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.

Listen to our full podcast episode to learn more about this diagnosis.

What is Oppositional Defiant Disorder (ODD)?

ODD is a pattern of persistent defiance, irritability, and argumentative behavior that lasts at least six months and creates significant challenges at home, school, or with peers. It goes beyond typical childhood stubbornness (and beyond squabbles with their siblings). Kids with ODD often struggle with authority figures, frequently lose their temper, and may intentionally push boundaries in ways that feel extreme.

Some common symptoms of Oppositional Defiant Disorder in children include:

• Frequent temper outbursts
• Excessive arguing with adults
• Refusing to follow rules or comply with requests
• Blaming others for their mistakes
• Purposefully annoying or provoking people
• Acting spiteful or vindictive

These behaviors usually show up more with certain people or in specific settings, like with parents, teachers, or at school.

Learn more:

How Is ODD Diagnosed?

ODD is diagnosed in roughly 2 to 11 percent of children and is more commonly identified in boys than girls. Although, this may be just due to differences in how our society interprets certain behaviors. No matter the diagnosis, the goal is to understand what is driving your child’s behavior and how to support them effectively.

A therapist will meet with you and your child to complete different assessments together. They’ll ask you questions about their behavior, how long these issues have been present, if there have been any major changes or adjustments in recent months, how their general health is, school performance, strengths, and goals for the therapeutic work. All of this information helps them to understand the clinical picture and recognize how to best treat the presenting issues. If you would like to get a more in-depth assessment done, you could work with a psychologist for a psychological evaluation, although this isn’t necessary.

A diagnosis of ODD does not mean you are a bad parent, and it does not mean your child is “bad” either. Kids with ODD often have underlying struggles, like ADHD, anxiety, mood disorders, or past trauma that influence their behavior. What looks like defiance is often a sign of deeper frustration, difficulty regulating emotions, or unmet needs.

Is It Really ODD or Something Else?

Behavioral challenges do not happen in isolation. If your child struggles with behaviors associated with ODD, consider other factors that might be at play. Conditions like ADHD, anxiety, autism, and trauma-related responses can all lead to similar patterns of defiance. Sometimes, what looks like oppositional behavior is really a child trying to regain control in a world that feels overwhelming or unpredictable.

How to Manage ODD Behavior in Children

Helping a child with ODD is not about “fixing” them and it definitely does not just mean that they are bad kids. It is about understanding their needs and guiding them toward better coping skills. Here are some evidence-based strategies that can make a difference:

Use Positive Reinforcement

Catch them being good. Instead of focusing only on what is going wrong, reinforce positive behaviors with praise, rewards, and encouragement.

Set Clear Boundaries and Consistency

Kids with ODD thrive on structure, even when they push against it. Be clear about expectations, stay consistent with consequences, and follow through with what you say.

Engage in Collaborative Problem-Solving

Instead of power struggles, involve your child in finding solutions. Ask questions like, “What made that situation hard for you?” or “How can we handle it differently next time?”

Focus on Connection First

Many kids with ODD act out because they feel misunderstood or disconnected. Strengthening your relationship through one-on-one time, validating their feelings, and staying calm in tough moments can reduce defiance over time.

Seek Family Support and Therapy

Parenting a child with ODD can be exhausting. Parent management training (PMT) and family therapy can provide practical tools to navigate difficult behaviors while strengthening your bond.

Some books that I recommend for kids struggling with behavior issues are:

• “The Red Beast: Helping Children Understand and Manage Anger” by K.I. Al-Ghani
  • Age Range: 5-9 years
  • This book uses the metaphor of a red beast to represent anger, teaching children ways to calm the “beast” when it wakes up.
• “When I Feel Angry” by Cornelia Maude Spelman
  • Age Range: 3-6 years
  • This book explores what it feels like to be angry and offers young children simple ways to deal with their emotions.
• “Hands Are Not for Hitting” by Martine Agassi
  • Age Range: 3-6 years
  • This book teaches children alternatives to using their hands when they are angry, promoting positive ways to express their feelings.
• “That Rule Doesn’t Apply to Me” by Julia Cook
  • Age Range: 4-7 years
  • This book is all about learning rules and following them, and why rules are important.

When to Seek Professional Help

If your child’s behaviors are significantly impacting family life, school, or friendships, it may be time to seek support from a therapist, psychologist, or behavioral specialist. Therapists can help to see what’s happening beneath the surface and problem solve with you. Kids learn emotional regulation skills in therapy, while parents can learn tools to set limits in a way that fosters cooperation rather than conflict.

Frequently Asked Questions (FAQs) about ODD

What are the early signs of Oppositional Defiant Disorder?

Early signs of ODD include frequent temper tantrums, refusal to follow rules, and ongoing defiance toward authority figures.

Can ODD go away on its own?

While some kids or teens outgrow ODD behaviors, early intervention with therapy and consistent parenting strategies can help manage symptoms effectively. Addressing some of the underlying issues can be crucial to resolving symptoms.

What is the best treatment for a child with ODD?

Behavioral therapy, parent management training, and structured routines are named as the most effective treatment options for children with ODD.

Can adults have oppositional defiant disorder?

ODD is primarily diagnosed in kids, but it is often the precursor to Conduct Disorder or other mood disorders or personality disorder in adults.

What causes ODD?

There is no one cause for oppositional defiant disorder. As discussed on the podcast, ODD can often be masking for or coupled with autism, ADHD, trauma, or other mood disorders. For kids, behavior is how they communicate.

Is ODD real?

A diagnosis is a grouping of symptoms, and Oppositional Defiant Disorder is a real diagnosis in the Diagnostic Statistical Manual (DSM).

This diagnosis has stirred up controversy because:

1. It is often diagnosed in kids that are strong-willed, rebellious, or defiant, which can be considered developmentally appropriate or somewhat subjective.
2. Family discipline and expectations can vary so widely—it can just be pathologizing inconsistent parenting and family stressors.
3. There is a lot of overlap of children diagnosed with ODD and children that have experienced trauma, are diagnosed with ADHD, or other mood disorders. For this reason, people argue that therapists are not always looking at the full clinical picture when using this diagnosis.

Final Note for Parents

A diagnosis like ODD feels heavy, but it is only one piece of a much larger puzzle. Kids are so much more than their behaviors, and we don’t want them to see themselves as “bad” or “difficult.”

Biases in how children’s behaviors are perceived can also influence how often ODD is diagnosed, especially across different cultural and racial backgrounds. As a parent or caregiver, you are your child’s best advocate. Make sure they are seen as a whole person, not just a set of symptoms.

If you are feeling like your child’s therapist isn’t looking at the full picture, don’t feel bad about switching providers. It’s crucial for you to feel listened to and that the therapist is on your side and supporting your family. A psychological evaluation might also be a helpful step towards ruling out other diagnoses or seeing what’s could be happening underneath these behaviors. Several years ago, I worked with a kid that had been previously diagnosed with ODD. After building rapport, learning more about him and his family, we realized that this kid was struggling with sensory issues and depression. Getting to the root of the issue and making some key adjustments made a huge difference for this kid’s behaviors.

Parenting a child with ODD can feel like an uphill battle, but you are not alone. With the right strategies, support, and understanding, you can help your child learn new ways to manage frustration and build healthier relationships. It will not happen overnight, but small steps add up over time.

