Healing From A Difficult Childbirth: Understanding Childbirth Trauma

Stocksy_txpa1bf53dfNrn100_Small_597487.jpg

Most women set out to get prepared emotionally and physically for the birth of their baby in some way, imagining what the experience will be like and even writing out detailed birth plans. So when things don't go as expected, what's supposed to be the happiest day of your life can lead to disappointment or crisis, and in some cases even traumatic stress.

What is Childbirth Trauma?

Birth trauma results from experiencing some part of childbirth as scary, frightening, distressing or life threatening. Simply put, if it felt traumatic to you, it was traumatic.

Post-traumatic stress disorder following childbirth is caused by real or perceived trauma during delivery or postpartum, resulting in feeling that you are not in control of what's happening while also fearing for your life or your baby's life. Traumas that can lead to postpartum post traumatic stress disorder (PTSD) include:

  • Unplanned C-section

  • Feeling powerless, out of control during childbirth

  • Not having your wishes respected

  • Lack of support and reassurance during/after delivery

  • Poor communication during/after delivery

  • Other emergency interventions( use of forceps/extractor)

  • Your baby had to go to the NICU

  • Prolapsed cord

  • Previous traumas, such as rape or sexual abuse, traumatic losses, previous medical trauma

  • Severe physical complication or injury related to pregnancy or childbirth(for example, 3rd or 4th degree tears, pre-eclampsia/emclampsia, hyperemisis, postpartum hemorrhage)

According to Postpartum Support International, about 9% of women experience postpartum post-traumatic stress disorder following childbirth. Women with a previous trauma, including childhood abuse, rape or sexual abuse, are at a higher risk for experiencing postpartum PTSD.

Common Symptoms of PTSD Following Childbirth:

  • Intrusive re-experiencing/replaying of a past traumatic event(of childbirth, or previous traumas)

  • Flashbacks or nightmares(replaying the birth in your dreams)

  • Avoidance of reminders connected to the event, including thoughts, feelings/emotions, people, places and details (for example hospitals, doctors, any reminders of childbirth including babies and other new moms, hearing other women's birth stories)

  • Feeling on edge, unable to relax

  • Anxiety/panic attacks

  • Feeling detached, “things don't seem real”

  • Easily startled

  • Hypervigilant

  • Sleep disturbance

  • Irritable or angry mood

  • Excessive worry about the baby/checking on the baby

Emotionally Traumatic Aspects of Childbirth

For many women, the most traumatic aspects of childbirth are caused by something other than a medical emergency. The way that women are treated or spoken to during labor and delivery can cause extreme distress--lack of communication, not feeling supported or reassured, or feeling pressured into making critical, complex decisions quickly during labor or immediately following the birth. Measures that are seen as routine or medically necessary to a medical professional may feel overwhelming to a new mom, and just intensify the feeling that you're out of control and helpless to help yourself or your baby-even when you and your baby are now “fine”.

If childbirth was difficult for you, it's important not to dismiss or minimize this part of your experience, especially when your distress or fears continue longer than the first month after your baby is born.  Postpartum depression, anxiety and PTSD are treatable. If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or write to me at hollyaevansmft@gmail.com

Postpartum Anxiety and Depression Are Preventable: Know Your Risk Factors

Stocksy_txp264a1834jCF200_Small_2086369.jpg

Anxiety and depression during and after pregnancy are common, yet many women don't recognize symptoms or know their own risk factors. Very often, expectant or new moms don’t know what to do for themselves when they begin to have problems. Many women try to push through without asking for help, which usually just make things harder.

Preventing Postpartum Anxiety and Depression

The U.S. Preventive Services Task Force has just announced their recommendation for preventing maternal anxiety and depression, recommending that doctors refer their patients to counseling—-before, during and after pregnancy. Their findings point to the effectiveness of counseling in preventing and treating postpartum mood and and anxiety disorders, in particular Cognitive Behavioral Therapy and Interpersonal Therapy.

Read the full article here:

https://www.npr.org/sections/health-shots/2019/02/12/693868871/task-force-to-prevent-postpartum-depression-at-risk-women-should-get-counseling

Know Your Risk Factors for Anxiety and Depression

As with any health issue, staying well means knowing when you’re at risk. There are a number of things that can increase your risk for postpartum anxiety and mood disorders. Knowing your risk factors can help you prevent anxiety and mood disorders by allowing you to act to take care of yourself before there is a problem. Risk factors include:

  • History of depression or anxiety

  • History of trauma, including childhood abuse and neglect, previous sexual assaults

  • Lack of social or family support

  • Previous miscarriages, still birth, newborn death

  • Complications during pregnancy or the birth process

  • Traumatic loss

How Counseling and Therapy Can Help

It’s important to know that you are not alone in what you’re going through, and that these issues are not only treatable, but preventable. One out of 7 women suffer from depression and anxiety during or after pregnancy. Counseling can help you in the following ways:

  • Learn new tools to support you in meeting the new challenges of parenting

  • Developing a preventive self care plan for pregnancy and postpartum

  • Strengthen your support system

  • Learn to ask for help and assert your needs

  • Learn self care and coping skills to minimize your risk and manage symptoms

Postpartum Depression and Anxiety are treatable and preventable.  If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or write to me at hollyaevansmft@gmail.com

