Perinatal mental health (mental health during pregnancy and the postpartum period) is a critical yet often overlooked topic. Many parents-to-be face challenges like anxiety, depression, and intrusive thoughts, yet stigma and lack of awareness often prevent them from seeking support. It’s understandable since they’re likely not sleeping well, hormones are probably all over the place, there are physical changes going on… I could go on and on.

In this blog post, I’ll share some of my personal experiences, along with insights into the common struggles many expectant and new parents face from a podcast episode I recorded with Amanda (a therapist) and Twilight Florido Burgad (a psychiatric nurse practitioner)—both providers specialize in this crucial period. Whether you’re currently pregnant, navigating postpartum, or supporting someone who is, this post is here to remind you that you’re not alone—and that there’s help and hope.

Let’s explore what perinatal mental health is, how it can show up, and what steps you can take to prioritize your well-being.

Here’s the podcast interview with Amanda and Twilight about perinatal and postpartum mental health:

What Is Perinatal Mental Health?

The perinatal period pregnancy covers pregnancy all through the first year of your baby’s life. This is a vulnerable and transformative time for parents, fundamentally altering their life and often their mental and physical health too. It makes sense that people struggle during this time!

Signs of Postpartum Depression and Anxiety

Postpartum depression or anxiety looks a lot like normal depression or anxiety, although its onset is during that perinatal period. Symptoms of postpartum depression usually include:

• Feeling sad or feeling like you’re not a good parent (especially if these feelings persist beyond the two-week baby blues period)
• A sense of overwhelming guilt,
• Feeling unable to cope with emotions
• Feeling disconnected from themselves
• Feeling tired or unable to get out of bed (although, this is a hard one to decipher because you’re probably not sleeping a ton)
• Lack of appetite or eating more than usual (again, this might be a tough one because lactating can cause some new eating habits)

Symptoms of Perinatal or Postpartum Anxiety

There is an increased risk of clinically significant anxiety during the perinatal period, with symptoms like racing thoughts, worrying about the baby’s safety, or having intrusive thoughts that might be distressing and lead to behaviors like not wanting to go down stairs for fear of dropping the baby.

In the initial weeks after I gave birth, I experienced intense anxiety around whether my baby was breathing while he was sleeping or if my cat or a blanket might suffocate him. While this is a common fear, I did find some relief as time went on (and especially after I started sleeping a little more). When I was struggling with these intrusive thoughts it helped me to verbalize them with close friends who were also parents—it made me feel like I wasn’t alone and their reassurance was what I needed at the time.

Common Mental Health Challenges During Pregnancy

Perinatal anxiety is the most common type of mental health issue during this time. Personally when I was pregnant, I experienced a lot of anxiety. Many of my friends had gone through miscarriages, physical health issues, and even stillbirths, so in the early days of my pregnancy, these thoughts consumed me. I found some relief after the very first doctor’s appointment where I heard the heartbeat, but I continued to have waves of anxiety that I needed to find new ways to cope through.

Tips for self-care during pregnancy:

1. Listening to pregnancy or non-pregnancy meditations.
2. Staying active by doing yoga, walking, or swimming (as long as it’s ok with your doctor).
3. Connecting with others in similar life stages or that are becoming parents through Facebook groups or prenatal classes.
4. Writing or reciting encouraging mantras, like “One day at a time,” “I can do this,” or “My body is amazing.”
5. Visualizing encouraging things, like your partner holding a baby at the end of the pregnancy, your children meeting the baby for the first time, or a peaceful birth.
6. Saying no to things that tire you or that don’t contribute to your peace.
7. Seeking therapy if you’re noticing that it’s difficult to control your worry or if you’re feeling more down and hopeless or extended periods of time. There are lots of therapists that specialize in pregnancy and perinatal mental health at Ellie Mental Health!

Beyond Postpartum Depression

Most of us have heard of postpartum depression, but it is just one of several perinatal mood disorders. There are other conditions like postpartum psychosis that are crucial to recognize and address. warns, must be treated as a psychiatric emergency due to its potential risks.

Symptoms of Postpartum Psychosis

The following are the most common symptoms of postpartum psychosis—but keep in mind that this diagnosis is fairly rare. They typically develop within two weeks of giving birth, but they could come on later.

• Delusions: Believing things that are true, when they’re not
  • Example: Believing that your baby was swapped with a different baby
• Hallucinations: Hearing, seeing or feeling things that aren’t actually there
  • Example: Hallucinating that someone is telling you to harm your baby
• Rapid mood swings
  • Example: Feeling euphoric or really happy and switching to hopelessness or depression
• Difficulty focusing or make sense of your words
• Paranoia: Feeling suspicious of others
  • Example: Believing that your mother is going to kidnap your baby
• Risk taking and impulsivity that is out of the ordinary
• Difficulty sleeping
• Thoughts of harming yourself, your baby, or suicidal ideation

If you or someone you love is experiencing these symptoms, please don’t ignore it. Postpartum psychosis is serious and should be treated right away by contacting your doctor or going to an emergency room. Typical treatment is a combination of medication and therapy.

Can Men Get Postpartum Depression?

Absolutely! In fact, research indicates that approximately 10% of new fathers encounter postpartum depression, with symptoms often peaking between 3 to 6 months after childbirth. For dads, this can look like irritability, fatigue, changes in sleep and appetite, difficulty bonding with the baby, and feelings of inadequacy

Can Adoptive Parents Experience Postpartum Depression?

Yes! Adoptive parents may experience a form of postpartum depression often referred to as post-adoptive depression, which shares many symptoms with PPD, including:

• Emotional changes: Feeling overwhelmed, anxious, or emotionally distant from the child. A lot of adoptive parents I work with share that the time following placement often just feels like “babysitting” because there’s not a lot of attachment there yet.
• Fatigue and sleep disturbances: You’re pooped. All of the time. Sleep issues are a very common issue in adopted kids—regardless if they’re infants or not. An adoptive family I worked with years ago shared that she had to sleep on the floor of her daughter’s room for a whole year before the kid felt comfortable falling asleep on her own. There can also be nightmares or night terrors because of trauma. 
• Feelings of inadequacy: Adoptive parents have to go through an enormous amount of trainings, background checks, and the entire homestudy process to “prove” that they are fit to be parents. You often feel like you’re under a microscope and every choice you make will be judged. Combine that with the secondary grief and separation that the birth parent and child may be experiencing, and it’s easy to feel like you’re not enough.
• Isolation: It’s a new dynamic and it can be lonely. Adoptive parents don’t always receive the same support biological parents do. While baby showers and meal trains are becoming more common for adoptive parents, it is unfortunately not always a given for every parent. 
• Unrealistic expectations leading to disappointment: As an adoptive parent, you’ve spent years preparing to be a parent and proving that you’ll be a great one… what happens when you struggle? In my experience, adoptive parents are less likely to speak up when things feel off or when they’re not measuring up to the rosy picture we had in our heads out of fear or pressure.
• Fear and anxiety: Depending on your state and program, there may be a period of time after the child is placed with you where the birth parent, agency or state can take the child back. This might be due to a birth parent changing their mind and deciding to parent, the birthparent getting legal custody through court after an involuntary removal of the child, or if a different placement option comes up that fulfills the rules of the Indian Child Welfare Act or the Sibling Bill of Rights. There can be a lot of unknowns until it is legally finalized.

If you’re interested in learning more about Post Adoption Depression, I highly recommend checking out Karen J. Foli’s research and book.

Normalizing the Postpartum Experience

It’s very common to experience the “baby blues” while you’re adjusting to parenthood, and counseling for new parents can be very helpful. The “baby blues” is when you’re feeling anxiety, overwhelm, sadness, irritability, crying, reduced appetite, and inability to sleep. It typically starts after delivery and can last up to two weeks.

We need to normalize the difficult emotions and experiences parents may face during this time period, while also highlighting what to do when things are feeling more serious. As Twilight emphasizes, it is essential for parents and clinicians to understand that having “scary thoughts” can often be a part of adjusting to parenthood. Amanda further adds that acknowledging and normalizing these experiences can prevent isolation and help new parents seek necessary support.

The Importance of Social Support

Social support is paramount during the perinatal period. Twilight advocates for building a strong support network well before the baby arrives, underscoring the importance of leaning on family, friends, and community resources. Programs like those offered by Postpartum Support International (PSI) provide valuable support and education for new parents.

Amanda Davis Scott shared: “Talk about what can happen, how common these things are, perinatal mood and anxiety disorders, what you can do to protect yourself, protect your sleep, utilize your resources and support around you so that you don’t run into the problem of expecting too much out of yourself or extending yourself too thin.”

Twilight added: “Not everybody is going to need medication. Not everybody is going to need therapy, but social support is the one essential that everybody needs during that time.”

No-one gets a parenting instruction manual, but that’s okay. The team of experts from Ellie Mental Health can guide you in your postpartum mental health journey. Find a perinatal therapist near you today.

Parent Self-Care and How to Support New Parents

Both Amanda and Twilight stressed the importance of parental self-care in the podcast episode. This includes eating healthy food, sleeping when you can, and mental health support. They encourage parents to shed societal pressures of perfection and to seek help without guilt.

When you become a new parent or you add another kid to your family, it can sometimes feel like you’re drowning and take some time to adjust. This adjustment period can feel even harder when you’re struggling with your own mental health too. Self-care looked different in those early days for me—it needed to be quick, require less energy, or just be simpler. It looked like:

• Sleeping or lounging around in cozy pajamas
• Going for a quick coffee run all by myself
• Dancing with my baby
• Going for a short walk (with or without the baby in the stroller)
• Using meal kids and grocery delivery instead of needing to run errands
• Rewatching favorite shows during the endless hours of feeding (Friends and Mr. Monk were my go-tos in the early postpartum days)
• Taking lots of warm baths
• Facetimes with other moms that I knew would get it
• Getting a new water bottle since I was suddenly thirsty all. the. time.
• Taking my older daughter on our own little dates

In the whirlwind of new parenthood, self-care can get pushed to the backburner (which is understandable—you’re suddenly caring for a whole new little person), but it’s important to prioritize even the smallest things for your mental health.

Think about some things that help you feel a little bit more like yourself (maybe it’s going for a walk with a friend or trying all of the Costco samples on a Sunday afternoon) and then don’t be afraid to ask your support system for help to make it happen.

If you, dear reader, are a support person to a new parent, be proactive! Buy the new parent comfy pajama pants, bring over dinner one night (pro tip: bring paper plates or offer to do the dishes afterwards), or offer to watch the kids while they catch up on some sleep.

