling very, very irritated. The difficulty to sleep or inability to sleep. Sometimes paranoia and what’s really hard about postpartum psychosis is that the symptoms wax and wane, meaning they come and go. So sometimes people can sort of be and feel like themselves and appear to be like their normal selves. And then sometimes people around them might observe that they don’t look like themselves or sound like themselves. So it can come and go for quite a few people. And then for some people, the symptoms, once the onset is there, just continue. So I know all that probably sounds pretty scary and serious and it actually is pretty scary and serious. Like I said before, it’s very rare. And people who have a history of a bipolar disorder are at a high risk, or if there’s bipolar disorder in the family, they’re at higher risk. Oftentimes psychosis in the postpartum is an undiagnosed bipolar disorder.

Gabe Howard: So let’s talk about that for a moment. I myself live with bipolar disorder. And I understand psychosis from a lived experience perspective because I have experienced psychosis. Is it the same? Is postpartum psychosis, and for lack of a better phrase, “Gabe Howard” psychosis, is this a similar thing or is it completely different?

Katayune Kaeni, Psy.D.: There’s certainly some similarities in terms of symptoms of psychosis are the same. But what’s very different here is that there is a new baby involved. And sometimes the delusions or hallucinations are in relation to this new child. This new very vulnerable child. And also the perinatal person is also very vulnerable. They’ve just given birth. They’ve had massive changes in hormones, both during pregnancy, at delivery and then in the postpartum there are really, really rapid kind of swings in the hormones during that time. And the sleep deprivation is, you know, when it’s sort of like just you quote unquote, you have capacity to possibly sleep. In these cases, there’s a baby involved. And babies cry and they wake people up. And that’s what they do and that’s what they’re supposed to do. But for somebody who needs sleep and isn’t getting it and can’t get it, it adds a whole other layer of complexity into into the life and into the symptoms, because you’re in relation to a baby while having psychosis for some time. That means that there’s like a hyper vigilance around the baby. Like it’s really hard to not be around them or to let anyone else support them. Or sometimes it’s like a kind of a total disregard. Like people in some psychoses, they will kind of forget that the baby is there. So it brings a whole other level of danger and complexity also. Then there’s this additional layer that people around them are thinking, oh, well, she’s had baby. She’s not quite herself or giving some other explanation for odd behaviors, the strange behaviors. And it kind of puts people in a more of a dangerous situation because symptoms are explained away because they’re not understood and it’s not expected that these kind of symptoms will show up.

Gabe Howard: I’m kind of assuming that the way that postpartum psychosis is played out in the media as well as how motherhood is played out in the media, those two things combined. Because like you said, we want to defend new parents. We don’t just want

Katayune Kaeni, Psy.D.: Right.

Gabe Howard: To throw every new mom under the bus and say, oh, well, you have a serious mental illness. That’s the problem. But of course, this can be dangerous because it lacks care. I suppose my specific question is, how is postpartum psychosis played out in popular culture?

Katayune Kaeni, Psy.D.: It’s actually in very dangerous ways. So in ways that further stigmatize the perinatal period. So mostly what we’re seeing in the media, what you see on the news, is that postpartum psychosis that has led to infanticide and this is a really, really hard topic for people to hear about. And also, this is a very real possibility with postpartum psychosis. Out of that 1 to 2 percent of people who have postpartum psychosis, 4 to 5 percent of those mothers will kill their children. They kill their baby. It’s really, really a hard reality to hear. And what I want people to know is that when this happens, women are not in their right mind at all. They are not themselves. They do not know what they’re doing. They are often being told by their delusions to do something. Sometimes there are delusions that the baby is possessed. So they can’t be here. Although this might not make any sense, but most of the time it’s really out of love. A lot of love, like the world is too harsh for this child. So they have to go. And this is a very severe departure from reality. The moms who are in this situation do not know what they have done. If they come out of it and get the medication that they need, they can’t even fathom what has happened. People think and say, oh, what a horrible person. I can’t believe she has done this. I would never do this to my child. And the thing is, is that if she were in her right mind, she wouldn’t either. So what we’re seeing in the media is usually the moms who have done something like this and who are being handcuffed or going on trial. So this most severe, this is the most severe consequence of perinatal mental health condition. Postpartum psychosis and infanticide is how postpartum psychosis is viewed. Most people with postpartum psychosis are experiencing hallucinations or delusions or some kind of waxing and waning symptoms that does not reach that level. Typically, they may need hospitalization and medication, but it’s not always that people go on to hurt their children in this way.

Gabe Howard: It’s very interesting what you said there, because, of course, when something as terrifying and scary as infanticide happens, we say, oh, I would never do that as a mom. I can’t believe that a mom would do that. I mean, we have a lot of like really fear-based reactions.

Katayune Kaeni, Psy.D.: Yeah.

Gabe Howard: Because it’s terrifying. But then when we hear about somebody getting help for mental illness after the birth of a baby or not being excited about the birth of a baby, which is very common, we also say that exact same thing. Well, I would never do that as a mom or, oh, my whole

Katayune Kaeni, Psy.D.: Mm-hmm.

Gabe Howard: Family was excited or I just can’t imagine not loving. It’s the same reaction and it stops people from getting help.

