Coping with postpartum depression

by Kim Vargas, LCSW

Jessica walked into my office in a sundress with her hair and makeup done. [For the purposes of illustrating key points, a fictitious client has been created.] She smiled and spoke in a calm, warm tone. Had I not had a phone conversation with her the day before where she detailed her reasons for making the appointment, I would never have guessed that this woman was suffering deeply. To look at Jessica, you would wouldn’t have known that she was terrified to be alone with her baby; that she wasn’t sleeping at all because she was so anxious that her baby would stop breathing if he wasn’t constantly monitored; that she felt hopeless and filled with despair almost all of the time; that she sometimes wondered if her baby would be better off without her; that she spent most of the day crying as soon as her partner left for the workday. To look at Jessica, you would never have known she was in the throes of postpartum depression.

Jessica’s mother told her that she was just suffering from the baby blues, and that all new moms go through a tough stretch. Her mom told her she just needed to get out of the house more, spend time in the sun, and pull herself together. For three months after her son was born, Jessica suffered in silence, and told herself that she was a terrible mom for not feeling joyful about her new baby. She was fearful that her baby would be taken away if she revealed the truth, so she made sure to act upbeat at her six week postpartum check-up.

As it turned out, Jessica was one of the 1 in 7 women who struggle with postpartum depression.

Luckily, Jessica had a sister-in-law who had previously suffered from postpartum depression (PPD), and knew to ask Jessica important questions about her mood and coping. Had that not been the case, Jessica could easily have fallen into the 50% of women who are never diagnosed (and consequently never get help) with postpartum mood disorders.

Women suffering from untreated PPD are more likely to develop Major Depressive Disorder down the road. They may have more difficulty bonding with their baby. These moms often have lower self esteem. Their babies may experience language delays, have more difficulty with self regulation, and experience depression themselves later in childhood.

Postpartum depression is more likely to occur in parents with a baby who spends time in the NICU, parents who experience complications at birth, parents with a history of depression, parents with a high needs infant, and/or parents with a lack of social, emotion, and financial supports.

It is worth noting that it is not only biological mothers that suffer from PPD. 1 in 10 fathers experience depression in the postpartum period. Adoptive and foster parents are also at risk. Because these parents did not give birth to the child, they sometimes feel unjustified in their depression, and are therefore unlikely to mention the feelings to anyone.

The good news is that there are many wonderful options for treatment and healing. Many parents find immediate relief in working with a therapist trained in postpartum issues. These professionals can validate and normalize the thoughts and feelings, make concrete suggestions for behavioral modifications, and assist new parents in finding resources to help manage new parenthood. Sometimes just being “allowed” to say the deepest, darkest thoughts and fears in a confidential setting lifts a tremendous burden.

Many women find that talking to their doctor about their mood enables the doctor to prescribe medication that helps manage the feelings. Doctors knowledgeable in postpartum issues may be able to prescribe a medication that is compatible with breast feeding, as that is often a concern for new parents.

Support groups offer an opportunity to connect with other new parents in a safe setting filled with individuals at a similar life stage. Sometimes parents benefit from hearing someone else speak a familiar thought, feeling, or fear. Likewise, joining local baby-centric activities connects new parents to each other, and offers a structured activity outside of the house. For breastfeeding mothers, attending a breastfeeding support group and/or getting the support of a lactation consultant can be extremely beneficial in making the breastfeeding process smoother and more comfortable, physically and emotionally.

Asking for help from friends, family, and/or paid professionals, especially in the very beginning, can go a long way toward allowing the new parents to heal. Because lack of sleep is often a contributing factor to postpartum depression, having someone else wake up with the baby some of the time may improve mood quickly.

The bottom line is that there is an extraordinary amount of help, support, and resources for people suffering from postpartum issues. Because postpartum mood disorders can develop any time during pregnancy, and up to a year following the birth of a child, it is imperative to know the signs and symptoms, and to seek help immediately.

Kim Vargas, LCSW has been a psychotherapist for over 19 years. She specializes in working with individuals and couples navigating the various stages of parenthood (including the journey to become parents). She is especially passionate about working with new parents surrounding issues of postpartum depression, anxiety, and identity. Kim can be reached at kimvargastherapy@gmail.com or 267-568-7846.