In another blog post about how to support a new parent, therapist Anna King recommends asking questions like, “I’m running by Starbucks, can I pick something up for you?” or “I really struggled adjusting to parenthood at first. How do you feel like you’re doing?” Be direct and pro-active, rather than just waiting for the new parent to ask for help.

Final Thoughts

Parenthood is a life-changing experience, but it’s not always the picture-perfect journey we see on social media. If you’re struggling with your mental health during pregnancy or postpartum, I want you to hear this loud and clear: you’re not alone, and it’s not your fault.

As a therapist (and a mom) I’ve been there. Those overwhelming feelings, the anxiety, the intrusive thoughts… they can make you feel like you’re the only one going through it. But trust me, so many parents face these challenges, even if we don’t always talk about it.

The good news? You don’t have to navigate it alone. Whether it’s finding a therapist who specializes in perinatal mental health or even just sharing your feelings with a friend or partner, there’s help out there.

If you’re a support person, don’t underestimate how much simple acts of kindness matter, like offering to pick up coffee or holding the baby while they nap.

You’re doing better than you think, and it’s okay to ask for help. Parenthood is tough, but you don’t have to go through it on your own. There’s so much support and hope waiting for you.

The post Let’s Talk About Perinatal Mental Health: You’re Not Alone appeared first on Ellie Mental Health, PLLP.

What does it actually mean to regulate your nervous system? For a long time, I thought that my nervous system would be regulated whenever I stopped feeling hard emotions. I’ve learned through years of personal and professional work that my belief was wrong. Hard emotions don’t just stop happening.

Nervous system regulation doesn’t exist in the absence of emotions. To experience nervous system regulation means to experience adaptive responses to emotions. When I can feel my emotions, experience, and move through them, without feeling totally overwhelmed and out of control, I know that I am regulated.

Dr. Dan Siegel identified a concept called the window of tolerance. He identified that when individuals are existing within the “optimal zone,” we are able to effectively cope with emotions that arise. Within this window, we are regulated. Our window of tolerance is flexible. It may shrink when we’re experiencing trauma or emotional overload. It can also grow as we develop and use regulation skills and build emotional resilience. When we are operating outside of this window of tolerance, we may be on one of two sides – hyperarousal or hypo arousal.

Hyperarousal vs. Hypo Arousal

If we think of nervous system regulation as a spectrum, then hyperarousal and hypo arousal lie at opposite ends. Different emotions, behaviors, and thinking patterns can indicate which state we might find ourselves experiencing, which can help us better understand ourselves and our needs.

When you think of the word hyper, you may imagine a little kid with a lot of energy. That is also true for the nervous system. When in hyperarousal, the body has a lot of energy and wants to do something. This is why someone experiencing hyperarousal might unexpectedly hit something or snap at a friend.

Symptoms of Hyperarousal

• Emotions like worry, panic, or anger
• Hypervigilance
• Irritability
• Racing heart
• Feeling hot/sweating

Hypoarousal is just the opposite. Think about a cell phone that you’ve set to low power mode. To conserve energy, the phone limits certain functions. Hypo arousal functions very similarly, although it operates subconsciously. When in hypo arousal, the body is attempting to conserve energy for the tasks the body deems most important. This is why a person experiencing hypo arousal might find themselves staring at their phone for hours, unable to start a task.

Symptoms of Hypo Arousal

• Immobilized, feeling stuck
• Fatigue
• Brain fog
• Boredom, indifference, apathy
• Dissociation

Tips for How to Regulate: Nervous System

Nervous system dysregulation can be tough to deal with. Once we realize that we are experiencing hyperarousal or hypo arousal, what do we do to shift back towards regulation? I’m going to share two emotional regulation techniques to help – mindfulness and radical acceptance.

Mindfulness: A Key to Emotional Regulation

Noticing where we are emotionally at any given moment is half the battle – and it can be a hard one!  Mindfulness isn’t about fixing or stopping emotions. It’s about simply noticing; allowing ourselves to witness our emotions with curiosity and non-judgment.

Mindfulness has a rich history, stemming from Eastern religions and spiritual institutions, such as Buddhism. After Jon Kabat-Zinn brought mindfulness to Western society in the 1970s, its popularity has risen throughout the decades to follow. Meditation is one very common form of mindfulness, but it’s not for everyone. That’s okay! There are several other options for those interested in practicing mindfulness – mindful movement, mindful creativity, even mindful eating. The goal of mindfulness is to build self-awareness, which can happen in a variety of contexts.

Mindfulness isn’t necessarily about what we’re doing, it’s about how we’re doing it. When practicing mindfulness, I decide that I’m going to spend time present with myself, not judging whatever emotions, thoughts, and sensations might come up for me.

Radical Acceptance: The Power of Letting Go

One of the ways I practice non-judgment towards myself is by practicing radical acceptance. The term radical acceptance was coined by Marsha Linehan. She describes complete and total acceptance of our reality. If I can be honest here, I struggled with this concept for a long time. It changed for me when I realized that acceptance is not synonymous with like. I can accept that I may be feeling anger, jealousy, anxiety, or any other emotion. That doesn’t mean that I have to like it, and that doesn’t mean that I have to sit in it either.

Linehan said, “You only have to accept the moment you’re in, but you can try to change the next moment.” Radical acceptance does not mean staying stuck. Radical acceptance allows us to embrace our current reality so that we can make the best choices we can moving forward. Pain cannot be avoided, and rejecting or resisting that pain doesn’t help. From my personal experience, acceptance provides a sense of clarity that allows me to work towards a potential solution.

Radical acceptance is a key part of DBT and ACT. A therapist that specializes in ACT or DBT might be a good place to start.

Final Reminder + a Sprinkle of Self-Compassion

Think back to the hypo arousal example. This person is using their phone, unable to start a task. Mindfulness can allow this person to bring their attention to the present moment and their current experience. Being careful not to slip into self-judgment, the person can practice radical acceptance – “I accept that I feel stuck right now. What can I do to feel slightly less stuck in the next moment?” Even the most regulated individuals may slip into hyperarousal or hypo arousal occasionally – it’s all part of the human experience. Regulation is all about our responses and our ability to mindfully shift into adaptive coping strategies.

One of my personal core beliefs is that we are all trying our best at any given moment. And our best often looks different moment to moment and day to day. Sometimes, we have so much space, capacity, and time and on other days, we just don’t. I’ve recently started to slow down and remember that I do my best. It’s okay that my best today might not be as good as my best yesterday. And it’s okay if that’s true for you too. Growth isn’t a straight path.

Frequently Asked Questions

What is Nervous System Regulation?

Nervous system regulation refers to the ability to respond to emotions in an adaptive way, rather than becoming overwhelmed by them. It’s all about being able to calm ourselves down when things are overwhelming.

What is the Difference Between Mindfulness and Meditation?

Mindfulness is a state of awareness and non-judgement, exploring one’s thoughts, emotions, and bodily sensations. To be mindful is to allow thoughts, emotions, and sensations to come up naturally, simply observing and noticing. Meditation is one form of mindfulness, and tends to be a more structured, formal process in which the meditator often focuses on something specific, such as an object, mantra, or the breath.

How Can I Practice Radical Acceptance in Everyday Life?

First, we must notice any resistance we are feeling. Sometimes emotions are not fun to feel, and we resist them. That’s a normal response! That resistance can act as a reminder, telling us to pause, notice, acknowledge, and accept what we are experiencing and feeling.

Let’s use an example. Many of us have found ourselves late to an appointment and stuck in traffic. Often, our response to this might look something like, “I can’t believe this! I’m already so late, I can’t deal with this.” To practice radical acceptance, we can first pause. Then, we can notice the emotions that are coming up, maybe anger, frustration, anxiety, boredom, etc. Once we notice it, we can acknowledge it by saying, “I accept that I’m stuck in traffic. I accept that I feel super frustrated about this situation.”

Okay, I’ve Practiced Mindfulness and Radical Acceptance – Now What?

These are great steps to take, but sometimes they may not feel like enough. Now that you’re feeling a bit more regulated, it’s a good time to focus on self-care. This article provides a great list of self-care activities you may find helpful.

The post Two Simple Ways to Regulate Your Nervous System for Better Mental Health appeared first on Ellie Mental Health, PLLP.

This blog post explores how gratitude can actually help to reduce symptoms of depression and anxiety, strengthen your relationships, and build emotional resilience and how to get started.

How Gratitude Rewires Your Brain

Research has shown that regularly practicing gratitude can improve mental health, increase life satisfaction, and even boost physical health. By shifting our focus from what we lack to what we have, gratitude allows us to adopt a more positive and appreciative perspective.

The Power of Gratitude on Depression

A pivotal study conducted by psychologist Dr. Robert Emmons, a leading gratitude researcher, found that people who regularly engage in gratitude practices report higher levels of happiness and lower levels of depression. Emmons suggested that gratitude helps shift focus away from negative thoughts and provides a more positive outlook on life, which can help fight depression and it’s symptoms.

Gratitude and Anxiety cannot coexist study

Cindy Stellers completed a study exploring the power of gratitude in tackling anxiety. The idea? Gratitude and anxiety can’t coexist. The finding? Focusing on the good stuff—those little moments of joy and thankfulness—can dial down anxiety levels. Those who made gratitude a daily habit found their minds less crowded with worries and felt a significant boost in well-being. According to Stellers, gratitude serves as a protective mental shield, shifting our attention from stress to positivity. This leaves less room for anxious thoughts to take hold. This means that weaving gratitude into the fabric of our everyday lives could be a remedy for anxiety symptoms. It’s a testament to the power of gratitude, showing its potential to transform our emotional world, pushing anxiety into the shadows.

Benefits of Gratitude

Gratitude Enhances Relationships

Expressing gratitude to partners, friends, and colleagues can enhance relationships. A simple thank you or acknowledgment of someone’s efforts can strengthen bonds and foster a sense of connection.

Gratitude Boosts Resilience

Life is full of challenges, but gratitude can help build resilience. By focusing on positive aspects, even during tough times, gratitude helps us cope better and bounce back faster.

Gratitude Improves Mental Wellbeing

Regularly practicing gratitude can reduce stress and enhance overall mental wellbeing. Cultivating gratitude can lead to a happier and more fulfilled life, with decreased anxiety and depression.

Incorporating Gratitude into Your Life

Start a Gratitude Journal

One practical way to cultivate gratitude is by keeping a gratitude journal. Each day, jot down three things you are thankful for. This simple practice can help shift your focus toward positivity.

Create a Gratitude Jar

This is a great way to involve kids in practicing gratitude. You could read this book about gratitude together and then every day add things into your gratitude jar. At the end of the month, open the jar and read what everyone wrote.