Katayune Kaeni, Psy.D.: Oh, totally. It absolutely does. Yeah. This is the stigma. And when you are feeling as bad as you might be feeling in the postpartum period, even if it’s not psychosis, you’re dealing with depression or anxiety or OCD or PTSD or even a bipolar disorder in postpartum. You being the one who’s not well, also have to sort of fight against people around you who don’t want to think that you’re not well to advocate for yourself to get help. And sometimes it’s with the medical providers, too, who unfortunately in their training don’t get a lot of education on this. So getting to the point where as a person who is suffering to also be in charge of finding the help that you need when you don’t know what’s going on is an incredible hill to climb. I see it all the time. I see it all the time. People who come in not wanting to say out loud how badly they feel. And they finally get to help. And then they get to learn about how common this is and how preventable or treatable. And all of that. There is an amazing amount of strength in people who are dealing with a mental health complication while pregnant or having a newborn. It is phenomenal.

Gabe Howard: We’ll be right back after these messages from our sponsors.

Sponsor Message: Hey folks, Gabe here. I host another podcast for Psych Central. It’s called Not Crazy. He hosts Not Crazy with me, Jackie Zimmerman, and it is all about navigating our lives with mental illness and mental health concerns. Listen now at Psych Central.com/NotCrazy or on your favorite podcast player.

Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Gabe Howard: We’re back discussing postpartum psychosis with Dr. Kat, the host of the Mom & Mind podcast. To switch gears a little bit, we know that you’re an accomplished therapist and you understand this, of course, from the medical side and helping people. But this is also something that you went through personally.

Katayune Kaeni, Psy.D.: Oh, yeah.

Gabe Howard: I imagine that these myths and misconceptions from both society and whatever lived in your brain made the treatment and the acceptance of it very, very difficult.

Katayune Kaeni, Psy.D.: Oh, my gosh. It really did. So I was already a psychologist. I had a full time job. You know, I was helping other people and I got pregnant. Pregnancy was fine. Birth was fine. But very quickly, like day one, after my daughter was born, anxiety was there. I was so hyper vigilant. Not your normal checking on the baby. Like I could not not watch her because I was so afraid she was going to die. And she was fine. Physically, she was fine. Looking back on it now. That was the first sign. I want to say, before I go into the rest of this, is that I was a therapist and I didn’t know what was going on. It took me a full year to figure it out. And I myself have a history of depression. But it felt different in part because of those myths that you mentioned. It was crying all the time. I felt really alone. I felt like I didn’t know what I was doing. Everything that I was doing was wrong. I started having intrusive thoughts that something bad is going to happen. And I had them all the time. But because I had this idea of motherhood, or maybe like an incorrect idea of motherhood, I thought to myself, well, I guess this is what it’s like. I guess this is normal. I guess this is what I’m supposed to be experiencing.

Katayune Kaeni, Psy.D.: And it didn’t fully register to me until later that it was depression and anxiety and then OCD. And it went on for a year, a good year. I felt horrible the whole time until I figured out what was happening. I had read about one of my symptoms in a book and immediately had immediate relief like, oh my God. It’s not just me. And then I started researching a little bit more and realized there’s this whole world of mental health conditions that I had never learned about in grad school. I never learned about in any of my training anywhere. Maybe there was like a one page in one book that described it, but really no actual education on it. So I didn’t even know that postpartum anxiety was a thing. Certainly not postpartum OCD. I had heard about postpartum depression, but I thought, oh, no, no, no, no, not me. I’m a therapist. I’ve gone to therapy. I’ve done a lot of work on this stuff. So that’s not what this is. And looking back on it now, I can see how and when I started and all the factors that contributed. But at the time, when you’re in it, it just feels horrible and it just feels like it’s only you. And it’s incredibly embarrassing and filled with shame.

Gabe Howard: When did you finally realize something was wrong and what steps did you take to get help?

Katayune Kaeni, Psy.D.: Yeah, it was about around my daughter’s first birthday. It was almost like after I made it to that year, something just cracked in me and I knew something was wrong for sure. So, again, I was a therapist. I was working in a major medical system and we give out the PHQ-9, a ten item questionnaire, which is a mental health depression screening. And I said, OK, I’m going to take this and I’m going to be honest so that I can see objectively really how bad off I am. Mind you, I had taken this PHQ-9 several times in just regular doctor’s visits and in my postpartum visits. And I lied. I lied on those. I did not want to be as bad off as I was because I was like, I know what this is asking. I know. Like, nobody else needs to know about how I feel. So anyhow, that day where I just sat down and had an honest conversation with myself and that was the turning point. Again, it was around a year. So I went back to my therapist and I talked with her about what I thought was going on. And unfortunately, she didn’t have training in this. So she disagreed with me that I was having postpartum depression. So I started doing my own reading and really learning as much as I could. And then that helped a lot. I wish I would have known at the time to seek out a specialist who could know what I was talking about. But yeah, I went to therapy. I did a couple of other things, like I went to get my thyroid checked out and I started a bunch of supportive types of things to help me get back. So I took that kind of a route. I had taken antidepressants in the past, but again, I didn’t really know enough about antidepressants during this period of time to feel okay about it. But knowing what I know now, I know that they’re largely safe. So I did go to therapy. I did reading and I sought out whatever kind of supportive things I could.

Gabe Howard: And you’ve described it as very scary, and as you pointed out, you’re a mental health professional.

Katayune Kaeni, Psy.D.: Mm-hmm.

Gabe Howard: If a mental health professional is scared to seek mental health treatment after the birth of her child, what are the odds for the rest of us? Which brings me to my next question. What are the odds for the rest of us? And that’s kind of an all encompassing question. How many people have postpartum psychosis that never get help? And I guess it naturally goes away or of course, something bad happens. Once you get help, what percentage of people get better? I know it’s kind of a big question, but what’s the prevalence rate of postpartum psychosis?

