Retrain Your Brain After Depression: Stop a Bad Day in its Tracks

Having a bad day sucks. Nobody likes it, but for people who struggle with depression a bad day can be really scary. The intense emotions generated can make you feel like you’re falling back down the rabbit hole of depression. The truth is when you have a history of depression sometimes all it take is a bad day to spiral you into another episode. Below are some tips to help you stop a bad day in its tracks before things get out of control.

  1. Breathe: When you get upset or agitated your sympathetic nervous system gets triggered and you go into fight or flight mode as if you were in real danger. Your adrenaline starts pumping, your muscles tense up and your breath gets shallow. Taking long slow deep breaths can start to turn that around. Deep breathing tells your mind and body to relax…there is nothing to fear.
  2. Do a body scan: Just sit or lay in a comfortable position. Focus your attention on each part of your body for a few moments. Notice where you are holding your emotional tension. Is it in your chest, your stomach, your shoulders? Allow yourself to feel the sensation in the body without judgment. Next imagine yourself letting it go with each exhalation. This exercise is not only deeply relaxing; it also helps you become more aware of the connection between mind and body.
  3. Practice benign interpretation: You are constantly making interpretations about everything. After a bad day, your mind might start turning in a negative direction. “This kind of thing always happens to me, my life sucks, I might as well give up.” Benign interpretation is simply not assuming the worst, but rather making a neutral or even a positive interpretation. With benign interpretation the above thoughts become: “This situation will end, I can get through this, tomorrow will be better.”
  4. Do something kind for yourself: After a bad day everyone needs a special treat. Get a massage, get your nails done, have your favorite treat, take a bubble bath, go out to dinner. Do something that makes you feel good. You deserve it after the day you’ve had!
  5. Call your therapist: Your therapist is there to support you. Maybe you just need a brief kind word or maybe you need an extra session. Remember you don’t have to get through this alone.

6 Ways to Retrain Your Brain After Depression

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If you’ve struggled with depression you are probably aware that depression changes your brain. Even after you’re stable on medication your thought process, behavior patterns and general sense of self well-being can be altered. You may still be behaving, thinking and feeling like a depressed person. Think of this way, when the cast comes off a broken leg or arm the bone is healed, but the muscles around it are weak. You need to do physical therapy to regain the strength you’ve lost. Healing after depression is similar.

Your thoughts might still turn in a negative way. You may still socially isolate, sleep too much, skip activities you once enjoyed. You may not feel like yourself and have no idea what to do about it.

Luckily, there is something you can do. The following are some strategies that can help. I encourage you to be patient with yourself, change takes time, but with regular effort you can retrain your brain after depression.

  1. Exercise: Walk, run, bike, etc. Do something to get your heart rate up and those endorphins pumping. Studies show that doing 30 minutes of exercise most days can improve your mood significantly. If you’re new to exercise check with your doctor before starting a routine, and go slowly at first.
  2. Meditate: Meditation can do amazing things for you mind and body. It can help relieve anxiety, improve sleep, boost concentration, lessen minor aches and pains and decrease depression. You can practice in many ways from focusing on the breath to repeating a mantra to listening to a guided meditation. The most important thing is to be consistent in your practice.
  3. Journal: Get your thoughts and feelings out of your head and onto the page. Sit for at least 15 minutes and just write what comes to mind. Don’t worry about spelling, grammar or punctuation…just write. Believe it or not writing on a regular basis can be as effective as psychotherapy.
  4. Talk about it: Studies show that we get as much of an endorphin boost from talking as we can from sex.  When problems live in our heads they often feel much more overwhelming.  Getting them out in the open is often a huge relief.  You don’t have to do this alone. Call a friend, call a family member, call your priest, minister or rabbi. Pick-up the phone and talk about it.
  5. Rediscover your creativity: Everyone is passionate about something. Those creative passions often get buried under the detritus of depression, and remain forgotten. Take a moment to remember the last time you did something that filled you with pure joy. It may be baking, gardening, painting or dancing. You might have to think back. Maybe it was singing in the high school musical, ice-skating as a child or building with legos. Remind yourself of that which makes your heart sing and do it!
  6. Get therapy! The recommended treatment for depression and anxiety is a combination of medication and psychotherapy. Still, so many people take the medication and skip the therapy. Seeing a therapist helps in so many ways from helping you manage your stress to helping you improve your relationships to helping you create a plan for coping with crisis. If you need help finding a therapist ask your psychiatrist, call your insurance company or feel free to contact me, 917-721-2257 or rebekah@rebekahshackney.com Together we can work to retrain your brain after depression.

 

The Therapist Takes Her Own Advice: Bye-bye Breastfeeding

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shutterstock_217419520 My baby is now 17.5 months old and for the majority of that time, I have been his primary source of sustenance and soothing. He never took a bottle. I tried different formulas and I pumped, but he just couldn’t get used to drinking from an artificial nipple. He screamed bloody murder when anyone tried to foist a bottle on him. (By the way, I have a very gently used top of the line breast pump if anyone wants it.) Forget the rubbery sippy cups, he just chewed on those. If any liquid accidentally got into his mouth he would just let it spill out onto the floor, the same goes for a regular cup and a straw…until recently.

I’m happy announce that my baby can drink from a cup and sip through a straw! But lets back up to the weaning part.