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21st Century Wellness on College Campuses

by Tracey A. Smith

June is a month for graduations and the start of summer. For parents getting ready to send their High School Seniors off to college – or to send older students back to campus for another year this August – you may have a lot of questions about how you can best assure your child’s well-being when they are no longer living at home. If you are a student trying to choose the right college campus setting, you may be curious about how universities are similar and different in addressing your wellness and promoting positive wellbeing. We may have heard a lot about stressors and challenges facing students on college campuses all over the country but less about programs specifically geared to support students with these challenges. You may be asking … how does a university address college students’ needs while upholding their mission and values? What resources or strategies does the university have in place that can assist with college students’ well-being? What opportunities will there be for college students to grow in their self-care?

What's happening on university and colleges campuses these days? Quite often you will find that student health, wellness and recreation centers are the hub for student health and engagement. Most universities provide a holistic approach to campus living, working, and learning. For many students, this may be their first time living away from home. For some, it will be their first time independently exercising life, problem-solving and decision-making skills. The Wellness programs and activities found on college campuses support students in making positive behavioral and lifestyle changes.

Universities’ comprehensive health and wellness services will include programs geared to support students in areas such as:

·      alcohol & substance abuse

·      healthy relationships, including information about dating violence

·      women and men’s health, including sexual health

·      managing anxiety and depression

·      nutrition, finances, and tools for life after graduation

·      managing stress and anger

Most college campuses include free counseling services for students. This is an important resource to support students in navigating the many changes and challenges they face during this time of transition. In addition to counseling services, academic advisors, professors, and residence life staff can provide additional support.

I have the unique opportunity to be a Life Coach on a college campus. It is a very rewarding experience, being employed by a university that values health and wellbeing. The service allows me the opportunity to help students navigate the college experience from freshman year to senior year. I assist the students in all areas of wellness, not just academic (intellectual wellness), but the whole student (emotional, spiritual, interpersonal, and physical). I am able to witness tremendous growth and development as students find their way in living their lives on their own terms. It is energizing to coordinate and provide programs that encourage this transformation.

Universities experience many challenges in light of the high levels of stress impacting our society. Challenges to academic success can include finances, poor sleep, unhealthy relationships, unhealthy and addictive use of social media, depression, anxiety, poor nutrition, trauma, and family issues. There is hope. It is encouraging to observe greater engagement of students in health and wellness programming that supports their needs. Below are some practices that have been documented to support healthy living on campuses.

Students First  

Student-driven programs and activities work the best. Students have formed Wellness Ambassador and Peer Education Groups and have designed and implemented special events from physical challenge activities and “healthy campus” weeks to mindfulness activities. The use of Health and Wellness Surveys can provide staff with vital information about student interests and needs.

Collaboration 

Calling All Practitioners! Most universities draw upon the expertise of outside health practitioners in order to provide additional wellness services and speaking engagements. This can include wellness education, counseling, yoga, trauma informed services, health education, and spirituality.

Campuses often offer a multitude of services, organizations, and events that can be used to support wellness. These can include student health services, campus life programs, student organizations, athletics, dietary services, career services, environmental services, disability offices, and LGBTQ/diversity groups. Collaboration may also appear as an intergenerational program that includes employees, students, community members and the online community. Thinking broader, collaboration may include linking with larger nonprofit agencies such as Michele Obama’s Partnership for Healthy Campus Initiative https://www.ahealthieramerica.org and National Consortium for Building Healthy Academic Communities https://healthyacademics.organd the

American Cancer Society https://www.cancer.org/.

Community Integration

Developing community partnerships is the key. This enables you to provide more comprehensive health and wellness services. Most colleges have strong alliances with outside healthcare agencies that help them to best meet the needs of students, staff, and faculty.

In conclusion, college campuses provide young people with the information, strategies, and supports that can serve as the foundation for a lifetime of healthy life practices, relationships, and resiliency. We can encourage students to make connections, access the services available, and experiment with new wellness practices can empower them to launch into the world as happy, healthy, and resilient adults. Ultimately, this benefits young people and also their families, friends, coworkers, and the communities in which they live.

Tracey A. Smith, M,Ed., CTRS, owner of Wellness W.R.K.S. LLC is a Certified Recreational Therapist, Wellness Lifestyle Management Educator, and Trainer. She is also a Life Coach at Cheyney University of Pennsylvania. Enthusiastically, she provides wellness education programs, workshops, trainings, conferences & retreats to companies, schools and community organizations to promote self-care and well-being. She specializes in Workplace Wellness and team-building for remote employees. To learn more about Tracey and how you can bring her creative, experiential workshops and consultations to your agency or business, contact her at tracey@wellnesswrksllc.com or 215-605-3221 or visit her website [Insert link to: https://www.wellnesswrksllc.com/].

