Lost Memories of Trauma

November 27, 2012

More than once I have had clients come into my office saying they think they may have been sexually abused as a child. You may be thinking “what? how do they not know?” But our memories are not perfect and our psyche can sometimes create obstacles to keep us from remembering in order to protect us. I won’t spend a whole lot of time going into detail on all of this but there are a few points that I would like to make because the feeling always is that they want to know for sure what happened and they want help from me in order to figure it out. Although our unconscious mind can access all those memories and I am able to get through to the unconscious mind via hypnosis, there have been too many claims in the past that therapists have implanted memories through suggestion, which in some situations is completely valid, and therefore I find this unethical to do. Another reason I find this to be unethical is because if you do not have a memory of something bad happening right now, there is probably a good reason, and what good would come of bringing that memory back to the surface? For the person remembering, likely none although I’m sure that some people could argue differently.

So now to discuss how our memories work for a bit. As I said, our memory is not perfect. In my work with clients, I typically refer to a study I remember learning about in my social psychology class in college some 7-8 years ago. As I tell the study, I describe that participants had to watch a video in which a car accident ocurred and after the video were asked if they saw the stop sign (which was not actually there) and they report that they did. In wanting to be able to refer to this study here I searched for it on the internet and found what sounds to be it here, posted by Elizabeth Loftus who states that she conducted the research. I will say that she describes the study with some slight different details than those that I remember, which I wanted to point out as another example of false memories, even if her research demonstrates being given misinformation and this is not quite the same thing. At least I remembered the lesson of the study, right? She also goes more into detail about creating false memories which would be a good read for those of you that are interested.  I often remind clients of certain phenomena that I’m sure they have experienced as well such as having a dream they have difficulty recalling as real life or a dream. Or having memories from childhood that other people cannot confirm. I have even shared my experience of truly believing that we had a certain type of dog, by a certain name, and recalling an incident in which he ran away and each member of my immediate family (4 other people) have confirmed that we never had such a dog! I’m not sure if this was a wish that I had to have this type of dog (which is possible- to have memories from daydreaming or fantasies as a child) or an actual dream while sleeping, but it was a vivid memory of mine! Also, as children we do not always understand what is going on around us. As we get older we do not gain this understanding and sometimes try to make sense out of certain experiences and without all the information do so inaccurately. Another phenomena that many people may have experienced is hearing a story told by a friend and getting so immersed in it that later down the line it feels as though it actually happened to us.

All of the examples in the previous paragraph are ways that false memories can be implanted, but what about true memories that are forgotten? If you believe Freud’s theory that our unconscious mind tries to protect us then this may be a good explanation. We have all heard about repressed memories in which our brain some how forgets big events in order to protect us from having to remember and relive it. Other people may imploy denial techniques as well. Even without these explanations, can you remember everything that ever happened to you? Likely not. Yes, we tend to think of it as being the small things that we forget but it’s also very likely that you don’t remember many details about your birthdays and christmases over the years either and those were pretty memorable when they happened. Other times it may just be that as children you may not understand the importance of the event and just push it to the side.

So, I say all of that to make the point that we cannot rely on our memories solely. The goals that I suggest for those that are not sure if they were abused as a child is to work on learning how to deal with not knowing and if you are experiencing any negative symptoms that you think are attributed to something that may have happened, to learn to deal with those. For some people that may be sexual difficulties, avoiding certain stimuli you attribute to the possible perpetrator or event, or even things such as low self-esteem and eating disorders.


Preventing Mood Disorders During Pregnancy & Postpartum

November 13, 2012

Of course there is only so much control that you have over your hormones, neurotransmitters, and genetics, all of which play a part in whether you will develop a mood disorder during pregnancy or postpartum. These are not the only factors that determine whether a person will develop a mood disorder or not, however, and there are things that you can do that can affect the neurotransmitters in the brain. I’m saying this because in some cases, there is not much that you can do to prevent a mood disorder, but in other people, engaging in some of these activities may make a big difference. If you would like to improve your mood during pregnacy and postpartum, here is a list of activities you can do in order to help. I will explain those that I believe warrant more explanation but please feel free to leave any comments or questions if you need. Also, these are not listed in any specific order, but instead just in the order that I thought about them!

1. Exercise- A good workout can help boost the feel good hormones in your brain and has been shown to even be helpful in improving mood in those who are currently experiencing a mood disorder!

2. Seek out a support network- You have heard me state this before, but having other people around you, feeling understood and cared for, and feeling like your not alone can go a long way in preventing mood problems.

3. Take care of yourself and your needs- Even though your focus may be on other people, especially the little ones you are growing and raising, you need to make sure you are doing things for yourself as well. If you are drained and unhappy then it makes it much harder to give of yourself and can start a downward spiral. This can be engaging in your hobbies and things you enjoy, getting a massage or pedicure, taking a bath, or anything else that is just for you.