Katayune Kaeni, Psy.D.: Prevalence for postpartum psychosis specifically is 1 to 2 percent, which is very low.

Gabe Howard: Very rare.

Katayune Kaeni, Psy.D.: Yeah. Very rare, but for postpartum depression and anxiety, it’s in around 20 percent, a huge number. So one in five people will deal with a perinatal mental health condition. So I’m talking about like the umbrella of things that can happen. 20 percent is a lot. And when you put that out into like the population of the United States, we’re getting into the hundreds of thousands of people every year who are dealing with this. So it is super treatable. And there are a lot of people who now are specializing in this area, perinatal mental health. So when people get help, symptoms resolve relatively quickly. All of these conditions are treatable. So if we can get somebody who is at risk for postpartum psychosis into the right psychiatrist and the right therapist or the right support team, then the symptoms can resolve relatively quickly. But the longer it goes on, the harder it is to heal and recover. So the sooner that we can get people in and seen, the sooner it will resolve and people go on to be fine. Absolutely fine. And also people who come in for therapy, sometimes there are some underlying things that have contributed to the anxiety or the depression or the OCD. And if people are getting the right kind of help, I really hear sometimes that they’re better off than they were before because they’ve caught something and gotten help for something that was actually had been bothering them for years. Let’s say anxiety for instance, a lot of people just live with anxiety and don’t specifically know that they have it. But if there’s a peak in symptoms during this period of time and it’s finally bringing them in for help, then we’re able to help them not only in the postpartum period, but also just help them with life skills that can benefit them for years.

Gabe Howard: It sounds to me like while postpartum psychosis is scary, it is treatable and it’s most treatable if you get help immediately. And one of the reasons that people aren’t seeking help immediately is because of a lot of, you know, myths and shame that isn’t really relevant to the disease that you have, the illness that you have, the disorder that you have. And then we’d be in a much better position if people got it checked out before it became, you know, bigger and bigger and bigger or before the worst case scenario happened.

Katayune Kaeni, Psy.D.: Absolutely. The sooner you get in, the better. And I’m also a really big fan of prevention. So if you are planning on getting pregnant or get pregnant and you know that your family has a history of any mental health conditions, I would say just find somebody who specializes in perinatal mental health. Go talk to them about your concerns and develop a plan. I think really when we can get ahead of it, it’s even better. So there are things that we know how to do, like protect sleep and negotiate that within the family to help with the baby and have meals brought in. There are so many things that we can do to help prevent this. And also sometimes it’s not completely preventable, but we can help reduce the intensity by quite a bit if we’re ahead of it. So although I know people kind of don’t want to think or believe that these kinds of things could happen and therefore sometimes don’t get preventative care, I would highly recommend to do that because it will make your experience so much better.

Gabe Howard: Dr. Kat, thank you so much for being here. I can’t thank you enough. And I hope that everybody checks out your Mom & Mind Podcast. Do you have a Web site where people can find you easily?

Katayune Kaeni, Psy.D.: Yes, www.momandmind.com.

Gabe Howard: Again, Dr. Kat, thank you so much for being here. Do you have any last words for our listeners?

Katayune Kaeni, Psy.D.: Thank you for having me. I would just like to say to anyone who’s listening, who is concerned about these symptoms, you are definitely not alone. There is help. And with the right help, you will be well.

Gabe Howard: Thank you so much. And remember, everybody, wherever you downloaded this podcast, I just need you to do a couple of things. Give as many stars as you feel comfortable giving. Hopefully it’s all of them. But no matter what, use your words. Tell people what you like or tell people what you don’t like. You can always e-mail show@PsychCentral.com and let me know what kind of shows you would like to hear. And remember, you can get one week of free, convenient, affordable, private online counseling anytime, anywhere, simply by visiting BetterHelp.com/PsychCentral. And we’ll see everybody next week.

Announcer: You’ve been listening to The Psych Central Podcast. Want your audience to be wowed at your next event? Feature an appearance and LIVE RECORDING of the Psych Central Podcast right from your stage! For more details, or to book an event, please email us at show@psychcentral.com. Previous episodes can be found at PsychCentral.com/Show or on your favorite podcast player. Psych Central is the internet’s oldest and largest independent mental health website run by mental health professionals. Overseen by Dr. John Grohol, Psych Central offers trusted resources and quizzes to help answer your questions about mental health, personality, psychotherapy, and more. Please visit us today at PsychCentral.com.  To learn more about our host, Gabe Howard, please visit his website at gabehoward.com. Thank you for listening and please share with your friends, family, and followers.

It is tempting to turn to the internet for quick answers and support. Perhaps your child is out of control. Or depressed. Or struggling in school. And you need advice… fast. It is comforting, helpful, and downright cathartic to vent and ask for guidance. We all know how worries and frustration can overwhelm. No family escapes the parenting years unscathed!

But when you post personal, detailed, and yes, unintentionally incriminating information online, it may affect your child’s social and emotional well-being, and leave a trail that persists well into the future. 

We warn our kids about the risks of posting embarrassing selfies, drunken party photos, or worse. We educate them about cyberbullying, and instill a healthy fear of what they might encounter online, along with tools for how to protect themselves. We remind them that whatever they post could reappear years later — and negatively impact a job prospect or college admissions. 

