Shore Therapy

Postnatal Depression and Anxiety

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Most of us have an idea of what postnatal depression is, but its important to understand the scope to which it can affect indivduals and families.Postnal Depression

Postnatal depression can include both depression and anxiety and can occur anywhere within the first year after the birth of your child. It is thought that somewhere between 10-20% of new mothers (this includes mums with baby number 2, 3, etc) may experience diagnosable postnatal depression.

There are a few widely accepted risk factors which many professionals believe may increase the probability of postnatal mental health issues forming. This includes but isn’t limited to:

  • A history of mental health issues – depression, anxiety and most other mental health conditions.
  • A lack of support before, during and after the birth – this can include issues with the relationship of the child’s parents, as well as a lack of social support such as isolation from family (e.g. Living in a different town/country from the rest of family etc.)
  • Life stresses – money issues, trouble at work, relationship problems etc.
  • Difficulties within the pregnancy itself – this can range from severe morning sickness (Hyperemesis Gravidarum), to break through bleeding, regular ED admissions or requiring extra scans etc.
  • Difficult birth – Post natal mental health issues appear to be more common in those who had tricky births and deliveries – emergency caesarean surgery, loss of blood, use of vontouse or forceps, episiotomies etc.
  • Health of the infant – if the baby is born with health issues, a lot of stress is placed on the family – particularly the parents. Often parents who have an unwell child at birth struggle with feelings of guilt, sadness and stress, which are all risk factors for depression and anxiety.
  • Lower socio-economic families – in the 2015 New Mothers Mental Health Survey (2015) it was found that mothers coming from a ‘Low Household income’ (Under $40,000) were more likely to develop post-partum mental health issues.
  • Issues with the baby after birth i.e. feeding issues, colic, sleeplessness etc

Many feelings and thought patterns associated with postnatal depression and anxiety are normal to feel as we adjust to life with a new baby so it is important to be able to recognize when help is required. Here are a few signs and symptoms to be aware of:

  • Feelings of hopelessness, confusion and sadness which linger.
  • A belief that you can’t cope. Not just one-off thoughts, but reoccurring or constant thoughts
  • Irritable and angry for no known reason
  • No pleasure in usual activities
  • Changes to sleeping and eating – above and beyond what is expected with a new baby
  • A lack of concern over appearance and self-care
  • Negative thoughts about the baby, an unwillingness to hold or care for the baby or thoughts of harming the baby
  • Being overly anxious, overwhelming uncertainty and excessive worry and fear
  • Feelings of guilt or worthlessness
  • Difficulty thinking clearly and making every day decisions.

The ‘Baby Blues’ are common in the first few weeks after baby is born which include several of the thoughts and feelings listed above. Postnatal depression and anxiety is when these issues linger for an extended period of time or become so severe that they interfere with everyday life affecting the care and health of both mum and baby.

As new parents, we often turn all of our attention to our new baby and forget to look after ourselves. It is important to remember that we need to be well in order for us to provide the best care for our children. The ‘Fourth Trimester’ or first 12 weeks after our baby is born is still a hugely important area for both mum and baby with a lot of physical and hormonal changes occurring, not to mention an adjustment to family dynamics, routines and our mental health. This period is when support systems are invaluable. Make use of family, friends, support groups, health professionals, call lines and mental health professionals. It is important to remember that a happy, healthy mum is going to immensely help your baby.

Recently there has been some media coverage about postnatal mental health and lack of help, delay of treatment and gaps within the current health system. Here in Auckland, there are several places you can reach out, detailed below. However, Shore Therapy caters to many parents dealing with different types of post-natal issues. We are baby friendly and often will have mum and dad in our offices, seeking therapy together. Babies are more than welcome to come along as we understand that separation, child care etc… is not always an option. Northland has high rates of post-natal issues, why this is, we’re not quite sure, but help is still available. If you want to visit Shore Therapy in their offices in the Whangarei area or Auckland Click Here to make a booking online or send us an email for more information.

