My Q + A for Hello Adams Family

What is a “normal” level of anxiety? My anxiety levels seem different from other people I know. / I constantly feel overwhelmed and it seems like the cycle of anxious thoughts never ends. How should I be dealing with this? / How do you know if you should start therapy or start taking medication for anxiety or depression? 

-This question is both easy and difficult to answer. If consistent feelings of dread, sadness, and/or worry are affecting your life in any way, then you should seek help from a professional. The onset of depression and anxiety can be gradual enough (or consistent as long as we can remember) that we often believe this is just how we are, and the severity of our condition is impossible to see. Anxiety and depression trick us into thinking about the negative things in our life or the world, and this accumulates over time. This makes it difficult to know when to draw the line in getting help. I could go on and on about different ways you can identify whether your anxiety is “bad enough”, but I think that if you are asking yourself (and me) this question, then it is. Again, if you feel that you may have anxiety or depression, please set something up with a counselor, social worker, clinical psychologist or psychiatrist. It is always best to be proactive with something that can affect your health and well-being so deeply. Worst case scenario: You go to an appointment, they tell you that you have no concerning symptoms, and you go home relieved!

 I know that I need to go to counseling for depression but I’m intimidated. How do I start the process? How will I know that a therapist is right for me? 

-Do a little research and ask around. Do you have a friend who you know has gotten a lot out of therapy? Ask for a referral! Another great resource is websites such as psychoglogytoday.com and goodtherapy.com. These sites give you the opportunity to search by location, insurance coverage, specialties, etc. to find a best fit. Then you can peruse the profiles to get a better feeling for each therapist’s personality and approach. Give yourself and the therapist a few appointments to get established. I have had clients tell me later on in our work that they weren’t sure about me at first (I was too young, didn’t have their condition myself so I might not understand them) but were so glad they gave me a chance. There are a lot of therapists out there who are very different from one another, so keep trying until you find someone you feel is helping you to improve. 

How can I get someone I love to start going to therapy? How should I be communicating and engaging with a spouse who suffers from anxiety and depression? 

-GREAT question! Approach them with a loving and concerned attitude. Avoid beginning with or including certain phrases in your discussion. “You need to do this because I think…” or criticism of their recent behaviors or choices will most likely not be helpful in getting your point across. I suggest you begin with, “I have been wanting to talk to you about this because you seem really stressed and unhappy lately. I am worried about you.” Ask leading questions to help get them to feel safe to open up. “Do you feel ok?” “Have you noticed a change in yourself?” Also, see your quest to help them as long term. Don’t give up talking with them about it after one or two attempts.  Many people (unfortunately) have a negative connotation with therapy so while there is no guarantee you will get them to call a health professional, it is a better approach to show consistent concern and care rather than frustration and disapproval. Also, having the information of a good therapist on hand once they agree can be the difference between someone going and not going to therapy. They can call or send an email in that moment they are feeling hopeful about the prospect of therapy.

Ever since I became a mom, my anxiety is through the roof! What can I do to stop worrying so much? 

-Part of becoming a parent is accepting we have more responsibility for this little person (or people, I have twins ah!) than we ever imagined. We have the false belief that if we can just do this perfectly, then things will be great. Throw in huge changes in your hormones, body, and lifestyle, and who even stands a chance at feeling normal?! Babies and kids get sick. Nursing can be painful or impossible. My friends all seem to be so happy. We have to work and find someone to watch them. I don’t have time for my partner. The list goes on! 

The chemical and biological shifts in new parent’s bodies and brains are no joke, and this is why we have to take these feelings very seriously. As I stated earlier, I advise you to see a professional if you have any concern that you are suffering from anxiety or depression. You need treatment suited to you because there is no catch all to help these complicated conditions subside.

