To the mama who is having a hard time, listen close. You ready?

You might feel alone when you are in these exhausting new days of motherhood, which challenge your capacity for everything. You might feel very alone if you are experiencing a flat, depressed mood for weeks, anxious thoughts that keep you from getting that tiny touch of sleep available, and/or that naggy voice telling you that you are doing a bad job, that your baby doesn't like you, that you aren't cut out for this after all.

And you might feel real real alone if you are keeping those experiences to yourself. Because isolation is the breeding ground for unchecked critical self-talk and shame. And of course loneliness.

But YOU ARE NOT ALONE. You are connected to every single woman who came before you and walks beside you in this world. Your maternal experience – the wonderful and the challenging – is shared across humanity. And your suffering -that ache that feels attached to you and only you - is shared as well. Maternal mental health disorders are thought to touch 15-20% of pregnant/postpartum women, and that of course only includes those willing to share their experiences.

And there are people who want to connect with you, to support you through this time.

But if I was just stronger, smarter, . . . If I was just more capable, adaptable. . .If I had a better attitude, diet. . .If I hadn't made this or that decision . . . If I was a different person I wouldn't be having these problems in the first place.

Hold on mama, cause YOU ARE NOT TO BLAME. Your hormones and brain chemistry are on the wildest ride of their lives. Sleep deprivation is considered a form of torture and you've been enduring it for a while now. You may have been raised with the belief that asking for help is weak, or encountered life circumstances that led you to rely solely on yourself. Perhaps you have a partner who doesn't yet know how to be of support. Oh, and you have just carried and delivered a human baby into this world, forever changing life as you knew it.

You're having a hard time not because of who you are, but because of an enormous, intense and complicated constellation of factors. It is so completely not your fault.

But what if I feel this way forever?

You won't. Anxiety is so uncomfortable that 30 seconds seems long. Depression has a heavy quality that gives the perception that time is moving slowly. Worrying about the livelihood of your child for a second feels like a second too long. But it's gonna pass, mama, it will. You gotta tend to you, because WITH HELP YOU WILL BE WELL. The first step is let someone know what's happening for you. Then the options are vast – support groups, therapy, medication, education, accessing your current and building new resources . . . 

You've been doing some heavy lifting. It's time to rest up and let others help hold you. You matter so much sweet mama, even on your darkest days.

"You are not alone. You are not to blame With help you will be well." is the key message shared with women and men around the globe by Postpartum Support International ~ www.postpartum.net. 1.800.944.4773

I recently returned to acupuncture after an accidental eight month hiatus and was instantly enveloped by its healing powers. Before falling into the zone of the treatment which can be best described as a deep and juicy nap, my mind started wandering to what it is, specifically, that I find helpful about this treatment modality (aside from the fact that my recurrent bronchitis never reoccurred after I started receiving it a few years ago). 

You see, I've recommended acupuncture to many and a lot of the time people try it and love it. But understandably there are still people who are reticent to try something so different than their usual healthcare. Because the energetic ins and outs of this component of traditional Chinese Medicine (TCM) are someone else's field of expertise, I wanted to offer up three aspects of the work that  I find deeply therapeutic, both as consumer and as a therapist :

1. You can talk to your acupuncturist about your symptom(s) without anticipating judgment. Let's face it: We don't address half the things we don't address because we are scared that our issues are too big, too complicated, or too shameful to say aloud (sometimes they are too something even to let into our awareness). But much like with psychotherapy, there is not much you can tell acupuncturists that they haven't heard before. Their education exposes them to every system of the body and their extensive hours of training allow them to witness what it is like for people to experience various issues. So whereas you may not always feel comfortable telling your friends or partner about some itchy aspect of your life, the regularity of your bowel movements, or even how often you feel weepy or anxious, your acupuncturist is ready to receive such information with an openness and readiness to alleviate your discomfort.

2. Each treatment session induces a state of sustained relaxation. Here's the world's quickest physiology lesson. Two main components of your autonomic (involuntary) nervous system are the sympathetic and the parasympathetic systems. The former is in charge of the “fight or flight” response, which is triggered by the perception of danger. Think increased heart rate, adrenaline rush, tensed muscles, and anything else that would help you gear up to fight for your life.

The latter is the ruler of the “rest and digest” response, which involves the slowing down of your heart rate, the relaxing of muscles, and other physical indications that you are safe, that you can let go. With our fast-paced world and big fat brains we spend a lot of time in the “fight or flight” zone even when we are not in actual danger (just imagining past dangers or anticipating new ones gets us going). 