Yet, many parents abandon all reserve when anxiety takes hold. The internet entices with the promise of delivering just the right clue to understanding our child’s struggles. And sometimes, it just feels good to know other parents feel the same way. In online forums, Facebook groups, and other venues, parents reveal confidential information about their child’s behaviors. Some post potentially incriminating information, such as concerns about drug abuse, acting out sexual behaviors, disciplinary problems, academic difficulties, or even actual IQ test scores or mental health diagnoses. 

When desperate for answers, it is easy to forget that sharing confidential information not only puts your child at risk, but also is a breach of privacy. Under duress, it is tempting to throw caution to the wind. So-called “closed” Facebook or other online groups typically boast 1,000 or more members and offer no promise of confidentiality, privacy, or guarantee that another “anonymous” member might not know your child. And while the immediacy and presumed anonymity of online feedback is certainly appealing, comments from strangers are no substitute for professional advice or the wisdom sometimes readily available among trusted family or friends who truly know your situation. 

Some parents ask for their child’s permission to share information online. This is a healthy first step. However, children cannot fully provide consent, or possess the maturity and wisdom to predict how current actions will affect them years from now. That is why parents are required to sign consent forms, and why children are not allowed to vote or make legal decisions. A child might agree to your request to post information for various reasons — to please you, avoid conflict, or because long-range concerns are just not on his or her radar. However, it is our job as parents to determine whether a decision with possible future implications is in their best interest — not assume that we can rely on their judgment.

As both a psychologist and parent, I urge you to think twice before oversharing online about your parenting struggles. Years from now, when your adult child is seeking a new job, vying for a security clearance, or possibly running for public office, data dredged from the internet about his or her mental health problems, dabbling with drugs, or cheating on a test in school, may limit career options. The momentary reassurance or advice you received just might not be worth the potential risk.

Before sharing, ask yourself the following:

1. Could this potentially embarrass or upset my child?
2. How would it affect him if his friends, teachers or community members accessed this information?
3. Even if she gives the okay now, will she resent this years from now?
4. What are the potential privacy risks now — and well into the future? If there is a privacy breach, could this potentially affect future job opportunities, college admissions, or my adult child’s reputation?

When sharing specific information online might pose a risk, exercise restraint, seek out real-time support from trusted friends and family, pursue expert support from licensed mental health professionals, attorneys, educators, school counselors, and medical professionals, and consider in-person support groups, such as Al-Anon or the National Alliance on Mental Illness (NAMI). Gather as much advice as you need through trusted websites, and consider using Google Scholar, where you can access peer-reviewed journals. But please use caution when sharing information about your child. You won’t regret it. 

It’s enough to make any reasonable person unreasonably anxious. It makes already anxious parents want to wrap their kids in bubble wrap to eliminate all risks and keep them under their watchful eye, often winning for themselves a not complimentary term — “helicopter parents.”

Let’s be clear. If you’ve been accused of being a “helicopter parent,” it’s only because you want to protect your kids. You love them. You want to keep them safe in a world that feels increasingly hostile and unpredictable.

You aren’t wrong to be anxious. But carried too far, protection can be detrimental. Kids who are overprotected from risks are also “protected” from learning what they need to know if they are to protect themselves. 

How to Get out of the Helicopter Seat

The key to making kids safe is not to eliminate risks but to build their resilience. Our job as parents is to give our kids the tools to keep themselves safe, not to do it for them. Here are some reminders to help you bring your helicopter in for a landing. 

Keep things in perspective: News sources don’t emphasize the positive, so it’s easy to miss that things are getting better. Crime is down in the U.S., not up. The percent of kids who drop out of school is down. Smoking and illegal drug use by kids is also down. Teen pregnancy rates are down. Risky sexual behavior by teens is no worse than when we were all kids.

Deal with your own anxiety: Learn how to keep your anxiety away from the kids, so they don’t “catch it” from you. If you can’t do it on your own, do consider seeing a therapist to help you. You’ll learn new skills for managing your fears as well as ways to help your kids deal with difficult situations.

Self-reflect: Being young means encountering things you haven’t done before that may be a bit scary. Think about risks you did and didn’t take while growing up. What lessons were helpful? What not? It can be reassuring to remember that you survived and even learned valuable lessons from taking chances. 

Do some reasonable scouting: without involving the kids. The parents of the kid who invited him for a sleepover may have rules similar to your own. That team your kids want to try out for may have a supportive coach. The field trip or dance your teen wants to go to may be well-supervised. Do your homework. If there is reasonable chance that your kids will be fine, respond to their requests with an enthusiastic “yes” instead of an automatic “no.”

Tell stories: Kids tune out from lectures. But they love to listen to stories about the “old days” when we were young. Sharing our experiences in risky situations with humility and some humor is often the best way to impart what wisdom we’ve got.

A Dad I know told his kids a story (complete with sound effects) about when he let some older kids who had a reputation for trouble talk him into going for a joy ride in a stolen car. Yes, they were caught by police. He was let off as a bystander but the experience taught him a lot about the importance of anticipating consequences — even when something seems exciting, even when the other kids are doing it. His kids got the point.

Teach decision making skills: Every activity has some element of risk, whether physical, social, or emotional. Instead of saying a simple yes or no, regularly engage your kids in conversations about whether the potential benefit of an activity is worth taking a chance by looking at pros and cons. 

