What Can I Do to Help? 5 Things You Can Do for Someone With Cancer

I was quoted regarding how to help and offer support to a loved one with a cancer diagnosis.

2 0 1 2Aug13

What Can I Do to Help? 5 Things You Can Do for Someone With Cancer

Posted by Staff

When it comes to a loved one being diagnosed with cancer, it can be hard to know the right things to do for them. Everyone has different preferences and ways of dealing with hard times, but there is always something you can do! Here are the best tips and pieces of advice from those who should know best!

1. Send letters, care packages or gift cards that offer a little extra support and help.

My coworkers went together and got me a very generous Visa Giftcard that we could use anywhere to help offset some of our gas, medication and other miscellaneous costs. This was incredibly nice and generous of them and really came in handy at a time when we needed some relief. -- Laura Ybarra, currently undergoing chemo for Hodgkin’s Lymphoma.

Choose gifts that are personal and useful that they will appreciate. My favorites are an e-reader that can be downloaded with books by that person's favorite author or an iPod shuffle that can be loaded with their favorite music. These are great welcome distractions during the long hours of chemo or waiting in a doctor's office. -- Lisa Lurie, cancer survivor and co-founder of Cancer Be Glammed.

Visits may be too much for someone who is severely ill or weak from treatment. If that's the case, get some greeting cards and mail one each day to the patient. Yes, snail mail -- it brightens someone's spirits to know they're thought of. Include jokes, affirmations, inspirational sayings and cartoons. -- Tina Tessina, psychotherapist and author.

2. Think of the other family members and caregivers. They need support, too!

If the person has children, schedule a few outings or daytrips with them. The parent can rest and recover at home, knowing that the kids are safe and having fun. -- Stacey Vitiello, breast cancer physician and radiologist.

Reach out to the spouse, parent or significant other to ask them what you can do to help. They will know best. Offer to bring a meal, do grocery shopping or any other errand with which they may need assistance. -- Helen Szablya, Peritoneal Carcinomatosis survivor.

If you’re not the main caretaker, ask that person how they’re doing. Offer them support. Give them a break. Bring over a dvd movie, a piece of fruit, some cookies—something for the caretaker alone, or that they can share. Give the caretaker has a few hours of “me time” while you stay with the patient. -- Claudia Mulcahy, breast cancer surivivor.

3. Keep things as normal as possible by being yourself and doing activities together!

I needed to live everyday as though my cancer was not there. Even if it is just doing one activity that the person loves and can handle. Let them decide to a degree to what they can handle as well.-- Laura Ann Tull, breast cancer survivor.

Be yourself and be present. Don’t shy away and disappear and don’t try to be another person. They want the person you were BEFORE the cancer diagnosis. -- Susan Bratton, Chief Executive Officer of Meals To Heal.

Encourage them to get out of their home. Come over and take a walk with them, drive them around the block or simply sit outside with them. -- Nerina Garcia-Arcement, Ph.D Licensed Clinical Psychologist.

4. Ask, don’t assume.

Instead of assuming what they need, simply ask. Many friends and family of patients think that they should already know what they need, and what they should be doing for them. They will appreciate your straightforwardness. -- Molly Tyler, Director of e+CancerHome.

Ask if the patient wants to get phone calls, and then call within the acceptable hours to give news, or to listen, but don't make the patient do the talking unless he or she wants to. -- Tina Tessina, psychotherapist and author.

5. Suggest support programs and websites.

Encourage the cancer patient or their support team to create a website so they can post the progress and not receive a million calls each day. -- Helen Szablya, Peritoneal Carcinomatosis survivor.

When someone is going through treatment for an illness, it’s hard for them to answer the phone and stay in touch with all the people who want to talk to them. Caring Bridge is a great service that they can use to keep everyone informed about how they are and in addition people can send them good wishes. -- Lisa Lurie, cancer survivor, co-founder of Cancer Be Glammed.

Encourage your friend or family member to join a cancer support group, this form of social support can extend their life. -- Nina Garcia-Arcement, Ph.D. Licensed Psychologist.

Link to article

Naming the Shame that Can Cripple

I was quoted on the causes of shame, how to cope and treatment options. By Marcia G. Yerman

When Amy Ferris asked me to contribute an essay to Dancing at the Shame Prom: Sharing the Stories That Kept Us Small, I wasn't sure that I had any shame. Then, when I thought about it, I realized that I did. I just hadn't framed it that way. I agreed to participate. After I handed in my essay, I heard back from co-editor Hollye Dexter. "I think you are holding back," she said. "Can you go a little deeper?" So I did. Along with twenty-six other women, I wrote openly about issues that had impacted my life.

Now that the book is out, I have taken off my memoirist hat and am writing as health journalist. Reading the stories that encompassed familial alcoholism, sexual abuse, parental suicide, distorted body images, hoarding, alienation, and racial identity anxiety - I wanted to get to the psychological root of how shame shapes who we are and how we live our lives.

I interviewed four practitioners who shared insights that were both clinical and revelatory. We focused on how shame specifically impacts girls and women. Many of their observations and verbiage overlapped. To a person, they all began the conversation by drawing a distinction between shame and guilt.

Shame is a feeling or belief that screams, "I am bad." Guilt is evidenced as, "I did something bad." Shame is feeling worthless. Guilt is external; you can fix it. Specifically, shame is, "I am damaged."

Amber Lewter, EdS., LAPC, whose background includes working as a survivor advocate at a rape crisis center, told me, "When women define themselves as being bad, it creates low self-esteem and a poor sense of self-worth." Treating those who have experienced childhood sexual trauma, Lewter sees women coming in for counseling with a lot of "shoulds" ("I should have told someone.").