One intervention is to identify unhelpful thoughts and dispute them. This worksheet https://www.getselfhelp.co.uk/docs/UnhelpfulThinkingHabitsWithAlternatives.pdf

 helps to break down whether a negative thought is unproductive, or just a normal worry. In a journal, or on your computer or phone, list out which of these categories (maybe all of them!) relates to you, and the specific beliefs that come along with each. Examples: Judgments- “I am a bad mom because I want a break”. Shoulds and musts- “I should always want to be with my kids”. Cross that out, and write something more helpful, accurate or positive. Each time that unhelpful thinking habit comes back, refer to the more helpful way of thinking. This requires consistency over time to see the benefits, but I promise it helps if you stick with it!

In addition, try to take some time to hone in on whether your concerns are logical or emotion based. We want our thoughts to have a balance. If your child has a fever, you want to be cautious and monitor them, but not let the very slim possibility that it is serious take over your well-being. Ask yourself when you are through the roof: What is most likely happening here? What would I tell a friend if I was trying to help her?

PLEASE view caring for yourself as caring for your children and family. In order to care for yourself, you need to first know what makes you feel fulfilled and energized. This might be working out, spending time with adults, journaling, going to therapy, meditating, working, or NOT working. Start observing what makes you feel happy and what seems to really be depleting you. This will give you a starting point to take care of yourself, and decrease anxiety symptoms.

Is it possible to feel the onset of post-partum anxiety when my child is a year old? 

-While anxiety that begins a year after birth may not fit the criteria for PPA, it can absolutely be stemming from the immense changes I mentioned. The timing of the onset of your symptoms does not make your anxiety less serious or important. If your condition doesn’t fit in the certain categories laid out by the medical filed for post-partum conditions, it can still be as a result of the changes in your body, brain and life over the last couple years

I know I’m anxious, but don’t know how to discuss my anxiety with my partner. How do I initiate these conversations? 

-Educate them. Find a book or article that you feel really illustrates the way you experience anxiety.  Tell them you think it would be very helpful for your relationship if they read it, and you two talked it over. This can open dialogue between the two of you, and you will feel less overwhelmed at the prospect of needing to find your own words to describe what is going on inside of you. 

How do I work through residual issues from my childhood that tend to result in low self-esteem and anxiety? 

-Negative childhood experiences that stick with us over the years are often a form of trauma. Many people usually associate “trauma” with soldiers who have been to war OR someone who has been attacked, but in fact, we all have experienced trauma on some scale in our lives. It could be our parent’s divorce, being bullied as a child, getting fired, or losing someone we cared about. There are some amazing therapeutic approaches out there to help work through the long-term issues we have managed to shove down.  I advise you to let your therapist know right away that working through these is a main goal for you. 

I take all of my work/life grievances out on my husband. How can I be better about this? 

-A specific approach you can take today regarding work stress: Stop and take a moment between work and walking through the door to take ownership of your mood and behavior. It is your responsibility to get it under control before you reenter home life. You won’t be perfect (no one is!), but if you can stop yourself each day, and commit to taking deep breaths and setting a positive tone for the rest of the evening, you can improve this. Also, you can talk with your partner about what you can both do at that time of day that could help lower tensions. Maybe you need 5 minutes to change when you get home. Maybe they could make efforts to tidy up before you get there. Also, be receptive to what they may need from you to improve this dynamic. Have this conversation when things are calm and you have a clear head.

This is also a great topic to work on in therapy. Of course :) 

Do you have any tips for dealing with anxiety around eating and exercising? / How do I know if I’m overdoing things, and/or how do I deal with guilt when I “fall off the wagon” or miss a workout? / I deal with a lot of negative self-talk, particularly surrounding body image. How can I feel better about myself? 

-Improving this aspect of self-care is a long-term process like so many others that are best resolved in therapy. You are unique, as are your experiences. One on one attention to your journey with food and body image is the best approach. There are still a few things that you can do that might help. Most of all, be kind to yourself. By switching up which words you use when speaking to yourself, you can build up a more positive self-image. Instead of “I’m not working out again today, I’m so lazy” say “I will get to exercising consistently when I feel up to it and have some more energy. No point in beating myself up about it right now.” I know, I know, MUCH easier said than done. But have you ever noticed how the more you beat yourself up, the less likely you are to make better decisions? This is the cycle of negative self-talk. My clients have argued with me that being cruel to themselves acts as motivation, but time and time again, we see that it doesn’t. Shame is not a healthy emotion, and it usually further strengthens whatever negative pattern is holding us back from making better choices.