I was very conflicted about the prospect of weaning. I love the closeness and the ability to comfort him. Still, it was really getting to be difficult for a variety of reasons.

The little guy does not like having anything covering his head so I often ended up flashing people when I nursed him. Plus, he recently began massaging the breast he wasn’t drinking from. Not just a little nuzzle, but full on up the shirt under the bra nipple massage action. This is actually very normal behavior, but it made me very uncomfortable. So I would take his hand out of my shirt, he would sneak it back. It felt like I was at once nursing and trying to keep him from going to second base. This was particularly fun while nursing in public.

I tried to cut back little by little, but I’ve always nursed on-demand. When I started to deny him, he would scream…for hours or as long as I was in his vicinity. When I left the room he was fine…little stinker.

Eventually we decided the best bet was to send him to grandma’s house for a few days, and that did the trick. A hop, skip and a weekend later, he was weaned, and I was on the couch using a bag of frozen tortellini to sooth my engorged breasts. Did I mention it's really not a good idea to stop breastfeeding cold turkey? Thankfully, a little Sudafed and some cabbage leaves (seriously) dried up my milk supply.

This is an important step, but I must admit it’s bitter sweet for me. On the one hand, I have my body back, and my toddler has become more affectionate. He offers more hugs and kisses, and he will now snuggle with me without trying to nurse (which he never did before). On the other hand, I miss the profound connection, and comfort we both got during the nursing process. He is my 3rd and final baby. I will never again give birth or nurse another child. I’m mourning the passing of this stage of life.

That said, it’s exciting to see how he’s growing and changing, and I look forward to watching his on-going progress.

On a side note, other day I got on the scale and saw that I was up 5 pounds. I hadn’t changed my eating or exercise habits. How did this happen? Oh, wait. I’m not burning calories by breastfeeding.

 

Tips on Taming End of School Year Stress

I've been thinking a lot about the stress students are under these days, particularly after seeing the new documentary, Race to Nowhere, a film that questions the benefits of giving so much homework students.  It seems anytime I speak to the parent of a school age child, they are telling me about how much stress their kids are under.  They have so many responsibilities with schoolwork, sports, music, community service, after school jobs, religion classes, etc. The pressure seems to double this time of the year with finals and other end of the year activities. Kids are not getting enough sleep, and they are totally stressed out.  So how can kids stay involved without losing their minds?  Here are a few tips:  

  1. Get more sleep:  Teens are often sleep deprived especially as finals loom.  But lack of sleep greatly effects a student's performance in school.  So do not sacrifice sleep for extra study.  Instead spend a set amount of time reviewing for the next day's test then turn out the lights, and sleep.  Reviewing right before bed can help solidify facts and make them easier to recall the next day.
  2. Exercise:  You probably know that exercise is great for stress relief.  What you may not know is that getting exercise immediately before a test or a big presentation has been shown to help students do better.  So skip the last minute cramming, and go for a run instead.
  3. Don't Multi-Task:  When you devote all of your focus to one thing at a time you are much more effective and faster then if you try to do many things at once.  In addition, if you put all of your attention on one task at a time you are less likely to be distracted and overwhelmed, and you retain more information.
  4. Vent:  Life is hard during finals, but it won't be hard forever.  Talking or writing about how you're feeling can help you process and move on rather than getting bogged down in negativity that keeps you from the task at hand.
  5. Visualize Success:  This may sound cheesy but it works!  Imagine yourself successfully taking that difficult test, making that presentation, accepting that diploma, etc.  You can also visualize the reward...relaxing during the summer break!
  6. Build in breaks and small rewards:  Work of any kind is much easier when you are looking forward to something.  Breaks also help to give your mind a rest allowing you to come back refreshed, and ready to work again.
  7. Get Help:  If you or your child is increasingly tearful, getting nauseated or vomiting in relation to stress, not eating, having difficulty sleeping, or displaying other concerning behaviors engage a qualified therapist.

 

 

Is it “Baby Blues” or Postpartum Depression

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The baby you have anxiously awaited has just arrived. You should be on top of the world. So why are you so sad? It’s not clear, but you are not alone. As many as 80% of women have some mood difficulties after giving birth. They feel alone, disconnected, upset, scared or unloving toward their baby…and, of course, guilty for having these feelings.For the majority of women, the symptoms are mild to moderate and go away on their own. However, about 10-20% of new mothers experience a more debilitating mood disorder called postpartum depression. So how do you know if its just common baby blues or something more serious?

The “baby blues” are a temporary state of heightened emotions that effect about half of mew mothers. This usually peaks 3-5 days after giving birth and can last for about 2 weeks. Indications of baby blues include, crying easily, difficulty sleeping, irritability, sadness and edginess. Baby blues are not considered an illness, and do not get in the way of a woman’s ability to care for her baby. The tendency to develop postpartum blues is not connected to a previous mental illness and is not brought on by stress.

On the other hand, postpartum depression is a serious illness, and it requires the mother to get help.  Postpartum depression occurs in about 10-20% of women who have recently given birth.  It usually happens within a few months of delivery, but it can develop anytime in the first year.  Risk factors include previous episodes of depression, severe stress, inadequate social support and previous premenstrual dysphoric disorder (a severe form of PMS).