She conducts an exploration of shame through expanding awareness of external factors, pointing out that what happened "was beyond the control" of the patient. She believes that shame is more of an issue for women because they are "relationship-centric" and therefore bring childhood shame and a "less than" mindset into their adult relationships.

Ph.D. and Licensed Clinical Psychologist, Nerina Garcia-Arcement, qualifies shame as "an insidious emotion, often at the root of mental health problems like depression and anxiety." She sees shame as creating "a sense of isolation which poisons an individual's self-esteem."

She told me, "My patients feel silenced due to their shame. Often, they can't even speak out loud what they feel ashamed about." Garcia-Arcement defines shame as a reflection of a "core value." Therefore, what results is a need to cover up what we feel ashamed about.

She related, "The power of shame is that it silences us and creates internal negative dialogue, such as, 'I wasn't good enough. I deserved it.' So we want to stay invisible. We don't want to feel vulnerable. This stunts our ability to grow." Garcia-Arcement explained how the fallout of shame translates into a "fear of takings risks."

"A silent killer," is how Lori Freson, Licensed Marriage and Family Therapist, describes shame. Her practice specializes in women's issues and self-esteem.

"Women don't always acknowledge shame as a presenting problem," she said. "Women can have body image problems and not realize it is shame."

She spelled out, "Shame about our bodies can lead to isolation, depression, and eating disorders." Shame about sexual abuse can lead to "avoidance of intimacy, relationships, sexual problems, and self-harm." Shame about an addiction "can delay or sabotage" efforts to recover.

Finally, she added the key observation, "Shame is connected to self-perception and how you think people perceive you."

Founder of the Critical Therapy Center, Silvia M. Dutchevici, spoke at length about how our culture "plays into our perceptions." Her philosophy embraces a holistic approach. "Psychology is not in a vacuum," she emphasized. She referenced the issue of race, class, gender, ideology, and economic status. Her point of view is that "society has issues as well," forcing people to "adapt to a false criteria rather than challenging that criteria."

Dutchevici was crystal clear in her assessment. "For women in particular, depending on the trauma, feelings of shame may arise from our culture's imposition of gender roles and the way women have been socially conditioned regarding their view of themselves. The more a society demands perfectionism," Dutchevici continued, "the more we have shame."

Both Freson and Garcia-Arcement addressed this element as well.

"A lot of shame comes from external societal factors," Freson said. "People want to be accepted. People are afraid of being different. Shame among women and girls is more prevalent because of cultural standards."

Freson pointed to celebrity media and fashion magazines. "People shut shame down because they want to have the perfect image." Her message about shame to young girls is, "You don't have to be perfect. Be your best self."

"The core expectation for women," said Garcia-Arcement, "is that we can do it all. Be beautiful and be everything to everybody." When girls and women buy into cultural norms they "learn to hate their bodies and themselves." It all comes back to not being "good enough." Garcia-Arcement illustrated shame from the ground level of family dynamics, up and outward toward group identification.

"Our family is a reflection of who we are," she said. "So if there is a family behavior [alcoholism, suicide, sexual abuse, domestic violence], it's still a part of us." Treatment by Garcia-Arcement entails the challenges faced by people of color. She identified that if a person from a minority community does something that the rest of the group is not proud of - it is seen as a "personal reflection on who they are."

In tandem, Dutchevici - a political refugee from Romania - touched on the use of shame as a tool of control in promoting a specific ideology. Shame also operates by keeping group memberships and affiliations intact.

So what can be done? All four women I spoke with communicated the need to explore an individual's experience through expanding consciousness.

Lewter articulated about introducing an awareness of "external factors." Freson, who maintains that if "shame is not exposed and dealt with it can destroy your relationships and your life," believes the more exposure the topic gets the more taboos are broken down.

Applauding the premise of the book, Freson sees it functioning as a tool for dialogue while enabling readers to discover, "Oh. It's not just me. I'm not the only one."

Dutchevici agreed. "The more people come out and talk about shame, the less power it has." She reiterated that it was important to "name the emotion."

"The first step is to realize that you are not alone," Garcia-Arcement reiterated. She uses a combination of talk therapy, cognitive behavior therapy, and insight-oriented work. She suggested mindfulness exercises, trying to connect the mind and body, sitting with your feelings, and being in the moment. Garcia-Arcement stressed the power of stories, advising the importance of sharing one's story.

"Empathy is essential to healing. If you can't say it out loud yet, write it down. Excise it from yourself. Writing is a useful tool, as there is no witness to the shame." An important element of eventually sharing the narrative is that it helps individuals "normalize their experience," through a realization that they are not alone and not to blame.

(The Shame Prom has a Tumblr blog where anyone can post a shame narrative, either with her name or anonymously).

Garcia-Arcement said definitively, "Everyone has shame. We just don't want to look at it."

In her essay, Elizabeth Geitz wrote, "I've learned letting go of shame is one of the most freeing things I've ever done. I've learned that I don't have to dance at the Shame Prom forever. The dress, the shoes, the long-wilted corsage are now gone.

"The music has finally stopped."

Link to article

Maternal Depression Can Impact Children's Health

Maternal depression is a topic that is difficult to discuss out loud. Mothers often feel shame as they struggle to cope with the demands of motherhood.  In this article I am quoted on the impact depression has on mothers and their children. I share helpful coping strategies and treatment options.

By Rheyanne Weaver HERWriter September 20, 2012 - 7:25am

Maternal depression is not only an ongoing struggle for mothers, but research suggests children of depressed mothers can be impacted in multiple ways.