Podcast Transcript:

Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda. I’m a licensed clinical social worker, and I’m here with Letisha and Gina, both are veterans of this podcast. They are like my two go to, hey, I want to talk about this topic. I want you to be on this podcast about it. And today we are talking about Oppositional Defiant Disorder. Gina, do you want to go ahead and introduce yourself before we get started?

Gina: Yeah, absolutely. I’m Gina Young. I’m an LICSW in the state of Minnesota and a director of community based programs in Minnesota.

I have been working with kids for the last 12 years and it has come across, my desk a few times, I’ve also supervised staff that have been working with kiddos that have been diagnosed with it.

Letisha: Letisha, do you want to introduce yourself? Certainly. I’m Letisha Harris, and I am a MA studying to get my license to be LPCC. I have been working with kids for a long time. I definitely am very curious about learning more about ODD. I don’t know a whole lot about it, but it’s always nice to learn something new. As well as, I’ve worked with kids for a long time, so I’ve seen it often and not really known exactly what it is or why,

Miranda: yeah, and this is one of those topics and one of these diagnoses that feels very taboo for a lot of reasons, and we’ll get into that.

But I wanted to talk through what does the DSM say? What are the symptoms of ODD? And then I want us to talk a little bit about the taboo nature of it, like why are so many clinicians like Gina very resistant to putting this diagnosis on someone’s chart? And then even just like maybe peeling back some of the layers, talking about some differential diagnosis and treatment.

So that’s what my hope is for today. Gina, do you want to just get us started by talking about what does the DSM say about What do you need to do to fit this diagnosis?

Gina: Yeah, and it starts off its own chapter of Disruptive Impulse Control and Conduct Disorders. And so the DSM 5 says that ODD is a pattern of angry, irritable mood, argumentative, defiant behavior, or vindictiveness lasting at least six months as evidenced by at least four symptoms from any of the following categories and exhibited during interaction with at least one individual who is not a sibling.

So the categories are angry, irritable, angry slash irritable mood, and there’s often loses temper, is often touchy or easily annoyed. is often angry and resentful. The next category is argumentative slash defiant behavior. Often argues with authority figures or for children and adolescents with adults.

Often actively defies or refuses to comply with requests from authority figures or with rules. Often deliberately annoys others. Often blames others for his or her mistakes or misbehavior. the last category is vindictiveness. has been spiteful. or vindictive at least twice within the past six months.

Unless otherwise noted for individuals five years or older, the behavior should occur at least once per week for at least six months, category B, the disturbance and behaviors associated with distress in the individual or others in his or her immediate social context. So family peer group work colleagues.

Or it impacts negatively on social, educational, occupational, or other important areas of functioning. category C, the behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. the criteria are not met for disruptive mood dysregulation disorder.

there are three levels of severity. Mild symptoms are confined to only one setting. Moderate symptoms are in at least two settings. And severe symptoms are present in three or more settings.

Miranda: Gosh it’s interesting because when you’re talking about different settings that raises some red flags around this diagnosis if you have a kid who is only being oppositional at school, or if you have a kid who is only being oppositional at home, it just gives me more questions than answers,

And I forget, and maybe you said this already, but is there an age range that has to meet ODD? No. Okay. I remember there being one for conduct disorder though, like you have to meet. Yeah, that one’s over 18. Okay. oftentimes, for conduct disorder, Part of the diagnosis is that they had ODD or it talks about the precursor.

So when we’re talking about oppositional defiance disorder, what’s your issue with this diagnosis?

Gina: So my main issue is throughout my career of working with children and I started off in an agency that was very much focused on the community and working with kiddos with trauma.

ODD is often given by hospitals and in acute settings because you’re getting a parent report and reports from other adults and the kiddo, but there’s usually a focus on the defiance behaviors. So that can happen. And then I think you see it more often in juvenile justice settings as wella kid that won’t listen, a kid that won’t follow the rules.

And in my time working with kiddos, I have never seen an ODD kid that doesn’t have something else going on. I’ve always found an underlying issue underneath the defiance, whether it be a mood disorder like anxiety or depression, or. In most cases, PTSD there’s always been another piece to it, right?

Children do not exist in a vacuum. They exist in environments and within systems that are heavily influencing their behaviors and their presentations. And ODD is saying. Often loses temper, touchy, angry, resentful, challenges authority, deliberately annoys others. That’s like a lot of children I know. It’s just so wide of a scope.

Miranda: And that’s even something with kids that have depression or kids that have anxiety or kids that have trauma. to me, it feels like ODD is almost a symptom instead of a diagnosis.

Do you know what I mean? It feels more like. This is a grouping of symptoms that leads to, of course, that’s what a diagnosis is, it’s a grouping of symptoms, but, to me, it feels like more of a symptom instead.

Gina: The defiance part of it was always Communicating that there was a greater need that we were addressingwhether it would be a family.

And when I was doing crisis work and going in the home, it was always a structural family issue. the kid had gotten an ODD diagnosis when they were. Six, seven, eight, and that had become the kid’s whole identity in the eyes of the parents, right? it was this grumpy, bad child and their parenting Changed once that diagnosis came through so their relationships changed with the child.

So I just have never met a kid that truly meets ODD criteria across a lot of settings without there being additional trauma and or mood issues. it’s the precursor to conduct disorder and then the precursor to juvenile justice and going to jail and prison, right?

To me, it’s more a lack of resources and a lack of skills and us meeting the needs of the kiddos in our community. And then we put them in jail, so that’s not great, and anybody who gives an ODD diagnosis for any child under the age of five, we will talk I’m not a fan of that.

Gina: And I’m going to name that I believe ODD is more often given to black boys. 100%. Yeah. I think we see that in the data that we know from kids that are getting suspended from school, like from kindergarten onward, is that It’s BIPOC kiddos that are getting sent home. And that are not being looked at with as much support and curiosity as we would give other cultures.

Letisha: Yeah. And that’s good reason because when you think about it, coming from my own perspective, just hearing you say that I’m thinking about my two year old, defiant, antagonizing his brother, like things that a two year old would normally do.

And as he gets older, that probably will continue. It might change and vary in different ways, but is that something that he would then be labeled as? more likely to be labeled as ODD as opposed to a normal two year old who has, obviously there are family structures that are different, right?

Obviously, He may have experienced some PTSD or some other things I’m a firm believer that everybody has experienced some PTSD at some time in their life. some people it affects more drastically than others, how will that impact him as he gets older?

And will this become something that would be more looked at when he’s in school as, more of a defiant behavior as. He resists to do something that maybe he’s not comfortable doing, or maybe doesn’t understand, or maybe doesn’t have a proper communication about what does that look like for him when he gets older, and speaking to it as a person of color, it’s more likely to be looked at as that as opposed to a child trying to figure out where his boundaries lie.

Miranda: Oh, yeah. I had a case a couple years ago where there was a kid who came to me with an ODD diagnosis. This was a kid who had gone through so many therapists, and either he fired them or they fired him.

I think he was only like 12. It was a really hard case because he met criteria for ODD. He met every single thing. And as a new therapist, I remember reading this and being like, he meets criteria, but I’m just really struggling with this diagnosis because I don’t want to put this on him.

I am just skeptical of this diagnosis and I think in that particular case, he ended up having psyche vows too because he, it was a long road coming to me up till that point, he had seen a lot of providers and he also met criteria for major depressive disorder.