Where to get help:

Bullying, Cyber Bullying and Mental Health

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bullyingBullying has unfortunately become more frequent in our society. Many of us associate bullying with children and youth, and while it is very prevalent in these demographics, it can also occur at any age, and in any setting. Work place bullying and cyber bullying can occur far more often than many of us realise and it can be very damaging to our mental health.

Firstly, it is important to understand what bullying actually is. The oxford dictionary defines a bully as “A person who habitually seeks to harm or intimidate those whom they perceive as vulnerable” 1.

To expand on this definition further, there are four main factors that are associated with bullying:

  • Harming another individual intentionally
  • A misuse of power within a relationship
  • Repetition – bullying is not usually a ‘one off’
  • Behavior that can cause harm

However, there are instances when someone’s aggression is not bullying, but can appear so when it feels directed at us. These often require a different approach, so it is important to be able to identify the differences, so the most appropriate action can be taken. These instances can include:

  • A one-off fight
  • A disagreement between friends where there is no difference in power
  • One off acts of meanness
  • A single act of social rejection

The important things to remember when identifying bullying is:

  • Intentional harm, power imbalance and repetitive behaviours 2

In a Victoria University of Wellington study, a survey of staff throughout schools around the country was completed. In this study, 94% of participants indicated that bullying occurred in their schools 3

A survey of 1700 participants demonstrated that one in five workers have experienced work place bullying 4.

Cyberbullying rates are on the rise, with all age groups being susceptible. It is believed that younger age groups are more likely to experience cyber bullying with approximately 46% of 18-19 year old’s experiencing some form of digital bullying 5.

Bullying has become a daily struggle for many individuals, and its impacts can be far reaching. In the Northland, Whangarei and Auckland areas, the suicide rates have increased, so much so, that the highest number of suicides was recorded in the 2016-2017 year compared to the last ten years. The highest proportion being those under 24years old 6.

There is numerous research that link bullying with a range of mental health issues, such as, lower self-esteem, higher rates of depression, stress, feelings of hopelessness and a higher probability of self-harm or suicide. For many individuals, frequent bullying can leave them feeling alone, victimized and with no options left to escape the threatening and abusive behavior. This may lead to an increase in suicidal or self-harming thoughts and tendencies 7.

In our youth, lower school performance, lower academic performance and lower school spirit has been linked to those who are bullied, both in person, or through digital media. This may lead to further social withdrawal and unwillingness to participate in social events which may continue to translate into adult life.

Many people who suffer bullying in school or high school believe that bullying had an impact on their mental health, and that this continued to impact the rest of their lives. However, with the likes of work-place bullying and cyber bullying, anyone can be vulnerable, and unfortunately, those who have been targeted in the past are more likely to be targeted by others as they seem to be “easy marks”. Low self-esteem and a history  of not standing up for oneself may contribute to this.

Along with depression, anxiety, low self-esteem and self-harming, a higher prevalence of psychosomatic problems can be evident. Psychosomatic problems are physical symptoms or ailments which are caused, aggravated or associated with mental factors. This can include many complaints ranging from skin disorders such as eczema and psoriasis, to heart issues and high blood pressure, to irritable bowel like symptoms. All of these issues can translate into lifetime problems and will continue to have an impact on a person as a whole. Unfortunately, this can cause a vicious cycle as some of these symptoms are visible or noticeable in everyday life and can cause an easy reason to be bullied (this is more obvious in children and youth). This in turn can make depressive and anxious thoughts increase which can then worsen visible symptoms. A good example of this is any skin conditions. It is easy to judge a person who has a visible rash or skin irritation, for which they are already feeling self-conscious over, however, actively criticising someone for it will only intensify these feelings and could therefore, make the rash more inflamed 8.

Being a victim of bullying of any kind can also increase the chances of substance abuse. The more common substances abused in these cases is usually alcohol and marijuana. We already know that there are implications for both our mental and physical health with bullying, however, when we add a substance abuse issue, the impact on our mental health multiplies. Along with our negative thought patterns, we now also have an addiction to battle. Often victims of bullying will turn to these substances to escape from their reality and numb or dull these thought patterns. However, the addiction itself can encourage and strengthen these patterns. This behavior is anti-social and will withdraw the individual further, causing less motivation to engage in social interactions and decrease general day to day function. This will also have an impact on any positive and supportive relationships that are in their lives, and therefore can become self-destructive 9.