I’m struggling with infertility and it’s starting to affect my relationships (especially when it seems like everyone else is getting pregnant easily). What can I do? 

-Speaking from professional AND personal experience, this is a wonderful time to seek therapy. A therapist who specializes in or has experienced this would be ideal, as the complexity of the methods and science around it can be exhausting to talk someone new through. Also, lean on those friends and family members who you feel are most in tune with you. Try not to hold on to anger towards those who are having a positive experience on their journey to parenthood, for it is not their fault. LET IT OUT to someone you trust, and who understands, on the really hard days. Don’t hold yourself to unrealistic standards of having to be at every baby shower or birthday party. You can still be a good friend and family member without having to sacrifice your emotional well-being. This is another wonderful example of an opportunity to educate those around you. Here are links to a few articles that you may find helpful in communicating with your families and friends about where you are in your infertility journey:

https://resolve.org/support/for-friends-and-family/

https://www.pullingdownthemoon.com/blog/2018/03/8-keys-to-communicating-staying-connected-during-infertility/

https://pregnantish.com/how-friends-family-can-support-people-going-through-infertility 

How can I calm down when experiencing a panic attack? 

-I know I am a broken record, but if you are experience panic attacks, you need to see a doctor and go to therapy. Through personalized treatment, you will learn which techniques best help you cope during panic attacks. Your therapist can help you learning grounding techniques, how to practice mindfulness, and calm the physical symptoms. Make an appointment! You can look into some well-known approaches in the meantime in these links: 

https://insighttimer.com/blog/54321-grounding-technique/

https://www.verywellmind.com/deep-breathing-for-panic-disorder-2584061

https://www.mindful.org/4-ways-curb-panic-attack/

Take notes on which aspects of these techniques help you. Bring them with you to therapy. Your therapist will be impressed J, and you will have a running start on finding solutions tailored to you!

How do I combat thoughts that my partner isn’t “the one” for me?

-We have been conditioned by entertainment to expect relationships to be a certain way if someone is the “right “person. We don’t expect perfection, but pretty close. The reality is you and your partner are two flawed (albeit wonderful) people, which makes it impossible to have a flawless relationship! Ask yourself if you think you are experiencing the “normal” growing pains of a long-term relationship (i.e.less sex, trouble resolving certain issues) or if there are things about this person you really don’t see in your forever partner? Are you values and morals aligned? Do you want the same things in the future? Happiness in relationships looks different for each of us, so I think some soul searching is in order if your concerns are pervasive.

I’ve been married for three months (we’ve been together for three years) and we’re really struggling to communicate. How can my partner and I improve our communication?

-Set time aside each day for 5 minutes, as well as each week for 30-60 minutes to connect and fill each other in on important happenings in your life. This is still doable in our busy world. Like anything else, practice makes perfect. You must make a conscious effort to speak effectively AND listen effectively.

My spouse and I argue on a daily basis. Is this normal, and what can we do to avoid these blow-ups? 

-I often resist telling people who I don’t know what is and is not healthy because every relationship is so different. However, I can say with confidence that intensely fighting every day is not healthy for you and your spouse. You need to become a united front against these ongoing habits. AND here I go again…Therapy should not be the last line of defense for couples. The more you can invest in your relationship now, the better it will be in the long run. Ask around to see if friends or family have any therapist recommendations. I think you will be surprised! In the meantime, you can start to identify (and maybe even change) some patterns that science has shown to be detrimental to marriages:

https://www.gottman.com/blog/the-four-horsemen-recognizing-criticism-contempt-defensiveness-and-stonewalling/

Also, pick up a book by Dr. John Gottman. He is a highly regarded couple’s therapist who spent years doing research on relationships and communication. Everyone can benefit from the resources on his site!