And kid didn’t have any trauma that we were aware of in his background, but it was one of those cases where you’re like, I just feel like I’m missing something like you. Yes, we have these symptoms. Yes, he’s on his sixth school in the last two years. But I just feel like I’m missing something.

And I think that for some clinicians, ODD can just feel like a lazy diagnosis where you’re not wanting to go that much deeper.

Gina: It feels to me like sometimes when people give adjustment disorder, I’m like, What are you doing?

Miranda: Adjustment disorder for three years,

Gina: Yeah, exactly. I’d be like, did they adjust to anything? Or what’s going on? And I think this aligns, with people who get diagnosed with borderline personality disorder.

Therapists are like, no, thank you. I don’t want to work with ODD. I don’t know how to work with ODD. And then it becomes, they just cycle through people, which just further ingrains the problem and the lack of connection.

Miranda: Yeah. I don’t remember who it was.

It was probably you, Gina. Someone who told me in my early years of being a therapist, when I was first doing that big wave of diagnostic assessments. I remember thinking about how A diagnostic assessment is really meant to be a snapshot of what is happening and a roadmap of where to go from here.

Yeah. It doesn’t have to be a detailed history on everything that this kid has been through or everything that he, that’s happened. It doesn’t have to be a super detailed it doesn’t have to go through every single diagnose, like there’s just there, there are kids in your life that you’ll work with that will meet multiple diagnoses

I had a chart in grad school that talks about the overlapping characteristics of trauma ODD is one of those overlapping diagnoses And I could have given that kid ODD. I could have given him, major depressive disorder.

I’ve seen plenty of kids that meet both of those and anxiety and you can tack on a million diagnoses onto a person’s assessment But I think the question that you have to ask yourself is this giving me the best clinical picture and the best roadmap forward?

Yeah, so I think you just like rather than just Seeing oh this kid has ODD. Oh this kid has You know, they’ve been diagnosed with X, Y, and Z in the past. it’s up to you as the clinician to say, does this still fit this picture even or, maybe we’re doing like a adjustment disorder for the first diagnosis or something while you’re getting to know them.

And while you’re trying to figure out what is contributing to this clinical picture because I feel like I’m missing something.

Gina: When I think also coming to it with a fresh set of eyes, right? I think we have some providers who read that stuff and some who don’t, and I stopped reading it because I was like, I don’t know what’s been tried, what’s worked, what hasn’t worked, we don’t want to reinvent the wheel.

And we want to get some information about that, but every time you meet a kid, you’ve got to be open to giving them a fresh set of eyes and a fair start some providers read that stuff and some who don’t, and I stopped reading it because I was like, This has so much of its own bias from all of the providers that came before I want to come in clear eyed to this situation so that I can make my own decision,

Letisha: Yeah. And to that point, the child if they’ve gone through multiple providers, they’re expecting for you to have that same perspective of them, right? They’re expecting that label is who they are. And you coming in with a fresh set of eyes allows for them to not be seen under that label, but to be seen as who they are, and then you can make a proper diagnosis because you’re looking at them from a fresh set of eyes.

And it can be very intimidating to see certain diagnoses as a clinician, and be like, oh, what kind of crap am I going to get myself into? What kind of person are they going to be, right? But if you allow yourself to have fresh eyes on it, then you can say that may be what somebody’s perspective of, as Gina was saying, that may be their perspective of this person.

But I do have to do my due diligence and allow myself to really see who this person is and see who this child is or this adult, right? See who they are under. That lens as opposed to under the lens of somebody else’s previous experience with them. One ODD child may not be the same as the last ODD child, right?

And one ADHD child may not be the same as the last ADHD child. Being able to See each child differently each day, right? Each week that you come in to see them, you have to have a different set of eyes. That was one thing I learned when I was working in child care, is that I cannot say, you did all of these things to me yesterday, right?

First of all, that’s a two year old or a four year old. They don’t really care or remember what they did to you yesterday, I can’t come in with that bias because then I’m not going to be able to truly educate them help them get to the treatment plan and help them move along in their journey.

Miranda: I think that’s especially key with diagnoses like oppositional defiant disorder where you come in and you’re just like, going to look at this. In a new way I think there’s also a lot of diagnoses, even for adults I was working with a client who came in as an adult and had borderline, I’m not afraid of borderline.

I love my borderline clients. my very first question is usually do you agree with this diagnosis? Do you think that this is, Yeah. Let’s just talk about this. I think that talking about it is going to decrease some of the stigma and the scariness about it.

But You can also take the same principles and think about it when you’re working with kids, about how parents might approach a kid, or if a parent is exhausted and they’re like, this is why my kid’s in therapy, or this is what the issue is, and then you sit down and you talk to the kid and you’re like what do you think the issue is?

Or what’s behind it for you? Or what do you want to be working on? your buy in is going to be so much greater, but then also, you’re going to get so much more insight, again, into the issues below the behaviors, because the parents are sometimes only looking parents, teachers, insert.

But a lot of times they’re only looking at “Oh, he got expelled again” or “Oh, he’s suspended.” And so I think that it’s important to be able to take those cases and try to be as unbiased as you can, because those kids probably have a lot of grownups in their life that don’t believe in them that just only take their behaviors at face value and say he’s a bad kid or he’s this way.

And I think that as therapists, it’s our role to hold on to the hope for our clients, but also be able to look deeper.

Letisha: Eliminate some of those expectations. Because it can be that they don’t. See much value in them, and it can also be that they see way too much value in them,

they think, oh he would never do that, They think so highly of them, right? And the pressure that puts on a child Is overwhelming. Or the enabling that can happen. You have to be this way. You have to do these things. when I was in high school, I had a friend who was overwhelmed with having requirements to be getting A’s all the time.

Miranda: And so that pressure that was on her was overwhelming. I can’t imagine that a child that is considered to be labeled, a certain way or a certain behavior, how much that behavior and the expectation for them to be different is put on them and how much pressure that is for them and they’ll start to that diagnosis, We talked around this a little bit, but let’s talk about differential diagnosis and what are some diagnoses or things that if you have a kid that’s labeled as ODD or maybe you’re considering this diagnosis yourself as a clinician, what are some kind of alternatives or even just what could we be looking at?

Yeah. A DHD. That is a big one. I work with a lot of kids with ADHD and I adore them and they can be really annoying. And there’s nothing wrong with that, right? They have big feelings. They have a hard time expressing them and they want them to get met and they feel like they’re the most important.

Gina: So I absolutely think they can lose their temper. They can be very touchy sometimes. They can have trouble following rules.

Miranda: I think they check a lot of these boxes as well. so it’s important to either make that referral for testing, if appropriate for ADHD.

Gina: Like Miranda said about a snapshot in time, this is a Polaroid of just this moment and we really need to get a view of the child’s functioning across their lifetime and in the various settings that they’re in too. I think there’s quite a bit of crossover with ADHD, I think there’s quite a bit of crossover with trauma.

Miranda: I think the difference with ADHD and ODD is it’s coming from a place of hyperactivity ODD. would look more like deliberate defiance, where an ADHD kid would maybe believe me, it’s they’re not looking at you in the face, in your face and being like, I’m not doing that.

It’s more of it might look different where they’re constantly forgetting they’re supposed to be doing something you were saying it also looks like trauma.

Gina: Trauma and autism. Those are the two things. Especially with trauma. And I think a lot of times from my past experience with kiddos with trauma that end up with an ODD diagnosis, it’s because they can’t trust adults because of things that have happened.