For example, a recent study published in the Journal of Affective Disorders noted that mothers who are depressed have a reduced responsiveness toward infant distress, which can lead to harmful effects on the child.

However, the small pilot study stated that women who received cognitive behavioral therapy treatment had a reduction in their depression and as a result, were also more responsive toward infant distress.

Another study published in the journal Pediatrics found that children ages 4 and 5 were more likely to be short for their age if their mothers were depressed starting around nine months after the child was born.

An article about the study on Medpage Today stated that children of depressed mothers could have an “increased stress response,” which could lead to higher cortisol levels and lower levels of growth hormones. This could lead to a shorter height.

Mothers with depression might practice “poor parenting behaviors and feeding practices” as well, and children might form an insecure attachment with depressed mothers.

The article added that stunted growth at a young age is associated with various negative outcomes, such as poor development, reduced scholastic performance, smaller body size as an adult, and higher levels of death.

Nerina Garcia-Arcement, a licensed clinical psychologist, said in an email that there are many negative health outcomes for children of depressed mothers. For example, children of depressed mothers tend to visit the emergency room more often, and they might even develop depression in their teens.

“A depressed mother often is less responsive to their child's needs (i.e., when distressed, hungry) and does not have the emotional and physical energy to play and cuddle with their child,” Garcia-Arcement said.

“This can be disruptive to forming a secure and healthy emotional bond with each other. When a child does not feel safe and secure they can go on to become isolated, have difficulties making friends and develop anxiety and depression.”

Mothers suffering from depression need to make treatment a priority for their own health as well as their children’s.

“A parent is modeling for a child how to cope with challenges,” Garcia-Arcement said.

“The best example a mother could set for her child is that when you don't feel well, you don't ignore it. Instead you prioritize your well-being and you seek out help. Things they can do includes speaking to a mental health professional, reaching out to friends and family for social support, attending mom groups in person or participating online.”

She suggested that mothers make a point of getting out of the house every day for 15 minutes minimum. It is best to exercise, but mothers can even take their children for a walk or saunter in the neighborhood or at the mall with their babies in a stroller.

“Mothers should ask for child care assistance from their partner, family or friends in order to have time to do things alone,” Garcia-Arcement said.

“Moms need time [to] rest and catch up on sleep (sleep deprivation makes depression worse). They must do something kind for themselves, such as taking a hot bath, reading a book, getting a massage, engaging in a neglected hobby, and watching a comedy that will make them laugh. Reach out and meet up with a supportive friend.”

She also suggested spending bonding time with children for at least 10 minutes a day, which can lead to a greater connection, and children can also feel more safe and secure.

Ramani Durvasula, a psychology professor at California State University, said in an email that since mothers tend to be primary caregivers, children can suffer in many aspects of life if their mothers are depressed.

For example, children might not receive the nutrition they need and might have reduced sleep. They could also develop anxiety, depression and social withdrawal.

Mothers need to eat healthy, sleep and exercise consistently. Especially for women who have a history of depression, it’s important to make a plan for increased support once the baby comes.

“Many mothers try to be superwoman/supermom - and maternal depression is not part of that plan,” Durvasula said.

“Lots of times people write it off to fatigue and stress, and untreated depression can get worse and worse. Depression is a treatable disorder, and when there are children involved it is critical that it be managed to ensure the health of mother and children.”

Link to article

Organizing Your Life

I was recently on the Colin Lively Show, discussing how to declutter your mind.  The entire show was filled with helpful tips on how to better organize your home, office and mind. The description for the show is below:

Oh lord, if this show wasn’t sent from on-high, than it was Hildamae’s dying wish coming true: get Colin to clean his room! So, there it is, the cat is out of my Birkin bag: I can be rather messy. But aren’t we all? Whether it be in mind, life, schedule, desk, purse, closet, or your inbox, somewhere you are a little messy; and a little messy can lead to a great deal of stress. It is, as Dawn Falcone put it, “stuck energy.” For me, Consuelo un-sticks my stuck energy four times a week, but that doesn’t cover all my bases: I still need to go to Dr. Feldheim, my therapist, and Dr. Koplowitz, my psychiatrist, to get my mind in order.

I was stunned to learn that our outer world is very much a reflection of our inner world. For instance, a messy desk can be a sign of a stressful work environment or chronic work overload. It is important to create systems that keep our lives orderly and neat. We do not need to be neat freaks, but organization is one of the keys to happiness. Growing up, we polished the silver under the iron fist of Hildamae, she said the harder we scrubbed the more we would feel her love. Boy was she right! Three hours of polishing spoons made my wrist feel so loved that they were practically stuck in an arthritic state until my mid-40s. “Sheets tight enough on which to bounce a quarter,” she would demand. By the time I went to college, I had had enough Old Dutch Cleanser, Clorox and Bon-Ami running through my blood that I vowed never to clean again. And I have not touched a mop since!

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

Dawn Falcone is not only passionate about organization, she knows it has a HUGE impact on personal sanity, success, and overall stress level. She emphasizes the point that reducing clutter and chaos will ultimately bring reward in the form of clarity, serenity, and time. She works closely with her clients to design spaces that reflect their personality and spirit. Dawn is a proud member of the (National Association of Professional Organizers) and is a certified interior environmental coach. Her work has appeared in many publications including: Real Simple, Woman’s World, Home And Garden Television, and Apartment Therapy.

Bonnie Joy Dewkett is the founder of The Joyful Organizer and is an organizing expert, author, motivational speaker, and radio personality – oh and she is an expert in time management! Boy oh boy does she know how to block-out a day!

Andrea Brundage of Simple Organized Solutions (S.O.S.) offers personalized hands-on organizational solutions to help small-to-medium sized business owners and homeowners function in efficient and organized environments. In partnership with its clients, S.O.S. creates “sensible solutions for your organizational needs.”