Bullying is a global issue which seems to be prevalent in many different societies and cultures. As a whole, we are more aware of bullying, and more attention, time and effort is being put into creating healthier environments and relationships. On a personal level, there are some small changes that you can make to allow you to feel safer and encourage you to regain some of your power, confidence and self-esteem.

  1. Stay Safe. As soon as you are uncomfortable and don’t feel safe in a situation, leave. Engage the help of others whether that be in the form of law enforcement, help hotlines or friends and family for support. They are all there to help you.
  2. Keep your distance. Where possible don’t engage with your bully, they are not worth your time or your energy and your self-worth is not tied to their opinions of you.
  3. Communicate. Talk about your experiences with those that you trust, a hotline, therapist, colleague, friend or family member. Suffering in silence only increases those negative thoughts. If you remain quiet about the bullying you’re experiencing, it can encourage the bully to repeat and intensify the behavior. Knowing that there is no consequence to their actions can mean the bully only escalates the abusive behaviours. Talking to someone about your experiences is a great stress relief for you but can also better equip you to deal with these actions.
  4. When interaction between you and your bully does occur, keep your cool. Reactions are what bullies thrive on. Think before you react, whether it is with a clear, concise response or simply keeping your composure, bullies are thrown off balance if they don’t receive the reaction they expect. This is not to say that you allow them to do what they like to you and you give no response. You can stick up for yourself, but responding in anger or embarrassment is the reaction they expect.
  5. In workplaces, it is important to recognize when bullying is occurring. When you realise that this is happening, put some barriers in place to safe guard yourself. Where possible, have a third-party present throughout your interactions with your bully and use formal communication through written media – there is a paper trail that can always be looked back upon 10.

Of course, these points don’t apply to everyone or every situation but they can be some good starting points. If you or someone you know is struggling with bullying, then please seek help. At the bottom of this article you will find links to several different places you can turn to for help. For help with some of the mental health side effects of bullying, reach out to our Therapists at Shore Therapy for some professional help.

HelpLines & More information:

Lifeline: 0800 543 354 (available 24/7)

Kidsline: 0800 543 754 (available 24/7)

The Raid Movement: http://www.theraidmovement.co.nz/

NetSafe: https://www.netsafe.org.nz/

REFERENCES:
1 https://en.oxforddictionaries.com/definition/bully 2018
2 https://www.bullyingfree.nz/about-bullying/what-is-bullying/
3 https://www.victoria.ac.nz/education/research/current-research-activity/new-research-into-bullying/Bullying-in-NZ-Schools.pdf (Green, Harcourt, Mattioni & Prior, 2013)
4O’Driscoll, M. P.,Cooper-Thomas, H. D., Bentley, T., Catley, B. E., Gardner, D. H., & Trenberth, L. (2011). Workplace bullying in New Zealand: A survey of employee perceptions and attitudes. Asia Pacific Journal of Human Resources, 49(4), 390- 408. doi:10.1177/1038411111422140
5 Steiner-Fox, H. W., Dutt, S. J., Christiansen, S. J., Newton, H. J., Matika, C. M., Lindsay, C., Sare, M. H. , Kapeli, S. A., & Stronge, S. (2016). Rates of cyberbullying among women and men in New Zealand in 2015. NZAVS Policy Brief, 3.
6 https://www.mentalhealth.org.nz/assets/Suicide/2016-2017-annual-provisional-suicide-figures-Final-version-Embargoed-midday-28-August-2017.pdf
7 Ford, King, Priest & Kavanagh, (2017), Bullying and mental health and suicidal behavior among 14 to 15 year olds in a representative sample of Australian Children. http://journals.sagepub.com/doi/full/10.1177/0004867417700275
8 Gini & Pozzoli, (2009). Association Between Bullying and Psychosomatic Problems: A Meta-analysis. American Academy of Paediatrics, vol123:Is3
9 Radliff, Wheaton, Robinson & Morris, (2012), Illuminating the relationship between bullying and substance use among middle and high school youth. Addictive Behaviours, vol37:Is4
10 Ni, (2016), 8 Keys to Handling Adult Bullies https://www.psychologytoday.com/intl/blog/communication-success/201611/8-keys-handling-adult-bullies

Social Drinking and how to opt out

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With Dry July just around the corner, it is a perfect opportunity to have a look at our social habits associated with drinking. With many of us choosing to partake in a dry month, it becomes more apparent of our ‘social dependency’ on alcohol.

