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Work Anxiety

Anxiety at Work

Every job has its own level of stress attached to it. Even if you truly love your job, or think your job is too easy to be stressful, don't be fooled; there is always a small level of pressure on a subconscious level. Even the little things can sometimes be a strain: having to get up at the same time each day to go to the same place, there could be someone you don’t get on with but have to put up with on a daily basis, the food may be off or even an unexpected request for overtime.

Those are minor annoyances that can disrupt our routines and may put additional pressure on us. That feeling of dread and pressure. The day drags on or goes too fast. You feel disconnected and grumpy. Nagging thoughts creep up on you. You start to think that there is no way you can get anything done now, and do it all on automatic pilot.

That is a real bad day.

Now think: how often do you feel this way?

There are many people who have these feelings every day and this group just keeps growing.

When anxiety is stress related it is hard to “get rid of it” as some might say. Work means having to be there day after day. So many people facing work stress feel as if they are descending into the gates of hell the moment they get up to get ready for another day at work. Then, at the end of the day, when the doors of their job close behind them there is no joy. There is only the continuous monotonous voice that tells them that “tomorrow will be exactly the same and so will the day after that and the day after that, and …”

These days the work floor is more competitive than ever. You have to work hard to stand out and be noticed. Overwork, trying to prove yourself, aiming for promotion and the fear of losing your job have made that many workers suffer extreme anxiety.

You might recognise some of the symptoms in you or in someone you know:

Mood Swings
Short temper
Highly Emotional
Hyperventilation
Heart Palpitations
Thoughts of death
Feeling of dread
Panic Attacks
Feeling out of control

This is not how work should make you feel. If you recognise this in yourself or see it in others, try to get them, or yourself help.

The biggest problem is the fear of talking about it. You may fear people will think the responsibility of your job is too much for you when admitting to feeling anxious. You may fear it might cost you your job. This is not likely, and in any event: if your symptoms get worse this could lead to making errors or a complete burnout and that is far more serious than just trying to get help.

You might wonder: What can a counsellor do for me? They can't do my job for me, can they? Sadly no, they are sadly unable to do that. But there is a lot that they can do to improve the quality of your life.

Research has shown that when it comes to treating anxiety disorders counselling and therapy are usually the most effective options. This is because the focus is placed not just on the symptoms, but on all the underlying problems. Your anxiety and stress did not suddenly appear out of nowhere, there was a build up to it that needs to be found. Counselling can also help you manage panic attacks, build your self-esteem and endurance and help you return to a more happy way of living.

If you are aware of anxiety building in your life or that of a loved one, don't think “well, I'm not making any mistakes yet.” Or “Other people can handle this, why can't I?” Many people have gone before you that thought the same way. They just wanted to “finish this project”, felt that one more all-nighter wouldn't matter etc. They were wrong and often led to consequences they regret to this day. So why would you wait until you have reached that wall, that point of no return? Why wait until that is accident or that completely preventable screw up?

Understand that there is no harm in seeking help, no shame. We seek help and treatment for all other parts of our body when these are in pain. Your brain is a part of your body and is suffering its own form of pain right now. If you cut yourself you put a band aid before the wound might become infected. If you pull a muscle when jogging you stop running for the day. Your brain is like a muscle that has been working too hard, give it the band aid or break it needs. Counselling is always there for you to help you do this.

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Fat Oppression – How to Reclaim Your Self-Esteem

In recent years fat oppression, more Eatingcommonly known as “fat shaming”, has become accepted as the “done thing”. Magazines, TV shows and public figures like Katie Hopkins have made “pointing out a person is fat” acceptable. When clicking on the comment section or a message board where people are discussing other people, more often than not the first things that is discussed is a person’s look and weight with their personality or accomplishments only mentioned as an afterthought. We are living in a shallow world, and anyone not possessing what is seen as the “ideal body” or just different in any way is in for scrutiny.