Woman and Wild

Woman and Wild

I can't tell you

the first time the wild

whispered into my 

tiny child heart

because the wild

has always been here...

always an undeniable

aliveness tucked just

behind my ribs

stretching from 

collar bone into the

rich bowl of my (now)

crone woman hips.

we occupy each other

as woman and wild

creating spaces

where life flourishes

each of us

utterly

unique

 each of us

utterly

interdependent

each of us

utterly

at home

© 2018 Tracie Nichols

A Poem about Hope and Place by Wendell Berry

Source: https://www.amazon.com/Leavings-Poems-Wendell-Berry/dp/158243624X

It is hard to have hope.

It is harder as you grow old,

For hope must not depend on feeling good
And there is the dream of loneliness at absolute midnight.
You also have withdrawn belief in the present reality
Of the future, which surely will surprise us,
…And hope is harder when it cannot come by prediction
Any more than by wishing. But stop dithering.
The young ask the old to hope. What will you tell them?
Tell them at least what you say to yourself.

Because we have not made our lives to fit
Our places, the forests are ruined, the fields eroded,
The streams polluted, the mountains overturned. Hope
Then to belong to your place by your own knowledge
Of what it is that no other place is, and by
Your caring for it as you care for no other place, this
Place that you belong to though it is not yours,
For it was from the beginning and will be to the end

Belong to your place by knowledge of the others who are
Your neighbors in it: the old man, sick and poor,
Who comes like a heron to fish in the creek,
And the fish in the creek, and the heron who manlike
Fishes for the fish in the creek, and the birds who sing
In the trees in the silence of the fisherman
And the heron, and the trees that keep the land
They stand upon as we too must keep it, or die.

This knowledge cannot be taken from you by power
Or by wealth. It will stop your ears to the powerful
when they ask for your faith, and to the wealthy
when they ask for your land and your work.
Answer with knowledge of the others who are here
And how to be here with them. By this knowledge
Make the sense you need to make. By it stand
In the dignity of good sense, whatever may follow.
Speak to your fellow humans as your place
Has taught you to speak, as it has spoken to you.
Speak its dialect as your old compatriots spoke it
Before they had heard a radio. Speak
Publicly what cannot be taught or learned in public.

Listen privately, silently to the voices that rise up
From the pages of books and from your own heart.
Be still and listen to the voices that belong
To the streambanks and the trees and the open fields.
There are songs and sayings that belong to this place,
By which it speaks for itself and no other.

Found your hope, then, on the ground under your feet.
Your hope of Heaven, let it rest on the ground
Underfoot. Be it lighted by the light that falls
Freely upon it after the darkness of the nights
And the darkness of our ignorance and madness.
Let it be lighted also by the light that is within you,
Which is the light of imagination. By it you see
The likeness of people in other places to yourself
In your place. It lights invariably the need for care
Toward other people, other creatures, in other places
As you would ask them for care toward your place and you.

No place at last is better than the world. The world
Is no better than its places. Its places at last
Are no better than their people while their people
Continue in them. When the people make
Dark the light within them, the world darkens.

Spring Perspective

by Tracie Nichols

In the spring, I wander the course of the stream that skirts the bottom of my yard. It’s one of hundreds – possibly thousands – of small, nameless, feeder streams striping the landscape here, meandering towards rivers that empty into the Atlantic Ocean.

It’s something I’ve been doing for over twenty years, now. As you can imagine, this stream and I have seen some life together. Over time, I’ve come to think of this wandering little waterway as family.

So this spring walk is when I discover where the stream is now, after the winds, snowmelt and hard rains of the winter months. By visiting before the riot of jewelweed and other creek bank plants overrun the terrain, I can see where banks have been undercut or collapsed. It’s easy to notice where the streambed has cut more deeply into the red sandstone bedrock, or where trees have fallen or held their ground.

This walk is also when I discover where I am, now and how my course has changed through winter. As I walk and notice the stream, I also notice myself. Where I’m feeling undercut, or rebuilt. Where I’m letting go and where I’m continuing to stand my ground.

Walking the length of this small stream is a moving meditation. An exercise in deep listening and deep presence, teaching me about cycles of death and rebirth in the land and in myself. Walking the length of this small stream offers me the gift of perspective, and anchors me in the reassuringly unending cycles of this land.