Symptoms can include depressed mood, tearfulness, inability to enjoy pleasurable activities, difficulty sleeping, low energy, change in appetite, suicidal thoughts, feelings of inadequacy as a parent, and impaired concentration.  A diagnosis is made when these symptoms are present for a least a week.  Unlike baby blues these symptoms do not resolve on their own, and they do interfere with the woman's ability to function.

If you experience postpartum depression, you may worry about the baby’s health and well-being. You may have negative thoughts about the baby and fears about harming the child (although women who have these thoughts rarely act on them). Postpartum depression  impedes a woman’s ability to care for herself and her baby, and if left untreated can create a very dangerous situation for both mother and child.

If you suspect that you or a loved one has postpartum depression call do not wait until the situation gets worse.  Call your obstetrician or contact Rebekah Shackney, LCSW at rebekah@rebekahshackney.com for questions or concerns regarding postpartum depression.

Improve Your Life With DBT: Mindfulness

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“Mindfulness is paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment."  Jon Kabat-Zinn When I first heard the word mindfulness it sounded like new age nonsense.  I couldn’t understand how it could help with everything from decreasing depression to increasing concentration to effectively manage pain.   But when I began to practice mindfulness, it became very clear how beneficial it could be.  The fact is that the benefits of practicing mindfulness are endless.  But you can’t just read about it.  You have to try it.  In this on-going series about improving your life with DBT Skills, this week’s topic is mindfulness.

 

Here are a few ways mindfulness is helpful:

Mindfulness gets us out of our heads and into our lives.  So many of us have a tape playing in our heads that is chockfull of criticisms, judgments and worries. (I’m stupid, I don’t deserve happiness, nothing will every get better).  Mindfulness helps us stop believing the negative messages in our heads, stop comparing this moment to any other, stop thinking about what should be and just be present in this moment.  This is particularly important for those who struggle with depression because those negative messages can spiral into an episode of depression.

Mindfulness helps us focus on one thing at a time.  I know multi-tasking is all the rage.  We are texting while listening to music while watching TV while talking on the phone.  Our attention is so divided and superficial that we are not really experiencing our life.  When we focus on one thing in the moment we are much more engaged, much less distracted and much more effective.

Mindfulness helps us accept reality as it.  When we fight again reality we are fighting a losing battle and ultimately creating more suffering for ourselves.  Mindfulness teaches us to stop fighting that which we cannot change.

So the question is how to you practice mindfulness? Like any other skill we learn in life, mindfulness is best learned step by step.  Observing and describing are the teaching steps that get us to the goal of participating.

1.  Observe:  The first step is observing, just noticing your experiences right now...notice sensations in your body.  Notice smells, tastes, textures, sights, thoughts, feelings, anything that may be part of you current experience.  Just notice without judgment.

2.  Describe:  Now put words to your experiences.  The idea is to clarify what you have noticed to yourself and to others.  Stick to the observable facts, and stay away from judgments.

3.  Participate:  Once you have practiced observing and describing your experiences its time to participate.  Throw yourself fully into the moment.  Participate completely and unselfconsciously, if you’re eating just eat, if you’re dancing just dance.  If you watch children at play they are always participating.  They are not worried about how they look, or what they are doing later they are completely engaged in the moment.

 

Try the simple mindfulness exercises: 

Taste something mindfully (a mint, gum, a cup of tea).

Play with play dough or silly putty mindfully

Notice your thoughts mindfully (watch them float by like clouds, don’t become attached to any of them).  Remember thoughts aren’t necessarily truths.

 

 

Improve Your Life with DBT Skills

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Do you want to increase you ability to survive a crisis, have more control over your emotions, improve your relationships, be more present and less judgmental?   Dialectical Behavioral Therapy  is for you.  

Dialectical Behavioral Therapy (DBT) is a model of therapy created by Marsha Linehan specifically to treat her clients who were struggling with chronic suicidal ideation and engaging in self-injury.  The therapy is very effective at decreasing suffering and ending problematic behaviors.  But DBT skills can be helpful, even if your pain is not life threatening.

 

I've been teaching DBT skills for many years to many different types of people from those who were overwhelmed with work stress to people struggling with parenthood to women trying to manage the symptoms of menopause.   They were all able to benefit from the skills.  During one group session, a woman participating said that she thought everyone should learn DBT skills.  She said she and the other group members were more emotionally competent then any other people she knew.  The fact is that DBT skills are good life skills from which anyone can benefit.

 

  1. Distress Tolerance Skills:  Everyone has distress, trauma, pain...some kind of discomfort at one time or another.  When you ignore, fight against, deny or otherwise avoid the pain it only grows causing suffering.  These skills teach you accept reality and get through crisis without making the situation worse
  2. Emotion Regulation Skills:  In this emotion phobic society, many of us have difficulty expressing our emotions.  These skills teach you to understand and experience emotions more comfortably.  The ultimate goal is to give you more control over your emotions rather than feeling like your emotions have control over you.
  3. Interpersonal Effectiveness Skills:  Whether it’s the boss, the kids, the parents or the partner, we all need to improve our communication with someone.  With these skills you learn to communicate more effectively so you can get your needs met without damaging your relationships.
  4. Mindfulness Skills (Skills for Paying Attention):  Mindfulness is often associated with meditation where in a structured setting you practice paying attention to the moment, noticing your thoughts and feelings without judgment.  These skills teach you to bring the practice of meditation into the activity of life.  Mindfulness has enormous benefits including: decreasing depression and anxiety, improving sleep, increasing pain tolerance and strengthening relationships.