Anything you can do to lure your parasympathetic system into action is a gift that keeps on giving (seriously, once you feel a truly relaxed state you will be very aware of what you've been missing) and easing into an acupuncture session, where you will be reclining in a comfortable position in a warm room for at least 45 minutes...well, I'm getting relaxed just thinking about it.

3.You can expect to be treated as a whole person, not just a walking symptom. I don't know about you, but when I go to the doctor, I am often surprised by how quick they are to offer a prescription without asking a lot of questions. Furthermore, the side effects of said prescription (which we all know tend to take up half the air time in commercials) first come to your attention in 16 font print at the pharmacy. Not so with acupuncture. When you engage with treatment they take a good history, and while your life context may not be the subject of conversation at your follow up visits, you know that they are keeping your story in mind (another commonality with many forms of psychotherapy).

You can also describe your mental and physical experiences in whatever terms make sense to you. Maybe you feel “ungrounded” or “meh” or you stomach doesn't hurt, but feels “hot.” There's room to describe your experiences without trying to wedge them into a limited check box and you will be met with curiosity and, again, the readiness to treat. The side effects? Well, let's just say your are more likely to need an extra five minutes to wake up before you drive home than you are to have temporary hair loss, incontinence, or trouble breathing.

So if fear of the unknown has kept you from this particular healing system, consider whether any of the above considerations could be of services to your health.  Don't your mind and body deserve it?

PS: One more thing to put your mind at ease: Acupuncture is very affordable. Many practitioners now take insurance and there are tons of community clinics popping up all over the country. Check out some local suggestions here!

A good night's sleep is one of the best avenues to improve overall health: Quality sleep leads to clear thinking (and less accidents!), weight management, better mood, and - important from the psychological perspective - the  ability to process information, thoughts, and experiences.  

It's not hard to see how those direct health benefits could then positively affect self-esteem and relationships as well.

While the sleep research is straight forward, the experience of having difficulty sleeping on an ongoing basis is even more clear: IT. FEELS. AWFUL. It is simply harder to go about your day when you are sleep deprived. A friend who's in the field of 0-5 mental health, working largely with new moms recently pointed out, "Sleep deprivation is a form of torture." Well said. 

As a recovering insomniac myself and a person who has helped numerous people find better relationships with sleep, I feel confident about the ability to change patterns - even those that have been with you for a while. Below is a recipe with items that you can truly mix and match to increase your chance of accessing quality sleep and reaping its benefits.

Ingredients:

1. Exercise (even lightly).
2. Acupuncture or acupressure
3. Decision to cut out or reduce caffeine intake (this may include coffee, chocolate, energy drinks, and caffeinated teas), especially in the later portion of the day. 
4. Herbal teas, such as chamomile, peppermint, valerian, and kava. There are plenty of common "sleepy time" mixes in grocery and health food stores.
5. Activities that stimulate your relaxation response, such as reading, meditating, stretching, putting your legs up the wall (or other restorative yoga exercises), or progressive muscle relaxation.
6. A hot bath with or without aromatherapy oils or salts*
7. A totally darkened room (if this is not possible, try a sleep mask)*
8. Sufficient warmth, especially for your feet*
9. A comfy relaxing space other than your bed
10. Journal

Recipe

During the day: Incorporate exercise into your daily routine or at least a few times per week. Add acupuncture or acupressure once a week specifically targeting this symptom (I'm a fan of Circle Community Acupuncture, but there are tons of others as well). Experiment with reducing or eliminating caffeine, as it's a stimulant. Alcohol and other drug use can impact sleep as well.

In the evening: Drink a calming tea a couple hours before you are wanting to go to bed (not too close to bed time, because waking up to pee isn't exactly relaxing). Instead of watching tv or being online, both activities that expose you to flashing lights and other stimulating material, incorporate a calming activity, one that sends the message to your body that it is okay to relax. Draw yourself a hot bath and soak for as long as it's comfortable.

At bed time: Make sure your sleeping space is free of clutter and light. Your brain needs darkness to really get the message that it's time for sleeping. Make sure that you are warm enough, adding blankets if necessary. 

Troubleshooting: If thoughts come up, tell yourself you can think them tomorrow. Write them down in your journal if you'd like. Try a progressive muscle relaxation recording or do it yourself by mentally scanning your body, slowly, from your toes to the crown of your head, scrunching your respective muscle groups then relaxing them and thinking "relax." If none of this draws you into sleep, go to another area away from your bed for a while. You don't want to associate your bed with a losing battle. 

As you experiment with different ingredients track your sleep patterns in your journal to see what is and is not working for you. 