Say your youngster wants to play hockey. Yes, the risk of injury is real. So is the risk to self-esteem by not being very good at it. But equipment, good instruction, and a coach who knows how to motivate kids positively can make it safer and fun. Being part of a team can teach important skills of cooperation and good sportsmanship. Talk together about how to look at both sides to make a wise decision. 

Teach exit strategies: Kids sometimes get into situations they want to get out of. Just like adults, kids are safer if they know how to control their impulsivity; how to gracefully leave a peer group that is doing something they shouldn’t; how to get help from the grown-ups when they need it. Don’t leave learning those skills to chance. Talk about them. Role play them. Tell more stories. Do remember that teens are more likely to call you when they need help if they know you will pick them up without judgment and save talking about it for later. The time to talk is when everyone has had time to calm down so you can have a rational conversation.

Give kids experience with risky situations: It’s tempting to want to change environments so kids can avoid all danger. Yes, playgrounds sometimes need repairs. Your kids’ school may have a bullying problem. Your child may not have the talent they think they have to be a star athlete. But avoiding playgrounds, keeping them out of school, or never letting them try out for a team doesn’t make kids safer. It hampers them. Better that they learn how to handle themselves. Celebrate moments when they’ve made good decisions and kept themselves safe. Debrief when they’ve stumbled. Teaching risk-management isn’t a “one and done” exercise. It’s an on-going educational conversation. 

“I was raised to believe that being frightened meant being alive. Timeo, ergo sum. That being scared is not a frailty but a skill. That I displayed intelligence by shunning whatever displayed itself as welcoming or wild. That the scariest time-bomb in the world was me.”

Some of us were raised to seek out scary things.

Not in a fun way. Not like skydiving or watching horror films.

Some of us were taught to expect and detect threats in every circumstance. Anticipating every buffet, ballgame and block party, every crosswalk, cough and conversation—we were taught to wonder: What could possibly go wrong?

Oh, this. Or this.

What in this tennis court or classroom could assault, infect, humiliate, or hurt me? Where in this palace or park awaits the as-yet-unseen splinter, strangler, quicksand, cliff? Where in this sweet hello hides the veiled insult or encoded curse?

Can I be saved?

We were taught that only one certainty exists: Danger looms everywhere like drums and fish in “Find the Hidden Picture” games.

We were raised to believe that fear is the only real feeling, the only one we must trust. We were told: Other feelings are either unfounded fantasy or clever cons, like vivid feathered fishing-lures attracting trout: “Fun” and “desire” are false fronts drawing us ever closer to certain doom.

We were told twenty million times: Trust your terrified gut. Let panic be your pilot. Listen when it whispers WORRY, FREEZE. FAWN. FLEE. Obey its command: CRY.

We were told: Yes, it hurts. … but fear just wants to help you. Fear is your best friend. You say your best friend is Amanda Brown? I bet she badmouths you behind your back. I bet she calls you fat.

Fear never lies. Exaggerates sometimes, but hey. How else to get its point across?

I was raised to believe that being frightened meant being alive. Timeo, ergo sum. That being scared is not a frailty but a skill. That I displayed intelligence by shunning whatever displayed itself as welcoming or wild. That the scariest time-bomb in the world was me.

The multiphasic process of seeking, detecting, fearing, then racing to escape real or perceived danger grows reflexive over time, creating in our brains a certain neurocircuitry unlike those in the brains of normal folks: a default warning blast and screaming siren we cannot turn off.

Just as wine-tasters have sensitive tongues, we who were raised to be afraid might have hyperdeveloped, hyperactive danger-signaling/emotion-processing amygdala—those tiny neural clusters deep in our temporal lobes which refuse, in our cases, to be soothed.

Studies suggest that trauma wields biochemical changes. In his book The Body Keeps the Score, PTSD specialist Bessel Van Der Kolk describes the brains of combat veterans as “rewired to be alert for emergencies, at the expense of being focused on the small details of everyday life.” The forced anxiety of our childhoods was one nonstop electric cord of traumas. Prepping constantly for traumas is traumatic.

Who or what would make us thus? What better way to wreck the lives of children than to ready them, body and soul, neither for joy nor spontaneity but only pain, panic, and flight? What kind of parent would leap out at us every five minutes shouting Boo, believing this would make us strong, safe, smart? What kind of parent would want fear to feel as intrinsic to us as bones?

Here’s who: Those who grew up afraid. Those who, as children, knew about starvation, crippling illness, bitter cold and being beaten in the street.

So who could blame those who, as children, wandered snow-slick cities stalked by strangers while their parents worked from dawn to dusk, mourning their missing—surely slaughtered—kin?

Who could blame our parents for fearing parenthood? Who could blame them for thinking, saddled with a sudden child almost against their will, that love was best expressed with warnings and alarms? That they must murmur never, “All is well” but “Cars are two-ton death machines” and “Toast is fattening” instead?

Who could blame scared parents for scaring us? For never staging auto-interventions into their own fear to stop it spreading down the family tree? Who could blame them for teaching us to cower and cringe as other kids learned to skate and sing?

Well, we could blame them. Which might solve some of our mysteries, such as Why Have I No Hobbies? and Why Am I Awake at 4 a.m.?

But beyond blame, what strategies have we? Van Der Kolk asserts that yoga and meditation can help fearful individuals like ourselves “regulate the core arousal system in the brain and feel safe” in our bodies. Can we find hope where spirituality meets biochemistry?

We are not seven billion, but we are enough to tell each other, starting right here: You are not alone.