 

So the question is who couldn't benefit from DBT Skills?  Stay tuned.  Next week, I'll go into more depth about how to practice mindfulness, and the benefits of incorporating it into your life.

 

Starting this Fall, I will be running a DBT Skills Group for adults.  For information on the group email rebekah@rebekahshackney.com or call 917-721-2251.

The Therapist Takes Her Own Advice: Unto the Breech

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  So I’m 38 weeks pregnant today.  I just come from the doctor who told me the baby is not only around 8 lbs, 15oz, but he is also breech.  The first part is not surprising as his brothers were both big boys as well, but breech…yikes.

If this guy doesn’t get into position, I’ll have to have a c-section.  This was not in my plan.  I wanted to go into labor naturally, and have a regular delivery.

This is really disappointing, but I suppose I have to practice what I preach.  I often tell clients who are expecting to make a birth plan, but be ready to throw the whole thing out the window if something changes.  Having a safe birth is far more important than following a birth plan.

Still, it’s going to be so hard to start life as the mother of 3 after having surgery.  Already, I feel guilty about the sacrifices my other two will have to make.  My 8 year old is being forced to share his room with his 3 year old brother until we get a bigger house.  This is not a tragedy, but it’s really annoying for a guy who is used to having his own space.

My 3 year old is not going to know what hit him when the baby comes.  He’s not going to like sharing his mommy with his baby brother.  He’s not going to like that his brother gets to breastfeed and he doesn’t.  He’s not going to like that his brother gets to sleep with mommy and he doesn’t.  He’s not going to like that his brother gets to use a Binky and he doesn’t…the list goes on and on.

If I focused on all that could go wrong, I might lose my mind.  For now, I’ll focus on what I can do.  I’ll talk to the boys about what to expect, and reassure them that they are and always will be loved.

By the way, I haven’t given up on getting the baby to move into a head down position.  I’ll try anything…acupuncture, visualization, headstands, etc.  If you have any suggestions please send them my way.

And at the end of the day, if he’s still breech, I’ll work on acceptance.

Resolve To Improve Your Life With Meditation

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I recently read an article about students at Visitacion Valley Middle School in San Francisco who were dramatically changed when the school incorporated meditation.  This was sold to the students as “Quiet Time.” 

The results were amazing.  Suspensions, fighting and stress decreased significantly while test scores, attendance and happiness increased significantly.

This happened in a neighborhood where shootings were so common the school had it’s own full-time grief counselor.  Almost everyone knew at least one person who had been wounded or killed.

If meditation can change the lives of these kids, imagine what it can do for you.

During this time of year so many of us make New Years Resolutions.  Maybe you find you want to lose weight, quit smoking, manage debt, start a fitness program or reduce stress.  If you do, you’re not alone.  Those are some of the most common New Years resolutions.

The problem is most people fail when they make resolutions, but why?

Well the truth is we are creatures of habit, not creatures of change.  Even when the habit is unhealthy or unpleasant making a change is hard.  Still, don’t let that fact discourage you.  Change is possible.  You just have to be smart about it.

My suggestion is to put your mind and body in the most optimal condition before  you start to work on your resolution.  Learn to meditate like the Visitacion Valley Middle School students.

Twice a day (in the morning and in the late afternoon ideally) take about 10 to 20 minutes to sit quietly and clear your mind.  Do that regularly for a month then start to work on your New Years Resolutions one at a time.

I can’t promise you will be successful.  However, if it worked to turn around the lives of those struggling students it just might work for you.

 

 

If you are interested in learning meditation in a supportive group setting contact me about joining my Mindfulness Group for Women.

THE THERAPIST TAKES HER OWN ADVICE: MY FATHER’S FINAL STRUGGLE, PART 2

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Last September, my father fell and broke his neck.  This fall impaired his ability to swallow, and he developed aspiration pneumonia several times. Then in April, Dad had surgery to correct the problem, and we were finally seeing a light at the end of the tunnel.  After all the recent turmoil, Dad seemed to be on the road to recovery.

Following surgery, Dad was moved to a rehab facility to rebuild his strength.  After spending so much time in a hospital bed, he had almost lost the ability to walk and his ability to talk was also severely impaired.  Still, we had hope.

It was slow going.  Dad was easily exhausted leaving him and the physical therapists frustrated.  He started to refuse treatment.

Then we learned that some of his pain medication had been discontinued while at the hospital.  No wonder he refused treatment.  His medication was restarted and hope was rekindled.

Still, he was not improving.  The nursing staff was becoming more and more frustrated saying Dad wasn’t trying hard enough.  They decided to discharge him.  They gave Mom one week’s notice to find another placement.

Mom couldn’t take him home as the house was not wheelchair accessible, and mom couldn’t care for him alone.

She was able to place him in a nursing home.  Though the care was good the place was to depressing (and expensive).  If he stayed, mom would exhaust all her savings in about 5 or 6 years.

Thankfully, my brother and his wife agreed to move in with mom to help care for Dad, and construction began to make the house wheelchair accessible.  We pinned our hope on the day Dad could return home.

But it was not meant to be.  Dad started developing pneumonia again, and his body became weaker and weaker.