Postpartum Anxiety: Learning to Listen to Your Instincts Without Letting Fear Take Over

All the noise and distraction that anxiety creates can drown out what you know about yourself—- your strengths and good instincts about how to be the mom you want to be.
Stocksy_txp6847b7044lh100_Small_1633426.jpg

When you were anticipating getting pregnant and having a baby, it's likely that you expected yourself to feel happy, excited. Maybe even confident and in charge of the situation. You probably didn't imagine feeling consumed with worry that keeps you up at night, or terrified at moments when certain thoughts cross your mind. Yet this is how many women experience their first months or years of motherhood. Feeling out of control, overwhelmed, and helpless. This kind of anxiety is like a thief, robbing you of the ability to enjoy the time you have with your brand new baby.

Most new moms experience a certain amount of fear and anxiety. However, some women become overwhelmed, preoccupied, and ruled by their fears. According to Postpartum Support International, 6% of pregnant women and 10% of postpartum women develop anxiety- sometimes alone, and sometimes with depression. When anxiety and fear begin to change your behavior and inform your decision making, it can become very hard to trust yourself, and hard to ask for help from people who might be able to support you. Moms with a history of trauma or abuse may be especially vulnerable to anxiety and constant worry about the safety of your own children. Unwanted thoughts, fears of something bad happening or disturbing memories make it difficult to think clearly and make good decisions for yourself and your baby. Relationships can become strained, and sleep deprivation makes everything worse.

All the noise and distraction that anxiety creates can drown out what you know about yourself--- your strengths and good instincts about how to be the mom you want to be. When anxiety takes over, it takes a lot of work to remind yourself of the parts of you that are strong and resilient and to listen to your own voice. If you're struggling with anxiety, here are some things to think about:

Arm yourself With Information About Postpartum Anxiety

If you're struggling with postpartum anxiety, it's important to know that it's not your fault and you didn't cause this to happen. Anxiety is treatable and with help you'll feel better. Getting support to help you manage anxiety is an important step to take. Learning to recognize and cope with your symptoms so that you can get to the root of what's causing your anxiety is a good starting point. Every woman's anxiety is experienced differently, but there are some common symptoms that you can begin to identify for yourself. Some good resources to educate yourself are:

Dropping the Baby and Other Scary Thoughts: Breaking The Cycle of Unwanted Thoughts by Karen Kleiman and Amy Wenzel

The Pregnancy & Postpartum Anxiety Workbook by Pamela S. Weigartz and Kevin L. Gyerkoe

Postpartum Support International Website postpartum.net

Carefully Consider Your Expectations of Yourself

One of the most common things women express to me is the belief that they're a bad mom because of how their anxiety is affecting them. Even if you've felt capable, competent, accomplished and in charge in other areas of your life, having a baby can lead to feelings of doubt, overwhelm, even a sense of failure. In Dropping the Baby and Other Scary Thoughts(by Karen Kleiman and Amy Wenzel, 2011), the authors write:“The period following the birth of a child is a transitional time that can challenge a woman in profound ways. She is deprived of precious sleep, she is hormonally compromised, and sometimes she is thinking things she cannot believe are crossing her mind. If a new mother experiences thoughts that are uncomfortable to her during a time when her family, friends, and society expect her to feel blissful, she is likely to be overcome by guilt and a crushing sense of failure.”

Learning how to quiet your anxiety and tune into your own instincts about how to be a mom is no easy feat. Moms are bombarded with all kinds of messages about the “right” way to parent, and how you’re supposed to feel about being a mom. There is no shortage of judgment, real and perceived. Becoming a mother changes your sense of who you are, and it's important to allow yourself explore how you're changing, growing—and how you're struggling. You've taken on the role of “mom”, and you may feel like there's no room for you to be anything else right now. It's important to acknowledge aspects of yourself and your life that feel lost or out of reach, and to make room for yourself to feel whatever you feel about how much your life has changed. Your values and beliefs, your hopes and dreams, and your most important life experiences can help you find your way to being the mom you want to be.

Getting Help For Postpartum Anxiety

Postpartum Depression and Anxiety are treatable. Opening up a conversation about how you're feeling can be difficult, but remaining silent or trying keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and get back to feeling more like yourself. If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or write to me at hollyaevansmft@gmail.com

What Is EMDR Therapy?: Common Questions About Eye Movement Desensitization and Reprocessing

Stocksy_txp5be9a0a816W100_Small_143176.jpg

When you're trying to decide how therapy can help you with anxiety, trauma or PTSD, you may have come across EMDR or Eye Movement Desensitization and Reprocessing. But even when you read about the research supporting it's effectiveness in treating trauma, or read descriptions of what it is, you're probably still left with some questions. That's because EMDR is very different from other forms of psychotherapy.

Here are some of the questions people frequently ask about EMDR:


What kinds of issues is EMDR used to treat?

EMDR was originally developed by psychologist Francine Shapiro in the 1980s to treat the effects of trauma, and is best known for relieving the symptoms of PTSD. Research is also showing EMDR to be effective in treating anxiety, panic, and fears connected to trauma.


How is EMDR different from other kinds of therapy?