This post courtesy of Spirituality & Health.

When mental illness is not alleviated, it can create C-PTSD (compound or complex PTSD), so it’s critical to reverse it early. What sometimes keeps the underlying factors of mental illness from accurately being addressed is that parents may not see the feelings of anxiety or depression as transient emotions that need to be processed, but instead create fixed labels. A child shouldn’t be labeled as “anxious child so-and-so” or “depressed teen so-and-so” but instead one should look behind the symptom at why they are feeling this way. You wouldn’t label a child a physical state such as “child with a fever and flu disorder”; you would help them heal from having a fever and flu. How ludicrous to call children the symptom of a passing disease they are suffering from instead of finding ways to remove it. Anxiety and depression are symptoms of outside stress. Fever, headaches, coughing are symptoms of outside bacteria and viruses. 

Although there are many factors that contribute to child, teen and young adult mental health, very few people, according to the APA (American Psychological Association), are born with mental illnesses. Epigenetic inter-generational trauma is sometimes passed down, but even that can be reversed if the child has a healthy environment. Most mental illnesses are formed by experiences and interactions the child has with others. The important thing is that the more aware a parent is, the better chance a child has of not incurring signs of mental illness. Parental self-awareness in itself creates the healthy trajectory the child needs to avoid mental illnesses.

Maslow’s hierarchy of needs, showcases the minimum requirements for creating a healthy functioning adult. His work depicts the prioritization of human resources utilized in parenting and teaching children, from the importance of sheltering a child to their self-actualization. In addition, psychologists have found that executive function isn’t often realized until the age of 25, so parenting with awareness through the young adult years is critical for their healthy development.

As we know from the studies of children who have experienced Adverse Childhood Experiences (ACE), a child can develop mental illness and subsequent trauma when the adult who is overseeing them fails to create safety, hasn’t created secure attachment with the child, isn’t co-regulating with them to process emotions, and a myriad of other negative parental traits. If a parent is wanting to grow a human being into adulthood, they will need to have awareness, by examining themselves, their motives and their behaviors so their children avoid developing mental illness. The charts below are helpful.

The 5 Parental Tenants for Pediatric Growth

• See and hear your child by being present and actively listening.
• Give your child emotional and physical safety.
• Build trust between you and your child by not exhibiting any Parental Trauma Factors. (see below)
• Allow your child their autonomy.
• Teach your child curiosity and life skills.

This chart is useful in identifying hidden behaviors in adults that may be hindering the child’s mental health:

Parental Trauma Factors (PTF’s)

• Not able to see (being present for) your child.
• Not listening actively to your child.
• Not building trust.
• Dismissing the thoughts of a child as silly.
• Lacking physical or emotional attachment.
• Childhood emotional neglect (CEN).
• Codependence or enmeshment.
• Authoritarian power dynamic.
• Parent living out their desires through a child instead of finding out the child’s personality.
• Not building their autonomy.
• Gaslighting.
• Lying.
• Undermining a child.
• Belittling or mocking a child.
• Creating food wars by controlling instead of offering choices.
• Trying to shock a child with inappropriate content.
• Inconsistency
• Permissive parenting
• Deflecting blame onto a child for issues you created.
• Having a detached parenting style.
• Escaping into addictions such as alcoholism and not available for the child.
• Not participating in the child’s school meetings and events.
• Not creating physical or emotional safety for your child.
• Not addressing your own mental illnesses and being in active recovery.

The more a parent exhibits the 5 PTFPG’s and the less a parent exhibits PTF’s, the greater chance that the child has of not developing mental illnesses. All parents have blindsides and may have learned certain patterns from their family of origin, yet these behaviors can be corrected. 

Remember that mental illness, like physical illness, is caused by an outside incident. It is not made up inside the person. It’s illogical and dehumanizing to label a child a mental illness without examining parental or other outside influences that are causing anxiety, depression or any co-occurring disorder. More awareness in examining the self in parenting will reduce these symptoms.

But young children also seek another important resource: power. According to Erik Erikson’s theory of development, from ages eighteen months to three years old, the child is working out the conundrum between autonomy and self-doubt. They are learning that they can do many things and discovering whether or not they can do these things by themselves.

Independence is an important skill to master, and it begins even at this early age. The fulfillment a child can experience when given the opportunity to explore their abilities without fearing criticism if they fail, is unmatched. Likewise, the frustration and disappointment they may feel, if they do not get enough opportunities to explore this about themselves, can build over time and contribute to negative behaviors we call “acting out.”

Many parents can attest to this stage of development, if they will recall the number of times they have been delayed for events because their toddler or preschooler has insisted, “I do it.”

But any professional in child development would agree, parents should allow their children to do it themselves, as much as possible, in a positive, age-appropriate environment, with support and care given if the child’s attempts fail. This is the way the child learns — by doing. 

This theory is true for adults as well, on a larger scale. Do we not enjoy the attention of others? Do we not crave a confidence in our ability to do things for ourselves? Maybe not always and if not, this conflict is often rooted in the lack of support we received during this stage of development in childhood. Erikson believed that each stage of development was resolved with either a positive, healthy new skill or a negative, inhibiting new habit. 

Humans are creatures of momentum. Our experiences layer one on top of the other as we reinforce beliefs we hold over time. But the good thing about momentum is that, if you can get it going one way, you can also get it going the other way.