Express Gratitude to Others

Don’t keep the gratitude to yourself. Share it with others. Whether it’s a heartfelt thank you note or a verbal acknowledgment, letting others know you appreciate them can make both of you feel good.

Practice Mindfulness

Take a few minutes each day to practice mindfulness and reflect on what you’re grateful for. This can be through meditation or simply pausing to contemplate the positive aspects of your life.

Focus on the Present

Gratitude helps us live in the moment. Instead of worrying about the future or dwelling on the past, gratitude encourages us to appreciate what we have right now.

Teaching Your Kids to Practice Gratitude

Encouraging kids to practice gratitude can set the foundation for a positive and fulfilling life. Begin a journey of gratitude with your little ones, setting the stage for a fulfilling life filled with positivity. Lead by example by expressing your thankfulness in the everyday, letting them witness gratitude in real time. Thank your partner for doing the dishes or thank your sister for who made dinner, because saying “thank you” shouldn’t be awkward or an afterthought!

Invite your kids to join in activities that encourage them to express their thankfulness, like drawing or writing about what makes their heart happy. Make gratitude a daily ritual, perhaps over dinner or before tucking them in, by sharing the day’s highlights that made you grateful. Involve them in random acts of kindness, from writing thank-you notes to helping a neighbor, to underscore the importance of appreciation. These simple yet powerful practices can help your kids grasp the concept of gratitude, shaping a habit that will enrich their lives.

How to Practice Gratitude When You’re Depressed (or When Things Aren’t Going Well)

We get it—practicing gratitude when feeling depressed can be challenging, but even small efforts can make giant impacts. One thing that I often recommend to clients who are right in the middle of a depressive episode is to write down one or two things each day that make you feel better or bring even a small sense of relief… maybe that is a cup of coffee, cuddles from your cat, sunshine after a rainy day, etc. If writing isn’t your thing, you can also tell them to a friend or tell them to your dog—it’s the reflecting part that is helpful.

Another thing that I recommend is listening to a guided meditation about gratitude – it doesn’t take much effort, but it can help shift your thoughts away from negativity or anxiety. Here’s one I recently recorded that you might find helpful!

Conclusion & the Importance of Gratitude

Gratitude is more than just a feeling! Incorporating gratitude into daily life can have transformative effects on our mental and emotional health. Research by Dr. Robert Emmons and Cindy Stellers highlights that gratitude can combat depression, reduce anxiety, and improve resilience. Whether you’re making a gratitude list, saying a heartfelt ‘thanks’ to your loved ones, or teaching your kids to recognize and express gratitude, small steps can create big changes. Go on, take a moment to cherish the little things—it’s your first stride towards a happier, healthier life.

The post The Power of Gratitude: Neuroscience and Practice Tips appeared first on Ellie Mental Health, PLLP.

Trust me, I get it. It’s a scary thing to talk about, but why? The reason that asking someone if they’re thinking about suicide is scary is because the answer might be yes. If the answer is yes, you’re then faced with having a potential life or death conversation. It’s a serious conversation and addressing their suicidal thoughts might be scary for YOU, but it can also be a relief for the person you’re talking to because it shows that you understand the facts and myths related to suicide, recognize the warning signs, and care enough to have a conversation that most people don’t want to have.

Common Facts and Myths About Suicide

Talking openly about suicide is crucial to breaking down the stigma and misconceptions that surround it. Misinformation can prevent people from seeking help or supporting others who may be struggling. In this section, we’ll explore common myths about suicide and uncover the facts to help promote understanding and awareness. Watch the video below to learn more, and check out the subsections for deeper insights:

Fact: The Word “Commit” Can Contribute to Stigma

Even though the word “commit” is frequently used as an action when people talk about someone who’s died by suicide, it tends to have a negative connotation and can contribute to the stigma associated with suicide. A more appropriate phrase to use would be “someone died by suicide.” 

Myth: People Who Talk about Suicide Aren’t Serious About Going Through with It

People who talk about their thoughts of suicide don’t want to continue living with the current difficulties in their lives; it’s not that they necessarily want to die. One of the things that we know about suicide prevention is that most of the time, people can talk themselves out of suicide if they have the opportunity to talk about it, which means they just need someone to listen to them.

Myth: Asking Someone About Suicide Puts the Idea in Their Head

This is actually one of the biggest myths associated with suicide. Humans are not that easy to influence, and naming it isn’t going to make someone’s thoughts about suicide worse. In fact, research actually shows that if you ask someone about suicide, it can provide them with a sense of relief!

Fact: Suicide is Not an Impulse Act

Most suicides are carefully planned and thought about for weeks, months, maybe even years. In fact, some research shows that about 95% of suicides have been carefully thought out before someone dies by suicide, which shows that most of the time, suicide is not an impulsive act.

Myth: All People Considering Suicide Are Fully Intent on Dying

People with thoughts of suicide typically have ambivalent thoughts, which means part of them wants to die, and part of them wants to live. We want to focus on the part of them that wants to live. 

Fact: Suicide Rates Are Highest in the Spring

People commonly think suicide rates are highest in the winter around the holidays. However, the reality is that they are highest in the spring. And research shows that that stands true across the country, even in places where it’s frigidly cold throughout the winter. 

Fact: 25% of People Who Die by Suicide Leave Notes Behind

When responding to scenes of suicides, a commonly asked question by family members is “did they leave a note?” Unfortunately, when working with survivors of suicide loss and notes are left behind, they tend to bring more questions instead of providing answers.

Fact: Suicide is The 2nd Leading Cause of Death For Children Ages 10 to 14

Suicide is a public health issue that significantly impacts our country’s youth. Having the conversation with our youth about suicide is an important part of suicide prevention. 

Common Warning Signs of Suicide

The challenge is that most people don’t know how to talk about suicide. They don’t know what to say if someone shows warning signs…. and many people don’t even know what warning signs are.

Warning signs are things that we can observe in others that might indicate that they are thinking about suicide. Warning signs can be things that people think, feel, or behaviors that they display.

What They Might Say

• I just want to die

• I don’t see how things will get any better

• What’s the point of living?

• I want to go to sleep and not wake up

• They’d be better off without me

• I feel trapped

Feelings They May Experience

● Hopeless

● Helpless

● Numb

● Trapped

● Burdensome

● Unbearable psychological pain

Behaviors They Might Display

• Increased alcohol or drug use

• Preparatory behaviors (gathering pills, purchasing gun, research)

• Withdrawing from activities

• Isolating from family and friends

• Sleeping or eating too much or too little

• Visiting or calling people to say goodbye

• Giving away possessions

• Increased aggression or anger

Now that you understand some of the most common suicide warning signs, it’s helpful to know what to do if you recognize any of these signs. Remember, these signs MIGHT mean that someone is thinking of suicide, it’s not guaranteed. The only way to know for sure if someone is thinking about suicide is to ask them!

Three Easy Steps: What to Say to Someone Who is Suicidal

Starting a conversation about suicide can feel overwhelming, but asking someone if they’re feeling suicidal is one of the most important steps you can take to help. It’s a direct, compassionate way to show that you care and that they’re not alone. In this section, we’ll guide you through three steps for how to approach this sensitive topic and provide examples to make the conversation feel more supportive and effective.

1. Show Them the Evidence

Tell them what you’ve noticed about their behavior and why you’re asking about suicide. Often, people are concerned that someone might get angry when you ask them about suicide. This is not typically the case, but if it was, by showing them the evidence, you mitigate the opportunity for them to respond and say, “What?! Why are you asking that?!”

Example: I’ve noticed that you’ve been showing up late for work, you’ve lost a lot of weight, and I know that you and your wife have been struggling to connect lately.

2. Normalize Their Thoughts

I like to tell people that given the circumstances (the evidence you just showed them), it’s understandable that they might be thinking about suicide. Example: In any of those situations, someone may be thinking about suicide.

3. Ask Them Directly

When asking someone about suicide, it’s important to be direct. We want to show the person that we’re comfortable talking about suicide and that we’re there to listen. This is why it’s important to be direct and say “Are you thinking about suicide?” or “Are you thinking about killing yourself?”

All together, it sounds like this:

I’ve noticed that you’ve been showing up late for work, you’ve lost a lot of weight, and I know that you and your wife have been struggling to connect lately. In any of those situations, someone may be thinking about suicide. Are you thinking about suicide?

Having a Conversation with Someone Who’s Thinking About Suicide

When you’re having a conversation with someone who’s thinking about suicide, remembering the following tips may be helpful:

• Treat it like any other conversation
• Be genuine and non-judgemental
• Be an understanding, active listener
• Ask for help if needed
• Connect to resources

If you’re talking to someone with thoughts of suicide and need extra help, you or the person with thoughts of suicide can call or text 988, the National Suicide and Crisis Lifeline.

The post How to Ask Someone If They Are Suicidal: Facts, Myths, and Signs appeared first on Ellie Mental Health, PLLP.

Seasonal affective disorder is a type of depression that typically takes place during seasonal changes in fall or winter. With the weather getting colder and the days getting shorter, people tend to recluse inside which can increase the depressive symptoms they are experiencing.

In this blog post we are going to unpack the symptoms and causes of SAD, how it differs from depression and the winter blues, and practical coping tips to help you navigate these winter months.

The Shortest Day of the Year

The shortest day of the year is around December 21^st, which is also referred to as the winter solstice. It is referred to as the shortest day of the year because the sun is up for a short period of time. During the solstice, the sun appears at its lowest point in the sky, creating the longest night and shortest day. Culturally and symbolically, the winter solstice has been celebrated for centuries as a time of reflection, renewal, and the promise of longer, brighter days ahead. It reminds us of the cyclical nature of seasons and the balance between darkness and light.

After the winter solstice, the days gradually start to get longer as the Earth continues its orbit around the sun. This increase in daylight continues until the summer solstice, around June 21st, which is the longest day of the year. The shift from shorter to longer days can bring a sense of hope and renewal, as more daylight often means increased energy and motivation for many people. This gradual return of light is significant in various cultures, symbolizing growth, warmth, and the approach of spring.

Sunlight and Mood

Why does daylight matter for our mental health? The lack of sun is important in understanding why fall and winter impact depressive symptoms which lead to seasonal affective disorder.

Sun is important to our mental health – it helps increase levels of serotonin which is the chemical that makes us feel good. It can be a great coping skill for depression, anxiety, and other mental health diagnoses because the warmth can be relaxing and allow us to focus on the heat on our body. Therefore, when the sun is out less during the winter and fall seasons, it can decrease those happy feelings and decrease our ability to use some coping skills.