Yeah. We’re talking about complex trauma over a lifetime, a child’s lifetime. We’re not talking about a car accident or one moment. We’re talking about repeated losses and repeated letdowns by systems and by adults. And so by the time you get to them, when they’re 15, they’re over it, like they’re not going to trust another adult.

They’re not going to talk to another therapist that hasn’t been helpful. And so instead the systems have judged and tried to control versus tried to understand and be curious. trauma looks like a lot of different things for different kiddos. a lot of the situations that I’ve come across underneath ODB has been a lot of experiences of trauma.

But other people maybe have not identified it as trauma.

Miranda: And think about it too, it is not a coincidence that when I worked in the foster care system, every kid, I, Worked with as a case manager had been diagnosed with ODD at some point whether it be attachment loss, real traumatic events, like whatever it is, there are things underneath it that are leading to exactly what you’re talking about, Gina.

And this is especially key when we’re thinking about kids who had pre verbal trauma who Can’t say what is bothering them. they feel it differently. They’re experiencing their trauma in their bodies rather than being able to like,

Gina: Nobody named that for them, right? It wasn’t okay to be scared. They had to just not cry and keep moving on with whatever they needed to do. So I agree. So many foster care kids end up with that diagnosis and that is, I think, really harmful to them.

Miranda: Oh, absolutely. when I worked as a home study worker, I would write home studies for families we thought they might be a good family for, then they would go through a period of what was called full disclosure, documentation on this kid so that they could get a full picture of who they might be adopting for so many of those families they would see ODD and they’d be like “ooh, I don’t know if I can do that. I don’t know if I can deal with being a super defiant kid all the time.”

And then, naturally my next thought would be like, “why are you doing this?” but also, I think that diagnosis was very harmful when it came to whether or not a child was quote unquote adoptable.

Gina: And so that was absolutely harmful for a lot of those kids.

Letisha: It’s very harmful when you think about the aspect of the child being accepted, right? If like you were just talking about with adoption, with foster care as well That child, my perception of defiance is different than another person’s perception,

I’m only going off of what I perceive to be defiant. if I’m saying defiant, I’m thinking like, this kid’s gonna be running away, this kid’s gonna be Cursing me out, this kid is going to be doing all of these things, right? Whereas this kid may just be a kid that says no, and it’s very deliberate about their no, if they don’t feel that safe space, they’re more likely to be like, I’m not doing that.

I’m not going there. that defiance is different than it. varies in that expectation of who that child is. you set the child up for failure when the person doesn’t really know the child except for on paper and what somebody else is perceiving to be their behavior.

Gina: What about mood disorders? how might this, what’s the Venn diagram of ODD? Irritability, especially in any kiddo under the age of 18 is definitely one of the criteria for MDD, right? And if we’ve met any teenagers, they’re challenging authority often. like everything’s on a continuum, like we’re talking about, right?

you are absolutely dipping into the mood disorder. Pop when you’re looking at ODD and the other one I was thinking about was autism too. Because let me tell you, they want it a certain way and it’s the only way their brain will accept it to be.

Letisha: Yeah.

Gina: And so here comes a grown up who wants it to be their way for whatever reason they have, especially in a school setting or anything like that.

Especially if they have sensory sensitivities or kids who have trouble communicating, like that are on the autism spectrum, kids use behavior as language.

Miranda: if they don’t want to do something and you’re trying to get them to, but they can’t verbalize that, it can look differently.

Gina: I’ve been learning more about persistent demand avoidance. And how big of an impact that can have on kids with autism and kids with ADHD with a nervous system that’s so dysregulated that it’s always going to look like defiance to other people when in reality it’s them needing it to be offered a different way or at a different time when they’re calmer and when their body is feeling safer.

It’s like your fight, flight, freeze response where if you are sensing that, you’re under attack or something, if your nervous system is sensing that something is wrong,

Miranda: Your amygdala is going to be like, okay, These are your options. for a lot of kids, that’s fight, for me, it’s fight. I’m not going to punch you, but I’m going to fight back, and so defiant.

I think this is just a key part of the conversation there are so many things that can look like this but the part that I think is very unique with ODD that you don’t see in these other diagnoses is the idea of vindictiveness.

Gina: it’s that idea of revenge. Yes.

Needing to get back at the person. when we started working together, you had a kiddo with ODD who could not let go of like, When they had been slighted, they kept a track in their brain of this person has, bumped me in the hallway, they took my lunch, they slid my locker, all of these little things that could be let go.

But for this kiddo, we’re so magnified that you don’t see necessarily in autism or in a mood disorder, but it’s very specific to ODD.

Miranda: it is like an obsession, though.

Gina: Agreed. To me, when we’re talking about a kid who cannot let go of something and it’s like they’re fixated on being slighted it doesn’t necessarily veer into OCD, but it reminds me of the obsessions, like I’m fixated on this and I feel like I have to do something about this, which again falls under anxiety, It’s this idea of injustice which is if the adults are not going to take care of it, then I’m going to get revenge for what I think was a very serious injustice to me, even if it was small And it gets not just obsessive, but magnified in their mind and becomes a much, much bigger deal than what is really going on.

Miranda: But everybody does that on some small level, too, though. I could have an argument with my partner, and then I’m gonna think about it, and it’s gonna get so much bigger in my mind. By the time I see him, we’re gonna have an argument about it.

Letisha: Your part gets smaller. But that’s what I’m saying, is it’s like, there are some parts of this that are common to all people.

Gina: there are shades of it, that are normalized to some extent.

Letisha: I get bitter and mad at some people sometimes and I can’t let it go.

But with a kid with maybe an overwhelmed nervous system and trauma and a lot of adults and systems that are like, you’re the problem. I can imagine. It’s no wonder this gets so big for him. And kids have so little control over so many aspects of their life.

And then you put this diagnosis on top of them. I can only imagine how invalidating that is.

Miranda: To piggyback off of that for a second though, like, how often are kids being told their diagnoses or are they seeing them on a piece of paper and being like, what does that mean?

I think that they’re adults alike where, you might be diagnosed with something and then it’s, I remember I wrote a home study for a family years ago when you’re going through the adoption process, you have to have a letter from a therapist if you are seeing a therapist, you have to have a letter from them that says this is the diagnosis and we approve them or whatever, which is, don’t get me started on that.

As an adoptive parent, it kept me from going to see a therapist during the adoption process because it was another cumbersome step. there’s a letter you need from a therapist if you’re seeing one.

I was writing a home study for this guy and he got a letter from his therapist or he, it like got sent to us and then we included it in the home study. then he was reviewing the home study and he was like, What? I’m diagnosed with Borderline Personality Disorder?

But it was a major diagnosis where he had no idea that he had been diagnosed with this. And I think that happens with kids too. I don’t know how I feel about it’s not like every kid needs to know exactly what their diagnosis is either, but it is just a weird thing.

we are labeling you and then Not talking to you about what this means

Gina: I could do a whole episode about the need to keep them informed at a developmentally appropriate space. I’m not going to be using the words that we’re finding in the DSM, but they’re going to know that they have worries that are affecting a lot of areas of their life.

Yes. as a kid who was in therapy themselves, like I didn’t know what I had into later on. And I was like, Oh, I should have known like that would have been really helpful. Like my parents maybe would have known somebody should talk to me. That would have been really helpful.