Dr. Nerina Garcia-Arcement is a licensed Clinical Psychologist and a Clinical Assistant Professor, in the Dept. of Psychiatry, at NYU School of Medicine. She specializes in challenges associated with life transitions, stress, anxiety, and depression.She provides a holistic therapeutic session by using a combination of Cognitive Behavioral Therapy and insight oriented/psychodynamic techniques to identify current problems, develop individualized strategies to ease stress, and gain insight into understanding one’s patterns in behavior. Dr. Garcia strongly advocates the act of self exploration, which helps us understand the way we think and act, it will also help shed light on our behaviors that worked in the past but are not effective any longer.

Link to podcast/show

Organizing Your Life

Mental Health Issues to Be Aware of in Your 20s

I was quoted in this article regarding typical mental health issues for people in their 20s. I discuss the impact of stressful transitions and how to cope. by Rheyanne Weaver |

People in their 20s seem to have it all: youth, energy, health, and looks. But they are also still figuring themselves out, and this time of change can bring certain mental health concerns as well. Experts have information on these issues that tend to impact people in their 20s, and provide some solutions for addressing and coping with these problems.

Clinical psychologist Dean Haddock, a marriage, family, and child counselor and the executive director and founder of Community Counseling and Psychological Services, points to a fairly common activity of 20-somethings that can lead to mental health issues if it’s not checked: alcohol and drug use.

“The first problem that leads to many others is alcohol and chemical abuse, which often leads to dependency,” Haddock said in an email. “The mental disorders that follow are often depression, anxiety, and brain injury. Of course, self-esteem and body-image problems often lead to eating disorders.”

Haddock gives three tips to help people in their 20s prevent and get through some common mental health concerns:

1. Know your genetic history of mental disorders. Knowing is half the battle to avoid those disorders in yourself.
2. Be choosey about your friends, as they will influence your decisions. Healthy friends lead to healthier decisions.
3. Self-esteem is often the result of the people who matter to you. If they do not esteem you, then you will not esteem yourself.

Nerina Garcia-Arcement, a clinical psychologist and clinical assistant professor at NYU School of Medicine, suggests that the many life changes people experience in their 20s can cause mental health issues at times.

“Your 20s are filled with life transitions that can be stressful,” Garcia-Arcement said. “This is a time when young adults are solidifying their personalities, developing their independence from family, starting or finishing college, beginning new jobs, developing a career, forming romantic relationships, and learning to manage their existing family relationships and friendships within these context.”

“Individuals in their 20s don’t have a lifetime of experience to draw on when managing multiple life transitions at once,” she added. “When someone experiences these transitions, anxiety and depressive disorders can occur.”

Here are six of Garcia-Arcement’s tips to help people in their 20s cope with mental health issues more common to that age group:

1. Seek out and form strong support networks.
2. Seek out others who are going through similar experiences and share your feelings, whether you are feeling worried, nervous, scared, sad, confused, or excited.
3. Know that you are not alone in your confusion about your career and relationships.
4. Seek out mentors who have achieved their goals, and ask for advice.
5. If you are feeling stress, sadness, or anxiety, engage in activities that will help you manage those feelings such as yoga, meditation, exercise, hobbies, social activities, relaxation exercises, and deep breathing.
6. If you feel you are not getting the necessary support and feel overwhelmed or depressed, seek out mental health professionals who can help you manage the feelings related to your life transitions.

Stephanie Sarkis, a licensed mental health counselor, said in an email that anxiety and depression are some of the main mental health issues 20-somethings face.

“We have seen an increase in these issues due to the lagging economy and difficulties finding employment,” Sarkis said. “Many people in their 20s have moved back in with their parents, which can trigger feelings of failure and frustration.”

Dr. Maiysha Clairborne, a family physician and wellness and stress management coach, added in an email that eating disorders associated with body dysmorphic disorder and body-image issues are also common for people in their 20s. She has three overall tips for people in this age group:

1. Talk to someone. The worst thing that a person can do when they are feeling depressed, anxious, or alone is to isolate more. Many times when we talk with someone we trust about what’s going on, we come to realize that we are not the only ones experiencing it and then we can get support.
2. Get active. Staying physically active not only helps to keep the body fit but also helps release endorphins and serotonin in the brain, which help keep the mood elevated. Physical activity is also a good release for stress and anxiety.
3. Minimize sugar and junk food. Sugar and processed junk foods can worsen the emotions of stress, anxiety, and depression because they cause erratic changes in your body’s blood sugars. This can disrupt the normal release of hormones in the brain that keep your moods stable.

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said there are many issues specific to people in their 20s, including problems associated with medication use.

“Many people were on stimulants/meds for their ADHD when they were younger, but they thought it was okay to stop their meds when they were done with school,” Carroll said. “Now they are struggling at work and don’t know why. I’ve also seen young adults stop all kinds of meds like their thyroid meds because they didn’t know why they were even on it, and then they have all kinds of problems.”

Bad habits involving drug and alcohol use can start to become a major substance abuse issue when people are in their 20s, and other mental health issues start coming to the forefront at this time in peoples’ lives. Examples include bipolar disorder and schizophrenia. Also, panic attacks can start for people who have a genetic predisposition and who have higher amounts of stress associated with newfound adulthood.

“The 20s are an important time of social/emotional development,” Carroll said. “Unlike previous generations, identity formation often takes the entire 20s due to the complexity of modern society. It could be said that adolescence lasts until the early 30s in today’s society due to [prolonged] periods of education (grad school, law school, med school, etc.), lack of stable job options, and delays in getting married and starting families.”