There are plenty of seasonal triggers that can affect your depressive symptoms or seasonal affective disorder:

• Decreased daylight can disrupt the body’s internal clock
• Cold weather can make us feel less inclined to go outside, which can lead to being less social
• Less exposure to sunlight can lead to a vitamin D deficiency
• Seasonal changes can also disrupt your melatonin levels, leading to overproduction and more sleepiness

Recognizing Symptoms of SAD

The symptoms of seasonal affective disorder are similar to the symptoms of major depressive disorder, however the cause is related to seasons and weather.

According to the Diagnostic and Statistical Manual of Mental Disorders, some common symptoms of SAD include:

• Feeling depressed on most days, during the season
• Reduced energy/fatigue
• Trouble sleeping or oversleeping
• Loss of concentration and interest in activities

These are the common symptoms to be aware of, however there are some uncommon or lesser known symptoms of SAD that include:

• Nausea or loss of appetite
• Could lead to weight loss
• Crave or eat more food
• Could lead to weight gain
• Feeling of worthlessness or hopelessness
• Could lead to suicidal thoughts, urges, and ideations
• Could also lead to increased urges to self-harm

The Difference Between SAD and Major Depressive Disorder

The symptoms listed above are similar to Major Depressive Disorder. To understand the difference between the two diagnoses, remember that the symptoms of SAD are related to fall or winter seasons. That means you might experience these symptoms during the winter time, but notice that they improve or disappear during the spring and summer when there’s more sunlight.

If you are feeling these symptoms in the summer or you’re noticing these symptoms return regularly, it may be major depressive disorder. MDD doesn’t follow a seasonality, and many of the symptoms for more severe—including hopelessness, feelings of unworthiness, and maybe even recurrent thoughts of death or suicide.

If you’re feeling suicidal, please remember that the 988 hotline or textline is there for you 24/7.

The Difference Between SAD and Winter Blues

Both Seasonal Affective Disorder (SAD) and the winter blues happen most often during fall and winter months. While the winter blues might cause temporary sadness, lethargy, or irritability, these feelings are usually mild and manageable without much disruption to daily life.

In contrast, SAD symptoms are persistent and more pronounced that the winter blues. People experiencing SAD may struggle to carry out routine tasks, maintain relationships, or find enjoyment in activities they once loved. If these symptoms persist for most of the day, nearly every day during the fall and winter, it may be a sign of SAD, and seeking professional help can be beneficial.

Find a therapist at Ellie here!

Tips for Managing SAD

There are plenty of coping strategies for navigating SAD.

• Light therapy is an important factor to help make up for the lack of sunlight that occurs in the fall and winter. Try searching for a “happy lamp” or UV light that omits rays to help your trick your brain and get that extra serotonin.
• Taking care of your body through eating well and exercising can also be a helpful tip to navigate SAD. Just a walk around your neighborhood can make a huge difference. If you do decide to walk outside, try the 54321 method.
• Maintaining a routine will also help decrease depressive symptoms. As mentioned above, depression makes you have less energy and less motivation. However, if you do your best to maintain routines, it feels less taxing.
• Spend time outside! We get it, it’s probably cold where you live. Bundle up and go cross country skiing, ice skating, sledding, or just go for a walk with a hot cup of coffee. Natural light, even in small doses, can make a big difference.
• Vitamin D Supplements might be helpful for you. Talk to your doctor or prescriber if you think this might be helpful or if you have questions.
• Spend time with friends or family. It’s so easy to be isolated in the winter months, and that can be detrimental to our mental health and wellbeing. Reach out to others, plan activities, and spend time with your community to combat feelings of SAD.
• Seeing a therapist can help get things back on track if your normal coping skills aren’t cutting it. Ellie Mental Health offers a variety of therapists near you that are equipped with navigating seasonal affective disorder.

Trying out these strategies can really help ease the symptoms of SAD and boost your mood during the winter months.

Find a therapist for seasonal affective disorder

How to Prevent SAD Before Winter

If you know that you have struggled with seasonal affective disorder in the past, start implementing these tips sooner rather than later. Get your happy lamp out, establish routines, and get connected with a new therapist ahead of time.

A soon as you start feeling a brisk wind or notice the leaves begin to change, start practicing these skills or fall back on your go-to list of things that you know bring you joy. The more stable and consistent you become with your coping strategies, the more you can become resilient against seasonal affective disorder. Stay warm and full of serotonin!

Final Thoughts

Seasonal Affective Disorder can cast shadows on our moods and daily routines when start temperatures drop and the days get shorter. But it doesn’t have to be define your winter. Recognizing the signs and understanding the causes of SAD empowers you to take charge of your mental well-being. With tools like light therapy, a regular routine, keeping in touch with your friends and family, or reaching out to a mental health professional, you can push back the winter gloom. By embracing these strategies, you can bring back the sunshine into your life, even when snow is all you see outside.

Remember, you’re in good company on this journey, and help is always within reach at Ellie—either in person or virtually.

The post Understanding Seasonal Affective Disorder: Symptoms, Causes, and Coping Strategies appeared first on Ellie Mental Health, PLLP.

We’re diving into the origins and mechanisms of Brainspotting: highlighting its focus on allowing clients to process trauma by fixing their gaze on specific spots and the science behind it. This blog also discusses the application of Brainspotting, including self-spotting, and its unique benefits for therapists who often juggle multiple stressors.

The Basics of Brainspotting

Brainspotting is a powerful treatment method developed by Dr. David Grand that helps people access, process, and overcome trauma, negative emotions, and various psychological and physical concerns. Billie explains the origins of Brainspotting:

Billie shares: “Brainspotting was really born out of EMDR. Dr. David Grand discovered Brainspotting during his work as an EMDR therapist… Last fall, I did a talk at a conference here in Oklahoma, where I had a room full of therapists, and I asked who was familiar with this modality. And only three or four people in that room had heard of it. And so, it really is coming on the scene, but it’s coming fast.”

Unlike EMDR, which involves moving the eyes back and forth to process trauma, Brainspotting focuses on finding a single spot where the client feels a strong emotional or physical response and staying there.

Brainspotting is great for anyone struggling with trauma, anxiety, or depression. It’s particularly helpful for people with PTSD or complex trauma, but it can also tackle things like performance anxiety and unresolved conflicts. Basically, it taps into the brain’s natural healing abilities to help you work through tough stuff and find relief.

The Science Behind Brainspotting

The science behind Brainspotting lies in the deep connection between eye position and brain function. Billie elaborates, “Our eyes are essentially just a part of our brain, made of neural cells. They are one of the first organs to develop in utero and come from brain cells… There are six major muscles that are connected to our eyes, and those muscles are connected to all of the pathways of the brain.”

The principle is that by holding the eye gaze at a specific spot, clients can unlock and process deeply held trauma and emotions. This approach differs from traditional talk therapy by integrating the body and mind more holistically.

During a Brainspotting session, a specific eye position, or “brainspot,” is identified—this spot is where the client’s brain holds onto traumatic memories or intense emotions. By maintaining focus on this spot, the therapy leverages the strong neural connections between the eyes and the brain. Additionally, Brainspotting often uses bilateral sound, which mimics the natural processing pathways of REM sleep, to help both hemispheres of the brain work together in processing the trauma. This dual activation facilitates the deep processing and integration of traumatic memories and emotions, offering a more holistic healing approach compared to traditional talk therapy.

Brainspotting in Practice

Billie provides insight into how Brainspotting works in practice:

“It’s going to be a different spot for everybody and even with each person there are going to be different spots, depending on a lot of factors: the different experiences, different emotions, or just different things that we’re working through.”

To find these spots, therapists use their attunement to observe their client’s reflexes, energy shifts, and bodily sensations. The client is then guided to focus on these spots while noticing and verbalizing their emotions and sensations.

The Therapeutic Journey with Brainspotting

During the podcast interview, Billie emphasized the flexibility and personal nature of Brainspotting: “Brainspotting leaves a lot of room for whatever is needed in that moment, which is a little bit different than EMDR… The big phrase that we use in Brainspotting is ‘follow the tail of the comet.’ Follow whatever’s coming up in the room, and that’s where we go.”

This approach allows sessions to be tailored to each individual’s needs, making the process both unique and effective. Billie explains that the emotional intensity of different “spots” can guide the therapy, whether towards grounding or processing through heightened anxiety.

Self-Spotting: Empowering Therapists

An intriguing aspect of Brainspotting is its applicability to use on your self. Billie describes self-spotting as a valuable tool for therapists:

“This has been one of the things that has been most helpful for me in my own processing and my self-care… Typically you’ll use bilateral sound… You can find bilateral sound if you search on Spotify, Apple Music, there’s YouTube videos.”

By finding their own Brainspot and using bilateral sound, therapists can work through any leftover stress or emotional baggage from their sessions. This helps them feel better and be even more effective in their work (because we know this can be really hard work!).

How to Find a Brainspotting Therapist

At Ellie, we make it easy to find the right therapist for you. You can search providers on our website, fill out a contact form, or give us a call. When you’re scheduling your first appointment, be sure to let the client access specialist know that you are looking for a Brainspotting-trained therapist. They’ll confirm the therapist has availability and takes your insurance.

Ready to begin with a Brainspotting-trained therapist? Click the link below to get started.

Another way to find a therapist trained in this modality is by going through the Brainspotting directory. You’ll be able to filter therapists by state and level of training.

Healing from Toxic Work Environments

In this podcast episode, we spent a lot of time talking about how Brainspotting can help therapists deal with the stress from toxic workplaces. Billie opened up about her own experiences in tough work environments, how they really took a toll on her, and how she used Brainspotting to reconnect with herself and set better boundaries.

If you’re dealing with a toxic work environment but not quite ready for Brainspotting, check out our blog post about setting professional boundaries here.

Action Steps for Incorporating Brainspotting into Sessions (for Therapists)

1. Educate Yourself: Start by reading Dr. David Grand’s book “Brainspotting,” which provides a comprehensive overview and practical tools that you can start using immediately with your clients.

2. Attend Trainings: While the book provides a solid foundation, attending official Brainspotting trainings can deepen your understanding and skills. (I just signed up to be trained through brainspotting.com—the website recommended by Billie!)

3. Try Self-Spotting: Begin practicing self-spotting to manage your stress and emotional health. Use bilateral sound and find your Brainspot to process daily stressors and residual work-related trauma.

4. Introduce it to Clients: Gradually incorporate Brainspotting techniques into your practice, observing how your clients respond and adapting as necessary.

5. Network and Support: It can be SO helpful to join consultation groups to talk and learn from other practitioners, especially when you’re just starting out.