On August 3rd, I got a call that Dad was nonresponsive, and I should come right away.  I booked the earliest flight I could, for 6am the next morning.

That evening, I went to a family party with my father’s brother and sisters and their families.  While there my brother called to tell me that Dad was awake and alert.

I told dad I loved him, and I was on my way.  Everyone at the party was thrilled to hear that the situation did not seem as dire as we originally thought.

But, the next morning as the car pulled up to LaGuardia, my phone rang.  It was 4:45am. My mom told me that Dad passed away.

When I spoke to Dad, he had just been anointed by his priest.  His responsiveness was the last burst of energy that often comes before death.

At first, I was disappointed that I didn’t get to say goodbye to Dad before he died.  Then I realized that the phone call the night before was our goodbye.

He knew I was with his siblings so they could share in the experience.  He also knew that I was on my way to Oklahoma to be with Mom.  He could go in peace.

THERAPIST TAKES HER OWN ADVICE: MY FATHER’S FINAL STRUGGLE PART 1

  As I have mentioned in previous blogs, my father has been ill this year.  Last September, fell and broke his neck.  He was just walking to his car, and he tripped.

My father was born with cerebral palsy, which means he walks with a limp, and he doesn’t have the use of his right hand.  So falling was not unusual.  But before you feel sorry for him, know that he has also run over 30 marathons (one of which he won) so his disability did not impede his ability to live his life.

After the fall, he had surgery (thankfully there was no paralysis), and he went back to life as usually.  It seemed there was no permanent damage done.

Then in December, he was hospitalized for pneumonia.  He recovered, and again went back to his life.

However, the pneumonia recurred in January, and it was then that the doctors discovered that his swallowing reflex was damaged. Every time he would eat or drink some of what he swallowed went into his lungs.

He was no longer allowed to eat or drink on his own, but instead he was fed and hydrated through a tube….boy did that piss him off.

Even with those precautions, he got pneumonia again and again.  He would be discharged from the hospital to rehab then he would have to be readmitted for pneumonia.  This cycle went on from January to April, during that time he never made it back home.

In April, Dad’s situation looked dire.  His kidneys were failing, and he had contracted mrsa.  Plus, he was physically and emotionally exhausted.  He was ready for an end to this terrible cycle.  I flew to Oklahoma to say goodbye to my father.

Just as everything was looking bleak, he doctor who had done the surgery on Dad’s neck stopped by when Mom was there.  She told him that since the surgery Dad has lost his ability to swallow and has had many episodes of aspiration pneumonia.

The doctor was certain that another surgery could fix the situation, and for the first time in months we had hope that dad would recover.  We all breathed a sigh of relief.

The Therapist Takes Her Own Advice: Goodbye Sheldon Leonard Shackney

It’s been just over a month since our cat, Sheldon, stopped eating.  Since then, we’ve been savoring the time we have with him.  We’ve been feeding him with syringes of fortified food from the vet.  He’s gotten vitamin B shots, steroid shots, appetite enhancing tablets and many loving thoughts and prayers from family and friends. For a long time, he seemed very content sitting at the foot of our bed in his regular spot.   He purred when we entered the room, and he eagerly accepted pets and nuzzles from us.   Whenever possible, I’ve taken my laptop upstairs to be with him while I worked.

Sadly all that changed yesterday afternoon.  Rather than sit contently on our bed he started crying non-stop.  He was clearly trying to tell us something.  After speaking to our veterinarian, we realized he was telling us he was ready to go.

So this morning we said goodbye to our sweet, lovable Sheldon Leonard Shackney.  My husband, David, took him as I couldn’t get out of work.  He held Sheldon’s paw as  he passed away peacefully.

Then as David drove home, he called me and we cried together on the phone…this man who has cried so few times in our life together (when our son’s were born and when we first found out Sheldon was ill) cried with me over the loss of the best cat in the world.

When the tears were spent, David walked me through the whole process.  He told me the vet asked if we wanted Sheldon’s ashes so we could sprinkle them over the place he liked best.

This standard question caused David to burst out laughing…startling the vet.   When she asked him why he was laughing he said “I love Sheldon, but I don’t want his ashes sprinkled at the foot of my bed.”

 

The Therapist Takes Her Own Advice: PMS and Pizza a Dangerous Combination

  February 23, 2013

Okay, so we have now entered the time by which I have failed most previous diets…only to restart them a few weeks later.  I’m officially having PMS.  I can feel it intensely.  My ability to be satisfied with a salad…even a hardy salad with roasted vegetables and hummus is extremely compromised.  My craving for carbs is intense.

To keep myself from eating an entire bag of pretzels, a whole loaf of bread or a dozen donuts, I’ve been satisfying my carb craving in little ways, one tortilla on fajita night instead of none, adding whole wheat noodles to my soup, etc.  It’s been working for the most part until…

Yesterday, I took my almost 2 year old, Harry, to a playdate where pizza was served…Pizza  I love pizza.  It’s my favorite food.  I once worked as a pizza delivery driver just to be around and eat more pizza…I loved that job.  Pizza is the food I crave when I have PMS.  So there I was, watching everyone eat PIZZA, and I was going to be strong, stick to my diet, not fall to temptation.  That lasted about 10 minutes, and then I gave up and gave in.  It tasted so good, and it made me so happy, and guess what, it was okay.