Carroll, who is also an assistant professor at the University of New Mexico School of Medicine, suggests that when it comes to serious relationships and marriage, people in their 20s should consider how their choices could eventually affect their mental health and how their brain plays a part in their decision.

“Many 20-somethings are tempted to get married, but it is generally a bad idea because the brain in not done developing until about 25 [years old] … which leaves young adults vulnerable to having their rational mind be overwhelmed by their feelings or stress,” Carroll said. “Relationship choices often dramatically change from the early 20s to the late 20s, so many people find that the person that was perfect at 22 is a disaster at 27.  This can be an incredibly hard transition, to have to break up with your former soul mate that you thought you’d love for life because you’ve changed so much over the last several years.”

Link to article

How to Quell the Fears of Childbirth

Anxiety can influence a woman's experience during labor. I was quoted in this article regarding how stress and worry can impact a woman's delivery and how to manage their anxiety. by Rheyanne Weaver |

It’s common to fear to some extent painful experiences we aren’t familiar with yet, such as childbirth for soon-to-be mothers. However, a new study found in BJOG: An International Journal of Obstetrics and Gynaecologysuggests that women who fear childbirth tend to actually be in labor for longer than women who aren’t fearful of giving birth.

A news release on www.ScienceDaily.com stated that 2,206 women were included in the study. These women were only giving birth to one child vaginally, and 7.5% of these women were determined to be fearful of childbirth at 32 weeks into their pregnancy. The report estimated that between 5% and 20% of pregnant women generally fear childbirth.

For women who feared childbirth, the average labor time was about 1 hour and 32 minutes longer than in women without as much fear. When other factors were considered, the women with fear of childbirth still took 47 minutes longer for labor than women without the same amount of fear. Women who feared childbirth were also more likely to need intervention during labor, such as instrumental vaginal delivery and emergency Caesarean section. However, most women who feared childbirth were still able to have a successful vaginal delivery.

The study added that there are different factors that cause women to fear childbirth, such as having a baby for the first time, being a young mother, having little social support, having a history of abuse, and suffering from psychological issues.  Other experts share their professional opinions on the causes of fear of childbirth and what women can do to decrease that fear.

Julie Hanks, a licensed clinical social worker, the owner and executive director of Wasatch Family Therapy, LLC, and a mother of four children, said in an email that she believes fear of childbirth is actually quite common in our society. “I think it is common for women to fear childbirth because it has become so medicalized in our society,” Hanks said. “Instead of viewing childbirth as a natural process that women’s bodies were created to do, it is viewed as a scary, painful, ‘out of control’ experience that needs medical intervention.”

She said that some women who have gone through specific painful experiences before might be more likely to have a fear of childbirth. “In my clinical practice I have seen a link between childhood sexual trauma and fear of childbirth,” Hanks said. “Since childbirth and sexual abuse involve the same organs, it is often emotionally tied together. Additionally, feelings of helplessness and of being controlled by a man may emerge during the childbirth process (often a male OB).”

General anxiety could also lead to fear of childbirth. “Certain mental illnesses, like anxiety disorders, may predispose certain women to anxiety about the childbirth process, especially with first-time moms,” she said.

The stories of other women who have had bad experiences with childbirth could also add to the fear for first-time moms. “Women may fear childbirth because of family stories surrounding their mother or sister’s childbirth experiences,” Hanks said. “Additionally, women tend to share their birth ‘horror stories’ more frequently than they share uncomplicated birth stories, playing into a cultural fear of childbirth. I think this can impact mental health in general.”

The whole concept of becoming a mother can bring up a lot of issues, not just childbirth itself. “Taking on the new role of becoming a mother is also emotionally loaded and may bring up a woman’s own fear of inadequacy and self-doubt about whether or not she will be able to provide the nurturing that this helpless baby requires,” Hanks said. “If a woman has emotional neglect, abuse, or other unresolved issues with her own mother, those ‘left over’ emotions may surface as a woman now faces becoming her mother.”

There are even more mental health issues that can be associated with pregnancy and childbirth. “Hormonal fluctuations may impact emotional health relating to childbirth,” Hanks said. “Also, family pressures, relatives coming into town to celebrate the birth of a new baby may add to the overall stress of childbirth experiences.”

If physical health is impacted, then mental health is also not far behind. “Eating disorders or distorted body image may play into mental health issues, anxiety, and obsessions around childbirth,” Hanks said. “The physical changes that often accompany pregnancy and childbirth are often frightening to women who have built their self-worth around their appearance.” Hanks shared her thoughts on helping women overcome any fear they may feel in relation to childbirth. She said, “I believe that a cultural shift in viewing childbirth as a normal, natural process that generally doesn’t require intervention would really help women embrace the process without fear. Also, sharing positive childbirth stories openly may help shift women’s views.”

Dr. Ingrid Rodia, an OB-GYN and associate professor of obstetrics and gynecology at Geffen School of Medicine at UCLA, said in an email that some women are more anxious in general, and others do have a higher risk in regard to childbirth, so these can both lead to issues with fear.  She added that the most common fears women have in relation to childbirth are pain, concerns about the baby coming out “normal,” and concerns about surviving childbirth. “Women might fear childbirth because they are already overwhelmed and wonder how they are going to deal with the additional demands,” Rodi said. “Women who did not plan the pregnancy, and especially those who did not want to be pregnant, are particularly at risk for anxiety and depression. Those women with a pre-existing mood or anxiety disorder are at increased risk of anxiety and depression, not only during the pregnancy, but also post partum … Psychological issues before the pregnancy can lead to more fear of childbirth.”