One of the things that many of my clients like about EMDR therapy is that there is a lot less talking about disturbing things that have happened to you. As you prepare for the part of EMDR that focuses on particular memories connected to the trauma, you'll develop a timeline of incidents. But it's not necessary to give details about these experiences. Instead, you'll be asked how the event has affected you and what you notice about your emotions, your behavior, your body, and what you think or believe about yourself.

If you're not certain what you current symptoms or problems stem from, you'll begin by focusing on current situations that are distressing and that you want to change.

How does EMDR address disturbing memories?

EMDR focuses on the ways that a traumatic event has affected you, and your therapist will help you notice and describe different aspects of a disturbing memory or event. These aspects are:

Thoughts- What you believe about yourself

Body Sensations- How your body responds to the memory.

Images that come to mind- memories of trauma are stored with mental pictures of what you experienced.

Emotions-how you feel emotionally when you think of a disturbing memory.

What does bi-lateral stimulation mean?

The thing that sounds the strangest about EMDR is the use of bi-lateral stimulation. Bi-lateral stimulation simply refers to right to left movements. Originally, this was done by following the therapist’s fingers with your eyes back and forth from left to right, repeatedly. Other types of bi-lateral stimulation are now used, including wearing earphones and listening to sounds that alternate from your right to your left ear; and “tapping”, which can be done by lightly tapping the sides of your legs or shoulders, or by holding small pulsers that alternate between your right and left hand. (This is NOT an electric shock, it is a vibration similar to a cell phone on “silent.”).

Is EMDR effective?

EMDR has been extensively researched for the past 20+ years and has been found to be effective in treating trauma and PTSD. There are numerous studies supporting it's success in helping people find relief from the effects of trauma. If you'd like to know more about EMDR research, check out the resources below.

emdria.org

emdr.com


What if I don't want to stay focused on my past?

EMDR doesn't just focus on the past. EMDR work in therapy helps you review and repair how you've been traumatized and hurt in the past. EMDR therapy also addresses current situations that are causing symptoms and distress, as well as future situations that you may face. EMDR helps you build up your resilience and strengths to take on the current challenges in your life, and plan for how to address concerns about and hopes for future situations.

What is Attachment-Focusd EMDR therapy?

I'm trained in Attachment-Focused EMDR, developed for the treatment of early and/or severe childhood trauma. This approach recognizes how our earliest relationships effect an individual's relationship with self and others.

As an Attachment Focused EMDR therapist, I recognize my relationship with my clients as a necessary part of repairing and healing from trauma. My work is client centered, personalizing therapy to the unique needs and experiences of each person. Attachment Focused EMDR combines processes to enhance individual strengths; using EMDR to process trauma; and traditional talk therapy to help integrate what is learned in EMDR sessions.


Can EMDR help me?

If you’re curious about how trauma therapy and EMDR (Eye Movement Desensitization and Reprocessing) can help, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com

Getting help when you’re struggling with anxiety, trauma, or PTSD is difficult, but remaining silent or trying keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and feel more confident and at peace. If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com


Finding A Starting Point For Trauma Therapy

Stocksy_txp05dc7413CZ6200_Small_1671750.jpg

When you're struggling with unresolved trauma, the last thing you may want to do is talk about what happened to you. Many people who've experienced a trauma-who've been sexually or physically abused or assaulted-try to avoid even thinking about what happened, much less talking about it. So it's understandable that asking for help or signing up for trauma therapy is not an easy thing to do.

It's hard to stop replaying the events in your mind, over and over again. Nightmares make it seem impossible to get a good night's sleep. Your body reacts to reminders of the trauma, causing you to feel out of control. Even reading or watching a movie feels risky, because it just doesn't take much to bring back a disturbing memory, to feel like the trauma is happening all over again.

Where To Start

Symptoms of PTSD and trauma can throw you off balance. The smallest thing can set off a chain reaction in your mind and body, overwhelm your ability to function in the most basic ways, and cause strain in relationships. If you have trouble at work, or find it difficult to take care of yourself and your family, the first step is to build on ways to improve your daily life. Before delving into painful or frightening memories it's important to have developed ways to calm and care for yourself when you're in distress. Having the tools and resources to manage your emotions and distressing thoughts connected to trauma will allow you to think more clearly and make decisions more easily--- so that you can heal what's hurting.

Finding What Works For You

In order to heal from trauma, you will need to discover what is best for you. Learning to listen to your own emotional and physical signals, and setting your own pace in your trauma recovery are important skills to learn. Babette Rothschild writes “Trauma recovery involves much more than remembering and processing traumatizing incidents. For some of you, focusing on the past will not be necessary, or desirable. Trauma must, first and foremost, improve your quality of life. Anything that furthers that goal is good for you; anything which compromises that goal is not” (8 Keys To Safe Trauma Recovery, 2010). Very often in therapy, what can help to move you in the right direction in healing trauma and PTSD is to understand how you've been impacted by your experiences, not only what happened to you. It's up to you to decide when to talk about your trauma and in how much detail.