The world didn’t end, nobody died and it didn’t erase all of the progress I have made this month because I didn’t let it lead me to the traditional downward spiral.  I didn’t then have chicken parm for dinner or go through a drive-thru for a midnight snack.  It didn’t erase my all the progress I’ve made this month because it didn’t become a pattern of behavior.  It happened, I enjoyed it, my craving was satisfied, now I’m moving on.

To Breastfeed or Not to Breastfeed that is the Question.

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Like so many new moms, my friend Sarah struggled with breast feeding.  She felt  tremendous pressure to be the sole provider of nourishment for her firstborn child, and she always worried about her daughter getting enough.  And, if she broke down and gave her a bottle, she felt like a failure.  Sarah is not alone.

Breastfeeding can be a very emotional issue for new mothers.  It can be immensely pleasurable, excruciatingly painful, extraordinarily frustrating, fulfilling, exhausting, joyful, etc.  When a new mom successfully feeds her baby with her own body there is a sense of mastery that is created at a time when everything else in the mother’s life is trial and error.  On the other hand, when breastfeeding does not go well the mother can be left feeling like a failure.

From the beginning, many new moms are flooded with information about the benefits of breastfeeding.   There is tons of research showing that breastfeeding is very beneficial for the child.   But here’s what I know, my grandmother and many of yours did not breastfeed.  In the 1950s, formula was the state-of-the-art so doctors recommended it.  My father, aunts and uncle never had a drop of breast-milk, and they became healthy, successful adults.  In the 1970s my mother-in-law shocked her family when she decided to breastfeed her children.  Both women made a choice that was right for her at the time, and their babies were non the worse for those decisions.

New moms encounter so many opinions from friends, family, books, doctors and society.  The bottom line is that there is no right or wrong answer.  Breast feeding is fabulous, but it is not essential.  Every woman must weigh the pros and cons and come up with a decision that makes sense for her life.

As for Sarah, by the time her second baby came along she had learned to be much more forgiving herself.

The Real Face of Postpartum Depression...Mine

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I am Rebekah Shackney. I’m a wife, a psychotherapist and the mother of two. Seven years ago, as I waited for my son’s birth, visions of rocking my baby in the nursery wearing a beautiful nightgown with bluebirds singing at the window danced in my head. I heard from friends that new motherhood was difficult, but like many women before me I didn’t take the warnings seriously. How hard could it be to care for my beautiful baby boy?

Well, let me tell you it was harder than I ever could have imagined.

It was not just the sleep deprivation, the pain, the crying, the lack of free-time, etc. I felt completely alone even though my husband worked from home, and my next-door neighbor also had a newborn. I felt desperately insecure about my abilities as a mother. I worried constantly that every wrong decision I made would ruin him for life. I was miserable.

New motherhood was not the fairytale fantasy I had imagined. Instead of a beautiful nightgown I wore milk-stained t-shirts as I sat on the couch with my son on my lap, unable to move. I was paralyzed with sadness, resentment and guilt. I was suffering with post partum depression, and I did not realize it.

How does such a thing happen to a person who spends her professional life educating people about their mental illnesses? Depression is a covert illness that infiltrates the mind and body so gradually that the pain it causes feels normal. I thought it was normal for a new mother feel as bad as I did.

Thankfully, I was wrong. I got help and so can you. It wasn’t an instant cure. It was a long process that took time and effort, but I can still remember the enormous relief I felt the day I made the call. It was then that I realized I was not alone, and neither are you.

If you are struggling with postpartum depression, don’t wait for it to get better on its own…it won’t. Get help right away. You owe it to yourself and your family.

Tips to Improve Your Adolescent’s Sleep

Make a Schedule. Set a regular sleep schedule. Go to bed and wake-up at the same time every night. Continue this routine even on weekends and vacations. I know your teen may not like this idea. Ask your teen to give it a try for a week to see how much better he or she feels. The schedule should not be interupted for more than two consecutive nights. Encourage them to avoid delaying bedtime for more than one hour. Awaken them the next day within two hours of the regular time.The Importance of Light. Teens should be exposed to bright light as soon as possible in the morning, but they should avoid it in the evening. The light signals the brain that its time to wake-up. Keep in mind that electronic light from computers, televisions, video games, etc. has the same effect as light, and therefore should be avoided close to bedtime. Teens should not have electronics in their rooms. Optimize Schedule for Sleep Patterns. Sleep patterns are biological and behavioral. Help your teens understand their circadian rhythms, and encourage them to optimize their schedule throughout the day based on their internal clocks. For example, encourage your teens to participate in stimulating activities or classes that are interactive first thing in the morning and late in the day if possible. Try not to take the most difficult classes at those times. Recognize Signs of Sleep Deprivation. If your teen requires more than one alarm to get up in the morning, if you find yourself shouting at the foot of your teen’s bed most days to get him or her up on the morning or if they are falling asleep during the day, they are almost certainly not getting enough sleep at night. Be in touch their teachers to find out how alert they appear during the day at school. Be aware that many signs of sleep deprivation, like difficulty focusing or remembering, can look a lot like signs of attention deficit hyperactivity disorder (ADHD). Educate Your Teen About Sleep. Help your son or daughter understand inadequate sleep can affect them. Poor sleeping habits can make them more irritable or depressed and can make it difficult for them to get along with others. Grades and relationships can suffer as a result of poor sleep. Nap. Naps are fine if they are not too late and not too long. Naps need to be less than an hour and taken before late afternoon. Keep and Eye On What They Eat and Drink. Caffeine and nicotine are stimulants and should be avoided particularly in the afternoon. Alcohol also can disturb sleep. Wind Down Before Bedtime. Teens should avoid studying, television, computer games, texting, etc. within one hour of going to bed. Don’t let them fall asleep with the television on as the light and sound will inhibit sleep. Get Help. If you think your teenager is not sleeping adequately at night, consult your primary care practitioner or a sleep specialist. Excessive sleepiness during the day and other sleep problems can indicate an underlying, biological sleep disorder, such as narcolepsy, sleep apnea and periodic limb movement disorder, or a circadian rhythm disorder such as delayed sleep phase syndrome. In most cases, symptoms of sleep disorders can be effectively treated.