And therapy is so scary for kids anyway, because it’s parents making them go. Unless you’re over, like 10 and up and you’re requesting to go, it’s really parents are bringing their littles in and are like, fix these kids. And so I’m not participating in that. it’s going to be a way more inclusive environment.

they’re going to know when I list and I ask all these questions, I want them to know what we’re going to be working on. And I want them to. De stigmatize whatever disorder we’re giving, right? And by not talking about it, we’re keeping it in secret.

Letisha: Aeah, I’m not a fan of that . I was just gonna say, also not weaponizing it against the child, because sometimes you have that parent who’s overwhelmed or frustrated, and it’s a weapon against that child, as opposed to You have this disorder, that is affecting and impacting your everyday life.

And these are the steps that we’re taking to help you manage that. That’s a different conversation than screaming at them because you’re overwhelmed about their diagnoses. And now they’re looking at that as a negative thing on top of all the other negative things that they may be experiencing.

So not using it as a weapon, but allowing them to understand what this does, how this impacts you, what things we’re doing to help manage that, and how we’re helping you to treat that diagnosis so that it helps them to better understand it and be able to work with it and process through it as opposed to it becoming something negative.

So how do you treat ODD?

Miranda: Gina.

Gina: I was doing a little bit of research before and I was looking at the prevalence rate and it’s 2 to 11%, which is really small. it is definitely seen more often in boys than it is girls. I honestly have never met a girl with ODD.

I don’t think I’ve ever encountered a kiddo. With ODD. in my encounters with it, it’s been family interventions that have worked with parents on how to support the kiddo and help them build the skills that they need, at home and then at school as well. And I want to get back to Leticia’s did something really great about weaponizing. ODD can be very much weaponized in schools. And so if you get a kiddo in special education that has an ODD diagnosis, I’ve never seen them in the mainstream setting.

I see them in level three and level four. Because it’s the teachers who are like, I’m not taking an ODD kid. They get shuffled along, and is this helping them having this diagnosis, or is it hurting them?

In fact, are the adults changing their behavior based on the diagnosis that this kid is coming in with? And they spend six hours a day in school, sometimes eight. That’s half their day. And if their teachers are feeling ill equipped and stigmatizing the child, it’s just going to make it worse.

Letisha: That’s true.

Miranda: Yeah. the kids that I’ve had that have been diagnosed with ODD, I have found the most success. With working with them when we come up with goals together When we are heavy with partnership and figuring out, like what are you getting out of this?

Can we come up with different reward systems? Can we do different things that will? Like I had one kid who I had a ticket system where he got a ticket every time he came to session and another ticket if he did something I wanted to do,

And so usually it’s going to be like, do you want to, read a book about it? What do you want to read a book about? and then he got two tickets if he brought something to talk to me about. this kid was obsessed with Pokemon cards, and so I went through a lot of Pokemon cards with this kid, but I want to be clear that when I started seeing this kid in therapy, I had a hard time at first because I was like, I don’t know what to do.

I don’t know if I’m making any progress. It feels like we’re taking forever to build rapport. And it feels as one of those clients where I’m like, oh, I don’t dread seeing you, but I’m also just I don’t know thrilled to see them either. But I think it’s because I was feeling ineffective. It was more about how I was feeling when I was with him. And then I realized that. I think I worked with him for a year or something like that.

By the end of the time that we worked together I’d love to be able to say he made some progress, which was great. but it was just a super hard case where I still think back on that case. I still think that I was missing something in there, whether it be some trauma or something. I was probably still missing something that, he wasn’t communicating to me, and I wasn’t getting from parents. there’s a lot of beauty in the hard cases and a lot of room for improvement. if you are a therapist listening to this being like I have an ODD case that I’ve, that I just am having so much hard, such a hard time with.

It’s I just want to say that, yeah, like they can be hard cases any diagnosis can be a hard case. not just ODD kids, there’s a lot of improvement that can happen. I would encourage you to look at the. individual symptoms and the things leading to this diagnosis,

Gina: You’re going to treat the different things causing distress around autism. I looked up some evidence based practice and one of them was parent management training, which involves teaching parents effective strategies to manage their child’s behavior through consistent positive reinforcement. It’s considered the gold standard of treatment.

Miranda: Makes sense that it’s positive reinforcement that works and not just like I’m taking away everything from you.

Gina: Which is, I think when I was working at Holmes, Parents were removing doors off the hinges and taking everything from the room.

And I was like, they look like a prisoner. This isn’t going to work. it’s not going to work. You can’t take everything from somebody and then still expect them to behave. You know what I mean?

Miranda: Especially if they’re a kid that has been in foster care or has had trauma because they’ll be like, I’ve had everything taken away from me before.

Gina: it just fine.

Miranda: Okay. That’s so interesting. And that kind of tracks with what you were just saying, where it’s so much of, involving the parents.

Letisha: They also listed cognitive behavioral therapy. It can help children with ODD learn to identify and manage their emotions, develop problem solving skills, and challenge negative thoughts, contributing to defiant behavior.

I try to talk about with the people that I supervise is I need you to get an idea of how the child views the world, right? If we can get a snapshot into their brain and understand what negative cognitions they might have that have shaped their identity and their behaviors.

That’s the thing that we can work on to change. And once you change the negative thoughts, you can then change the behaviors. and I think you can do that at a young age too, but somewhere along the line with kids with ODD, it was instead of do what everyone else is doing, I’m going to defy and act out.

And what messages did you get around that, right? And so exploring that more, I think CBT is a cornerstone for a lot of the therapy that we do. And so I’m happy to hear that it’s in here too, as a tool for kids with ODD.

Miranda: This has been awesome. Thank you so much to both of you for joining. This has been a really good discussion and hopefully this has been helpful for people listening just to hear some clinicians talk through how they’ve struggled with this diagnosis and where to go from here because it’s something that’s being diagnosed we need to know how to navigate it and also just how to See what’s underlying too.

I think it’s important. I agree. I don’t think kids are inherently bad. And I think that’s maybe why I struggle with this one. Thank you both so much.

Letisha: Thanks, Miranda

The post Oppositional Defiant Disorder (ODD) in Kids: Symptoms, Causes, and How to Help appeared first on Ellie Mental Health, PLLP.

But what about divorce? Do we go through these same 5 stages of grief? And does the person initiating the divorce go through the same stages of grief as the person who doesn’t want the marriage to end?

Divorce and Loss

First, let’s take a moment to identify the losses that come with divorce. Obviously there’s the loss of a marriage, but we are also grieving our own future. No one gets married expecting to get divorced; rather, we anticipate spending our entire future with that person. We make financial decisions based on a shared vision of our future, we create shared friend groups, attend the same church, get close to our partner’s family. All of this is based on an assumption that we are building a lasting future together as a couple. For those of us who have children, we plan to raise those children together, celebrating this family we’ve created. We talk about where we want to live when our kids leave the nest, what trips we want to take, what hobbies we might pursue together, we imagine ourselves growing old next to that person we vowed to love ‘till death do us part.

And now that future is gone. Granted, we may still have a future with that person, especially if we are co-parenting with them, but it’s going to look a lot different than we previously envisioned, and probably not in a good way. So when we talk about loss as it relates to divorce, we are talking about the loss of plans, dreams, hopes, and expectations. On top of that, many of us also experience the loss of financial security, mutual friends, and our partner’s family. If we’re coparenting, we also lose time with our children. That’s a lot of loss, which means there’s a lot to grieve.