If sleep continues to be an struggle, especially one involving repetitive thoughts, it might be time to start counseling to address the rumination and worries. Remember, just because you have "gotten used to" getting by with minimal sleep does not mean it's helping you function as your best self!  


* These items directly stimulate the parasympathetic nervous system (your body's relaxation machine) to kick in.

I'm excited to announce that I am expanding my practice hours and accepting new clients. I have a new office in the Bay Natural Medicine suite at 919 Irving Street (between 10th and 11th Avenues)! It is  a small, light-filled, serene space with the healing energy of massage, acupuncture, and naturopathic medicine flowing through. 

If you or someone you know have been struggling with difficult emotions, life experiences, and relationships...if you feel stuck, anxious, sad, or unbalanced more often than you would like to...if you struggle with critical or negative thoughts that are so familiar they feel normal, therapy can help. But here's the thing: The only way to start is to start. Making that initial phone call or email contact can be hard, but taking that first step does two things: One, it brings you closer to addressing your needs. Two, it sends the message that your needs deserve to be met in the first place. This is huge.

I continue to be inspired by those who allow me to be part of their exploration, even when it gets difficult, and who are willing to try on different thoughts, beliefs, and tools. 

Speaking of which, thanks for your feedback on the various Wellness Tools and other blogs posts I've been writing. I find that observations and insights are most meaningful when put to use, and it's a real joy when people describe the ways they've been applying them to their lives and sharing them with others (post on paying things forward, coming soon). 

Please let me know if there are any subjects you are particularly interested in, questions about anything you've read, or suggestions for how to make whole person health resources more accessible (comment below or shoot me an email). 

Yours in wellness, self-care, and compassion, 

Shana Averbach, LMFT

919 Irving Street, Suite 104
San Francisco, CA 94122
Tel/Fax 415.963.3546

www.shanaaverbach.com


PS I can't help but sneak in a link to my most recent favorite online yoga video that aligns nicely with the subject of moving and expanding. It's very gentle, good for the end of the day...

What if I sat beside you whispering in your ear all my negative perceptions of you—every disappointing or regrettable situation from birth to the present, every loss or failure, and every judgment of your body and character? And when those distant voices of positivity, reframe, balance, and perspective came along trying to tell you something different I puffed my chest, got in their faces, and scared them into hiding? Wouldn't you think that was outlandishly mean and totally unacceptable?

Depression doesn't consider your life experiences, your history of loss or trauma, or your complicated brain chemistry, but simply calls you weak, self-centered, and beyond help. It also tells you that the only thing you can do with yourself is sit, lie, and stay, and last I checked you are a capable human being, not a dog. It tells you such things because it is brutal, narrow-minded, and dishonest. And you my friend are deserving of a well-balanced truth.

I know it feels like you cannot do anything. You feel like you're walking through mud. You are winded by a trip to the fridge. Your body hurts. But please don't listen to Depression's erroneous opinion that sitting still is the only answer. Consider that doing something is better than doing nothing. Go outside for a walk, even if it's only for three minutes. Listen to some new music or something you liked on a brighter day. Call a friend. Make the decision to seek help. 

Sometimes we try sitting still to conserve the minimal energy we have, when we can create new energy by exposing ourselves to novel stimuli. This may be counterintuitive, but at least it's honest.

Remember that if you have been doing nothing for a long time, doing something is going to feel different. Different may feel weird, at best, and scary-as-hell at worst. But don't let Depression trick you into thinking that different is wrong. (And don't you dare let it tell you that “something” could be lifting the remote, fork, cigarette, or something else that may have negative consequences. You know better.)

Be aware that if you opt for the phone-a-friend option, Depression might tell you that being alone is the best thing to do. It might tell you that your energy is toxic, that you are burdensome or overwhelming. To this I ask you to consider that the act of isolating a person from his or her community of support is characteristic of an abusive relationship.

You can choose to not succumb to this abusive tendency. I invite you to think of a time that you were there for someone else in a time of need. Did their suffering knock you over or were you able to stay grounded and have compassion for that friend? Perhaps you even found meaning in being of support? It is no different with you on the other side. This is what our friends and family are for. If you can't identify a person to reach out to in this moment, don't let Depression tell you that it is because you aren't worthy. Or that you are truly alone. Add it to your list of things to cultivate in your life. In the mean time, call a support line or a professional instead.

You of course are free to make your own decisions, but there is just one more thing I want you to consider. Just because the voice of Depression is loud, does not mean it is right.

Remember that the voices of positivity, reframe, balance, and perspective are not gone, but are simply hiding. You can take the steps, however small, to find a safe space for them to emerge.