An important study was conducted by the University of Virginia and published in the journal of Child Development in December 2016. It examined preschool classrooms with students who exhibited frequent disruptive and defiant behaviors. What the study found is that when teachers spent deliberate, positive, often child-led, one-on-one time with these disruptive students, the students’ incidents of disruptive behaviors declined. 

This intentional time was called “Banking Time” and essentially, it is a practice of banking positive experiences in order to counteract the momentum of negative experiences that often accrue for repeatedly disruptive children over the course of many teacher interventions or redirections. 

It makes sense, as creatures of momentum, if a child experiences frequent teacher redirections or criticism, coupled with his or her own frustration and displeasure with the lack of autonomy and control over the situation, it is a recipe for disaster. What is beautiful about this concept of “banking time” is that it is a proactive approach to undoing the negative momentum and replacing it with positivity. 

An additional challenge to this practice is that it requires a very self-aware teacher or parent to implement. Having a child in your classroom or family that is constantly disruptive would try the patience of even the most compassionate adult. But this study shows us we can reverse the negative momentum of disruptive behaviors, without giving up the limits and boundaries that keep our children safe and courteous.

As adults, I don’t believe that our banks for this positive and negative energy ever really go away. We still balance these two in our relationships and interactions on a daily basis. We see this anytime we respond to a negative situation with more negativity, perpetuating the problem, or when we respond with deliberate kindness, and we can see that kindness fill someone else’s positive energy bucket and it becomes contagious. 

Both are committed to their careers and work full-time. Both are exhausted by the end of the day. They want to have peaceful evenings and weekends, but the kids act up and they end up acting up, too. They’ve tried everything from the “naughty chair” to letting the kids duke it out to separating them. Nothing works. What can they do?

It’s said that there is no manual for how to raise kids. Actually, there are hundreds of “manuals” on the market. Each book recommends a different technique. Often the suggestions in one contradict the suggestions in another. Kelly and her husband, Jim, have dutifully read and tried out several. They’ve come to me in desperation. They had dreams of a happy family. To their dismay, they find themselves sometimes wishing they’d never had kids.

These are good people. They love their kids. They are trying their best. They’ve bought the books and even read and tried to apply them. They came to me in yet another effort to make their family better. “Is it too late to change things?” they ask. 

Not at all. The kids know they are loved. Destructive patterns haven’t gone on for so long that they will be difficult to change. The couple is willing to do some work with me. My basic framework for parent education with couples like Kelly and Jim includes these 4 “rules”:

Rule #1: Ditch all the books.

In their efforts to find the perfect way to discipline children, Kelly and Jim have tried a number of methods. By applying the book of the week, they’ve been so inconsistent the kids don’t know what to expect.

We work together to find one consistent approach they feel most comfortable with. Consistency alone will help. As long as their choice doesn’t support abusive treatment of kids in the name of “discipline” (spanking, shaming, or extended time-outs that leave a child feeling abandoned, etc.) I’m willing to work with it.

Rule #2: Understand that not everything a kid does that parents don’t like is misbehavior.

Sometimes kids are hungry, tired, bored silly, or needing attention. Their ability to cope collapses and they whine or get balky or act up.

Kelly and Jim come home tired and hungry and wanting attention from each other. The kids come home from daycare tired and hungry and needing parental attention. Everyone is on a thin thread. I ask them to make homecoming for everyone go differently. We talk about how they can put aside their own needs for an hour to provide a small snack for everyone, to do a quiet activity with the kids like reading a story, and to give the kids lots of positive attention by talking about the day while snuggled on the couch.

Rule #3: Stop being impatient with the kids and start analyzing.

Kids’ misbehavior is often a behavior that “misses.” It doesn’t get them the positive attention they want and need. When parents don’t anticipate their needs or when requests don’t work, children cast about for something that does.

The most common reasons children misbehave are these: 

• Attention: One of my best teachers often said that young children need attention like a plant needs sun and water. If they feel they can’t get it directly, they will do whatever it takes to finally get mom or dad to pay attention. Negative attention, even being yelled at or deprived of something they want, is preferable to no attention at all.
• Plea for help: A child is so tired or frustrated or upset, they don’t know what to do with themselves. They act up to get a parent to fix it. If a parent meets the kids’ pleas with impatience or ignoring due to their own exhaustion and frustration, the upsets just go from bad to worse.
• Figuring out limits: When parents are inconsistent, the kids don’t know when a “no” really means “no.” They’ll keep up a behavior until the parent explodes. “Okay,” they think. “Now I know what the limit really is.”
• Problem solving: Children don’t come to us knowing how to engage us or how to solve problems, so they experiment. Some of the experiments win praise and positive involvement from the big people. Some experiments result in broken toys and hurt feelings, which also gets the big people involved but not very happily. 
• Figuring out how to use power: Little kids want what they want. Stronger kids take the toys away from the weaker ones. Big kids try out intimidation. They aren’t being “bad.” They don’t yet know social rules. It’s up to the adults to teach children how to share, how to get along with others, and how to use their power productively. 
• Normal separation/individuation: The “no’s” and “why’s” of preschoolers can be frustrating to adults, but they are an important part of normal development. It’s the way a child begins to separate from a parent and find their own identity. When adults react with humor and explanations, the result is a positive step in growth. When adults react by just overpowering the child, the child’s sense of self suffers. 

Kelly and Jim ruefully admitted that their kids do all of these. Jim admitted he’s especially apt to give in when he is tired so his “no’s” aren’t always solid. They both acknowledged that they have been reacting more than teaching — which brings us to Rule #4.