Tracie Nichols, M.A., IAC believes that if there ever was a time when the deep perspective of 50-ish+ sensitive, introverted womxn is needed, it’s now. She is a mentor, poet, aromatherapist and rebel crone creating spaces where sister Rebel Crones can find community, information and support to unfurl their voices, be who they choose to be and do what they choose to do. You can learn more about her at tracienichols.com.

Finding Your Sense of Place at Home

by Heather Hill, MSS, LCSW

The weather is quickly warming up and soon we will find ourselves outside more, traveling to the beach or the mountains to relax, slow down, and enjoy the beauty of nature. We may experience a sense of awe and wonder when we realize just how connected we are to the universe.  But what happens to that connection when we return home again, when routine takes over like an invasive vine and The Commute, the Target Run and the school or work commitments become the focus of our day?  Do we check out the sunset?  Do we know what the plants and the birds are doing?  Do we have any inkling of the water level in our local streams?  If not, what’s the psychological effect of living like this: an “alien” or a tourist in our own land?

These are the types of questions that Eco-psychologists study in their efforts to create a sustainable, livable world and to foster a more psychologically healthy population.  Their premise is that the attachment and meaning given to a particular place is central to the health of the planet and the person. A “sense of place” here refers to “...a psychological construct that involves attributing a geographical location with meaning, values, and a sense of “connection.” [From: The Power of Connection: Sustainable Lifestyles and Sense of Place.  Ecopsychology Journal Vol 4, No. 4 Jan 31, 2013, found at https://www.liebertpub.com/doi/10.1089/eco.2012.0079].  It follows then that if more people felt a sense of connection to their natural environment, they would feel motivated to engage in actions for sustainability. I would also add that having a sense of place cultivates curiosity, belonging, connection, and a greater sense of well-being in us.

A disconnection to the land may be a uniquely American problem.  As Americans, most of us came here as immigrants.  Because of that we may have an evolutionary proclivity to restlessness.  We are always on the move, searching for greener pastures and hoping a change of location will promise a better life.  Over caffeinated, hyper busy and digitally connected 24/7, we move through our daily life at an unnatural pace.  The downside of this movement, borne of our pioneering spirit and freedom to roam is an underlying feeling of displacement, alienation and a lack of identity.  Wendell Berry says we don’t know who we are unless we know where we are. So, who exactly are we?  How do we connect to an adopted land?

Know the Plants

One way to counteract alienation is to reclaim the space where we live or as Robin Wall Kimmerer says, in Braiding Sweetgrass, to become “naturalized” citizens of the land.  Kimmerer would agree with the poet Gary Snyder, who teaches that spirit of place is accessed only through knowledge gained by direct experience in a specific locale.  "Know the plants" is his mantra. Once you become curious and start to know the names of the plants and trees around you, it’s like a faucet has turned on.  More questions come and you begin to be curious about all the things you may have previously ignored and taken for granted.  The plants become like familiar friends or trusted allies.  This is the beginning of belonging and connection.

Write a Poem or a Love Letter

Wallace Stegner in his great essay entitled “Sense of Place” states, “that no place is a place until it has had a poet.”  

[Insert link to: http://www.pugetsound.edu/files/resources/7040_Stegner,%20Wallace%20%20Sense%20of%20Place.pdf  ]  Who is our poet?  Edgar Allen Poe wrote about the Wissahickon, sure, but who is the modern day poet laureate of the entire region?  Beth Kephart who writes Flow, a prose poem history of the Schuylkill River may be a contender.  You can read an excerpt here. [Insert link to: https://hiddencityphila.org/2014/06/how-can-you-know-what-it-means-to-be-here/

Many people have written love letters to their favorite places in the Wissahickon.  It was inspiring to read this article about how many people went to the Red Covered Bridge to feel their “fullest and best versions of themselves”:  https://www.philly.com/philly/columnists/helen_ubinas/wissahickon-helen-ubinas-thomas-mill-red-covered-bridge-love-letters-20180905.html?fbclid=IwAR3oFN3c6l_pU7ej0pfJVNfgIdVkA6PdjjAAPiXoaKB2gH1bHecPI6w7EZg  Go to your favorite place in your local park and try to write it a love letter.  You may feel a deeper attachment to it after you’ve expressed how you feel. 