In Closing

Brainspotting is a versatile and accessible modality that offers profound benefits for therapists and clients alike. Whether dealing with trauma, stress, or the residuals of a toxic work environment, this practice provides actionable tools for effective emotional and psychological healing. We hope this exploration inspires you to consider integrating Brainspotting into your practice, benefiting both you and your clients on the journey to wellness.

For more resources and in-depth discussions, don’t forget to check out our full podcast episode with Billie Ferguson, LMFT.

The post What Is Brainspotting Therapy? A Comprehensive Guide for Beginners appeared first on Ellie Mental Health, PLLP.

Depression can be sneaky, showing up as more than just the blues. You might be noticing changes in sleep, eating habits, and even their interest in things they used to love.

But don’t worry, you don’t need a psychology degree to help (although encouraging them to seek therapy is going to be helpful for them too). Just being there, offering a non-judgmental ear, and knowing when to nudge them towards professional help can make all the difference. So, grab a coffee, get comfy, and let’s chat about how to be the best damn friend you can be.

How to Tell if Your Friend is Depressed

Have you had concerns about your friend’s mental health recently? Maybe they haven’t been acting like themselves recently or they seem more down or hopeless than usual. It can feel odd when they seem out of sorts, but it’s super helpful to familiarize yourself with the signs of depression and learn how to provide support if your friend is going through a tough time.

Signs Your Friend is Depressed

• Feeling Sad: They may appear down, sad, and tearful, finding less joy in activities that used to bring them happiness.
• Hopelessness: They could express feelings of emptiness, feeling worthless, or feeling stuck. They might say things like, “I feel lost in life” or “I feel stuck in life.”
• Sleep Troubles: They may be sleeping more than usual, oversleeping, or having difficulty sleeping.
• Physical Complaints: They may report headaches, pains, or digestive issues.
• Irritability: They might exhibit more irritability than usual, like being quick to snap at you.
• Self-Esteem: They may exhibit low self-esteem or engage in more reckless behavior. You might hear them say things like, “I feel like no one likes me” or “I feel broken.”
• Trouble Focusing: They might appear distracted or restless, or talking about finding it hard to concentrate on tasks.

If you are worried about your friend’s mental health, it can be helpful to say something to them and offer support. It might feel awkward to bring it up, but it can make a huge difference.

Questions to Ask a Person with Depression

If you are noticing some of these signs, you might feel compelled to say something or reach out. First step is to point out what you’re noticing and share your concern:

• “Hey, you haven’t really been seeming like yourself recently. I’m here if you need to talk.”
• “I’ve noticed that you haven’t been hanging out with people as much as usual, are you feeling ok?”
• “You mentioned you haven’t been sleeping much, is everything ok?”
• “I’ve been worried about you recently. How are you doing?”
• “I haven’t seen you around much, how are you holding up?”

For more information on how to start the conversation and express your concerns, visit our blog post on how to start a conversation about mental health to discover how you can express your concerns in a loving, supportive and non-confrontational manner.

Things NOT to Say to a Depressed Person

You might feel the urge to say things like “get over it” or “”You have nothing to be sad about.” If you’re supporting a loved one dealing with depression (which seems to be the case since you’re here), here are some phrases to avoid:

• “Just try to think positively”
• “Wow you finally got out of bed.”
• “You have it a lot better off than others”
• “Medication will only be a crutch, you need to get through this on your own”
• “I started drinking tea and it cured my depression”
• “Why can’t you just get better?”

What to Say to a Depressed Friend

Ok, obviously if we’re going to talk about what NOT to say to a friend struggling with depression, we’re going to share what to say instead. There’s nothing you can say that will cure your friend’s depression, but here are some things that our therapists recommend saying:

• “I’m here no matter what.”
• “You aren’t alone in this.”
• “It’s ok to cry and feel sad.”
• “I’m just here to listen.”
• “I’m coming by with groceries.”
• “Want to go for a walk with me?”
• “Do you want to talk about it?”
• “I know things are hard right now, but you’ll get through this.”
• “I love you.”

How to Support Someone with Depression

There are lots of ways that you can show up for your friend when they are struggling, but not sure how to help? First of all, kudos to you for wanting to be there for them!

It’s a big deal, and sometimes just showing up is half the battle. Here are some tips to keep in mind:

1. Just Listen, Don’t Try to Fix: It’s tempting to play the hero and try to solve all their problems, but sometimes all your friend needs is someone to vent to. Let them talk, cry, or even just sit in silence. Your job isn’t to fix them; it’s to be there with them. Think of it like being a co-pilot. You’re there to support, not take control of the flight.
2. Check-In, But Don’t Hover: You want to keep in touch, but don’t be a helicopter friend. A simple “Hey, thinking about you. How’re you holding up?” can do wonders. It shows you care without being overbearing. If they don’t respond right away, don’t sweat it. They’ll reach out when they’re ready.
3. Encourage Professional Help: Look, you’re awesome, but you’re not a therapist (unless you are, in which case, kudos again!). Gently suggest that they talk to a mental health professional. It’s not about pushing them, but more about opening the door for them to consider it. You could say something like, “Hey, have you thought about talking to someone who’s really good at this stuff?”
4. Be There For the Little Things: Sometimes, depression makes even the smallest tasks feel monumental. Offer to help with groceries, or just hang out and watch their favorite show. Little gestures can mean a lot and can help break up the isolation they might be feeling.
5. Take Care of Yourself Too: Supporting a friend can be emotionally draining. Make sure you’re also taking care of your own mental health. It’s like the airplane oxygen mask rule: put on your own mask before assisting others. You can’t pour from an empty cup, you know?

Remember, you don’t have to have all the answers. Just being there, showing empathy, and offering a shoulder to lean on can be a lifeline for someone struggling with depression. You got this, and so does your friend.

Get matched with the perfect therapist for your needs at Ellie Mental Health using the link below.

Navigating Depression Together

Remember, you don’t have to have it all figured out and say all of the perfect things all of the time. The most important thing you can do to help someone with depression is to be present, be supportive, be empathetic, and take care of yourself too. Your friendship and support is crucial!

The post How to Help and Support a Friend with Depression appeared first on Ellie Mental Health, PLLP.

How to Tell if your Partner is Depressed

Have you had concerns about your partner’s mental health recently? Maybe they haven’t been acting like themselves recently or they seem more down or hopeless than usual. It can be unsettling when they seem out of sorts, but it’s beneficial to familiarize yourself with the signs of depression and learn how to provide support if your partner is going through a tough time.

Signs Your Partner is Depressed

• Sad: They might seem down, sad, and tearful. Things that used to make them happy might not anymore.
• Hopeless: They might talk about feeling empty or hopeless
• Sleep issues: They might seem more tired, oversleep, and or have difficulty sleeping
• Physical issues: They might complain of headaches, pains, or have digestive problems
• Short-tempered: They might seem more irritable than normal and snap at you or your kids more easily
• Self-esteem: They might seem down on themselves or more reckless than usual
• Difficulty concentrating: They might seem distracted or restless

If you are worried about a loved one’s mental health, it is crucial to handle the situation with compassion and sensitivity. Although discussing mental health can be challenging, it is essential to address the issue and offer support.

How do I Support my Depressed Partner?

Dealing with a partner who’s going through depression can feel like walking through a foggy forest without a map. But hey, you’re not alone, and there are ways to help your partner feel supported. Here are four tips to keep in mind:

1. Listen Without Fixing

First off, don’t play Dr. Fix-It. Your partner doesn’t need a solution as much as they need a shoulder to lean on. Just listen. Nod your head, say “I hear you,” and let them vent. Sometimes, a listening ear is the best medicine.

2. Encourage Professional Help

It’s totally okay to suggest seeing a therapist or counselor. Mental health pros exist for a reason! Just make sure you approach it gently. You could say something like, “Hey, have you thought about talking to someone who can really help?” It’s not about pushing; it’s about opening a door. You might consider seeking your own professional support and talking about your experience. You could say things like, “I have found talking about this stuff with my therapist about this to be really helpful.”

Sometimes taking that first step to finding a therapist can be really daunting or feel intimidating. Offer to look up therapists near you and help them make that first call (at Ellie we make it easy and you can just fill out a handy-dandy form on your nearest clinic’s page instead and we’ll call them back).

If you’re in school, finances can contribute to stress and depression. Here are tips for how to deal with stress as a student.

3. Be Patient and Present

Depression doesn’t have an expiration date, so patience is key. Be there in the little moments—whether it’s watching their favorite show together or just sitting in silence. Your presence can be really comforting. Remember, this isn’t a sprint; it’s a marathon.

4. Take Care of Yourself Too

You can’t pour from an empty cup, right? Make sure you’re looking after your own mental health as well. Dealing with a depressed partner can be hard. Take breaks, talk to your friends, and maybe even join a support group. Your well-being is just as important.

Hang in there, and remember, that your love and support can make a world of difference. Just by being with them through this tough time is the most helpful thing you can do.

Mental Health Stigma: How to Help a Husband or Boyfriend with Depression

You might be reading this and say, “ok, but my husband (or boyfriend) is depressed and he won’t let me help him.”  We get it—you’re in a tough place. The stigma with men’s mental health is real, and yet over 6 million men (about twice the population of Arkansas) suffer from depression each year.

Men often feel like they need to have everything together or that they can’t show weakness. If your husband is resistant to seeking professional help or even admitting that they’re struggling, start by pointing out what you’re noticing and your concern:

• “I’ve noticed that you haven’t been sleeping much, and I’m concerned. I’m here if you need to talk.”
• “You haven’t been hanging out with your friends as much as usual, are you feeling ok?”
• “You mentioned you haven’t had much of an appetite, is everything ok?”
• “I’ve been worried about you recently. How are you doing?”

What Goes Through a Person with Depression’s Mind

For people who have never experienced depression or other mental health issues, it’s hard to understand what’s happening. If Google search terms are any indication to what is going through a depression person’s mind, it might be something like this:

• “I feel lost”
• “I feel lonely”
• “I am worthless”
• “It’s not going to get better”
• “Why am I so useless?”
• “No one cares”
• “I feel broken”
• “I feel stuck in life”
• “I feel trapped”

Through therapy, a person might learn how to identify those negative thoughts and consider the evidence for and evidence against that thought (this is a typical intervention in CBT). Mindfulness and distraction are also ways that a person might learn to counter those thoughts.

Ellie Mental Health can match you with the perfect therapist for you or a loved one going through depression. Click the link below to find a locations near you today.