5 Stages of Divorce Grief

It’s normal to have a lot of conflicting feelings when going through a divorce, and it’s also normal to experience these feelings at all different times. It’s also important to note that you might experience these feelings differently if the divorce is mutual, if you’re the one initiating the divorce, or if your spouse is initiating. You might feel depressed one moment and anger in the next– this blog post will be dissecting some of these feelings and how you can cope through each:

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

1. Denial

For the person initiating the divorce, they will have gone through much of the grieving process before telling their partner they want a divorce. What that looks like will vary from person to person. For example, there is usually a period of time when they may deny that they are no longer invested in the marriage by keeping busy at work or with friends, or stating they want to go to couples therapy but then making little to no effort outside of therapy to work on the marriage.

For the person who does not want the marriage to end, grieving begins the moment their partner announces they want a divorce. The rejected spouse may refuse to go to mediation or hire an attorney, they won’t sign any papers or tell their parents that the marriage is over. They still plan family vacations and try to act as if none of this is actually happening. 

That said, in my observation the Denial stage usually begins well before that moment, albeit outside their conscious awareness. Most unhappy spouses are quite vocal about their marital dissatisfaction for months, if not years, before announcing the divorce. For whatever reason, however, their partner could not hear it for what it was, and are then legitimately shocked to learn the marriage is over.

2. Anger

For the person initiating the divorce, they may start to show anger toward their spouse for not being the kind of partner they wanted, becoming hypercritical, leaving their partner to feel as though nothing they do is right.

Anger often starts building long before the initiator says the words out loud. It can come from years of feeling unheard, unmet needs, or repeated conflicts that never get resolved. That frustration can make it hard to communicate openly, leading to resentment and shutting down instead of working through issues. It can also cloud judgment, making decisions feel reactive rather than thoughtful.

Anger doesn’t always stay within the relationship—it can spill over into work, friendships, or even self-criticism, showing up as irritability, impatience, or burnout. Some people push it down to avoid confrontation, while others become more reactive, interpreting everything their partner does through a lens of frustration. Often, this anger is a warning sign that the relationship is in trouble, even before the decision to leave feels final. Working through these emotions with anger management therapy can help process them in a healthier way, making it easier to approach divorce with clarity rather than resentment.

The Anger stage can be the scariest one for the partner initiating the divorce, for reasons that make national headlines on a regular basis. Thankfully, most rejected spouses are just angry, not dangerous, though it can still be an acutely painful and scary time for the leaving spouse and any children who get caught in the mix.

For the spouse who wasn’t expecting the divorce, anger often comes with a mix of betrayal, rejection, and deep hurt. They may feel blindsided, wondering how long their partner has been planning to leave and why they weren’t given a chance to fix things. The realization that their partner’s anger had been building in silence can feel like deception, leaving them to question the authenticity of their shared past. This sense of abandonment can trigger intense emotional reactions, ranging from lashing out in frustration, to withdrawing in pain.

In some cases, this anger can become all-consuming, fueling destructive behaviors like blaming, retaliation, revenge, or attempts to regain control. Feelings of powerlessness can escalate into resentment, making even necessary conversations feel impossible. The mix of anger and grief can also lead to self-doubt—wondering if they were ever truly loved or if they somehow caused the relationship’s breakdown. These are all relatively normal feelings, but without support, these emotions can spiral, making healing and closure even more difficult.

3. Bargaining

The Bargaining stage can take any number of shapes. I think affairs often fall under this heading, as an attempt by the person to find happiness without having to leave the marriage (“If I can just find a way to be happy without getting divorced, maybe divorce won’t be necessary). Same goes with getting a new job, or spending more money on trips and possessions, or moving the family to a new city: all can be attempts to find happiness within a marriage that is effectively already over.

Bargaining is often more straightforward with the rejected spouse, who may insist they will make all the changes the leaving spouse has requested in the past, in order to save the marriage, only to find their promises have come too late.

4. Depression

For the person initiating the divorce, depression often sets in long before they make the final decision. The weight of emotional exhaustion, unspoken resentment, and the fear of upending their life can lead to deep withdrawal from the relationship. They may find themselves disengaging—going through the motions but feeling emotionally disconnected. This isolation isn’t just from their partner; they might also pull away from friends and family, struggling to share the turmoil they’re experiencing.

Guilt and self-blame are very common during this stage, especially if they still care about their partner but know the relationship isn’t working. They may question whether they tried hard enough or worry about being seen as the “bad guy” for leaving. This internal struggle can be overwhelming, leading many to seek therapy as they try to process their emotions, find clarity, and work through the grief of letting go.

Depression is the second most worrisome stage of the grieving process for the rejected spouse, as this is when we see spikes in suicide, especially among men, who are far more likely to be the rejected spouse in heterosexual divorce situations.

For the spouse who didn’t initiate the divorce, the depression stage can be devastating, often hitting after the initial shock and anger wear off. Feelings of rejection, abandonment, and grief can lead to deep sadness, hopelessness, and a loss of self-worth. They may replay conversations, searching for where things went wrong, or blame themselves for not seeing the signs sooner. This emotional pain can also bring physical symptoms like fatigue, changes in appetite, or difficulty sleeping, making even basic daily tasks feel overwhelming.

Behaviorally, they might withdraw from social connections, struggling to engage in activities they once enjoyed. Some become consumed by the past, fixating on memories of the relationship, while others feel numb, going through life on autopilot. Motivation can plummet, and in some cases, depression can spiral into deeper mental health struggles, especially if they lack a strong support system. Seeking therapy during this stage can be crucial in helping them process their grief, regain a sense of stability, and start rebuilding their life.

5. Acceptance

For the person initiating the divorce, the Acceptance stage is when they tell their partner the marriage is over. The grieving process does not end there, however. Many will feel a tremendous sense of relief following their decision to leave the marriage. Often, they will take this as a sign that they made the right choice and are ready to move on, having accepted that the marriage is over and taken the first and hardest step toward making it official. Rarely does this play out as expected, however.

Check out our top ten book recommendations for someone going through a divorce.

How Long Does Grief Last After Divorce?

Because the divorce process itself can be so emotionally challenging, and as they witness the fallout from their decision and the losses become more real, the leaving spouse will often go through a second grieving process, one they did not necessarily anticipate.

It can take the rejected spouse a long time to get to the Acceptance stage. I’ve seen rejected spouses cycle through the previous four stages for months or years – sometimes even decades – after the divorce is final.

At this point you may be wondering, Do people ever get to the Acceptance stage after divorce and leave the grief behind? The answer: Usually, but not always. Most of us know people who have been divorced for years and still talk about their ex with the same bitterness they had when it was fresh. 

So what does acceptance look like? Initially, I believe it looks like indifference. Once you’ve let go of all your big feelings, accepting that the relationship is over and you will be moving on with your life without that person by your side, you may feel indifferent toward them. From there, as you continue to heal, you may notice some positive feelings emerge, as you incorporate both the negative and the positive parts of your history together, forming an adaptive and holistic narrative that allows you to move forward with your life, beyond the grief, a little stronger and wiser than you were before.

How to Cope with Divorce Grief

If you are struggling to get to this final stage of grief following your divorce, I would encourage you to reach out to a therapist with experience working with divorcing and divorced individuals. There are also support groups for people affected by divorce, which can help mitigate the loneliness and feelings of isolation that often accompany divorce. With the right supports in place, I believe anyone can learn to accept their divorce and move forward with their life, no matter the circumstances. 