Breaking Your Silence

Trauma and PTSD interfere with your life and change how you feel about yourself and others; and the effects of trauma can show up years after the event is over. Bessel Van Der Kolk writes “As long as you keep secrets and suppress information, you are fundamentally at war with yourself. Hiding your core feelings takes an enormous amount of energy, it saps your motivation to pursue worthwhile goals, and it leaves you feeling bored and shut down....Only after you identify the source of these responses can you start using your feelings as signals of problems that require your urgent attention” (The Body Keeps The Score, 2014).


If you've been physically or sexually abused or assaulted, reaching out for help is difficult. But remaining silent or trying to keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and get back to feeling more like yourself. If you'd like to learn more about how trauma therapy and EMDR (Eye Movement Desensitization and Reprocessing) can help, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com

A Note on Taking Care of You

Stocksy_txp4333664er35200_Small_928027.jpg

When you're going through a stressful time, it takes a lot of work to try to “hold it all together”. Working so hard to push your emotions down to get through the day, or putting on a good face can be exhausting—and you may end up finding it difficult to take care of yourself in the most basic ways. During a crisis, a major life change, or while struggling with your mood and anxiety, your basic physical, social and emotional needs can easily slide to the bottom of your list of priorities.

For many people, the notion of self care can sound foreign, unnecessary, or even selfish. It can seem easier to keep pushing yourself through, but this can often prolong your problems. Whether you're a postpartum mom swept up in the moment to moment care of your family or someone struggling with anxiety or depression, tending to your own emotional and physical well-being can be a daunting, but very important task.

There is a very strong connection between emotional well-being and basic self care. At the most basic level, self care includes how well you sleep, your diet and exercise, and rest and relaxation. Other important types of self care focus on taking care of important relationships and your emotional well-being. Taking good care of yourself also helps build resilience, so that you can weather difficulties, and maintain a healthy relationship with yourself and others. What self care looks like is different for everyone—ranging from eating well to joining a support group, avoiding alcohol or setting a boundary by saying no. Here are some things to think about:

Keep It Simple

Just a small boost can get you moving in a better direction. If you're going through a challenging time, your mental, emotional and physical energy can easily become depleted. Symptoms of depression, anxiety and PTSD can make it difficult just to get out of bed. Deciding to make big changes or set ambitious goals for yourself are not likely to be successful-or helpful. But by paying attention to the physical and emotional signals that your body and mind are sending you, you can identify small steps that can help you make a little bit of time and space for yourself. When life feels overwhelming, focusing on the simplest ways of nurturing yourself is more likely help you find relief.

Think Beyond Physical Self Care

When you're busy just trying to get through the day, it can seem difficult to find the time and energy to do even the simplest things that might help you feel better. Depression, anxiety and PTSD commonly lead to difficulties in maintaining important relationships, and can make it difficult to meet the day to day demands of life(physically and emotionally). Asking for support(professional or from friends/family), deliberately checking in with a friend, or learning healthy coping skills can keep you connected to the important people in your life and the things you enjoy.

Saying No

Saying no doesn't come easily to everyone. If this is true for you, you may find yourself trying to make sure you don't let anyone down, even when it means sacrificing your own well-being. Asking yourself if you need to start saying no, let go of a few commitments or adjust your expectations of yourself is a good place to begin. And if saying no brings up feelings of guilt, self doubt or anxiety, then this might be a good time to take a look at how this issue is really impacting you.


If you’re going through a stressful time and finding it difficult cope on your own, help is available. To learn more about how therapy can help you overcome anxiety, depression and trauma/PTSD, please give me a call at (626) 808-5463 or email me at hollyaevansmft@gmail.com.  I look forward to talking to you- Holly


Getting Help for Post Traumatic Stress Disorder (PTSD)

You know that you've lived through a horrible experience. You survived and you know that it's over. But it may be hard to understand why you continue to have physical or emotional reactions to reminders of what happened, or why it's so difficult to keep disturbing memories from intruding into your thoughts.  Living with PTSD makes you feel like the traumatic event continues on.

Nightmares, flashbacks, feeling on edge, being easily startled, and avoiding people, places or activities that remind you of the trauma- these are all common features of PTSD that can interfere with living your daily life, your work and your relationships.

What Is Post Traumatic Stress Disorder(PTSD)?

Stocksy_txpfec6e9ddYQh100_Small_1406161.jpg

Post Traumatic Stress Disorder is a reaction to a traumatic event(or events), and develops in some people who have been through a life threatening, frightening, or shocking experience. PTSD can develop in the months following the event, or even many years later.

Many types of events can lead to PTSD including:

  • Childhood abuse, including physical abuse, sexual abuse, emotional abuse

  • Rape or sexual assault

  • Physical assault

  • Being bullied

  • Being subjected to racism/bigotry

  • Being diagnosed with a with a life-threatening illness

  • Accidents (car, plane, etc.)

  • Living through natural disaster (fires, earthquakes, floods)

  • Combat

  • Witnessing or learning of a traumatic event involving a loved one or even a stranger

 

Symptoms of PTSD

People with PTSD will experience 3 main types of symptoms:

Reliving the trauma

Memories that are intrusive or feel out of control, nightmares, and flashbacks can make it feel like the traumatic event is happening again. These memories are easily brought back by reminders of the event(including sights, sounds, people, specific situations).

Avoidance

People with PTSD will try to avoid thinking about the horrible experience they've been through. This includes avoiding people, places, books, movies-anything that they might associate with the trauma. It's common to feel numb or disconnected from other people, and to even feel that no one understands what you're going through.