Financial issues, a poor relationship with the father, and psychological issues can add to fear of childbirth as well. “Basically, in order to decrease the fear of childbirth, the pregnancy should be desired, the woman should feel financially and personally supported, and she should have medical and psychiatric problems identified and treated prior to pregnancy,” Rodi said.

Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at NYU School of Medicine, said in an email that pain and negativity associated with childbirth tends to be exaggerated in the media and among family and friends, adding to a fear of childbirth. “The media’s portrayal of childbirth with women screaming in agony makes it understandable why women might fear childbirth,” Garcia-Arcement said. “Rarely are stories of childbirth portrayed as calm and peaceful, where women are in control of the experience and the pain. Some women have heard negative stories of long and difficult labor from family and friends. If this is their first child, fear of the unknown is common. Women worry about what might happen, what might go wrong and how they will react to the pain of childbirth. This is an experience perceived as out of their control, which can be scary.”

Women who have mental disorders and have certain personality types might fear childbirth more than others. “Women that are already experiencing anxiety and depression symptoms prior to pregnancy are likely to have those symptoms exacerbated by things like a difficult pregnancy or worry about what to expect during childbirth,” Garcia-Arcement said. “Individuals that like to be in control of their experiences will likely worry about childbirth, an experience that cannot be dictated by a mother but can be managed.”

Women do have real concerns in regard to pregnancy, because each pregnancy and childbirth experience is different, and some women do require C-sections, endure more pain, and have complications with delivery, adding to that fear. However, Garcia-Arcement does have several tips for women who may fear an upcoming childbirth experience.

1. Become informed about what will happen during labor and childbirth. She said, “Childbirth itself might not be within a woman’s control, but how she reacts to it is. Being informed can be empowering. Avoidance of what is feared will only make it worse.  Becoming an informed consumer will help women feel they can make better choices during childbirth. Women ought to learn about what typical labor medical procedures and medications are used.”
2. Choose the doctor or midwife who is right for you, and plan to use the hospital or birthing center that matches your beliefs about childbirth.
3. Create a birth plan and discuss concerns and wishes with your medical provider. This is your baby and your body, so don’t be afraid to ask questions before and during labor.
4. Learn how to use deep breathing techniques, muscle relaxation exercises, and imagery of a safe peaceful place to reduce anxiety.
5. Plan to use distraction with positive self-care activities.
6. Seek support from other women, whether in a group setting or online.

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Coping While You Wait For Medical Test Results

In this article I am quoted on typical reactions to the unknown, such as stress and anxiety, and how to manage your feelings and cope with the uncertainty. By Rheyanne Weaver  |

Waiting for the weekend to come or a long-desired vacation can bring excitement, but what happens when you’re waiting for something nerve-racking, like medical test results and a potential diagnosis?

Experts explore the connection between fearing the unknown (which can happen when you’re waiting for medical test results), and provide tips for how you can keep positive in a potentially negative situation.

Nerina Garcia-Arcement, a licensed clinical psychologist and a clinical assistant professor at the NYU School of Medicine, said in an email that fearing the unknown is something we all experience at some point in life.

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“Fear of the unknown (especially when [the] outcome can be negative) is a normal human reaction,” Garcia-Arcement said. “That is why many avoid going to the doctor to begin with. They fear hearing that they are ill or whatever they imagine.”

Besides the common fear and anxiety that can be associated with waiting for medical test results, there are other emotions and thoughts that people can experience.

“Other common emotions are numbness ... worry, sadness and guilt (that they didn't go sooner and now might be ill) and concern about how this might impact their lives, plans and families,” Garcia-Arcement said.

So now that you’re waiting for medical test results, how can you cope with some of these negative emotions you may be experiencing?

“[The] best way is to acknowledge what they are feeling, normalize it/know that it is normal to feel that way, and then use healthy coping strategies to deal with what they are feeling,” Garcia-Arcement said. “If they are anxious and worried, do breathing exercises, distract themselves with activities and people they enjoy, do visualization exercises or any other type of self-care activity that will help them ‘get through’ until they receive their diagnosis.”

If you’re almost positive that the medical test results you’re waiting for will lead to a diagnosis of some kind, there are some ways you can prepare yourself for this potentially devastating situation.

“I have my patients imagine worst case [scenarios],” Garcia-Arcement said.

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20 Ways Shrinks Stay Sane

Here I am quoted on coping strategies to reduce stress. By Julie Hanks, LCSW  |

It’s mental health month! Like many of you, I’ve been actively sharing mental health information as a way to increase education and reduce stigma surrounding mental illness. While it’s an honor to be in a profession that focuses on supporting the mental health of others, being a therapist often requires regularly going to “dark” places with clients, and that can take a toll on our ownmental health.

After nearly 20 years in the field, I’ve noticed that a lot of therapists (myself included) tend to be caretakers, people-pleasers, and self-sacrificers, making us particularly vulnerable to neglecting our own mental health in the name of caring for others. I have learned to become fiercely dedicated to self-care, self- awareness and to maintaining my own relationships in order to protect and nurture my own mental health.

I wanted to reach out beyond my own experience to therapists around the world to see how they nurture their own mental health in a profession that can be emotionally and mentally exhausting. Here’s what they had to say.

1. Live in the present

“I make myself more present by asking ‘Where am I in space right now? What do i hear? What do I feel? What do I taste and smell? What do I see?’ ” Natalie Robinson Garfield.

“I find 20 minutes a day to escape from the world and enjoy the peace and quiet.” Deborah Serani, Ph.D.

“I meditate regularly and journal about my dreams.”  Dr. Will Courtenay

2. Surround yourself with positive people

“I rid myself of toxic relationships and situations immediately and I engage in religious activities, especially prayer,” says Leticia R. Reed, LCSW.