Being bigger than others has never been easy, except maybe when living in Rubenesque times, I can testify to this: even in the 1990's growing up as a “big kid” was hell at school. But this was AT SCHOOL, kids usually grow up knowing better and stop the bullying when they reach 19. Not this generation: adults gleefully approach other adults in the street, asking “when is it due”, knowing a person isn't pregnant. They think nothing of saying: “should you be doing that”, if they see what they consider to be a “fat person” eating in the street. This used to be taboo. Not anymore.
Many people think pointing out a person is fat helps the “fat person” in some twisted way. Well, no it doesn't: usually they are aware of the problem, thank you, pointing it out only works demotivating.
Of course not everyone is like this, there are many people out there who don't care about how you look. In fact, there are even so called “chubby chasers” out there, folk only falling for those that have “something to grab hold off”. Good to know, of course. But when you are feeling insecure about your weight and have suffered several upsetting altercations with people that judged you, knowing this won’t help: you are sure the entire world is against you and these people are just lying to be kind.
Nobody chooses to be fat and often it has little to do with food intake. My weight gain was sudden. When I was about 7 my weight suddenly changed, almost overnight. I had not changed eating habits, I was a dancer so got a lot of exercise. Still I became fat, and as a result people begun to treat me differently. “I'm not sure you should” were added when cake and candies were handed out at birthdays, judgemental looks were included with my chips, etc. I was never a binger, hardly able to empty my plate at the best of times. My mum schlepped me around from clinic to clinic to find what was wrong with me. At around age 12 I was virtually anorexic, dancing to Michael Jackson most of the day and still I did not lose weight. I tried diet after diet, miracle cure after miracle cure and guess what: I still have nothing to show for it.
This is true for many people.
Of course there are people that gain weight because of food, but it is not something they choose to do either. Usually there is something deeper than “I like to eat” that makes people reach out for comfort foods.
No matter how you gained weight, the end results are often the same: insecurity and a constant fear of being judged. This causes stress and stress often results in weight gain, even if you try to diet. Dieting and not losing weight is even more depressing and you can end up in a vicious self-hating cycle. Others may lose weight, but often find they are still not happy on the inside, not even after all that work.
This vicious cycle is something not many people are able to break, and only few are aware that counselling is an option that could help break it. It is understandable that a person that has been or at least felt judged all his or her life may find it difficult to seek help. This is understandable because some might have met, in the past, with unsympathetic doctors or others in the “care” industry that were not as caring as they could have been. The difference here is that a counsellor is not there to look at your shape and size of your body and judge you. He or she is there to look at your internal world and how this is reflected in your relation with your body and with others. He/she might assist you in finding your self-worth and self-love before you try changing anything about your body. Once you have accepted yourself on the inside, you might not even care about the outside. This is what a counsellor can help you to achieve: inner peace, self-respect to make you see that no one should be able to make you feel bad about yourself, no one has that power.
The support and advice of a counsellor can break years of bad programming you may have internalised. It can also help you on the road to reclaim your self-esteem and help you either accept yourself as you are or help you find a way to lose weight on your own terms. But accepting yourself comes first. Always. No matter how thin or big you are, only the love you have for yourself can make you look truly beautiful and once you find that, weight no longer matters.

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Dealing with anxiety…

AnxietyWhen anxiety becomes recurrent and overwhelming, it can cripple an individual’s ability to function, and can lead to other symptoms that include dizziness, shortness of breath, and a racing heartbeat. Anxiety is worrying excessively about something fearsome that is not actually there and the assumption that the problem is there for sure.

If your life has been marred by anxiety disorders such as incapacitating phobia, unrelenting worry, obsessive thoughts, or panic attacks, it is important to seek help before these symptoms develop into more serious health concerns. You might find it useful to seek for help. There are a few ways you can get the support you need:

Talking about your fears - The best results dealing with most anxiety disorders are a combination of cognitive and non cognitive-behavioral therapy. The core purpose behind cognitive-behavioral therapy is to help you regain control of situations that cause anxiety in your life. The thoughts that produce anxiety can be identified and modified using different techniques that alter behavioral responses and eliminate the anxiety reaction.

For instance, your therapist might suggest some training in deep breathing and relaxation to counteract the rapid breathing that comes along with certain anxiety disorders. The cognitive therapy approach involves educating you to understand how your thoughts can lead to the feelings of anxiety and how you can change such thoughts to minimize the possibility of occurrence and the level of reaction. This is often combined with some cognitive awareness techniques to help you tolerate and confront a fearful situation in a safe and controlled environment. During this process your negative thoughts will be identified, analysed and modified in order to make your responses more positive and under your own control.