4. Get help around the house- We are one of the few cultures that do not give moms more help with chores during pregnancy and postpartum (and we have the higher rates of issues!) It will just take a little bit of stress off of you to allow others to help you.

5. Yoga- I’m feeling a whole blog entry about the benefits of yoga during pregnancy because the benefits are just too many to list here but suffice it to say that it is a great stress reducer.

6. Change your thought patterns- Pay attention to your thoughts, notice any negative thought patterns or cycles and begin by interrupting them and counteracting them. Our thoughts influence our feelings which influence our actions!

7. Get out of the house- It can become so easy to get stuck in a rut, to feel too worn out to leave the house, or to just be worried about exposing a new baby to germs but staying home all the time can lead to feelings of isolation.

8. Spend time outdoors- The bright sunshine, fresh air, and appeal of nature are known for improving moods.

9. Alternative Medicine- There are many alternative medical practices that are safe during pregnancy and can help improve moods. Homeopathic remedies (my doctor uses drops) are safe and helpful, or you could check into acupunture, acupressure (although some points are not recommended during pregnancy), aromatherapy (again not all is safe during pregnancy so do your research first) or chiropractic care as well as other alternative therapies.

10. Massage- This therapeutic touch can not only be relaxing but can help release endorphins.

11. Meditation & deep breathing- It is important to ensure that you and your baby are getting all the oxygen you need and meditation can help you focus on your breathing while relaxing your body as you release all the stress and nagging thoughts of the day.

12. Increase your omega 3 fatty acids- Research has shown that people who get more omega 3 fatty acids in their diet have a lower incidence of depression. It will also help ensure your baby is getting enough in utero or through breastmilk to help develop the brain develop effectively.

13. Imitate joy- Sometimes just by acting happy even when you don’t feel like it can help snap you out of the mood and get you doing the very things that will help you improve.

14. Participate in activities you enjoy- If possible, don’t stop activities you enjoy. Due to limitations of pregnancy or for other reasons it may be necessary, but make sure to find other things you enjoy just as much!

15. Music- Music can have a big effect on your thoughts and mood. Choose music that makes you happy or relaxed.

16. Hire a doula- A doula can be a positive support person who can help you through the pregnancy, birthing, and postpartum process.

17. Sleep- It may be hard during different stages of pregnacy or even during the first few sleepless months but it will be important to sleep when you can (while also not sleeping too much- if thats even possible during this time) to give your body the rest in needs to repair itself and for you to think properly.

18. Nurse if possible- Nursing releases oxytocin another feel good hormone.

19. Placenta pills- Now I don’t know much about this one but it was brought up to me while I was presenting on this topic the last time. You can have someone take the placenta and make pills out of it and it is said to be helpful with postpartum depression and with menopause. Maybe something to consider if you aren’t too squeamish!

Miracle Making You Miserable? Mental Health During Pregnancy

October 23, 2012

It used to be believed that pregnancy would protect women from mental health problems and immediately made them happy and even ecstatic. Luckily for those who don’t experience this, we now know that this isn’t true. Although being pregnant is a wonderful blessing for many, the hormone changes, symptoms of discomfort, and reality of how life will be changing can make this time fraught with stress, guilt, depression, anxiety, and mood swings as well.

Women are more likely to experience a  mood or anxiety disorder than men, and even more so during the childbearing years. You may be wondering why this is so, and there are a couple of answers for this. The first is that hormone changes can be abrupt and drastic. Just as hormones can affect women during their menstrual cycle, they can affect women emotionally and psychologically during pregnancy. Although I’m not going to go into detail, basically the changes also effects the neurotransmitters in the brain that regulate mood. Although all pregnant women experience the hormone changes, not all develop anxiety, mood disorders, or other mental health issues. It is believed that a person is more likely to experience a mental health disorder if they are predisposed to it, meaning they have the gene. If a person is predisposed, they still need something to happen to switch the gene from inactive to active, and the hormone changes of pregnancy is likely to do that. In addition, for those who have already experienced problems with mood and anxiety, the hormone changes may be enough to activate another episode.

Other reasons that women are more likely to experience these issues during pregnancy is due to insecurities over changes that are ocurring during pregnancy or about their own capabilities as a parent as well as their own situation not being seen as ideal. Some women have a difficult time adjusting to the weight changes and may begin eating disorderly in order to compensate while others use it as an excuse to binge on food as they are now “eating for two”.  Knowing that you will now be completely responsibile for another human being can be anxiety provoking. Other women feel as though they were not ready to be having a baby (or another baby) and may be less than thrilled about their living situation, financial status, and other relationships.