Physical Distress

PTSD shows up in the body. Troubled sleep, feeling on guard or tense, difficulty concentrating, and feeling irritable or easily angered, gastrointestinal distress are all typical physical responses to trauma.

When To Get Help for PTSD

For people who've experienced trauma and develop PTSD, anxiety becomes overwhelming, making it difficult to stop thinking about the event(s). PTSD can also lead to other problems such as depression, anxiety, drug and alcohol abuse, and phobias. The symptoms of PTSD can be mild or severe, and commonly interfere with how you go about daily life, your ability to go to work/fulfill work obligations, and impacts your relationships.

Getting help for trauma is difficult, but remaining silent or trying keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and get back to feeling more like yourself. If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com

Making a Case for Self Compassion

Stocksy_txpef42987chgx100_Small_287032.jpg

We all have moments when we feel bad about ourselves.  But if you're struggling with a trauma history and PTSD, depression or anxiety, the way you feel about yourself in the face of disappointments, simple mistakes or to a traumatic event can spiral into shame and self loathing, self-blame, or self contempt. You might find yourself thinking nasty, harsh, abusive things about yourself---things you'd never say to a friend or someone you care about.  These thoughts and feelings can take over, and leave little space for self compassion at the very moment when you most need it the most, doing damage your sense of self.  

A recent piece in the New York Times, "Why You Should Stop Being So Hard On Yourself" points out that certain types of self-criticism "can have measurably destructive effects, including symptoms of depression, anxiety, substance abuse, negative self-image and, in a particularly vicious twist, decreased motivation and productivity, according to a study published in the Journal of Psychotherapy Integration. Another study, published in Personality and Social Psychology Bulletin, found that self-criticism leads people to becoming preoccupied with failure."

As with any relationship, your relationship with yourself needs to be tended to, especially when things get rough.  The way you talk to yourself matters, so if you're curious about how to develop some self compassion, check out the full article here:

https://www.nytimes.com/2018/05/22/smarter-living/why-you-should-stop-being-so-hard-on-yourself.html?action=click&module=Smarter%20Living&pgtype=Homepage

If you're struggling through a difficult experience and noticing that you're self esteem is at a low point, help is available.  To learn more about how therapy can help you overcome anxiety, depression and trauma/PTSD, please give me a call at (626) 808-5463 or email me at hollyaevansmft@gmail.com.  I look forward to talking to you- Holly

Postpartum Depression and Anxiety: Recognizing When You Need Support

Having a baby is to supposed to be one of the happiest times of your life. But what if it isn't?

Stocksy_txp2d6d56d1aew100_Small_1783195.jpg

If you've recently had a baby and aren't feeling like yourself, you're not alone. As many as 15 to 20% of new moms experience changes in mood that make taking care themselves and their new babies a struggle. Bringing a new baby home-whether it's your first or your third child-will naturally create some upheaval and stress, even in the best of circumstances. But if you're noticing significant changes in your mood past the first several weeks postpartum, it could be more than the “baby blues”.

Postpartum depression and anxiety is experienced differently for every woman, but here are some good things to know:

You're Not Alone: Postpartum Depression and Anxiety is Common

One of the things I make sure new moms know is that postpartum depression and anxiety is one of the most common complications of delivering a baby. They're often surprised and relieved, because they feel so alone in their experience. It can seem like every new mom is so together, handling new motherhood with confidence and joy. But appearances can be deceiving, as many women struggling with postpartum depression and anxiety are really good at masking what they're going through.

Postpartum Depression and Anxiety Don't Discriminate

Any woman can be susceptible to postpartum depression and anxiety, regardless of age, income, ethnicity, how much support you have in your life, or how well your pregnancy and delivery went. According to the American Psychological Association, for half of women diagnosed with postpartum depression, it's their first depressive episode. It's common to hear new moms say that it doesn't make sense that they're experiencing problems with mood and anxiety when things in their lives are going well. This confusion can fuel guilt and cause women to stay quiet about what they're going through, ultimately preventing them from getting help.

Having Postpartum Depression Doesn't Mean You're a Bad Mom

Depression and anxiety can make just getting through the day exhausting-emotionally and physically. Many women feel wracked with guilt when they have thoughts and feelings about their babies and motherhood that aren't happy ones. Postpartum depression is treatable, and with support you can feel better. Reaching out for help from family and friends, support groups, or seeking therapy is important. Postpartum depression doesn't usually just go away on it's own. Understanding what you're going through and that it isn't your fault is an important part of finding your way back to feeling more like yourself and living a healthy, happy life with your new baby.

If you or a mom in your life is struggling with the adjustment to motherhood, getting informed is a good first step to take.  To learn more, here are some good resources:

Postpartum Support International

www.postpartum.net

American Psychological Association

http://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx

Postpartum Depression and Anxiety are treatable. Opening up a conversation about how you're feeling can be difficult, but remaining silent or trying keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and get back to feeling more like yourself. If you'd like to learn more about how I can help, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com

How to Stop a Panic Attack

What is a Panic Attack?