What to NOT Say to Someone with Depression

I get it, it’s hard to see something struggling, especially when you don’t understand what’s going on. You want to be able to say “snap out of it” or “why can’t you just find motivation to do it?” If you are someone that is trying to support your loved one with depression (since you’re here, I think you probably are), here are some things NOT to say.

• “Just try to think positively”
• “You have nothing to be sad about”
• “You have it a lot better off than others.”
• “Medication will only be a crutch; you need to get through this on your own.”
• “I cut out caffeine and it cured my depression.” 
• “Why can’t you just get better?”

Gifts for People with Depression

As mentioned before, the best gift you can give to someone who is struggling with depression is the gift of being present (and maybe even encouraging therapy too). But if they’re birthday is rolling around or if they have the love language of gifts, here are some ideas that might help lift their mood or encourage some healthy coping skills as well.

Gifts That Encourage You to Spend Time in Nature

Did you know that spending time outdoors is helpful for people struggling with depression? Sunlight triggers the release of serotonin and vitamin D, plus it can help us disconnect from media and stress. Getting your loved one things or experiences that encourage them to get out in the fresh air is a great idea!

1. National Parks Pass or your own state park pass
2. Hammock
3. Yard games
4. An invitation for a walk or bike ride together
5. A giftcard for outdoor rentals to go hiking, kayaking, or skiing (REI is my go-to outdoor rental place)

Adult Coloring Books

Our art therapists love adult coloring books as a tool for grounding and concentrating on something soothing. Pair these with some gel markers and colored pencils and you are all set! Psst… we loved this one for obvious reasons:

Gifts that Encourage Gratitude

The research around gratitude and depression is astounding: people who have more gratitude also tend to have lower levels of depression [ClinMed Journal]. (Psst… here’s a cool podcast that covers this topic too)

There are great products and tools out there to encourage cultivating gratitude, include this five-minute journal and this kit to practice gratitude all year long.

Meditation Subscription

It’s no secret that meditating is a great relaxation technique and mood booster. One of our therapists shared, “I love the Headspace app for anyone that is looking to get into meditation. It has great guided visualizations and even ones for when you’re having difficulty sleeping.”

Help Normalize What They’re Experiencing

Ok, these might not be “gifts” per se, but sending notes like “I’ve felt that way before” and “I found medication helpful when I was dealing with depression last year” can go a long way. Laughter can also be helpful for many people, so some clever memes about depression might help them feel like they aren’t alone in this struggle. Here are a few of my favorite memes about depression (know your audience before you send these!):

Navigating Depression Together

Remember, you’re not just a partner; you’re a teammate. Be present, be ready to listen, and don’t forget to take care of yourself too. Dealing with depression is tough, but with support, empathy, and a sprinkle of humor, you can both navigate through the difficult times together. Stay strong, stay connected, and know you’re making a difference just by being there.

The post How to Help and Support a Spouse with Depression appeared first on Ellie Mental Health, PLLP.

If you are feeling suicidal or if you are worried about a loved one, you can call or text the National Suicide Prevention Lifeline at 988

Recognizing the Signs of Suicidal Thoughts and Self Harm

It is important to recognize that suicidal thoughts and self-harm look different for everyone. As a therapist, I’ll ask clients the question, “Is it your intent to want to hurt yourself, make yourself feel something, punish yourself, etc.?”

Suicidal thoughts can be passive or continuously active. A passive suicidal thought could be something as brief as “Wouldn’t it be crazy if I just died right now?” while enjoying a bowl of cereal in the morning. Whereas, active suicidality is “I truly wish I wasn’t alive at this moment” and it is usually met with deeper feelings of sadness, grief, pain, etc.

While talking to someone who is suicidal, it can be tough to recognize the signs. As a loved one, some warning signs that you could look for if you suspect someone is experiencing suicidal ideation is:

• If they are more irritable or sad than normal,
• If they are talking about the future as if it is not obtainable,
• If they are giving away some of their beloved items,
• Withdrawing from others or any special interests of theirs,
• Talking about being a burden or how others may be better off without them

And many more. Please view this list created by the National Institute of Mental Health for a more intensive list:  Suicide Prevention – National Institute of Mental Health (NIMH).

Self-harm also has its own magnitudes. Usually when someone refers to self-harm, it is common for people to picture someone cutting themselves with a sharp object, but self-harm can be more complex than that. Self-harm could be pulling your hair, burning yourself, making yourself work extreme hours, taking EXTREMELY hot showers, etc. These aren’t uncommon, however the question is “why am I doing this? What is the intent?” For most folks, it is to ignore the pain that they are experiencing in their head.

What are Potential Causes of Suicidality?

There’s no perfect answer as to why someone may be experiencing suicidal thoughts or urges to self-harm, however there are common causes that may contribute to why your brain is allowing you to feel and do these things.

Suicidality can come from feeling that there is no other way to cope with stressors. Stressors can be bullying, conflicts arising in various environments, confrontational situations, etc. Of course, some people may experience these situations and not experience suicidal ideation. These differences may be based on how your prefrontal cortex is processing and navigating your emotional and impulsive reactions.  

In a less scientific way, sometimes I explain to clients that even if they feel like they have no reason to be suicidal, sometimes their brain just has fewer “happy chemicals”. Sometimes people think that if they have a good life and have no trauma, it means that they should not be feeling this way, which is simply not true. There are certain chemicals in your brain that lead to happiness, motivation, love, etc. For some folks, those happy chemicals aren’t as plentiful as the average human being. That is why you’ll often hear from professionals that medications and therapy is the best combination to treat majority of mental health conditions.

Some people are worried about taking medication. You know when you’re watching TV and an antidepressant commercial comes on and you hear the fast-talking warnings towards the end that says “may lead to suicidal thoughts” – you might be thinking “well why would I want to take a pill that may increase what I’m already feeling?” That’s valid, because it can be scary, and it is always a risk with any potential medication. The majority of people find relief when they are on medications, and should be monitoring any side effects closely with their prescriber.

Have you ever put on a sweater that looks SO good on the model or a best friend, and then you put it on and it looks NOTHING like how you thought it would? Medications are similar. Medications that work for some people might have a different effect on others. Some of that has to do with your brain chemistry and some has to do with how your body metabolizes and absorbs chemicals. It is can be trial-and-error process finding a medication that works for you and your fancy dancy brain chemicals, and that’s why having a prescriber you trust is important.

Philppe Courtet and Jorge Lopez-Castroman did research on the concern that antidepressants could lead to increased suicides, however they found that suicide is more likely for those who do not take any medications versus those who are on medications.

Suicide Statistics

Here are some statistics regarding who are most likely to be affected by suicide according to information gathered by the CDC in 2021:

• Non-Hispanic American Indian / Alaska Native have the highest rates of suicide with non-Hispanic white individuals following second
• Males are four times more likely to be affected by suicide than women
• People ages 85+ have the highest rates of suicide
• LGBTQIA+ individuals are four times likely to commit suicide than their peers
• Nearly 20% of high schoolers report having serious thoughts about suicide, and 9% admit to a suicide attempt.

What Should I Do If I am Experiencing Suicidal Thoughts?

First things first: You can call or text the National Suicide Prevention Lifeline at 988. If you don’t think you can keep yourself safe in that moment, call 911 or go to your nearest emergency room to get help right away. 

Second, seek professional help from a medical provider or therapist. A therapist can help you manage your suicidal thoughts and also help manage self-harm, especially if you notice it is interfering with your day to day life. If you begin to formulate a plan for your suicide, inpatient hospitalization may be more necessary for you.

The difference between inpatient and outpatient therapy is that outpatient therapy is what you envision as your “typical” therapy, like talk therapy in a therapy office. Inpatient therapy is what the kids call “grippy sock jail”, where you are hospitalized for a period of time to help manage your suicide thoughts and urges. Inpatient hospitalization can be a helpful way to meet peers who are also struggling through group therapy sessions, pausing outside stressors until you have necessary coping skills, and even medication management if necessary. That can help you feel like you’re not alone.

If you’re worried about someone that you love, check out our blog post about how to ask someone about suicide.

As a therapist, some coping skills that I teach my clients that might also be helpful for you too, (but keep in mind that seeing your own therapist and getting your own professional help is going to be the best course of action) may be the TIPP method:

T: Temperature

Temperature is a great resource for suicidal thoughts, and for any other rumination. Temperature is a part of using the senses, which can be great grounding. A tool that is often recommended as part of the temperature idea is to squeeze an ice cube in your hand, have a fan blow cold fan in your face, take a really hot or really cold shower, etc. Your goal is to distract your mind by putting pressure on your body using the senses in a healthy manner. This is similar to the idea of intense exercise. The sweat, soreness, etc., provides a great distraction.

I: Intense exercise

The I stands for intensive exercise; Pushing your body to sweat, be warm, and end up being sore is a way to “feel the burn” but in a constructive manner. The body sensations also adds to the idea that the senses are important in regulating emotions.

P: Paced breathing

Paced breathing is also a great tool for all mental health conditions. You can do box breathing by holding your breath for four seconds, breathing in your nose for four seconds, holding for four, and letting the air out of your mouth for four seconds.

P: Progressive Muscle Relaxation (PMR)

Progressive muscle relaxation means to work your way either up or down your body by squeezing all of your muscles then releasing. This process helps individuals become more aware of and release tension in their muscles, and it can counteract the body’s stress response, leading to reduced feelings of anxiety and improved overall well-being.

Suicide and Self-Harm Prevention Resources

Ellie Mental Health can be a great resource to find a therapist to help manage any suicidal symptoms you are experiencing.

If you are feeling suicidal, you can call or text the National Suicide Prevention Lifeline: 988

You can also chat online here or call the Trevor Project (866) 488-7386.

If you are worried that you can’t keep yourself safe, call 911.

Some books and blogs that may help educate you or others on suicidal thoughts or self-harm:

• Understanding and Responding to Self-Harm: The One Stop Guide: Practical Advice for Anybody Affected by Self-Harm by Allan House
• Reasons to Stay Alive by Matt Haig
• Adolescents and Suicide Prevention: A Guide for Clinicians
• Three Easy Steps to Ask Someone about Suicide
• The Complex Relationship Between Mental Health Medications and Suicidal Thoughts
• A Parents’ Guide: Anxiety and Depression in Children

Other Resources and Sources:

Suicide Prevention – National Institute of Mental Health (NIMH) (nih.gov)

Antidepressants and suicide risk in depression – PMC (nih.gov)

Suicide Data and Statistics | Suicide Prevention | CDC

The post Understanding and Addressing Suicidal Thoughts and Self Harm appeared first on Ellie Mental Health, PLLP.