Surrounding yourself with positive people also includes you. Kim Olver, LCPC checks the stories she tells herself about her own life. “If they serve me great, if they don’t I’ll change them. I’m the one who makes them up after all,” says Olver.

3. Go to your own therapy

“I go to my own therapy on a regular basis.” Dr. Will Courtenay

“I take care of my mental health by checking in with my own counselor when I need someone objective to bounce things off of and get centered or grounded.” Xiomara A. Sosa

“I have entered therapy 3 times since my core training. 3 different styles to suit the issues I was experiencing. I also do workshops and retreats throughout the year for personal/spiritual development.” Jodie Gale

4. Get moving

“I have two Labrador retrievers who demand a lot of attention. I find a great escape just going out into the backyard and throwing the Frisbee for an hour.” Regina Bright, LMHC

“I salsa dance! I rely on the nonverbal connection with my partner and happy music to get through some challenging weeks.” Dr. Amy E. Keller

“Every day I take time to meditate or participate in Pilates or yoga.” Diane Petrella, MSW

5. Nurture a sense of humor 

“I try to maintain a good sense of humor and find ways to laugh during life’s challenges.” Ashley Bretting, LMFT

“My spouse and I attend a comedy show every week.”  Stacey Kinney, LMFT

6. Maintain friendships

“I make sure to have tea or lunch at least once a week with a friend that is supportive and makes me laugh.” Nerina Garcia-Arcement, Ph.D.

“I find that participating through friendship in the life of someone outside the field is even more refreshing and grounding than the peer consultation we used to do.” Mark E. Sharp, Ph.D.

7. Take a break

“I love vacationing to Costa Rica.”Dr. Amy E. Keller

“I enjoy watching funny and/or inspirational YouTube videos.” Hugh A Forde, PhD

“Hiking is a great activity that helps reduce my stress levels.” Dr. Karen Sherman

8. Catch some zzzz’s regularly

This one is an important one for me. I try to take a long naps every Sunday afternoon.

“My goal is to get at least eight hours of sleep every night.” Stephanie Moulton Sarkis PhD

9. Uplifting media

“I like to read books, listen to music, and subscribe to inspirational Facebook pages.” Dr. Matthew Clark

10. Reach out to those in need

“I do volunteer work with Mission Outreach, a non-profit group that collects unused medical supplies in the United States and sends them to third world countries. Being able to help others in such a simple, easy way does wonders for one’s outlook on life.” Sujatha Ramakrishna, M.D.

11. Create fun each day

“I ask myself, ‘Have I had fun today?’ If the answer is no, then make it happen before the night is over!” Natalie Robinson Garfield

“I pursue my hobbies of photography, painting, and jewelry making.” Stacey Brown 

12. Say no

“I have found that out is easier to say “no” when I realize that if you say “no” to one thing, you are always saying “yes” to something else. If I say “no” to a new client, I am saying “yes” to time with family and a less busy mind.” Joseph R. Sanok, LPC

“I hold stringently to my practice days and hours—keeping mornings for myself to exercise and write, using afternoon to early evening for clients, and taking off Fridays for whatever I want to do.” Karen R. Koenig, LCSW, M.Ed.

13. Celebrate nature

“I love to spend time in nature by walking through the woods or listening to the birds chirp.” Sujatha Ramakrishna, M.D.

“I work in a professional office setting and need to be reminded that I am an animal. Getting out to a park or the beach or a hike in the mountain, or even a drive up the coast with the top down are instant healing techniques.” Nancy B. Irwin Psy.D

14) Express yourself creatively

“I nurture my own mental health through my other profession which is as a comic/writer….in writing my own material I get to see the humor in almost every situation and in performing it, I get to bring laughter…one of the greatest stress reducers of life….to others.” Jane Stroll

“I write in a journal often.” Xiomara A. Sosa

“I take a writing class, so that I can stay creative and do something that’s just for me!” Janet Zinn, LCSW

15. Get pampered

My personal favorites are a message and a pedicure. I try to do at least two pampering activities a month to help me relax and to nurture myself.  Ashley Bretting, MFT gets pampered by having her hair washed by someone else. Whether it’s a hot bubble bath or a leisurely walk, do something that feels nurturing on a regular basis.

16. Be a kid

Ashley Bretting “I bring out her inner child by coloring with crayons or paints!”

“I spend time with animals and children. The unconditional, pure love and affection from these creatures soothes the soul.” Nancy B. Irwin Psy.D

17. Get out of your head

“I bike to work as much as I can — this is a 30 minute commute by bike, 20 minutes by car.  In doing this, I ensure that I arrive at work very relaxed & calm (having just spent time close to nature — hearing the birds chirp and the wind blow and seeing green around).  When I leave the office at the end of the day, all of my worries get worked out by the time I get home.  So, I arrive at home very relaxed also!” Sally Palaian, PhD

18. Process your feelings regularly

Karen Hylen, Ph.D, of Summit Malibu Treatment Center suggest regularly sharing  your feelings with a friend or a loved one to avoid emotional explosions. Hylen shares this analogy:

When you bottle up your emotions, you are figuratively assembling a bomb in your head. Each feeling you bury in your head is you  putting together another piece of the bomb. Keep enough of your feelings to yourself and before you know it you’ll have an emotional explosion.

19. Focus on family

I enjoy spending time with my family. Going to the beach and reading or walking is especially refreshing. I take two trips a year with the family and then one with just my husband. Regina Bright, LMHC

“I make sure I make time for my loved ones. It is an anchoring force,” shares Dr. Anandhi Narasimhan.