Stocksy_txp6f57ace8jxt100_Small_866897.jpg

If you've ever had a panic attack, you know they can be terrifying. A panic attack can lead you to frightening thoughts like “I'm dying”, “I'm losing my mind” or “I'm out of control”. They can occur “out of nowhere” or be brought on by a stressful situation.

A panic attack (or anxiety attack) is a sudden and intense onset of apprehension, fear, or sense of impending doom coupled with an overwhelming physical response.  Symptoms of panic are intensely physical, and often mimic symptoms of serious physical problem (such as a heart attack). It's always a good idea to see your doctor if you're experiencing these symptoms to rule out a serious physical condition, and to address your concerns about your physical symptoms. If your doctor believes you're suffering from panic and anxiety, they can help you take steps to find help.

Panic attacks can indicate that you're struggling with Panic Disorder, but panic also accompanies depression, anxiety and PTSD. Having one panic attack does not necessarily mean that you have a diagnosis, but they can be your mind's way of trying to tell you that something needs your attention.

Learning to recognize how you respond to stress and anxiety

The first step to overcoming panic is to recognize your symptoms and the situations that may trigger them. Anxiety and panic have three main parts, affecting your body and mind, and influencing your behavior. It's important to notice how you're responding to stress and anxiety in these three areas, so that you can take steps to help yourself. Knowing that you're experiencing anxiety can help you regain some control and develop a better understanding of what you're going through.

Symptoms of Panic:

  • numbness or tingling
  • racing heart
  • feeling short of breath
  • feeling of choking
  • nausea
  • trembling
  • tightness or discomfort in your chest
  • feeling weak or dizzy
  • fear of dying
  • fear of losing control
  • fear of “going crazy”

Another symptom of panic is avoidance.  It's common to try to cope with anxiety and panic by avoiding situations that may trigger anxiety. For example, you may stop driving on highways, or avoid situations where a quick exit is not easy; or you may make an effort to avoid thoughts and feelings that can trigger panic and anxiety.

What to do if you're having a panic attack

Panic attacks can be scary and confusing, but there are things that you can do to begin to help yourself cope:

Do the opposite of avoidance. Accepting your symptoms helps you get prepared to take preventive and proactive steps to cope with anxiety and stress. Avoidance is a natural reaction to unpleasant, painful experiences. But resisting or fighting against symptoms usually makes them worsen. How you talk to yourself during a panic attack is very important. As difficult as it can be, try to label your experience as anxiety; acknowledge how your anxiety makes you feel; and remind yourself that you've gotten through this before. This is my anxiety making me feel this way. It can really upset my day, but I've gotten through this before and I'm safe.

Concentrate on your breathing. To help you bring your focus to your breathing, experiment with simply counting (out loud or to yourself) as you breath in and out.

Check in with your senses. What do you see or hear? (for example what color is the carpet, how many framed pictures are hanging on the wall,is someone talking, can you hear the birds chirping). Can you hug a pillow or feel the upholstery on your chair? Or chew some gum or a mint and focus on the taste.

Learn some grounding techniques. Grounding refers to things you can do to help you feel fully present in your body in the present moment. Some simple grounding techniques include holding an ice cube in your hand, rub some fragrant lotion into your skin, check the time and date, counting backwards from 100 in a different language, move your body(exercise).

Remember that new skills take time to learn, and it's important to figure out what coping skills are right for you. What works for someone else may not be what's best for you.

Getting Help for Panic Attacks and Anxiety

If panic is interfering with your life, you understandably want relief. The good news is that panic is treatable. I offer therapy for anxiety disorders, and for unresolved trauma and depression which commonly occur along with panic attacks. Anxiety takes many forms and effects each person in unique ways. I integrate traditional talk therapies (Psychodynamic and Cognitive Behavioral Therapy) as well as EMDR, (a therapy developed for the treatment of trauma) to create an approach that's responsive to your needs and experience.

If you'd like to learn more about how I can help you overcome anxiety, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com 

 

 

 

The Pain of Family Estrangement

A strained, distant or broken relationship with a family member is one of the most painful things a person can experience. When your childhood was complicated by abuse, neglect or trauma, the relationships you have with your family in adulthood can continue to be painful, confusing and sometimes difficult to endure. Often, the hurtful or dysfunctional behaviors continue, even after you've left home and established your own life.

Stocksy_txpfec6e9ddYQh100_Small_614128 (1).jpg

From the outside, it can be so hard to understand how family members can become estranged from each other. But the heartbreak of distancing or cutting off contact with a parent or sibling can stem from traumatic events, such as emotional abuse, sexual abuse, physical abuse and neglect, growing up in a household with mental illness or addiction. According to Kylie Agllias, author of Family Estrangement: A Matter of Perspective, these particular issues strain family relationships in ways that make families vulnerable to estrangement.

Estrangement takes many forms—efforts to establish emotional distance while maintaining contact, a breakdown of support, or a complete cut off of communication and contact. Trying to figure out what kind of relationship you can have with someone who's hurt, neglected or abused you is a painful process. Many questions arise during the process of trying to determine how to approach such damaged relationships. How much time can you spend talking with or visiting them? How much will you let them know about your life? Do you need to take a break from the relationship for awhile to give yourself time work through and heal from trauma? Or is contact with this person just too painful, damaging?