Now that you have a greater understanding of why women are likely to experience some of these issues during and after pregnancy, next week we will talk about how to prevent them from happening to you and what to do if you do begin to experience symptoms.

Postpartum Psychosis

October 16, 2012

Before we begin, I want to state that there is no actual disorder called Postpartum Psychosis, at least according to the DSM which is the manual used for diagnosing mental health disorder. The true name is Brief Psychotic Disorder with Postpartum Onset. For ease of typing and due to popularity, however, I will also use the term postpartum psychosis.

Postpartum psychosis typically occurs within the first two weeks (or up to 3 months) after childbirth and effects 1 out of 1000 new moms. Women with Bipolar Disorder or Schizoaffective Disorder are at higher risk than the general population for experiencing postpartum psychosis. For some, postpartum depression can turn into postpartum psychosis, and for others there are no warning signs and it seems to come out of nowhere. Some of the possible symptoms include paranoia, hallucinations, thoughts or actually acting to harm the baby, rapid mood swings, depression, insomnia, delusions, and suicidal ideation or attempts. Many times the woman’s hallucinations involve instructions to harm the baby. In general, they lose touch with reality.

Part of the trouble with postpartum psychosis is that due to the nature of the disorder, many women do not realize that there is something wrong on their own. Many people who are experiencing hallucinations, delusions, or are paranoid truly believe that what they are experiencing is real and their concerns are valid. Those who do realize that there is something wrong, are afraid to get help for fear that they will have their baby taken away.  Therefore it is very important for others to look for signs and encourage mothers that are experiencing these symptoms to get the help they need. It is a very serious disorder which can end terribly without help.

Outcomes are typically good when a woman seeks psychiatric help. She may need to be hospitalized until she is stabilized and then will most likely remain on antipsychotic for some time after. With the help of the medication and other treatment, many women do not have any more symptoms. There is an increased risk for experiencing postpartum psychosis with subsequent births, however, and many women choose not to risk another episode.

Postpartum Depression

October 9, 2012

First, let me get this out of the way. There is technically no disorder called Postpartum Depression, at least in the DSM which is the manual used to diagnose mental health disorders. It is actually Major Depressive Disorde with Postpartum Onset, but since that is long and everyone knows it by Postpartum Depression, I will be using that or PPD for short.

PPD is a mental health disorder in which a woman becomes clinically depressed within one year of childbirth. It may be hard for some people to tell the difference at first between typical baby blues and PPD. PPD is characterized by feelings of sadness, loneliness, depression, helplessness, hopelessness, mood swings, changes in appetite and sleeping, loss of interests and loss of energy. You may also experience anxiety, tearfulness, feelings of vulnerability, irritability, and feel disconnected from your baby but these are also symptoms of the baby blues.  You do not have to have all symptoms but would need to be experiencing some of these symptoms and they must last for over 3 weeks.  Some of the differences are that the baby blues will start a few days to one month after childbirth instead of anytime during the first year, and will last less than 3 weeks. There is also differences in severity, the first list of symptoms are not as likely with the baby blues.

Women who have a history of depression, meaning that they have already experienced a depressive episode in the past are much more likely to experience PPD. Other factors that could increase your risk of PPD are low self-esteem, history of anxiety, lack of social support, history of eating disorders, and a family history of depression. If you have experienced any of these you may want to look into taking precautions to reduce your risk of PPD. I will provide a list in upcoming blog entries with things you can do to reduce your risk but one thing that I have already mentioned is increasing your support such as through a group as the pregnancy support group that I started.

Some of the possible effects of experiencing PPD for mom and the baby include a feeling of detachment and being disconnected as mom is not as interested in taking care of the baby and may shy away from her responsibilities or just be unable to perform them during this time. This can effect the bond of mom and baby, although it can always be recovered later. It will also increase the amount of stress and anxiety the baby feels, will increase crying, will make it more difficult for the baby to self-regulate and self-soothe themselves, and they are likely to show signs of decreased social engagement. A woman’s milk supply can also be effected negatively. As I stated already, once a person experiences depression they are more likely to have another episode in the future and this applies to when a woman experiences PPD.

If you are experiencing PPD, there are two therapies available, medication and counseling/therapy. I’m no expert on medication so you would need to weigh the pros and cons out with your doctor and decide on an individual basis about whether medication will be right for you. Whether you take medication or not, however, counseling is a good idea. A therapist can help you identify thinking patterns and behaviors that might be able to be changed in order to alleviate the symptoms of your depression and end the depressive episode.

Importance of Support During and After Pregnancy

September 25, 2012

Ok quick announcement before I get started with the regularly scheduled blog for today. For all my loyal followers (I know there are a few of you out there) I have had to make the executive decision to switch my blogging day from Monday to Tuesday due to my little guy deciding he no longer needs naps and being in a preschool program on Tuesday mornings. So from now on, look for blog posts on Tuesday, end of announcement!