To be or not to be....A WORKING MOM?

That seems to be the question for many of my generation’s women.  The number of hours that I have spent talking about this with friends would shock the men in our lives, but we never seem to find a definite answer. I suppose that is because everyone’s life is different, and because we all want different things.  The fact remains that we find ourselves having this conversation because we have all felt pressure from both sides. Whether it’s our parents breathing down our necks to get married so we can deliver them grand children to play with, or it’s society shoving the notion that money and success are the ultimate goal down our throats, we are receiving conflicting messages of what is most important.

How is one supposed to be able to work the hours of a full time gig, and be there for every moment of their children’s lives? She can’t, and that’s where the panic sets in.  It is physically impossible for a woman to fully deliver on both ends.  Either way you choose, you can be met with disapproval.

So my question now changes. Do we care what the world thinks about this particular life choice? And should we care? Some would strongly argue yes because of tradition or personal values. Some may say no, do what feels right for you and makes your life work.  I can honestly see both sides of it, but that doesn’t help the anxiety I feel over the choice. Will I be happy if I give up my career and stay home with my kids? Or will I regret missing those mornings and afternoons when they are learning about the world?  It is something many women will need to process, and ultimately decide.

Our generation is the first that has had to tackle this issue with such strong messages from both sides.  We need to break the glass ceiling! But we also need to be there the first time our kids say “mama”! Both are important, and I believe it is each woman’s personal choice.  There is no avoiding the backlash whichever she chooses, but I hope to support the women in my life whichever they decide.  Choosing to stay home with her children does not make a woman any less intelligent, driven or interesting.  Choosing to work does not mean she is less loving or invested in her family.  It is my hope that women and their families can live a balanced life which works for all involved, and that will never look the same for two families.

Anxiety in Relationships

When I began my work in helping clients cope with anxiety, I figured it would be mainly working on their inner dialogue and thoughts they have about themselves and the things that are occurring in his or her life. In a short time, I realized a huge impact that anxiety has is on how people interpret and communicate with those they love.  The misinterpretation that can occur within an anxious person’s mind can cause serious damage to a relationship, despite the true intention of a disagreement or statement.  One party can feel that the anxious party is “putting words in their mouth” by assuming the message meant something much worse than it was intended.

An example I have seen of this in my work with families is with a daughter and anxious mother. The daughter was going to a friends house and it happened to be around dinner time so she asked her mother if she could eat dinner at her friends’ home instead.

While the mother said yes, she also interpreted her daughters question to mean that she did not like her mother’s cooking and she didn’t want to have dinner with their family.

The daughter felt completely blindsided by this misinterpretation and felt scared to communicate that the situation was in no way like the mothers’ interpretation.

If one can misunderstand us so severely, it can discourage future communication from being attempted. It is always necessary to get back on the same page before moving forward with the conversation or relationship.  This can be extremely detrimental to a relationship when it happens time and time again and is never resolved.

I have worked with couples and families who have gone years thinking their loved one meant something very hurtful when they had no such intentions.  Our own life experiences contribute to how we process what other’s say to us, and if we don’t clarify what someone meant, we will go on thinking that person meant to hurt us. Over time, this can harbor serious resentment and growth apart from one another.

Counseling is a good step to take if you feel this happens in any of your relationships, but you also have to be open-minded and accept that your anxiety plays a role in how you may be misunderstanding those around you.

I have helped partners and family members to learn how to better communicate so these important messages don’t get lost in translation, and it is crucial to clear up these misunderstandings to have a healthy relationship where both parties know what the other is attempting to communicate to them.  Our anxieties play a huge role in these misinterpretations, and finding out how that happens can be extremely beneficial to both sides of the relationship.