Many of the people I see in my therapy practice are struggling with this painful issue-either after becoming estranged from family members or as they're trying to find a way to stay connected. When there has been abuse or a failure on the part of a parent to acknowledge or protect against abuse, the adult parent child relationship is often deeply effected. If estrangement has grown out of a history of abuse between parent and child, the decision to cut off contact or find a way to maintain some sort of connection is naturally fraught with having to make decisions that will promote your own well-being and healing.

In her book Family Estrangement: A Matter of Perspective, Kylie Agllias writes that: “estrangement from a perpetrator of abuse is a legitimate and often essential way to promote health and healing for survivors. There are times when reconciliation is not appropriate. There are other instances where survivors of abuse find some form of reconciliation or forgiveness important to their health and healing. The very personal decision to estrange or attempt some form of reconciliation is one that should always be respected.”

A broken family relationship is often difficult to talk about openly. Trying to explain why you're estranged or distant from your family can add to the distress of your experience- and add to the guilt, anxiety and shame that can become overwhelming at times. It's common for those who are estranged from their family to try to conceal this part of their lives, for fear of being judged, criticized or to avoid stigma. Add to this the fact that abuse is often kept secret, hidden away from others in the family and the community, making it that much more difficult to find the understanding and support you need.

Therapy can be a safe place to thoughtfully explore what you need for your own healing and how to best approach your family relationships-whether you're ready to work toward a reconciliation, to grieve the loss of the relationship that you can no longer be a part of, or to find somewhere in between.

To read more on this topic, check out this recent article from the New York Times:https://www.nytimes.com/2017/12/20/well/family/debunking-myths-about-estrangement.html

If you're concerned about how the past is impacting you now, help is available.  To learn more about how therapy can help, please give me a call at (626) 808-5463 or email me at hollyaevansmft@gmail.com.  I look forward to talking to you- Holly

Haunted: Living With Unresolved Childhood Trauma

Stocksy_txp60226418U1i100_Small_789083.jpg

Like a ghost, your traumatic past can come back to haunt you long after that part of your life is over. Disturbing memories may intrude, and stir up feelings about events that you thought you'd left behind. Because of the way traumatic memories are stored, reminders of disturbing events can stir up trouble in your body, your mind and your relationships, and make the past feel ever present.

Ghosts from the past

Common life experiences can bring up reminders of the past. Traumas large and small, issues that you may have already worked through, or that hadn't been bothering you for years can be reignited by a big change in your life or a seemingly minor event.

A situation at work may leave you feeling on edge, wary of others. A health crisis leaves you feeling dependent, or helpless. Changes in relationships can unsettle your sense of security. Life altering events like having a baby, a sudden loss or death, or a taking on a new roles, such as caregiving for a parent- all of these kinds of situations can open up old feelings and memories and bring the past rushing back. And often, like a troublesome ghost, it can be difficult to figure out just exactly where your emotional and physical reactions are coming from, what's causing you to feel this way.

Strong connections exist between childhood trauma and challenges in adulthood.

Unresolved trauma is one of the most common reasons people seek therapy, and early experiences are a common focus in trying to answer questions about why you're struggling right now.

Childhood is a time when we need to experience a sense of security and being loved, to help develop a sense trust in self and others. But when childhood is complicated by abuse (physical abuse, sexual abuse, emotional abuse), neglect, and other types of traumas (large and small), the ability to trust ourselves and connect to others can be compromised. Common problems linked to childhood trauma include:

  • difficulty handling emotions

  • increased risk for anxiety, depression, PTSD

  • feelings of shame and guilt

  • low self esteem

  • feeling alienated and difficulty relating to others

  • self destructive behaviors, including problems with alcohol/drugs

But this happened so long ago. It shouldn't be bothering me now.”

Adults who find themselves once again dealing with the past often make comments like “I'm a grownup. This shouldn't still be bothering me”. However, study after study has shown that adverse events in our younger years can be linked to problems in adulthood. One recent longitudinal study published earlier this year found that women who experience adverse events during their formative years (abuse, neglect or family dysfunction) are more likely to experience depression during midlife when compared to women who did not experience these kinds of stressors. (Read the study here: https://www.eurekalert.org/pub_releases/2017-03/uops-tas032717.php). Another important longitudinal study, The Adverse Childhood Experiences Study (ACE Study) showed important connections between childhood abuse and neglect and a person's health and well-being later in life.

Overcoming Childhood Trauma

While childhood trauma can make your life more challenging at times, it doesn't have to define you and how you live your life. Therapy can help you establish a sense of safety, and develop the tools and understanding of yourself you need in order to free yourself from the grip that trauma can have on you. So that you can enjoy your life and the people in it. Develop more confidence and trust in yourself. Find peace of mind.

If you're concerned about how the past is impacting you now, help is available.  To learn more about how therapy can help, please give me a call at (626) 808-5463 or email me at hollyaevansmft@gmail.com.  I look forward to talking to you- Holly

When Anxiety Does More Than Make You Worry

What is Anxiety?

Stocksy_txp938c0475B7h100_Small_98566.jpg

There are plenty of reasons to feel anxious these days. Just a quick glance at news headlines can rattle nerves. Relationships can cause us to fret and worry. Careers create apprehension and angst. Managing stress and anxiety is something everyone must do to some extent. It's just a part of life.