Getting more education about anxiety - For you to overcome anxiety you have to understand your thought process. Getting yourself educated about what the triggers and causes of various aspects of your worries are might go a long way in helping you overcome your worries. Although education alone won’t solve the problem entirely, it will enable you to reap the most benefit out of therapy.

Connecting More With People - A problem shared is a problem halved. In the same vein, isolation and loneliness set a bigger stage for anxiety. Minimize your vulnerability by reaching out to others. Try as much as possible to join support or self-help groups, see friends, or share your fears and worries with a trusted one. This has proven to have a great positive impact on people’s fight against anxiety and depression.

Practicing Healthy Lifestyle Habit - Make out time for regular exercise because it relieves anxiety and tension. It is going to be counterproductive to try and cope with your symptoms with drugs and alcohol. Your problems may just multiply threefold. Stimulants such as nicotine and caffeine can also increase your anxiety.

There is no immediate formula to fix anxiety. Overcoming anxiety disorders requires commitment and time. Most therapies aimed at reducing anxiety will involve facing your fears rather than avoiding them, so before you get better, you may feel worse.

However, one important thing is to stick with your chosen treatment. If you are not satisfied with the rate of recovery, bear in mind that therapies to treat anxiety are more effective in the long run. You will definitely reap the rewards of your steadfastness if you can see it through to the end.

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Social Anxiety

Social AnxietySocial anxiety disorder, previously referred to as social phobia, has been redefined in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).  Social phobia referred to a fear of performing or public speaking. However, researchers have come to realize that this definition was too narrow.  A person can experience extreme discomfort or fear when socializing, performing, working or even eating in public.

Social anxiety disorder is essentially brought on by any activity in which a person feels they are being watched and criticized. Furthermore, the person may go to great lengths to avoid feared social or performance situations, which may negatively impact their occupational, academic or daily functioning.  Additionally, the impacts of social anxiety disorder make it difficult to create or maintain healthy personal relationships.

For example:

A woman is fearful of attending a team meeting because she knows she’ll have to discuss her project in front of all of her coworkers, so she calls in sick to avoid the situation and sends her boss an email update on her project.

A man is meeting a friend at a new bar up the street.  The man gets there first and is flooded with anxiety because he feels everyone else at the bar is judging him.  He knows this is irrational, but the fear begins to mount.  His heart is racing and he is paralyzed unable to give the bartender his drink order.

Diagnosis of Social Anxiety Disorder

According to the DSM-5, the criteria for being diagnosed with social anxiety require a person’s anxiety level to be disproportionate to the situation and the symptoms must be persistent over the span of six months or more.  Social anxiety disorder is not to be confused with panic disorders.  A person experiencing a panic attack fears that what they are experiencing is indicative of a physical ailment, such as a heart attack.  A person experiencing an anxiety attack is aware that their symptoms are a result of their anxiety.

Treatment for Social Anxiety Disorder

Traditionally, Cognitive Behavior Therapy (CBT) has been a proven treatment modality for anxiety disorder. CBT addresses and corrects maladaptive thoughts and behaviors that are often associated with anxiety disorders.  For example, CBT addresses thoughts such as, “everyone thinks I’m stupid” or behaviors such as avoiding social gatherings due to anxiety by providing techniques and strategies to lessen anxiety.  CBT focused support groups are particularly helpful for social anxiety disorders because it aids in developing coping strategies for social interactions in a therapeutic environment. One’s success with CBT therapeutic technique requires practicing coping strategies both in session and at home.

Emotion-focused therapy (EFT) is a recent humanistic approach to therapy that incorporates structured techniques with unconditional positive regard and empathy to address a client’s issues.  Although EFT was developed for the treatment of depression it has been applied to trauma and anxiety over the last 20 years.  Whereas CBT focuses on correcting maladaptive thoughts and behaviors, EFT addresses the emotional process behind those thoughts and behaviors.  For example, addressing childhood trauma that has led to the dysfunctional thoughts and behaviors that cause anxiety.

Regardless of the therapeutic model used, social anxiety disorder will not right itself or dissipate with time.  In fact, anxiety disorders have been proven to worsen overtime if not addressed.  Reaching out to a mental health professional and committing to utilizing appropriate strategies and techniques are the best way to combat social anxiety.