I don’t think I have really posted much on here about the new group that I have started. I was lucky enough to get to present to the Space Coast Birth Network on this subject on Friday and wanted to finish the presentation before I started posting about all my research (I feel a blog series coming!) If you haven’t already guessed, my new group is a pregnancy support group. In Brevard County, where I am, there are no support groups and only a few programs in place for pregnant women, especially ones who are not having a high risk pregnancy or at high risk for other things. So obviously there was a void in the area but why might you ask did I feel the need to fill it? Well, it was due to research that I had been reading.

To recap some of the research very quickly, a new field has emerged called fetal origins that states that everything a woman is exposed to while pregnant can effect her baby’s health and mental health throughout the baby’s entire lifespan. Of course I’m no medical doctor but I found this to be amazing and wanted to do something to help women create healthier individuals. So, the mental health piece of this for me is stress, or helping women to reduce the amount of stress they are exposed to as a result of circumstances, depression, anxiety and so forth through relaxation techniques and support in order to minimize the amount of cortisol the fetus is exposed to. Fetal origins is still pretty new to the research scene and there haven’t been a lot of studies on these specific factors but here is one article that talks about how extreme levels of cortisol effect the fetus.

Another related topic that has been studied is how to prevent mental health disorders during and after pregnancy. The childbearing years for women is when they are most likely to experience anxiety and depression. I will go a bit more in detail in another blog entry but suffice it to say that hormones can play a big part in flipping the switch for some women who are predisposed to these disorders. When a women becomes pregnant or shortly after she has her baby, she is especially likely to experience a mood episode or a bout of anxiety as well as other possible disorders. Knowing that we cannot change one of the main causes, hormones, it has been important to find other ways to reduce the chances of these disorders being experienced by pregnant and postnatal women.

One of the biggest factors that has been proven to be helpful in greatly reducing this risk is support during and after pregnancy. Think about it, it can be a very stressful time in one’s life with a multitude of changes ocurring and other people having strong views and not always correct information and this can cause a lot of pressure for a soon to be or new mom. Add to the mix that mom is likely to be home, trying to keep baby away from germs and dad will go back to work within a short amount of time and she is likely to feel lonely and isolated. Combine this with the hormone changes and it can very well be a recipe for depression and anxiety. As I stated, however, women who have an increased amount of support are better able to deal with this and are less likely to feel lonely and isolated. Support starts becoming a protective factor during pregnancy in order to reduce the likelihood of postpartum depression. This is very important considering once a person experiences an episode of major depression they are more likely to experience another one in the future. You can get this support from friends, family, church, or a formal group such as the one I have started.

My pregnancy support group is designed to specifically help create the sense of support needed to reduce the risk of postpartum depression when attended regularly. The group begins with a guided imagery or relaxation technique and then is opened up for each member to have a chance to talk about whatever they desire and to receive feedback and advice from the group as needed. The group then closes with an assignment that will help to increase the level of mother-fetal bonding. If you are in the Brevard County area, you can attend this group on Thursdays from 6-7pm at Discovery Institute, P.A. in Rockledge. The first session is free and each additional session is $10. No need to R.S.V.P., you can just stop in!

Time to Relax

April 23, 2012

North Carolina RoadAs I am typing this I am supposed to be on vacation. My usual definition of vacation is fitting in as many things as I possibly can. For this trip in North Carolina that would mean hiking, shopping, visiting downtown, and more hiking. Unfortunately I am sitting at the table writing this blog post instead. Well, the part that is real unfortunate is the reason. I was the lucky one who got sick on vacation and my cough and congestion doesn’t make hiking an easy task in high elevations. Instead of dwelling on the fact that I am stuck at the house while everyone is out playing, I am choosing to relish the quiet. I have a 20 month old boy and we took this trip with two other couples, one of which also has a 20 month old boy. You can imagine my life does not give me much opportunity for quiet and solace, which makes it easy to keep up the busy pace. This is giving me the chance to catch up on magazines, take a nap, and relax, all things I normally don’t get to do.

You may be wondering why I am choosing to share this with you on a mental health and relationship blog. See, even I need reminders to take time out of my busy schedule and relax sometimes and to engage in a little self care. I could have chosen to go along for the ride today along the windy mountain roads with the toddlers and adult children, putting up with the crying, whining, and car sickness on top of the cold I am dealing with but I chose not to be super mom. This is me being honest with you about how even the advice I give out regularly and sounds so easy, even I struggle with. This is me giving you permission to relax just for a few minutes and recoup from a long day so you don’t end up overwhelmed, stressed, and with a weakend immune system! That is all for now, it is time for me to take in the mountain views, the fall of snow (from the warm confines of the couch) and take a nap before the chaos of our vacation arrives back home!!