Have you ever been at a bar/pub/backyard BBQ and felt awkward and uncomfortable because you are the only one not drinking? In New Zealand we have a large binge drinking culture which has been well publicized. However, we also have a tendency to link alcohol with most of our positive, social experiences. Weddings, Birthdays, after work drinks at an Auckland bar, a casual weekend at your Northland Bach – can you remember a time alcohol wasn’t a part of this? This can make it seem like alcohol is required for us to have a good time,  but can also make it difficult to opt out.

Firstly, we should understand what drives our desire to drink while in these situations. Is it to enjoy a glass of wine with dinner, or to “bring you out of your shell”? Is it to numb any thoughts or feelings, or simply because its what everyone else is doing? Understanding the motivation, is the first step of learning how to be comfortable in social situations without the use of alcohol. This can sometimes require a more in-depth approach which can be explored under appropriate guidance from a mental health professional. However here are a few pointers and strategies that can be used to ease that transition into sobriety, even if it is just for one month.

  • Know what you would like to drink. Have a favourite drink that you order from a bar (Mocktail, soda etc.). If the event is BYO – take your favourite drink with you, just like you would take your box of beer or bottle of wine. Be confident in what you are ordering or asking for, the language that we use when ordering is important for our perceptions e.g. “I’ll have a sparkling mineral water in a wine glass please” vs “I’m not drinking alcohol anymore…” the negative connotations in our language can transfer to our mood.
  • Hold your drink in your hand. When you’re holding your drink, you’re less likely to be offered another, and therefore you can field less of those “why aren’t you drinking?” questions.
  • Have an answer ready for those that ask why you aren’t drinking – give as little or as much detail as you are comfortable with but something like “I’m giving it a miss tonight” or “I’m not drinking anymore” is often sufficient.
  • Tell your friends and family – they can support you with your decision to not drink and can help keep you on track.
  • Understanding yourself and others can be helpful. Watch others and their behavior change with alcohol, consider what influences it has on you and how your behavior and experience of social situations is different. It’s important to remember that alcohol isn’t needed to meet and communicate with people. The more that you do this without the influence of alcohol the easier it can become.
  • Enjoy the morning after – notice how great it feels to wake up without a hangover! Use that morning to do something you love rather than nursing a sore head. This is great motivation for the next social gathering that you’d like to skip the alcohol for.
  • It gets easier! Know that in time, it will become your new normal. You will get used to communicating and having a great time without the need for alcohol. You’ll find that those that care about you will accept and embrace your choice of sobriety, even if it is temporary.

“Dry July” is just one step in the right direction for a social dependency on alcohol. As a society we’re beginning to recognize that this is an issue and more open and honest conversations are beginning to be had. However, sometimes a more individualized approach is required. If you are concerned about your drinking, or that of someone you care about please seek professional help. If you need to talk about your drinking with a therapist in Auckland, reach out to the team at Shore Therapy. For some alternative resources on managing drinking see https://www.alcohol.org.nz/

 

Social Media and Mental Health

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We are all guilty of posing, filtering and posting on social media. But what are the true effects of Facebook, Instagram, Twitter and other social media sites on our mental health?

How many of us check out social media apps on a daily basis and leave feeling worse about ourselves and our lives? How many times do we look at old school friends or ex-partners and think how much more wonderful their lives are? The reality is, we all post our most rose-tinted view of ourselves and we constantly compare and compete with those around us. This surely has an effect on how we feel about ourselves and those around us.