Mental Health Concerns and Warning Signs

Have you had recent concerns about a loved one’s mental health? Maybe you’ve noticed that they haven’t been acting like themselves, or they have been more isolated recently. It can be helpful to educate yourself about some of the warning signs that they are struggling with their mental health:

• Missing work or social events
• Sleeping or eating too much or too little
• Increased anger or irritability
• Not leaving home as much as usual
• Increased drug or alcohol use
• Decrease in self-care or neglecting personal hygiene
• Mental health can even affect physical health and cause pain or illness

Every person is different, but if you are noticing some of these signs, you might feel compelled to say something or reach out. It can be difficult to know how to even start the conversation about mental health. In many families and communities, there is still a stigma associated with mental illness or reaching out for help. Consequently, it can be difficult to know what to say, but you don’t have to be an expert, or therapist, or a trained professional to have a conversation with someone about their mental health. The best thing you can do is reassure them that you are there for them and that you care about them. If you want to do more, but aren’t sure where to start, here are a few suggestions.

If you or someone you know is struggling with their mental health, don’t hesitate to reach out! Schedule an appointment at one of our clinics nationwide today.

5 Tips for Talking to Someone About Their Mental Health

1. Express your concerns in a loving, supportive and non-confrontational manner. Your loved one may be experiencing feelings of shame, guilt, or embarrassment, so it is essential to be gentle and supportive.
2. Focus on the specific signs & symptoms that cause you to be concerned (i.e. “I’ve noticed that you aren’t leaving the house as much as usual” or “You mentioned you’re not sleeping much, is everything ok?”)
3. Remember to use “I” or “I feel” statements instead of using accusatory “you” statements and avoid giving simple solutions (i.e. I feel worried when I don’t hear from you for long periods of time”, “I’ve been worried about you recently,” NOT: “If you’d just calm down then everything would be better”)
4. Normalize it (i.e. “It’s normal to feel this way when that happens” or “A lot of people feel hopeless this time of year”)
5. Avoid Judgment and Criticism: Avoid using language that could be interpreted as critical or dismissive, since that could cause more harm (i.e. “You’re being too sensitive,” “You need to toughen up,” or “Just snap out of it.”).

Offering support can look different depending on the person and your relationship. For example, if you are looking to have a more specific conversation with your child about mental health, you might need to make small tweaks depending on their openness to the subject or even to account for age-appropriateness. For some people, just talking about their mental health struggles can be helpful. For others, they might need a little more help around the house, with their kids, or finding a therapist or medication provider (for someone that is struggling with their mental health, it’s often overwhelming or difficult to know where to start when seeking out mental health care!). Offering a variety of different support options is a good way to start.

Mental Health Questions for Discussion: Conversation Starters

We get it- talking about mental health can be awkward. But it doesn’t have to be and we want to help you navigate those important conversations with your loved ones! In this section, you’ll find conversation starters and example dialogues to make discussing mental health feel a little less daunting and a lot more natural. Because caring for someone’s well-being shouldn’t be complicated.

Examples of mental health conversation starters include:

• “I’ve noticed that you haven’t been acting like yourself recently, is everything ok?”
• “You mentioned that you haven’t been leaving the house a lot this week– are you feeling ok?”
• “This time of year is really hard for me sometimes, how have you been coping with things?” 
• “It sounds like work has been really overwhelming, how are you holding up?”
• “Politics can be really mentally exhausting, has it been this way for you?”
• “I’ve been worried about how you’re balancing all of these changes– are you doing ok?”

Examples of Conversations About Mental Health

Still not sure how to approach things? Here’s an example conversation that might help you navigate some different scenarios or responses.

Start the conversation by pointing out your observation without any judgment: “Hey, I haven’t heard from you in awhile and I know things have been difficult recently. How have you been doing?”

If your loved one seems hesitant to answer or if they say something like, “Oh I don’t want to bother you with my problems,” Then you might respond with reassurance: “I care about you so I’m here to support and help you however I can.” 

If they continue to brush things off, say something like, “Well I’m here to talk whenever you need a listening ear.”

If they do decide to open up about how things have truly been, it’s important to listen with empathy and not just jump into problem-solving-mode. Don’t just try to fix things– usually what people really need is just someone to be present. If they say: “Yeah, I’ve feel like I’ve just been in this funk recently. I’ve been crying for no reason and not had the energy to get out of bed,” then you could respond something like, “It’s normal to feel this way sometimes. I’m sorry you’re going through that.” 

As a therapist in situations like this, sometimes I like to use a question skill called “exception questions.” This is when you ask about when they’re struggle has been present and try to tease out what might have been different at those times: “When was the last time you felt better?” or “Tell me about the last good day you had.” Then a follow up question might be, “What was different then?” 

Encourage professional help: You could say something like, “Hey, have you thought about talking to someone who can really help?” or “I have found talking about this stuff with my therapist about this to be really helpful.”

Maybe you’re concerned, but you’re uncomfortable reaching out in person? Here’s an example of a text conversation you could have if you’re concerned about a loved one’s mental health: 

Start the conversation off with what you’re noticing:  “Hey! I’ve been thinking about you and have noticed you’ve missed a lot of classes recently. How are you doing?” (It can be helpful to ask an open-ended question that prompts more than just a yes or no response)

If they respond that they’ve been busy or haven’t been doing well, try to normalize things or ask more questions: “It’s totally normal to feel overwhelmed this time of year. How are you holding up?” 

If they open up and share that they’ve been struggling, try not to just jump into offering solutions, but instead offer support: “I’m sorry things have been tough recently. Would it help if I called and just listened?” Sometimes a listening ear is exactly what a friend needs when they’re struggling.

If you’ve been through a similar struggle or had a positive experience with therapy or medication, it might be helpful to share that: “When I’m feeling down or overwhelmed, talking to a therapist might be helpful.”

If they just became a parent, try suggesting counseling for new parents.

Ok, but maybe you’re thinking, “What if the person I’m concerned about is an employee or peer at work? Can I ask them about their mental health?” Here’s a handy-dandy downloadable for you to reference.

Talking About Suicide

One of our therapists and suicidologists at Ellie, Dr. Brittany Miskowiec says, “one of the most common myths about suicide is that talking about it will put the idea in someone’s head.” But that’s not true. For many, being asked about suicide and how they’re doing can give them some relief to actually talk about things. If you are concerned that a loved one might be contemplating suicide, read our blog post about how to talk to others about suicide.

Of course, if you’re talking to someone with thoughts of suicide, you, or the person with thoughts of suicide can call or text 988, the National Suicide and Crisis Lifeline.

Finding Support for Yourself

It’s not easy to see a loved one struggle, and sometimes we get so caught up in helping them that we forget to care for ourselves. Remind yourself that you can care about another person, be a support for them, and offer help when you can, but ultimately, you can’t make someone get help. It’s also important to make sure you aren’t sacrificing your own mental health in an effort to help someone else with theirs.  It’s always a good idea to check in with a therapist if you find yourself needing some extra support or joining a support group through NAMI.

Having a conversation with a loved one about mental health can be challenging, but it is necessary to provide support and guidance. By following these tips and having the bravery to reach out, you are decreasing the stigma around mental health and showing your loved one that you care. Remember that mental health is a journey, and it is important to be patient, supportive, and understanding.

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What are we talking about here? Not just that monthly visitor that we all would rather not hear knocking at the door (our periods), but PMS. Yes, that one. However, there is also another version of PMS, and this one can be much more severe and debilitating.

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are two conditions that affect many women worldwide. Both PMS and PMDD are related to a woman’s menstrual cycle and can cause a variety of physical and emotional symptoms. However, there are some key differences between the two conditions that are important to understand.

Here, we’ll explore the differences between PMS and PMDD as well as the symptoms, causes, available treatments, and what you can do to cope.

Are severe symptoms of PMS or PMDD affecting your daily life? Reach out to Ellie Mental Health today to talk with a compassionate and qualified therapist.

Difference Between PMS and PMDD

Premenstrual syndrome (PMS) is a common condition that affects many women during their menstrual cycle. It typically occurs in the days or weeks leading up to a woman’s period and is thought to be caused by hormonal changes in the body. 

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that affects around 3-8% of women. Although the symptoms of PMDD are similar to those of PMS, they are typically more severe and can significantly impact your daily life. PMDD is also caused by hormonal changes in the body, but the exact cause is not fully understood. In fact, some medical professionals have theorized that PMDD may be genetic. PMDD symptoms typically occur in the days leading up to a woman’s period and usually subside within a few days after the period begins. Though in some severe cases, PMDD can last for several weeks. And if this is the case, it is recommended that you see your healthcare provider as soon as possible.

PMS vs PMDD Symptoms

Let’s be real: periods can be a total pain. But if you’ve ever wondered why some months feel like a minor inconvenience and others like an emotional rollercoaster, you’re not alone. We’re diving into the nitty-gritty of the actual symptom differences between PMS and PMDD.

Symptoms of PMS

Physical symptoms of PMS include:

• Breast tenderness or swelling
• Bloating and water retention
• Headaches or migraines
• Fatigue or lack of energy
• Changes in appetite or food cravings
• Muscle aches and joint pain

Emotional symptoms of PMS include:

• Mood swings or irritability
• Anxiety or depression
• Difficulty sleeping
• Poor concentration or memory
• Changes in libido

Symptoms of PMDD

In addition to symptoms of PMS, someone with PMDD may also experience the following symptoms:

• Insomnia
• Feeling overwhelmed
• Suicidal thoughts or feelings
• Extreme changes in libido

While having some emotional ups and downs is normal with the hormonal changes that come with that time of the month, PMDD feels more intense and comes with more extreme changes in the week before and then disappear entirely a few days into your period. You might notice severe depressive symptoms, mood swings, and feeling like you’re on high alert.

How is PMDD Diagnosed?

The diagnosis of PMDD is typically based on the woman’s reported symptoms. If you are suspecting that you might be dealing with PMDD, a first step you could take is to see your primary care physician for hormonal testing. There’s no specific test for PMDD, but some blood tests can rule out other possible conditions that cause similar symptoms. After that, therapy can be an excellent way to learn tools and skills for coping with the emotional symptoms. 

To diagnose PMDD, a woman typically must have at least five of the emotional and physical symptoms listed above, and these symptoms must occur only the week before her period starts. The symptoms must also be severe enough to interfere with her daily life.

What causes PMS and PMDD?

The exact cause of PMS and PMDD is not fully understood, but they are both thought to be caused by hormonal changes in the body. Specifically, PMS and PMDD are thought to be caused by fluctuations in estrogen and progesterone levels during the menstrual cycle.