Having a Healthy Marriage

Some new statistics surrounding marriage caught me of guard this week.  The divorce rate among 25-29 year olds is on the rise although the overall divorce rate is dropping! As a 30-year-old who has been married for 3 years, I want to know why this is. A theory that has recurred in my head is that we are a generation of divorced parents. Of my group of 10 best friends, there are only three of us whose parents are still married to one another.  Perhaps that percentage is small relative to the world, but it demonstrates how divorce has become more normal than abnormal in the community I grew up in.

While the divorce of one’s parent’s doesn’t always cause him or her to avoid marriage altogether, I don’t think it is an encouraging factor.  I have discussed with each of these women how it affected their desire to get married, and it was not something that made them any less nervous when the situation presented itself.  They wish they had a healthy example of marriage from a young age, but also have faith in themselves that their marriage and commitment can be different.

So, how can someone who was raised by divorced parents feel more secure in beginning their lifelong commitment to their spouse?  I believe there are a few key factors in feeling safe and sure that you want to make this commitment to the man or woman in your life:

1  Have realistic expectations of what it takes to make a marriage work- I hate to say it, but there is no happily ever after. Life will throw the two of you challenges that you will need to work through together. Fights will occur, feelings will get hurt, and difficult decisions will need to be made. Accepting that can help you to feel better prepared when the inevitable ups and downs affect your new family.  They can also help you and your spouse to grow closer in the hard times instead of growing apart.

2  Learn how to communicate before you get married- I have heard many stories of people getting married despite feelings of apprehension because they assumed everything would get better if they were married.  It would be the solution, but in reality, it just compounds the problems because they still need to be worked out and now there is a life long commitment in place. That increases the intensity, in turn, making it even more difficult to communicate with one another. Counseling is a wonderful way to learn strategies to communicate, but it needs to begin with a foundation of openness and honesty.

3  Discuss the BIG issues before walking down the aisle- Money, kids, religion, and expectations of marriage are all things that should be discussed before you get married. People often step into marriage thinking their life together will be one way while their spouse is hoping for a totally different lifestyle. Counseling can also help sort through these major life areas together.

This is not so serve as a warning sheet! I don’t mean to make marriage sound impossible or like a full-time job you hate! I am simply hoping to set out the reality of what it will take when you commit your life to another person.  If you can learn to communicate well, be flexible, and focus on the positive, you stand a wonderful shot at making your marriage healthy and rewarding. This is easier for some people, but with the right attitude and support for one another, a long marriage can be life’s ultimate reward!

High School Survival Guide

It wasn’t so long ago that I was in high school (even though I did have my 10 year reunion!) and I hear from my young clients that it is still a difficult time both personally and socially.

They are supposed to be “the best years of your life”, but I have never found a person who believes this to be so.  How we look, what we say, and how we perform in school and sports never seems to be scrutinized to the same degree as it is in those 4 years.

So, the question remains: Can anyone get out of high school with his or her self-esteem fully intact? I believe it is possible, but there are many things that need to be kept in perspective along the way:

1  Your “popularity” does not determine how successful you will be, or how attractive you are.  The criteria for being popular in high school often doesn’t fit what makes us appealing in the adult world, and it does not define your place in the world. You are an individual who has numerous gifts and skills that don’t always show in adolescence.

2  Making a mistake will not determine your future. While getting in trouble, or getting an F is never a positive experience, be careful to avoid viewing it as a catastrophe.  Fear of never recovering can be a slippery slope, and learning from a mistake or two (or three) is the correct step after a blunder. Take the positive lesson from each experience, set goals, and keep moving forward!

There is a much bigger world out there for you! Although our world can feel like it is ending when we fail a test or our best friend stabs us in the back, you have your whole life ahead of you.  There are thousands of people and experiences waiting for you after high school, and the negative events can’t scare you from opening up once you pass the threshold into the real world!

Become A Better Version of Yourself

Perhaps it’s because I am a therapist who specializes in anxiety, BUT I find that many people are overwhelmed nowadays in our culture.

All of the choices, information and expectations that we face can take its toll on our ability to stay calm and collected throughout the day, even once we arrive home.