Warning Signs for Adolescent Suicide

Predicting which teen will attempt suicide is almost impossible. Still, there are clues that parents can be aware of that may indicate your teen is planning to make a suicide attempt. The American Academy of Child and Adolescent Psychiatry has put together a list of signs. If your teen displays one of more of these signs professional help should be saught immediately.

Unusual changes in eating and sleeping habits

Withdrawal from friends, family, and regular activities

Violent actions, rebellious behavior, or running away

Excessive drug and alcohol abuse

Unusual neglect of personal appearance

Marked personality change

Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork

Frequent complaints about physical symptoms such as stomachaches, headaches, fatigue, etc.

Loss of interest in pleasurable activities

Not tolerating praise or rewards

Complaints of feeling “rotten inside”

Giving verbal hints such as “Nothing matters,” “It’s no use,” or “I won’t be a problem for you much longer”

Putting his or her affairs in order by giving or throwing away favorite possessions or belongings

Becoming suddenly cheerful after an episode of depression

Diectectical Behavioral Therapy, DBT, is currently the treatment of choice in treating adolescents with multiple problems including depression, self-injury and suicidal ideation.

The Power of Eating Mindfully

“Mindful eating has the powerful potential to transform people’s relationship to food and eating, to improve overall health, body image, relationships and self-esteem.”  The Center for Eating Mindfully  

Take a moment and think about the old adage: “You are what you eat.”  If you really think about it, the role of food becomes deeply important.  Food nourishes the body, and gives you energy to live your life.  It creates the arms that hold your baby, the legs that carry you on your journeys, and all of the other miraculous parts that embody you.  When considered in this way how could you not mindfully choose, prepare and eat that food.

 

The term mindfulness simply means paying attention to the present moment, to what is happening in your mind, body and the environment, nonjudgmentally.  When practicing mindfulness you learn to slow down, to focus on one thing at a time and to accept reality as it.

 

You don’t have to make a huge time commitment to benefit from mindfulness practice.  All it takes is 3 minutes to reap the rewards.  Researchers have found that people who devote as little as 3 minutes a day to mindfulness practice, change rewire their brains and improve their lives.

 

Try being mindful for 3 minutes:  Take 3 minutes, and focus on your breath. Just notice what comes to mind, and let it go like a leaf floating down a river.  Notice what is happening in your body, in you mind, in your environment, etc.  If you get lost in thought just bring yourself back without judging yourself.

 

When considered mindfully, judgments about weight and food fall away.  Weight becomes just a number on the scale, just information to use in adjusting your eating and moving habits.  The adversarial relationship with food evolves into one of nourishment and pleasure.

 

Studies find that when people eat mindfully they eat less and enjoy the food more.  When you practice eating mindfully you change your perception about food.  Any previous conflicts with food fall away over time.  You begin to listen to your body's needs.  You learn to notice when you're hungry and when you're full.  You come to think in terms of balance and moderation rather than deprivation.  So foods you once vilified can now be enjoyed.

 

Try eating mindfully:  Prepare a meal.  Eat it slowly, putting your fork down between each bite. Notice the smell, taste, texture, temperature as you eat.  Notice any thoughts that pop up.  Just notice them, and let them go.  Notice any emotions that are evoked.  Notice any sensations in the body as you eat.  Particularly pay attention as your hunger begins to be satisfied.  Listen to your body and stop eating when you are full.  When you have completed your meal notice how you feel.

 

Of course, eating this way at every meal is not feasible for most people, and that’s okay.  You can incorporate mindful eating into your life in whatever way makes sense.  Some days that may mean taking a few mindful bites of breakfast before rushing out the door.  You don’t need to devote hours

 

By making at least small efforts everyday and larger efforts when you are able you can profoundly reshape your relationship with food.

 

IMPROVE YOU LIFE WITH DBT: RADICAL ACCEPTANCE

Today I've been thinking about the concept of Radical Acceptance mostly because I'm having a difficult time with it right now.  I have a medical condition that causes a great deal of pain, has no known cause, and treatment options that don't work well.  So my doctor can neither help me prevent the symptoms or effectively treat the pain.  Now I realize that many people are dealing with far worse situations.  This is not a life-threatening  problem or even a major life changing problem, but its really uncomfortable and unlikely to end.  