However, there may be other factors that contribute to the development of PMS and PMDD, including:

• Genetics: There may be a genetic component to PMS and PMDD, as they tend to run in families.
• Brain chemistry: Some studies suggest that women with PMS and PMDD may have abnormal levels of certain neurotransmitters, such as serotonin.
• Environmental factors: Stress, poor diet, lack of exercise, and other environmental factors may contribute to the development of PMS and PMDD.

PMS and PMDD Treatments

The treatment of PMS and PMDD depends on the severity of the symptoms and how much they interfere with a woman’s daily life. The treatment for these conditions might include therapy, mental health medications, and recommended home care. In fact, many women report reduced symptoms after they alter their diets or implement stress-management activities.

A few home care methods for addressing symptoms of both PMS and PMDD include:

• Implementing healthy food choices
• Eliminating alcohol and caffeine
• Regular weekly exercise
• Heat therapy
• Stress management techniques (Yoga, meditation, Tai Chi)
• Proper sleep each night
• OTC medications such as Acetaminophen or Ibuprofen

It’s important to note that if you’ve been trying home remedies such as changing your diet and implementing stress-relieving activities and you’re still experiencing severe or debilitating symptoms, this is when it’s time to throw in the towel and see a medical professional.

While home care can be beneficial, some women have severe symptoms that may drastically alter their mental state. If conditions become severe, seeking out a therapist to talk to about your symptoms is highly recommended. For example, a therapist can work with you to help you manage mental health medications such as antidepressants and learn coping skills to manage symptoms of PMS/PMDD that may be affecting your mood and behavior.

The most common medications prescribed for PMDD are serotonin medications like SSRIs (Lexapro, Zoloft, Celexa, Prozac). Some people take SSRI medication continuously and find this helps best and others take it only for the weeks leading up to their period. One of our prescribers, Sara Polley, MD added: “I had a patient who normally takes 10mg Lexapro daily and then increases to 15mg daily for a week out of a month and feels this helps.” 

SSRIs can be combined with hormonal contraceptive medications (birth control pills for example) that blunt the hormone changes during someone’s menstrual cycle. For some people, using birth control to skip their periods can be helpful, but for others this doesn’t make a difference.

Bottomline: There are many medication options available if you’re struggling with PMDD.

Some side effects of these medications can include changes in weight, libido, sleep changes, headaches, stomach upset – although these are rare and most people do not experience side effects with SSRI medication or hormonal contraceptive medications. We recommend reaching out to your prescriber if you notice any changes with your body or mood that are bothersome to discuss as they could be a side effect of your medication and your prescriber can discuss other options.

When Should I See a Therapist for PMS or PMDD?

At the end of the day, if your symptoms are significantly disrupting your daily life and making it difficult for you to get through simple tasks, a therapist can help direct you toward the best path of coping with your symptoms. And if therapy proves ineffective, a therapist may recommend that you see a gynecologist or other healthcare professional.

Mood swings, irritability, and poor concentration are a few symptoms that may make daily life difficult for those with severe PMS or PMDD. But when you begin withdrawing socially or begin having unprovoked moments of anger, thoughts of suicide, or other dark thoughts – don’t try to endure these symptoms alone.

At Ellie, we’re here to help guide you toward greater mental health. And sometimes, just talking about how you’re feeling can be the first step toward coping with your symptoms and getting the help that you need. Are you having difficulty coping with symptoms related to PMS or PMDD? Contact Ellie Mental Health today to speak with a compassionate and qualified therapist.

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Finding the Right Therapist for your Child

There are lots of therapists out there, and not everyone is a good fit (and the fit is crucial to making therapy successful!). Every therapist has different specializations, approaches, and techniques. You and your child need find someone that best suits your needs—but how? In an initial therapy intake, you might ask the therapist questions like:

• How long have you been in this field?
• What does a typical therapy session look like?
• What modalities are you trained in?
• How does mental health treatment work?
• What kinds of therapy do you think will help my child based on their diagnosis?
• How often do we assess goals?
• What does parent involvement in therapy look like?

I encourage families to try meeting with the therapist for several sessions before determining if they aren’t a good fit, as it often takes a while for a child to feel comfortable. If after several sessions your child doesn’t seem comfortable or you’re not noticing any changes, you can ask your therapist for referrals. Do not feel bad if this happens—you want what is best for your child, and part of your job as a parent is to advocate for your child’s needs. We are trained professionals, and we want what is best for them too, even if we are not the right fit.

Ready to take the next step? Click the link below and get matched with the perfect therapist for your child’s needs.

How Long Does My Kid Need to be in Therapy?

Therapy can be expensive and time-consuming, and so while I’d love to tell you the exact amount of time you can expect your child to be in therapy… unfortunately, the answer to this question varies. The length of time your child is in counseling depends on your child’s needs, parent’s involvement in therapy, therapy goals, and how much effort you and your family are willing to put in. Therapy can last just a few months, or it can last a year or more.

Keep in mind that if your child has been struggling for a year or more, then the odds are it will take longer than that for them to recover. It takes a while to rewire your brain. Please try your best to be patient and set realistic expectations.

Role of Parents in their Children’s Therapy

Parents’ involvement in therapy varies depending on the age of the child and the point of therapy. The first two sessions typically require parent participation so the therapist can complete the diagnostic assessment (insurance word for the child mental health assessment) and treatment plan (where we set therapy goals). Parents help fill out assessments during the therapy intake, describe symptoms, and give the therapist another perspective of the presenting problem. Then during the treatment planning session, parents will help the therapist come up with therapy goals.

Other Times that Parents’ Involvement in Therapy is Expected

The therapy space needs to feel safe for your child, so I often encourage parents to only be present for certain sessions, unless this is specifically family therapy. Here are some other tips for when a parent might be a part of their child’s therapy:

• Kids need time to build trust and rapport with their therapist in the beginning, so it’s not unusual for them to request that their parents to be present as they warm up to their therapist.
• Kids and teens should also know that parent participation is required whenever a therapist might have a concern about their safety and wellbeing.
• Kids can also request for their parents to be present if there is an issue they would like to discuss with their parents that they would like me to help facilitate.
• Parents can request to be present if there is something they would like me to help discuss with their child as well.

Many parents are surprised to find out that kids have a right to confidentiality. That means that parents need to know that their child’s therapist will not tell them everything that is discussed in the session. It’s important that a kid can discuss things with their therapist freely without worrying that they might turn around and tell everything to their parents. Of course, there are limits to thus, which I detail below.

How Does Therapy With Kids Differ from Therapy With Adults?

Good question! It can vary quite a bit, especially the younger your child is. With children, we often do more activities. We will play board games, create art, and even imaginative play. We usually do less talk therapy than we would with adults. This is developmentally appropriate because children actually make sense of the world, process and speak through their play. It’s also helpful because oftentimes children do not have the attention span to talk about mental health the entire hour or so of session.

I’ve had parents ask me why a few months in to therapy with their child I am still playing games and not pushing to discuss the “real issues”. Remember that children need to feel safe within the therapy environment. We will often spend months just building rapport so they can feel safe within the therapy space. In order for therapy to be successful, we need that sense of safety and security to be built.

Using Therapy Techniques at Home

Parents often ask me about how they can create a supportive environment and use therapy techniques at home. I love this question because I know that their support and help is crucial to making therapy work.

Tips for Reinforcing Therapy Skills at Home:

• Ask your child’s therapist what they are working on! For example, if your child is working on self-esteem, perhaps their therapist will have some book recommendations you could be reading together at night.
• Ask the therapist directly for feedback. I often provide parents with parent coaching sessions and resources to help learn new parenting strategies. Sometimes the strategies you are using are great, but do not meet your child’s needs. In that case, we as therapists may suggest something different to better meet your child’s needs.
• Try to implement recommended strategies as best you can. Even though change is hard and it requires more time and effort on your part, therapy is often faster and more effective if everyone is on board.

Some parents send their child to therapy in hopes that the therapist will just be able to work their magic and fix the child. However, most therapists take a systemic approach to therapy, especially family therapy. We do not believe in one “bad guy”. Not the parents, or the child. This can be frustrating for some parents when we give them suggestions or ask for their help. In order to improve your child’s mental health, it may require change in their home environment and others around them. This is not to place blame, but to help improve everyone’s quality of life and overall wellbeing. You as a parent might be exhausted, but hopefully at the end of therapy, you will feel much better.

Will My Child Complain About Me in Therapy?

If your child feels comfortable with their therapist, at some point your child will likely complain about you. This is VERY common for children and especially for teenagers. It’s developmentally appropriate for children, and their therapist knows that there is more than one side to every story. I generally take complaints with a grain of salt since parents are disciplinarians, so of course children will be upset from time to time. If you are doing your job as a parent, at some point your child will be mad at you. That is normal.

It is important to note that this does not apply in cases of abuse or neglect. If your child reports that they are unsafe and being harmed by a parent, we are legally obligated to report that. If a child is at risk of being harmed, harming themselves, or harming others, we have to report that to ensure the child is safe. We are not investigators, just reporters. The child may be lying, and in that case, CPS will determine if that is what is happening. In the scenario that CPS becomes involved, we can work with your family alongside of CPS to help support your child and the needs of your family.

What Happens if Therapy Doesn’t Work Right Away?

As cliché as it sounds, kids’ behaviors can often get worse before they get better. This is tough for parents to hear since they are often already at their wit’s end. I encourage you to be patient and trust the process. People in general do not like change, so your child may push against the recommendations we are making in therapy. That is normal and to be expected. Please do not give up on therapy immediately or on implementing these strategies right away. Give it a month or so before you decide it is not working because your child will likely fight against that change before they see that it can be helpful.

If things have escalated and your child’s safety is in question, please contact a crisis line or call 988. You may want to go over a safety plan with your child’s therapist to discuss what to do in the case of an emergency. It can be helpful for parents and their children to know at what point they should go to the hospital.

If it is determined that your child needs a higher level of care due to their current risk, your therapist will likely put things on pause so your child can focus on that therapy. They can always come back to their outpatient therapist when their treatment is complete.

Beginning the Therapy Journey

Therapy can be a wonderful experience for your child, and it can provide support and healing for them and for you as well! By bringing your child to therapy and working on these things earlier rather than later, you are providing them the opportunity to be more successful as adults. This can also allow you to feel more relaxed at home as things start to improve.

You are vital to your child’s recovery. Parents’ participation and buy-in is crucial to determining how successful therapy can be. I encourage you to continue to advocate on behalf of your child and to learn alongside them. I am excited for you and your child as you begin this journey.

Ready to take the next step? Click the link below and get matched with the perfect therapist for your child’s needs.

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