According to a recent UK study, 62% of people surveyed reported feeling inadequate and jealous after visiting social media sites and many even reported symptoms associated with anxiety and depression. This has been linked to the idea that when we look on Facebook etc, we innately compare our life to these photos, and of course our regular day to day life will never compete to the fantasy world displayed on social media. How can a terrible day at work and a bad hair day, compare to a friend’s perfectly filtered photo in front of Central Park? The truth is it can’t compare. But it doesn’t mean that our life is terrible or that we aren’t successful.

Since the dawn of social media, our self esteem seems to be intrinsically linked to how many friends or followers we have, or how many ‘likes’ we get for our latest post. ‘Likes’ seem to have become a way for us to quantify how loveable, likeable or meaningful we are to other people, and if we don’t receive enough of these, then it therefore means we are un-loveable or invisible.

For many people who use Facebook or Instagram regularly, their self-worth is so reliant on their followers that face to face social interactions become less meaningful. It becomes more important to post about our lives than actually live it and spend the time talking to those around us. A study from the Harvard Business Review (2017) mentioned that the use of social media has produced a number of negative impacts, all of which have caused severe issues in our self-confidence and has dramatically reduced social interactions. The research stated that regular use of social media reduces pleasure in meaningful activities, self-esteem and face to face interactions with our loved ones and actually increases internet addiction, and sedentary behaviour. All of which have been linked to mental ill health.

So what to do about it?

    1. Sign out of Facebook, Instagram and other social media sites on all devices.
    2. This adds a barrier to you being able to access these sites instantaneously, and many people find the annoyance of having to sign in each time, outweighs the ‘pleasure’ we get from social media. We then naturally become less reliant on social media to meet our needs.
  • Put your focus into face to face social interactions, or other activities that give back to you emotionally.
  • This may give you a more meaningful pleasure and more often than not, give you deeper connections with those around you. You may even find that begin to notice more and enjoy the experiences fully.
  • It is also important to remember that what is posted on social media isn’t real, it is all just fantasy. Don’t get sucked in!
  • Stop torturing yourself by comparing your life with everyone else’s fantasy photos. Seek to improve your own life in a realistic manner. Choose to look at the positives and to celebrate your wins.
  • Don’t use social media when you are feeling low, down or anxious.
  • This encourages the feelings of rejection, low self-esteem and low mood. Instead put your focus into physical or social activities that give back to you.

 

Note: If you feel your use of the internet or social media is impacting your quality of life, or you experience low mood the majority of every day, please seek professional help.

Working through divorce and seperation

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Family problemIn our society we seem to have predetermined ideas about marriage and divorce, many of which are unconscious and are based around the ‘happily ever after’ principle. Movies, books and fairy tales talk to us of finding our ‘one true love’ that will last a life time, but unfortunately for some of us, this isn’t the case. Due to so much pressure to find and hold on to ‘the one’ there can be a lot of shame associated with separation or divorce, many people speak of feeling like ‘damaged’ or ‘used’ goods, and often hide their divorce from future partners or simply don’t continue to date again.
When we journey through separation or divorce, the feelings of shame, anger and resentment can often accompany the process. Many couples struggle to remain amicable with each other and it can often become an emotional war. Things get more complicated when children are involved, and often, kids can be put in the middle of parents fighting and separation negotiations. This can cause parental alienation where a child is used as a weapon, usually fed negative information about their other parent which can then influence their feelings towards that parent. If one parent tells the children that their father is a liar and should never be trusted, it can be difficult for the child involved to remain impartial to that parent. Often this creates mistrust and guilt for the child and can influence their own ability as an adult to trust and connect within relationships. Parents may do this unconsciously, as a way to get back at their partner for the hurt, betrayal and shame that can be associated with divorce and separation.
There is a way however, to divorce or separate in a healthy and amicable way, if both parties are willing to work together.

 

Parenting Through Divorce

When parent’s divorce or separate, children tend to feel the pressure to choose a parent or take sides. This can be distressing and traumatic for the child as for them, it can feel like their world has just turned upside down.
It is important for parents to realised that while they are no longer a romantic couple, they still need to work as a parental couple. This is essential for the child/children