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Sleeping Problems

Sleeping ProblemsIt’s 3:00 a.m. and you still cannot sleep.  Between tossing and turning you mentally scream, “Just go to sleep!”, but it doesn’t come. You begin to calculate how many hours before you need to get up to go to work. Your to-do list begins to run through your mind later morphing into an in-depth analysis of your life:

Will I be able to pay my bills this month?

Why has my boyfriend been so distant lately?

I really don’t want to give that presentation at work tomorrow!

Suddenly, it’s 7:00 a.m. and your alarm is screeching.  Time to get up and face the day on as little as 1-2 hours of sleep.

If the above scenario sounds familiar, you may be suffering from sleeping problems also known as sleep deprivation and insomnia. According to the Mental Health Foundation, as many as 30% of people in the UK are suffering from severe sleep deprivation.  Lack of sleep can lead to a variety of issues, including mental health issues.  If you are having difficulty falling or maintaining sleep during the evening or suffering from irritability and lack of mental and physical alertness during the day, it may be insomnia.

Causes

Insomnia can be tied to a temporary cause such as stress about starting a new job. However, insomnia can also be continual and it has been tied to a variety of physical and psychological causes.

Medical Issues: Chronic pain, allergies, cold and flu, asthma, acid reflux or side effects of some medications, particularly those that contain caffeine.

Sleep Disorders: Sleep apnea, sleepwalking, restless leg syndrome and narcolepsy.

Psychological Issues: Anxiety, depression, post-traumatic stress disorder, bipolar disorder, and general stress.

Lifestyle Issues:  Shift work, frequent travel, caffeine or alcohol intake, drug use, and social life

Effects

The effects of sleep deprivation can affect one’s mind and body, including a significant decrease in alertness.  Studies show that alertness and performance can be reduced by 32% with as little as a half hour reduction in sleep.

Additionally, memory and cognitive functions decrease, making it difficult to process or retain information. These impairments can affect a person’s ability to drive a vehicle or operate machinery; it can also result in occupational consequences, such as poor work performance or getting reprimanded by a boss.

Lack of sleep not only affects the individual, but their partner. When one partner is tossing and turning, it disrupts their partner’s sleep, as well.  When one or both partners are suffering from the effects of sleep deprivation this may lead to irritability and conflicts within the relationship. And if suffering from chronic sleep deprivation it may even lead to separate bedrooms or divorce.

Treatment

It has been proven that maintaining a consistent sleep routine can improve sleep habits.  Therefore, by making minor lifestyle changes, you too may be able to break the vicious cycle of insomnia and improve the quality of your sleep.

Exercise: Regular exercise is not only good for you physically; it can also help reduce stress levels that have been proven to increase insomnia.

Bedtime routine: Creating a bedtime routine in which you go to bed and get up at the same time everyday will help to reestablish your circadian rhythm. Also, partaking in relaxing bedtime rituals, such as taking a warm bath or shower prior to bed or putting on lavender lotion can help the body relax into sleep. Lastly, set aside 8 hours for sleep.

Bedroom décor: The bedroom should be the most relaxing room in your home.  Using warm colors, such as blue, is psychologically proven to be relaxing.  Additionally, using heavy curtains or wearing a sleep mask to block out the light.

Electronics: In our society, disconnecting from our gadgets may give us some anxiety, but it is important to turn off the TV, smartphones, IPads and Computers a few hours before bed. This is due to the stimulating effects they have on the brain and the interference with sleep.

If lifestyle changes are not effective in improving your quality of sleep, you may want to consult with a general doctor or mental health professional to address the physical or psychological issues, listed above, which may be interfering with your ability to sleep well.

 

 

 

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Why Couples Counselling

Couples TherapyWhen we fall in love the last thing on our minds is future pain. The beginning of love is joyand quite thick rose tinted glasses. Everything about our partner is perfect, nothing is annoying, and it is all practically perfect.

But everything changes with time, including the way we view people and the one we love is not immune to this. Tiny things you liked as a “quirk” in the past might begin to grate on you in the present. Things you used to agree on can now lead to arguments, as you or your partner might have changed opinions on them. You may feel you have grown and your partner has stayed the same and is becoming boring. Maybe you feel as if you've grown apart. All this could lead to not feeling happy or satisfied in your relationship anymore.

