Online Help for Anxiety

One of the tricky things about anxiety is that it is often an isolating force in our lives, just at the time when we most need connection. One way to connect to anti-anxiety resources without leaving home is the Internet. The Anxiety Disorders Association of America (www.adaa.org) Web site offers tips to help one sleep better (e.g. don't do your bills just before bedtime--listen to soft music or read a book instead), a listing of therapists and support groups in your area, and self-tests for adults, teens, parents, and family members to determine if anxiety is getting in the way of one's daily life.

If you have a favorite anti-anxiety resource, please let me know, and I'll be glad to write about it here.

Overcoming Birth and New Parenting Anxiety

Many parents-to-be experience a heightened level of anxiety in the days leading up to birth. One way to abate anxiety's weight is to hire a labor doula who will coach you through labor and delivery. You can expect your doula to have practical knowledge about coping techniques, translating medical jargon, developing a birth plan, even helping you decide what to take to the hospital, or what to have on-hand for a home birth. To find a labor doula in Seattle, check out PALS. Many doulas offer sliding-fee scales to make their services accessible to everyone, so be sure to ask around for a doula who will meet your price point. They are out there. (Thank you, Jennifer!)

After the baby arrives, you may find anxiety nagging you: "Are you sure you're doing this right?" Finding a supportive person to tell anxiety, "Yes, you are absolutely doing this right" may be the best way to end anxiety's nagging. A postpartum doula can help you "find your feet" as a parent. Having a network of people who support your parenting is widely noted in helping new parents keep mood disorders at bay. Again, many doulas also do this work on a sliding-fee basis, making this care surprisingly inexpensive. In the Seattle area, NAPS offers a free postpartum doula referral service and can match you with someone who specializes in your particular need area (e.g. multiples, sliding fee scale, mood difficulties, lactation challenges, etc.).

We are especially blessed here in Seattle to have some especially dedicated, caring, and skillful doulas whose work I just cannot say enough good things about. Helping parents be at their best ensures that their children can also thrive.

A Quarter Century of PEPS

As seasoned parents know, one tried and true way of dealing with parenting anxiety is to have a supportive network with whom you can share your parenting joys, frustrations, questions, and concerns. In Seattle, we are fortunate to have the Program for Early Parent Support (PEPS) do the organizational heavy lifting for us. PEPS connects parents of similarly-aged babies within a neighborhood with a facilitator who guides them in discussions of couples' issues, post-partum mood disorders, returning to work, sleep, and the like. The PEPS model could certainly be replicated by some well-connected and enthusiastic parents in other cities and towns, as well.

For those in Seattle who want to show their support for PEPS and the work it does on behalf of parents, mark your calendar for the 25th Anniversary Luncheon on Tues. April 29, 2008. Speaking at the event will be newscaster Jean Enersen and author of the "Arthur" series Marc Brown.

Holiday Anxiety

With the holidays upon us, many of us will feel anxiety's pull more acutely than at other times of the year. Part of the reason for this phenomenon, I suppose, is due to just how different the holidays are than the rest of the year. This difference can be exciting. We eat differently, shop differently, visit different places, see different people. But all this difference can also leave us vulnerable to anxiety's arsenal of tricks. I've often observed with clients how a strong offense is the best defense against difficult transitions. One way to defend against anxiety is to maintain the regimen that keeps one feeling well. What I've noticed in folks affected by anxiety is this recurring theme of needing to strike a balance between personal and public time. This balance may look very different on an individual basis, but the need for balance is universal. Being taken out of our usual work/family/private life routine can be exciting, but aiming for a similar balance during the uniqueness of the holidays may be the strongest innoculation against anxiety.

Some questions to ask yourself may include: When I'm feeling at my best, what does the balance between alone and social time look like? During the holidays, do I expect that balance to shift? If the holidays tend to be a time of greater sociability for me, where are my opportunities for alone time? Are there some social engagements I could cut out if I start to feel too out of balance? If the holidays tend to be a time of greater solitude, where are my opportunities for greater sociability? How might I create opportunities for more public time if I begin to feel too out of balance? Is there someone who could check in with me about how I'm doing in my aim to balance personal and social time?

And with that, I wish you all happy and balanced holidays.

Sleeping off the Baby Weight

As we all know, getting enough sleep is important for our mood and overall ability to function. Additionally, new research shows that women who get at least seven hours of sleep a night are much more likely to return to their pre-pregnancy weight than women who got only five hours per night. Just another reason to ensure all moms of newborns are getting the sleep they need for good health and well-being.

Help Karen Kleiman with her Important Research

Karen Kleiman is a tireless author, clinician, trainer, and advocate for advancements in ppmd research and treatment. I cannot say enough good things about the work she does. If you've had a baby in the past year, please consider participating in her latest research project:

As many of you know, I have been collaborating with a research team at the University of Pennsylvania School of Medicine who have expertise in postpartum distress and scale design. We have performed an initial statistical analysis on a new postpartum distress scale.

At this stage, we would like to re-test our proposed scale items, along with established measures, such as the Edinburgh Postpartum Depression Scale (EPDS).

We need approximately 100 postpartum women (with babies up to 12-months old) to complete this phase of the study. I am hoping that you will post a link to the questionnaire, which is offered online, for your members or your clients, to help us further validate this measure.

No problem, Karen! Please click on this link to be directed to her survey.

Tuning Your Instrument

In the Yoga Therapeutics workshop I attended today with veteran teacher J.J. Gormley, she used the metaphor of body as instrument. I think this is a particularly apt metaphor in thinking about the mind-body connection. When mind is "in tune", everything is in balance. Anxiety and depression can cause our instrument to go out of tune. Depression can cause our instrument to go flat. Tightening up the strings will bring the instrument back into tune. Anxiety makes our instrument play sharp. In that case, the strings need to be slackened.

Depression is an introverting force (or, langana, in Sanskrit) that encourages us to fold inward, close down. To bring the body back into balance (samana), start with the inclination to fold in, and gently coax the body outward. One way to do this is to start in staff pose. Inhale. Exhale and bend at the waist into a seated forward bend with your shins as your drishti, or focal point. Return to staff pose. Now, try seated forward bend, but make your toes your drishti. Come in and out of seated forward bend several times, moving your drishti incrementally higher each time, while noting any differences in your body's tuning in each subsequent staff pose. (Note: in order to keep your neck long, you will be bending less and less at the waist each time, keeping your head, neck, and torso in good alignment.) After doing the seated forward bend with your focal point at different heights, close the practice with your eyes focused on your shins one more time. What differences do you notice on your mind and body between holding your gaze outward versus downward?

Anxiety, on the contrary, is an agitating force (or in Sanskrit,brhmana), keeping the mind very busy. Start in table-top position. Inhale for 6 counts into cow pose. Exhale for 4 counts into cat. Repeat this a few times. Then equalize your breath for five counts each in cat and cow. After a few repetitions of equal breaths in cat and cow, shorten the inhale into cow to 4 breaths, and lengthen the exhale into cat to 6 breaths. Rest in child's pose. Notice if lengthening your exhale has had any effect on your instrument. Repeat the exercise again, keeping an awareness of how the change in breath alters the tuning of your instrument.

In your home practice, play around with poses using different gazing points or breathing techniques. Note which you experience as calming and which as energizing. When you start to sense anxiety or depression tapping on your shoulder, refer back to your catalogue of poses and implement those counter-balancing poses that could bring your instrument back into balance.