Don’t Get Discouraged by Urbanism

Even in this major East Coast city, we can still feel a sense of place that doesn’t involve cheesesteaks and Rocky.  We who live in the Greater Philadelphia area are lucky to have an active urban garden scene, two major rivers, Fairmount Park, the Wissahickon, Pennypack, Morris and Awbury Arboretums and Bartram’s Gardens.  We may not be able to walk barefoot through the parks, but we can walk like “each step is a greeting to Mother Earth”.  With respect and reverence and love.  Slow down, observe the little things that are all too easy to overlook.  Our personal wellbeing and our planetary survival just might depend on it.  What’s happening right now outside your window?

Ways to Connect with Local Nature:

• How Can We Connect with Nature in our Cities [Insert link to: https://permaculturenews.org/2017/02/20/can-connect-nature-cities/
• Download the Inaturalist app to start identifying what lives right in your own backyard.
• Join Wild Foodies Meetup or check out: http://www.wildfoodies.org/
• Come on the Resiliency Nature Walk, the 2nd and 4th Wednesdays of the month at 9 AM.

• Join Friends of the Wissahickon or the Wissahickon Valley Watershed Association or Like them on Facebook.  They post a lot about the local wildlife and plants.
• Start an in-home naturalist training course through the Wilderness Awareness School: (I loved this program.  Please reach out if you want to learn more about my experience) https://www.wildernessawareness.org/adult-programs/kamana

• Enroll in a Master Naturalist Program http://www.schuylkillcenter.org/programs/foradults/naturalist.php

Heather Hill, MSS, LCSW has been a psychotherapist for over 10 years. She specializes in helping anxious and depressed teens and women connect to and live in harmony with their true nature.  Heather is passionate about using mindfulness and Eco-therapeutic approaches to restore balance, reduce isolation, and create a greater sense of wellbeing. She can be reached at Heatherhilltherapy@gmail.com  or 215-485-7205.

Spring Explosions

by Lisa Grant-Feeley

Ahhh, Spring!  The time when the air starts to have a softer, gentler feel to it.  The days are longer and brighter and the the renewal of life is a promise waiting for us.  

For some, there is an explosion of energy that is funneled into throwing open the windows, packing away the unwanted heaviness of winter, preparing for a lighter, brighter time of year.  For others, it is the next season of a child’s explosions of frustration, verbal or possibly physical attacks of big emotions, and feelings of helplessness as the child that is known is transformed into a child in need, and of not knowing how to meet that need.  

For children with ADHD, and some without, big feelings can get the best of them and they don’t have the skills to manage those feelings without an explosion of difficult behaviors.  Understanding the ADHD brain, as well as the high level of sensitivity and intelligence that are often characteristics of children with ADHD, helps to maintain a connection of compassion and closeness that can be difficult for parents to access during explosive behaviors.  It’s important to remember that children do the best they can with the skills they have, and often have feelings of remorse, guilt or shame because of their behavior and inability to control themselves. The added layer of thinking that they are different from other children who do not display these behaviors as well as thinking that they are responsible for the discord in their family and the source of upset for their parents, magnifies their negative self image.  Over time, this sequence of events can lead to feelings of low self-worth, and eventually anxiety and/or depression.

Finding a safe place for families to understand the complexity of ADHD and related characteristics and to learn strategies for supporting a child with ADHD, is needed to to begin the work of restoring a home to a place of peace and calm.  Bibliotherapy (using books therapeutically) with young clients who have ADHD provides a “side door” into discussing their behaviors without directly pointing the finger at them.  This often appeals to the highly sensitive child for whom it it difficult to be vulnerable by admitting that she has big, unmanageable feelings and all the layers that go with them.  

Siblings need guidelines and solutions for behaviors they are currently struggling with that can add to the sense of discord in the home.  Parents are often pleasantly surprised at the changes their children make when given the opportunity to work together to create sibling rules to address the concerns they have.  Typically, when siblings work together to make their own rules, they are invested in change and change often occurs.  

Parents often want to learn more about the way their child’s brain works. This helps them understand their child better and develop a way of parenting their child that works.  Learning strategies to set boundaries with their children in a loving, respectful way as well as supporting them in processing their feelings of concern for their child.  Seeing their child struggle is difficult, seeing them hurt is unbearable, and being able to share those feelings and to create solutions that work for their child is the first step in creating the future they hope for.

Lisa Grant-Feeley, MS, LPC, is a Licensed Professional Counselor who provides support and counseling to children and teens who struggle with ADHD and explosive behaviors as well as those who have symptoms of anxiety and depression.  She works with their families in gaining understanding of what their child or teen is experiencing and in learning ways to support them during difficult times. To learn more, contact her at 267-625-2565 or lisagrantfeeley@gmail.com.

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