Obviously this could be resolved by simply talking to one another, but often this is where the problem begins: you or your partner could be scared of admitting that there are problems. Or you might want to talk, but don't know how. You have tried to talk, but things came out wrong or are simply misunderstood, leading to an argument and a continuous strain in the relationship. Some people just let things build up between one another, until inevitably they grow apart to such a degree that separation seems to be the only option. Or maybe you are arguing about hundreds of little things instead of discussing the one thing that matters, this too often leads to the mutual decision of ending the relationship.

What if deep down inside you still love your partner and you want to make it work but just don't know how? There are things that can be done, but you need to be open to accepting outside help from a stranger. Someone, trained in dealing with problems like these, could help you talk about your problems in a new environment without history.

Relationship Counselling also known as Couples Counselling or Marriage Guidance, is one of the more well-known forms of counselling, mainly because TV shows often use it as some sort of jokey plot devise. This has led to couples being wary of taking this step. These couples are missing out on valuable help, as Couples Counselling can be an effective way of getting couples to open up to each other, listen and to help them understand where problems lay. Contrary to the TV shows: you will NOT be told what to do, or receive some hippy-dippy therapy: Instead you will finally sit down with your partner and reflect on the past and present, while looking toward the future. The counsellor is there to guide, to raise awareness on issues that get ignored in the heat of the moment and to keep the conversation going. They do not take decisions for you, they do not take sides, and they are there for both of you as the relationship is the priority, not the individual.

The biggest fear of talking to a partner can be that of opening up even more: you live with a person every day and they already know so much, what more do you want to share? Often they don't know as much as you think, and things simply hover in the air unsaid. Gentle guidance of a trained counsellor can help you to speak words you have been afraid to say. Letting go of so much anxiety and fear in front of a partner can give quite a boost to a relationship, because a deeper understanding is built.

Is there a right time to seek help? You might wonder. The right time to seek help is when it feels right for you. If you feel you need help, then you need help. Don't worry if a problem may be “too little”. A small problem is never small if it stands in the way of your happiness. You might also worry that a problem is not really a “couples’ problem”. But in fact: anything that stands between two partners IS a couples’ problem.

Of course taking Couples Counselling will not necessarily mean the two of you will be together. But even then it is beneficial: it will help both of you realise where you went wrong and support you for the further decisions. You will end up with everything out in the open: no questions, no lingering “what ifs” or loose ends. You will find it easier to separate on good terms and stay friendly, if it comes to that. This will also benefit children, if they are in the picture.

You may end up feeling stronger as a couple, as a person or both. Don't wait until a “small” problem has grown. You are together right now and deserve to spend time together in love, not sadness. Take the step towards making things better.

Dannii Cohen

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You Can Overcome Eating Disorders

eating disorderYou Can Overcome an Eating Disorder

In the UK, eating disorders are more common than most people think. In fact, healthcare professionals assert that approximately 1.4 million men, women, and youth contend with an eating disorder like anorexia, bulimia, and binge eating.  That is a lot of suffering occurring right there.

An eating disorder can be classified as a disorder in which one focuses on food much of the time and finds it difficult to focus on other things. Experiencing such a disorder can pose many health threats and can even become life-threatening.

Do you have an eating disorder?

Those that suffer with an eating disorder have a difficult time recognizing that they do. It is usually family members or friends that become concerned about their behaviors associated with food.  They may begin to lose weight rapidly and/or take exercise to an addiction level. They may obsess about food, preparing delicious meals or becoming obsessed with recipes, yet they will only eat tiny bits of foods themselves. They may continually talk about how overweight they are, even though they are not. An eating disorder can literally take over your life.  Along with obsessing about food, you may begin to experience a host of negative emotions like sadness, anxiety, anger, frustration, shame, and more. You may also become fatigued, having little energy to go about your normal daily routine.

If you think you are struggling with an eating disorder, it is important that you be courageous and seek professional help for the matter. No, it might not be easy to pick up the phone or email for an appointment with a counselor, but it is the very first step to overcoming the eating disorder and the emotional and/or mental problems that may accompany it.

What are some red flags when it comes to eating disorders?

  • Not eating at meal time
  • Eating just a tiny bit at meal times, often the foods that have little calories
  • Preparing wonderful meals for others, yet choosing not to eat them yourself
  • Obsessing about recipes/collecting many
  • Skipping many meals
  • Displaying odd eating rituals/habits, like cutting up your food into little pieces
  • Binging on food and then purging
  • Using laxatives
  • Seeing yourself as overweight when others tell you that you are too thin
  • Hiding your body under baggy clothes
  • Only eating in secret

If you recognize yourself in some of these symptoms, you should consider seeing a professional for an assessment.  You could very well be suffering from an eating disorder.