20. Consult regularly on difficult situations

When I first went into independent practice I set up to have lunch or breakfast with a colleague also in independent practice every couple of weeks. It allowed us to bounce ideas off of each other and not feel so isolated in our work. Mark Sharp, Ph.D

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How Are Diabetes And Mental Health Connected?

I am quoted in a discussion of how Diabetes impact mental health and ways to cope. By Rheyanne Weaver |

Diabetes is a growing health condition that affects 25.8 million people of all ages in the United States, according to 2010 statistics from the Centers for Disease Control and Prevention website.

These most recent statistics also state that 8.3 percent of the U.S. population has diabetes. While the number of people with diabetes increases, there are not only concerns for how diabetes impacts physical health but also mental health.

The American Diabetes Association website suggests that some people living with diabetes can experience some mental health issues due to having diabetes. These can include anger toward having a diagnosis in the first place, denial toward the diagnosis, and in more severe cases depression can result.

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Living with diabetes can be stressful as well, according to the American Psychological Association website. For example, people with diabetes might stress over their eating options at restaurants, so it’s important to develop coping methods for stress and to make sure to plan ahead for some situation.

People with diabetes can also learn to recognize negative feelings they have toward diabetes, and then learn how they can treat their diabetes. Mental health professionals can help people with diabetes develop intervention and treatment plans, and they can help with coping strategies.

The American Psychological Association website also stated that according to different studies, diabetes can lead to mental health issues like depression and slow mental processing. People with depression may also in general be more prone to type 2 diabetes.

The website emphasizes that a very small percentage of people who are diagnosed with diabetes actually follow a treatment plan involving changes in diet, exercise and taking medication, suggesting that people with diabetes are having issues with lifestyle changes.

Another study found that people who did work with a mental health professional on behavior change along with making lifestyle changes decreased their chances of getting diabetes.

Some experts share even more information about the link between diabetes and mental health.

Sujatha Ramakrishna, a clinical psychiatrist, said in an email that people with mental illnesses can be more prone to diabetes and other health problems because they are more likely to make unhealthy choices related to overall health, such as poor eating and exercise habits.

People with mental illnesses who take medication can also unknowingly increase their risk of getting diabetes.

“Antipsychotic medications, also known as mood stabilizers, are associated with an increased risk of diabetes,” Ramakrishna said. “It's recommended that patients who take these medications have their weight and blood sugar levels checked regularly by their physician. Other psychotropic medications, including SSRIs such as Prozac, can also cause weight gain, which in turn increases the chance that patients might develop diabetes.”

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Nerina Garcia-Arcement, a licensed clinical psychologist and a clinical assistant professor at the NYU School of Medicine, said in an email that there are many mental health issues to consider that are connected to diabetes.

“If someone has diabetes, this impacts and limits their physical abilities and diet,” Garcia-Arcement said. “This often leads to people experiencing sadness, anxiety, frustration and loss. If there are [amputations] due to complications from the diabetes, this often negatively impacts mental health.”

There are also many contributing factors related to diabetes that can lead to depression.

“The stress related to managing a chronic illness, plus fear/worry about a negative prognosis are excellent causes for depression,” Garcia-Arcement added.

Taking diabetes medication can lead to mental health issues indirectly, in addition to psychiatric medication leading to diabetes in some cases.

“Having to monitor sugar levels and take insulin is stressful, limiting of everyday activities and can lead to worry, stress, anxiety and sadness,” Garcia-Arcement said.

In general, especially if you have a mental illness, it’s beneficial to talk to a mental health professional so they can help with motivation, behavior changes and understanding the link between mood and health so you can maintain good health, she said.

“Research has shown that people with mental illness have shorter life spans, often because they neglect their health,” Garcia-Arcement said.

“For example, if you are depressed, you are less motivated to engage in pleasurable activities, get out and socialize, eat healthy ... and exercise. Many don't take their medication as prescribed, often forget doctor’s appointments, or don't have the motivation to make appointments and keep them. This in turn worsens their diabetes. As they get sicker, they often get more anxious and depressed.”

Elizabeth Mwanga, who was diagnosed in 2007 with type 1.5 diabetes (latent autoimmune diabetes), used to be morbidly obese and was close to death due to her diabetes. However, she made major changes in her eating and fitness routines, and since 2009 she hasn’t needed to take medication for diabetes and has even kept off the 100 pounds that she lost.

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She definitely sees a connection between mental health and diabetes, especially because many diabetics have high and low blood sugar levels that tend to affect mood.

“Blood sugar lows and highs can cause mood swings, which can be very disruptive,” Mwanga said in an email.

She said low blood sugar levels can lead to anger and minimal energy, and sometimes hallucinations and delirium. With high blood sugar levels, depression and mood swings can be a result.

“Diabetes requires 24/7 self-care management,” Mwanga said. “Sometimes this can be frustrating, overwhelming and depressing.”

“Food and fitness is linked to better physical health and diabetes management, which in turn effects mental health,” Mwanga added.

“I find myself feeling a lot more energetic and happier when I eat a diet full of fresh fruit and vegetables. I have also begun doing research on foods that raise serotonin levels. For example, I drink green tea (for the energy boost/antioxidants) during the day, and chamomile at night (for the calming effect, also full of antioxidants and anti-inflammatory properties). I eat whole raw almonds a lot, and lean turkey.

All of these foods are low GI ([low] glycemic foods are best for diabetics) and studies have shown that all aid to the process of serotonin.”

There is never a better time to make health your priority. Proper exercise, healthy diet and sleep routines are all key to the best overall health, and at least paying special attention to these areas of life will most likely decrease your risk of developing diabetes, other physical and mental health issues.

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