Need some help navigating the stages of divorce grief? Contact the experts at Ellie Mental Health today for support.

The post Examining the Grieving Stages of Divorce appeared first on Ellie Mental Health, PLLP.

No one should have to deal with their mental health alone, and you might not quite understand why you feel the way you do. Therapy can make a big difference in helping you navigate mental health issues, stress, grief, or difficult life situations, and understanding how to ask your parents for therapy can be a good first step to getting the help you need.

Looking for a therapist you can trust? Get matched with a therapist near you today!

Why Can’t I Talk to My Parents About My Feelings?

Depending on your home situation, telling your parents what you’ve been experiencing might not be easy. You might feel afraid that your parents won’t understand how you feel or downplay the seriousness of what’s going on. On the other hand, if you share that you’re experiencing depression, anxiety, or other concerning mental health symptoms, you might be anxious that they’ll overreact or treat you differently.

The reality is that not everyone has a safe relationship with their parents. If your parents aren’t a great source of support for you, you live in an abusive household, or you’re simply not ready to share with your parents, you are not wrong for not wanting to tell them how you’re feeling.

It’s possible that you’ve already tried telling your parents that you need support, only for them to brush off the situation or make you feel like you’re being dramatic. You might even feel like your parents contribute to your poor mental health – if you have parents that are neglectful or abusive, that can have a very negative effect on your emotional and mental well-being.

If it’s not safe to talk to your parents about how you’re feeling or you just don’t feel comfortable talking with them yet, you don’t need to delay in getting the help you need. If possible, find another adult you can trust or confide in. This might be a teacher, a friend’s parent, a coach, a pastor, or maybe a different family member. There are also hotlines you can call if you don’t know where else to turn or need support right away, including:

• 988 Suicide & Crisis Lifeline (The National Suicide Prevention Lifeline): 988
• Teen Line: 800-852-8336
• Hopeline: 877-YOUTHLINE

How to Tell Your Parents You’re Struggling with Mental Health

When your parents love and support you, the last thing they want is for you to struggle alone. It makes total sense that you’re nervous to talk to them – even adults struggle to be vulnerable and reach out for help. However, deciding to talk to your parents about your mental health can make a huge difference in your life, both now and in the future.

Here are 5 tips on how to talk to your parents about your mental health:

1. Write Down What You Want to Say

If you’re worried you won’t have the right words to express how you’ve been feeling, it can help to put it in writing first. You could spend some time journaling before you talk with your parents to get your thoughts together, or, if it’s easier, you could write them a letter that you could read or show them, or even text or email. 

Writing down your thoughts and feelings isn’t just about prepping for the conversation—it can also help you gain a deeper understanding of what you’re experiencing. Putting emotions into words forces you to slow down and reflect, which can bring clarity to feelings that might otherwise feel overwhelming or confusing. It also gives you a sense of control over those emotions, allowing you to process them in a way that feels safer and more manageable. The more you organize your thoughts in writing, the more confident you may feel when it comes time to share them, making the conversation with your parents a little easier to navigate.

Sidenote: Sometimes it can feel less scary or we have an easier time saying what we intend through text. If this is something you want to say but you’re nervous to do it in person, try saying it through text instead. You could write, “I want to bring something up, but I don’t know how to say it. I’ve been feeling really ____ lately and I think talking to a therapist might help.”

Looking for more tips on starting a mental health conversation? Check out our other blog for tips on how to talk to someone about their mental health.

2. Make Sure the Time is Right

Bring up the conversation during a time when your parents seem relaxed and can give you their full attention. This could be during your drive home from school or on a weekend when your parents are unoccupied. You can also let your parents know that you’d like to talk and schedule a time to have the conversation. 

If talking to both parents at once feels like too much, it’s okay to approach them individually. You might feel more comfortable starting with the parent who tends to be more understanding or easier to talk to. And if one parent isn’t as approachable, you don’t have to force the conversation with both—starting with the person you trust most can help you feel more supported, and they may even be able to help you navigate things with the other parent later.

3. Express Your Need for Help

Tell your parents that you want to see someone who can help you, like a therapist. If you are direct in saying that you need help, your parents will better understand how they can support you. 

Let your parents know that you want to talk to someone who can help, like a therapist. It might feel a little awkward or intimidating, but being direct about what you need makes it easier for them to understand how to support you. You don’t have to have all the details figured out—just saying that you’ve been struggling and think a therapist could help is enough. The more clear and direct you are, the more likely your parents are to take your request seriously.

Some ideas:

• “I’ve been feeling really _______ lately, and I think talking to a therapist could help.”
• “I’ve been struggling with a lot of stress and anxiety, and I don’t always know how to deal with it. I think a therapist could help me figure things out.”
• “I’ve been feeling really down lately and I’ve been wondering if medication might help.”

4. Get Extra Support If You Need it

If you’re worried about how your parents will react or want someone else there, you can reach out to another adult you trust or talk to a school counselor if there is one available to you. This extra person can give you advice on what to say, help you practice the conversation, or even be in the room while you talk to your parents.

5. GIve Your Parents Time to Process

It can be difficult for your parents to process that you are struggling. They might blame themselves, try to lecture you, act defensively, or not understand the seriousness of what you’re experiencing. Your parents might need some time to process what you’ve told them. If you express how you feel and your parents don’t get you the help you need right away, try again another time and explain that you still need support.

How Your Parents Can Help You With Your Mental Health

Once you tell your parents that you are struggling with your mental health, there are many ways they can support you:

They Can Support You in Therapy

Going to therapy can be difficult. If you’ve experienced trauma or struggle with suicidal thoughts, it can be really hard to talk about and work through those feelings. It can help if your parents understand what you’re going through so they know to expect shifts in your mood as you begin treatment. Your parents can help you find a therapist and can even attend the first sessions with you if you are afraid to go by yourself to start. Your parents can even seek therapy to help with their own mental health issues or to learn how to better support you.

They Can Help You Make Lifestyle Changes

If you struggle to sleep well, spend excessive time on social media, or don’t get enough exercise, these can all affect your mental health. Your therapist can help you identify lifestyle changes that could help you. But it’s hard changing your routine and the behaviors you’re used to! Your parents can help you stick to the changes you say you want to make.

They Can Talk Out Difficult Situations With You

Once you talk to your parents about your mental health, it makes it easier to talk to them about other areas in your life where you’re struggling. If you are struggling with your grades, are being bullied, or consistently feel sad, venting to your parents can help you feel heard and supported.

They Can Help You Practice and Learn Helpful Skills

Many people struggle with regulating their mood or knowing how to cope with difficult emotions. Your parents can help you practice skills your therapist teaches you, like what to do when you feel bad or how to deal with conflict or relationship issues.

Do You Need Help From a Therapist?

Reaching out for help is difficult, but your mental health is worth it! Whether you’re feeling stressed at school, having issues with your friends or your significant other, or experiencing low self-esteem or confidence, a therapist can help you feel seen and heard in your struggles. While talking with someone you don’t know can feel scary and uncomfortable at first, your therapist can help you navigate difficult feelings and situations in school, at home, or in your relationships. And if you’re struggling with a mental illness like depression, anxiety, or post-traumatic stress disorder (PTSD), your therapist can guide you in receiving the treatment you need.