So I have two choices.  I can get really upset and wallow in the pain, tell myself that it's unfair, why did this have to happen to me, etc.  Or I can figure out a way to accept it.  This has been going on for months, and for months I've been going with plan A.  I've been whining, complaining, getting worked-up and spending hours on-line trying to find a website or a blogger or someone who can tell the opposite of what my doctors have said over and over again.  There is no known way to prevent or treat this condition.  Plan A is not working.  It's only making my feel worse when I'm trying to find a way to feel better.

 

USING RADICAL ACCEPTANCE TO EASE PAIN

Moving on to Plan B, Radical Acceptance.  Radical Acceptance  occurs when we accept what we cannot change without fighting it, without judging it and without trying to control the experience.  Keep in mind that accepting a situation is much different than approving of it.  You do not have to like something to radically accept it.  In addition, radical acceptance does not mean accepting everything without questions.  It means accepting what cannot be changed, and being open to making the changes that are possible and necessary.

 

Usually, when we perceive pain, whether physical or emotional, we tense up our muscles turning them into an armor against the enemy pain. Next, our minds start to spin wondering why this pain is happening and how can I stop it...now.  These instinctive actions were necessary when we where hunters and gatherers and the enemy was a wild animal bent on killing.  Our world has evolved past that threat, but our minds and bodies have not.  The problem is when we tense-up and try to think our way out of pain, the pain doesn't go away it intensifies.

 

PRACTICING RADICAL ACCEPTANCE

When we radically accept pain, we open ourselves up to the experience.  We relax our bodies, slow our breathing and experience each moment as it unfolds.  We stop trying to figure out what we did wrong to bring on the pain.  Instead, we tell ourselves it won't last forever, and it won't destroy us.

 

We all have to accept pain at some point in our lives.  Whether you are waiting for an OTC medication to kick in to quell a migraine or you are fuming with anger after an argument or you have a chronic condition that you must tolerate on a daily basis practicing radical acceptance can help.  I am not suggesting that it is a miracle cure, but it will decrease your suffering.

 

Start today.  What do you need to radically accept?

7 Strategies to Start Healing the Damage of Depression

Here's the bad news...depression damages your brain.  This is particularly true when depression goes untreated for long periods of time, and when there are repeated episodes of depression. In addition, the likelihood of relapse increases with every subsequent episode.  This damage can cause problems with memory, planning, prioritizing and decision making.

People who struggle with depression often spend a great deal of time ruminating, which starts as trying to figure things out, but ends in triggering the fear responses in the brain.  This causes the depressed person to remain stuck and hopeless.  Plus, this pattern of negative thought becomes more and more solidified the longer it continues.

Here's the good news...the damage can be undone.

Below, I've outlined several strategies that can help begin to reverse the damage that has already been done. Remember that healing comes over a period of time with daily effort.

  1. Fish oil:  Research shows that taking fish oil can improve the mood and stave off repeated episodes of depression.  This is because low levels of Omega-3 Fatty Acids in the system are connected with many mental disorders, including depression.   Dr. Andrew Weil recommends taking between two and four grams of omega-3 fatty acids daily with a meal for optimal results.  Its Important that the product you choose be guaranteed to be free of harmful contaminants.  If you are a vegetarian omega-3s can be found abundantly in eggs and flax seed.  Of course, check with your doctor before adding this or any supplement to your diet.
  2. Breath:  When we are tense or anxious our breath has a tendency to be short and shallow.  This sends a danger message to the brain, adrenaline is released, and we become more tense, more anxious, more likely to increase our depression.  To counter this, try spending some time each day focusing on your breath.  Breathe in and out slowly and deeply.  When you find your mind beginning to wander just return it to the breath...again and again.  Doing this for just 3 minutes a day can begin to greatly increase your overall feeling of relaxed calm.
  3. Talk:  Studies show that we get as much of an endorphin boost from talking as we can from sex.  When problems live in our heads they often feel much more overwhelming.  Getting them out in the open is often a huge relief.  So when you feel yourself starting to worry or ruminate, call a friend, call a family member or call a professional.
  4. Walk:  I know you've heard about the benefits of exercise again and again, but that is because it’s true.  Thirty minutes of cardiovascular exercise most days is as effective as antidepressant medications for treating depression.  If you have never exercised before maybe 5 minutes is all you can manage at first, maybe fewer.  Do what you can do, and remember it’s the action that precedes the feeling.  You may not feel like working out, but you will likely feel better once you do it.  Please check with your doctor to get the ok before beginning an exercise routine.
  5. Yoga:  Like exercise, the benefits of yoga are too many to list here.  But for people who struggle with depression, yoga gets you out of your head and into the moment.  You focus on where you hold tension in your body, and you work to let it go.  Yoga also offers a profound sense of relaxation and well-being particularly when practiced over time.  Again, check with your doctor before beginning a new exercise routine.
  6. Write:  Keep a journal of your emotions.  Take note of how you feel several times throughout the day.  This will help you pay attention to what triggers your emotions, and how often your emotions fluctuate during the day.  Emotions always come from somewhere.  When you learn to pay attention to you these triggers you can have more control over your reactions.
  7. Seek Help:  If doing this on your own feels overwhelming, its important that you seek out a qualified therapist to help you.  Feel free to contact me, 917-721-2257 or rebekah@rebekahshackney.com  Together we can undo the damage that depression has done.