What most people don’t realize is how the stress we feel from this barrage of information and responsibilities can spread into how we communicate and feel emotions.

Have you ever snapped at a family member or friend when they have done absolutely nothing wrong, all because you are having a bad day or feel overwhelmed? And then continued to defend yourself or justify your behavior once that person gets upset?

Or perhaps you have felt slighted by someone so you lash back to get revenge, or to make a point? You are sure to give them a piece of your mind, and as a result, you take part in the escalation of conflict? I would be lying if I didn’t say I have done both of these things!

The right course of action to take would be to apologize in the moment, own that you were wrong, and adjust your behavior accordingly.

Unfortunately, that’s not how this situation usually goes. The stress and anxiety we experience in this scenario can make us feel justified in our actions, and assist us in further putting up a wall so we don’t have to admit our guilt.

Here are some suggestions to improve:

The first step to help us own our actions is to identify when we are doing something hurtful, rude or inconsiderate. 

This is probably the most difficult part of the “ownership” process because we have to admit we were wrong.  It doesn’t sound like that big of a deal, but for most people, it is. It does not make you weak or bad to admit you made a mistake. Quite the contrary, it is brave and will make those around you feel more safe to express their own feelings and faults.

Once you are able to see the opportunities in which you may better your communication, you can begin catching yourself in the moment.

Perhaps it is a look on someone’s face who is receiving the aggression, or a specific tone, word or phrase you use that seems to weave throughout these less positive methods of communication.

Admit to yourself it is happening, and take a time out to reassess how you would like to respond instead of just automatically reacting how you have in the past. 

To take ownership at this point might sound like, “I had a very stressful day. I know that I tend to take it out on others, and don’t want you to be on the receiving end. That wouldn’t be fair to you. I think I just need a few minutes to calm down and then we can talk.”

This is about stopping BEFORE things escalate, which is very difficult. Be open to other’s suggestions or input to further your insight, instead of getting defensive.

By continuously catching yourself, and making improvements in taking ownership of your behavior, it should alleviate the stress in the home or relationship that existed before.

Apologies become less frequent, and those hurtful words that can often stay with us won’t continue to pile up.

Success in this area should also reduce overall stress levels that rise as a result of conflict, defensiveness, and denial.

Admitting we don’t do everything right and owning our flaws shows humility and strength all at once, and nurtures openness and security in relationships. Try it out!

Life Lessons

Life is a winding road that sets out many types of challenges for us. How can we make it through the tougher times without our relationships and well-being falling apart?

Every one of us has our “issues”. Whether it is relationship problems, past traumatic experiences, difficult family dynamics, or career/money concerns, our mood and emotional well being is affected by these dilemmas.  How can we make it through these more difficult phases with our relationships, dreams, and emotional stability intact? There are a few things I believe are important to remember when you feel you have been blindsided by a problem or bad luck:

1. You have made it through difficult times before- I know when we are feeling “stuck”, we can’t see how we have managed to pull ourselves out in the past, but look to your experiences as a way to grow and learn for future plights.  This is not the first, nor will it be the last time you are struggling. You have gotten through it before. Know that you will come out this time as well.
2. Keep your thoughts and feelings in control by expressing them- Whether this be journaling, talking to friends and family, or seeking professional assistance from a counselor, don’t feel you have to do this all on your own.  By unleashing your feelings and thoughts from inside, you can take their intensity down a few notches and sort them so they do not feel as overwhelming.
3. Don’t dwell on mistakes you have made that have put you here- Learn from your past mistakes and move forward!  Negative self-talk and dwelling on your faults will keep you in the “stuck” place.  Make realistic goals for yourself and knock them out one by one.
4. You are worthy of being in a happier state- No one is perfect, and not one of us has lived without making (huge!) mistakes.  You are an individual, and you are on your own journey through life. What has happened to you, and what you have done in the past can be healed and learned from.  You have something to offer that no one else is this world does, and dwelling on the negative will not help you figure that out any faster.