But when anxiety does more than make you worry, fearful thoughts and panic can balloon out of proportion, and make it difficult just getting through the day. And if you've survived trauma, anxiety often worsens traumatic stress and PTSD.  Knowing the difference between normal worry or stress and serious anxiety can be a bit confusing.  But if anxiety is interfering in how you take care of yourself and your ability to engage in your life, it's important to try to figure it out.

Good things to know about anxiety

The statistics:

If anxiety is interfering with your life, you're not alone. According to the National Institute of Mental Health, anxiety is the most common mental health problem in the United States, affecting almost one-third of adults.

(And adolescents. Parents, read this recent article:

https://www.nytimes.com/2017/10/11/magazine/why-are-more-american-teenagers-than-ever-suffering-from-severe-anxiety.html).

Why we all have some anxiety:

Anxiety has a purpose. It helps us notice and avoid dangerous or risky situations. But when anxiety takes over, you may begin to avoid anxiety producing situations to try to get it to stop. Anxiety symptoms can feel so intense, you just want to rid yourself of it. Staying within a comfort zone(or trying to appease your anxiety) can feel like a relief in the short term. But this kind of coping strategy usually just leads to worsening the anxiety in the long run.

When anxiety takes charge:

Anxiety can quickly become a bully(as many people have described their anxiety to me), pushing you around and controlling too much of your life. Anxiety can affect the way you feel about yourself,and influence how you go about your day-to-day. And anxiety is very common among those who are recovering from depression, trauma, or PTSD, just making things more difficult.

Help for anxiety:

When you're struggling to manage anxiety, a positive first step is to equip yourself with some facts.

The symptoms of anxiety can be very physical, and can easily be mistaken for something else. Many of the people I've worked with commonly end up in the doctor's office or emergency room with panic or anxiety, thinking that they're having heart or breathing problems. Digestive issues can also worsen with anxiety, requiring medical help. Sometimes, you might feel like you're going “crazy”, or that something is very wrong with you. Getting to know how anxiety is showing up in your life will help you free yourself from its grip.

If you're curious about common signs/symptoms of anxiety, here is a link to a helpful article:

https://www.goodtherapy.org/learn-about-therapy/issues/anxiety

 

One last note about anxiety:

If you're suffering with anxiety, you understandably want relief. The good news is that anxiety is highly treatable. I offer therapy for anxiety disorders, and for unresolved trauma and depression which commonly occur along with anxiety. Anxiety takes many forms and effects each person in unique ways. I integrate traditional talk therapies (Psychodynamic and Cognitive Behavioral Therapy) as well as EMDR, (a therapy developed for the treatment of trauma) to create an approach that's responsive to your needs and experience.

If you'd like to learn more about how I can help you overcome anxiety, please contact me for a free phone consultation at (626) 808-5463 or hollyaevansmft@gmail.com 

 

 

 

 

What is Postpartum Anxiety?

When you venture into motherhood, it's natural and expected to struggle with some level of anxiety. So how do you know when your anxiety has become a problem?

Will I be a good mom? Will my baby be healthy? What if something bad happens? Most moms can relate to anxiety producing questions like these because there are so many unknowns when you have a baby. 

But for many women, anxiety can get in the way of enjoying your new baby. If worry, fear or panic begin to take hold and overwhelm your ability to take care of yourself and your family, it may be time to get help.

Here are some things to know if you're struggling with anxiety:

Your experience is not unusual. Anxiety during pregnancy and postpartum is common. Due to so many changes during and after pregnancy, women become more vulnerable to serious problems with anxiety during pregnancy and after delivery. According to Postpartum Support International 6 - 10% of women will develop problems with anxiety during pregnancy and postpartum(including panic, OCD, generalized anxiety, post traumatic stress), and even more will experience anxiety along with depression.

Anxiety is experienced differently for each woman. Symptoms of anxiety can be felt in your body, your mind and often result in changes in how you go about your day. Learning to effectively manage anxiety usually involves recognizing how anxiety is affecting you -how it shows up in your daily life and impacts your ability to take care of yourself and your baby. Common signs of problematic anxiety are:

  • physical tension, racing heart, nausea/stomach distress, shallow breathing, tight chest

  • avoiding daily activities due to fear, like driving, going out of the house with the baby

  • relentless worry and obsessing, imagining worst case scenarios

  • panic

  • scary/disturbing intrusive thoughts, usually about harm coming to the baby

  • sleep disturbance due to worried thoughts or behaviors, such as frequently feeling the need to check on the baby throughout the night

  • feeling nervous, on edge for most of the day

  • avoiding certain situations or activities, such as driving or leaving the house

  • concern about being alone with the baby

Anxiety is treatable. Getting the right kind of support can help you learn to effectively manage anxiety and find relief. Opening up a conversation about how anxiety is affecting you can be difficult, and many women believe that they should be able to handle problems on their own. But remaining silent or trying keep up the appearance that everything is okay usually just prolongs the problem. The sooner you get help, the more quickly you'll find relief and get back to feeling more like yourself.

Call (626) 808-5463 for a free 15 minute phone consultation.  I would love to talk to you about how I can help.