The causes of eating disorders vary. Here are a few theories:

Biological Issues. Some theorize that sufferers could be predisposed to genes that make them more vulnerable to experiencing an eating disorder.

Psychological Issues.  Some people that struggle with eating disorders have psychological or emotional issues that may contribute.  They may have low self-worth, shame, or have suffered some trauma at some point in their lives.

Societal Issues. For those that live in the West, society tends to equate thinness with beauty and success, which is completely false. The media promotes this often, so it is important that men, women, and youth recognize that this type of reinforcement is simply hogwash.

Treatment

Should you feel you are struggling with an eating disorder, you may benefit greatly from counselling.  You can learn to manage your symptoms and cope with stress and negative emotions with positive coping skills. As you contend with any underlying issues, freeing yourself from the pain and suffering associated with it, you might become more confident and happy with yourself- inside and out!

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Postnatal Depression

Postnatal DepressionThe hormonal rollercoaster experienced after giving birth can lead to what is commonly referred to as the “Baby Blues”.  One minute you’re cooing over your newborn infant, the next instant you’re weeping. This is perfectly normal and can last anywhere from a few days to a few weeks following birth.  However, if the symptoms continue or worsen, it could be Postnatal Depression.

Postnatal Depression, also referred to as postpartum depression, is a form of depression experienced after giving birth.  Postnatal depression is characterized by depressed mood, fatigue, anxiety, crying spells, feelings of guilt or shame, insomnia, poor concentration and suicidal thoughts.  The onset can occur within 4 weeks to 30 days postpartum.

The symptoms of postnatal depression do not only affect the mother, but the infant and the family, as well.  An infant’s level of care requires constant attention, which a mother experiencing postnatal depression may not be able to provide, given low energy and fatigue. Mothers with postnatal depression are less likely to hold their children, breast feed, or play with their children, all an important part of developing healthy attachments. An inability to provide developmentally appropriate care can result in a child who is withdrawn or insecure in later life.

A misconception of postnatal depression is that it is a rare occurrence.  Many women may believe that because they have a tendency toward a cheerful disposition that it cannot happen to them.  However, postnatal depression is more common than one may think and can affect all ethnic groups equally.

Princess Diana was among the most prominent women in the world to develop postnatal depression following the birth of her first son, Prince William.  In order to de-stigmatize postnatal depression, Princess Diana spoke openly about her symptoms and how it affected her ability to be the type of mother and wife she wanted to be.  A feeling that resonated among many women who were suffering in silence.

The American Psychology Association (APA) estimates that 9% - 16% of women will experience postpartum depression.  Those odds increase to 41% if the woman has experienced postpartum depression previously.  Although the risk of developing postnatal depression is increased for those with a history of mental illness, the statistics above show that it can (and does) happen to anyone.

If you or someone you know may be experiencing postnatal depression, there are treatment options.  It is imperative that anyone with postnatal depression seek immediate mental health care.  Women can consult their GP for further referral for mental health care.  You may be asking yourself, “Why should I seek counseling?”  Many believe that by asking for help they are admitting defeat and perceive themselves as weak.  That couldn’t be further from the truth.  Asking for help when you need it most is actually a sign of great strength.

Counseling for postnatal depression can provide much needed emotional support for new mothers by helping them to explore the meaning of this experience for themselves. Counselling can help women to make sense of their symptoms in the context of their entire lives, which can be significantly empowering for them, correcting maladaptive thinking such as “I’m a terrible mother” and thereby eradicating feelings of guilt or shame. It can also be an opportunity to work on unresolved emotional aspects of their lives.

Parenting courses are also offered to diminish levels of anxiety commonly experienced by new parents.  Ultimately, counseling and psychoeducational courses help women with postnatal depression to feel they are not alone and encourage bonding, which will result in a healthier mother and child.

In addition to seeking professional help, social support is crucial for all new mothers, particularly those suffering from postnatal depression.  Getting rest, exercising, good nutrition, the help and support of family and friends have all been proven to be successful strategies.

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