Rule #4: Teach skills.

The word “discipline” has the same root as “disciple.” It doesn’t mean “to punish.” It means “to teach.” Our most important job as parents is to teach our kids how to get along with others and how to solve problems. Whether we teach skills purposefully or not, the kids learn by watching the grown-ups.

That can be fine when a kid’s parents have good relationships with family and friends and have a calm and effective way to deal with challenges. The children will still need explanations, but they will generally pick up a positive way to interact with the world. However, when parents treat others harshly or respond to problems by getting overwhelmed and angry, the children will pick that up as well.

Three months later: Things aren’t perfect, but they are much better. Kelly and Jim really worked hard to turn things around. The first hour of homecoming is now something the whole family looks forward to. Both are doing their best to be consistent and to focus on teaching, instead of just reacting. They are now feeling optimistic that they can have the kind of family they had dreamed of.

Instead, we unleash our rage… and anxiety and shame. We bash ourselves. We panic. We minimize the impact (while subconsciously freaking out).

According to therapist and self-compassion expert Lea Seigen Shinraku, MFT, these are all ways we try to maintain some semblance of control.

Because “when we’ve really screwed up, we feel like the situation is out of control.”

So, we think to ourselves: If only I’d done things the right way; this would’ve never happened, and everything would be fine.

Or, when minimizing the impact of a mistake (or bad decision), we think, it’s not that bad, “even if it is extremely ‘bad,’” said Shinraku, founder of The San Francisco Center for Self-Compassion.

Besides grasping for control, we bash ourselves because one of our basic needs is to feel loved and connected, and our inner critics attempt to protect us from being rejected (and repeating the same behavior), according to Karen Bluth, Ph.D, a mindfulness and self-compassion teacher. Which is why they sound so cold and harsh (“that was so stupid! you shouldn’t have done that!”).

But just because self-compassion doesn’t come naturally doesn’t mean we should be awful to ourselves, even when we’ve screwed up. Because this is precisely when we need our own gentle, understanding support.

Many people dismiss self-compassion because they see it as a copout, as an excuse to behave badly. However, practicing self-compassion includes taking responsibility for your actions, said Bluth, author The Self-Compassion Workbook for Teens.

“The question is, how much do we need to beat ourselves up? We probably beat ourselves up too much.”

Below, Shinraku and Bluth shared a range of strategies for practicing self-compassion—from giving a sincere apology to soothing yourself.

Take a self-compassion break. This is particularly helpful to do when you’re feeling bad in the moment. According to Bluth, a self-compassion break incorporates the three components of self-compassion: mindfulness, common humanity, and self-kindness, which you’ll find below.

• Recognize that you’re struggling right now, and say to yourself: “This is a moment of struggle,” “This hurts,” or “This is really hard.”
• Acknowledge that everyone struggles, and say something like: “I’m not alone. Struggling is part of being a human being and alive on this planet.”
• Say something kind and supportive to yourself and pair it with a soothing gesture. For example, put your hand on your heart and say, “This won’t be forever. You are strong. You’ll get through this.”

Take responsibility. Self-compassion isn’t about minimizing your role in a situation or exaggerating it. Instead, Shinraku said, mindfully identify the facts of the situation (without focusing on “your feelings or hopes about what is happening”). Consider what you can do and/or say to “atone for your actions.”

If you’re going to apologize, make sure it’s “true, necessary, and kind,” and that it focuses on your impact on the other person (versus on how awful and horrible you are), Shinraku said.

In short, don’t make it about yourself (even though that’s hard!). For example, according to Shinraku, avoid saying: “You must hate me! I’m the worst! I can’t believe how clueless and selfish I was in making you wait 45 minutes. I just got so caught up in re-organizing my closet that I lost track of time.”

Instead, here’s a kind, genuine apology: “I’m sorry that I’m so late and that I didn’t let you know what was happening. I care about you and our friendship and I want to talk about how this impacted you.”

Soften, soothe, allow. This self-compassion technique helps you process difficult emotions, such as being angry with yourself. According to Bluth, recognize what you’re feeling; name it (e.g., “I’m feeling anger”); and find where you’re experiencing it in your body (e.g., tension in your neck).

Then focus on soothing that place. For example, you might imagine a warm wash cloth, she said. Finally, allow yourself to experience this emotion without resisting it, judging it (or yourself), and wanting it to disappear.

Try supportive touch. One way we comfort others is by giving them a hug, patting them on the back, or putting our arm around them, Bluth said. Such kind gestures trigger the release of oxytocin, which can decrease heart rate and the stress hormone cortisol. We can do the same for ourselves. Bluth suggested putting both hands over your heart, stroking your cheek, giving yourself a hug, or holding one hand in the other on your lap.

Forgive yourself. A helpful tool for self-forgiveness is journaling. Because it’s easy to veer off into self-blame, Shinraku suggested using the principles of nonviolent communication.

Begin by jotting down the facts surrounding the situation. Second, name the emotions you’re experiencing. Third, reflect on the needs you’ve had or have in this situation. Lastly, consider if there’s a way to meet these needs right now. “For example, if you discover that you have a need to be loved, is there a way that you can remind yourself that you are loved?” Shinraku said.

If guilt or shame still arise, “pause and remind yourself that it’s normal to make mistakes and that making mistakes does not mean that you are a ‘bad’ person. It means that you are human.”

Because practicing self-compassion on your own can be tough, Bluth suggested taking a mindful self-compassion class.