Your mental health is so important! Get the help you need at Ellie Mental Health and we’ll help you find a therapist that’s the perfect fit.

The post How To Talk to Your Parents About Your Mental Health appeared first on Ellie Mental Health, PLLP.

When I first dipped my toes into MI training, I found myself in a training with doctors, vets, nurses, dietitians…you name it. This just goes to show that it doesn’t matter what your 9-5 looks like, MI can help sprinkle some magic in your professional relations and hey, even give a little zing to your personal life.

So, buckle up pals, ’cause we’re about to dive into what Motivational Interviewing is all about. In this post, we’re going to explore the essence of Motivational Interviewing, demystify its core components, and show how it might be useful for therapists and non-therapists alike.

What is Motivational Interviewing?

Motivational Interviewing is a therapeutic style designed to help individuals overcome ambivalence about change. Contrary to modalities like Cognitive Behavioral Therapy or Somatic Experiencing, MI is non-confrontational and focuses on evoking the participant’s own motivation. It’s not solely a therapy; it’s a way of engaging someone in an open and empathetic dialogue and helping them in making decisions aligned with their values.

Initially developed by William R. Miller and Stephen Rollnick in the 1980s, MI was aimed at helping clients that were struggling with substance use disorders and feeling ambivalent about whether or not to quit their substance use. However, its application has broadened significantly over time, encompassing a variety of professional and personal situations.

The Spirit of Motivational Interviewing

“Spirit of MI” concept emphasizes partnership, acceptance, compassion, and evocation, steering away from the expert-patient dynamic towards a more equal relationship. To put simply: we’re accompanying someone on their decision-making journey rather than telling them what to do.

Four Principles of Motivational Interviewing

1. Engaging and Building Rapport

Establish a safe, supportive environment where individuals feel heard. Whether you’re a teacher or a manager, developing a level of trust is crucial.

2. Focusing

Identify and prioritize the key issues from the individual’s perspective. This process involves honing in on specific areas that might require change.

3. Evoking

Encourage the expression of the individual’s own reasons for change. This involves listening for “change talk vs. sustain talk,” which hints at the person’s motivation to alter their behavior.

4. Planning

Once the person is ready, collaboratively develop a detailed, actionable plan to guide them toward their goals.

Change Talk vs Sustain Talk in Motivational Interviewing

I think one of the most powerful lessons in MI is to be listening for how someone is talking about a possible change. For example, if someone is saying: “I should probably quit smoking,” you know that they have probably spent some time thinking about this decision, want to make that choice, and maybe just need some extra push towards it. We would call this “change talk.”

Another thing to listen to is “sustain talk”: this is when someone is talking about or using language that argues for keeping the status quo.

Examples of Sustain Talk

Sustain talk signals that perhaps the person isn’t ready for change quite yet. They might say things like:

• “I’ve tried ____ before and it didn’t work for me.”
• “I’m not sure I’m ready for that.”
• “Smoking helps me relax.”
• “Drinking is the main way I have fun.”
• “I don’t think my exercise habits need to change.”
• “I don’t think things are bad enough.”

Examples of Change Talk

Change talk shows us that this person is further along in the “stages of change.” They’re either thinking about making changes in their life or making plans to do it eventually.

• “I want to be healthier.”
• “I’ve thought about _____.”
• “I really wish I could feel less _____.”
• “I need to quit _____.”
• “I should probably ____ less.”
• “If I were home more, I would probably have a better relationship with my partner.”
• “It’s important to be to be a role model for my kids.”
• “I am trying to drink less this week.”

So where do you go from here? You elicit and explore that change talk, and OARS is a great acronym of tools to help you get started.

OARS: A Toolkit for Motivational Dialogue

The acronym OARS represents four core communication skills in Motivational Interviewing:

Using open-ended questions in MI

These types of questions move beyond simple “yes” or “no” answers. These questions encourage get people thinking and encourage them to share more.

Instead of asking something like, “Do you want to quit smoking?” (which just gets you a yes or no), you could ask, “What’s been on your mind about quitting smoking?” This kind of question encourages someone to think and talk about their feelings, motivations, and goals. It’s amazing how much insight you can gain just by asking the right kind of question.

Using Affirmations in MI

Affirmations are little gems of encouragement. They’re about pointing out someone’s strengths or acknowledging their progress or efforts, and they can go a long way in boosting confidence.  As Dr. Polley says, “Part of the process of making change is a person has to believe in their ability to do things.”

Examples of an affirmations is: “You’ve been honest about your struggles, and that kind of self-awareness is an important step forward.”

Using Reflections in MI

Reflective listening involves mirroring back what you’ve heard. It’s about letting them know you’re really listening and that you understand where they’re coming from. For instance, if someone says, “I want to exercise more, but I just don’t have time,” you might respond with, “Sounds like you’re feeling torn—you care about your health, but your schedule feels overwhelming.” This helps people feel heard and often gets them to dig a little deeper into their own

Using Summaries in MI

Summaries are a way to pull everything together and show someone the bigger picture.  They helps consolidate what’s been discussed, reinforcing the change talk, and letting the person see their own words reflected back. Dr. Polley describes it like picking a bouquet of flowers:

“Think of a summary as though you’re walking through a wildflower garden and you’re going to build a bouquet. You walk through and keep your eye out for flowers that you think are pretty, for the colors that you like, for the vibe of the bouquet that you’re trying to go for. You don’t just, like, grab up all the flowers and then hand them to the person, right?

You’re careful, you’re deliberate about what you’re choosing. And then you’re creating this beautiful bouquet to give back to the person… The idea being that you’re emphasizing change talk in your summary.”

Example: You might say, “So, there are a lot of things you like about smoking marijuana. You’re having more issues with focusing and you’re wondering if your ADHD medication is interacting with the marijuana or if your ADHD is getting worse, and you’ve recognized it negatively impacts your relationship with your mom.”

Dr. Polley also highlights that it’s key to put the “sustain talk” at the beginning of the summary and end with the “change talk.” People naturally respond to what was said last, so it either evokes more change talk or helps explore the ambivalence.

Motivational Interviewing Basics Video and Examples:

Applying Motivational Interviewing in the “Real World”

For the non-therapist, MI can be an empowering way to guide discussions about personal growth. Here are a few ways MI principles might be integrated into everyday roles:

Managers

Engaging employees in career planning, talking about goals and barriers.

Parents

Using MI to guide teens through difficult decisions, offering them a safe space to express doubts and explore solutions.

Educators

Applying MI to support students in setting priorities and building confidence in their academic pursuits.

Dieticians

Using MI to help patients make dietary or nutritional changes.

Doctors

Discussing decisions healthcare changes like smoking cessation or addressing chronic issues.

Nurses

Supporting patients in exploring their health goals and fostering motivation for positive behavior changes, like for medication adherence or lifestyle improvements.

Motivational Interviewing allows anyone to help others navigate challenges with empathy and collaboration. By focusing on listening, understanding, and guiding rather than just telling someone what to do, MI empowers others make positive changes in their lives.

PS. Motivational interviewing is also a helpful tool for your marriage or in-law relationships too.

Anyone Can Do Motivational Interviewing

Motivational Interviewing may appear complicated at first glance, but its core principles are actually simple and useful. By focusing on partnership, active listening, and the OARS tools, MI creates an effective framework for change (while not taking away the person’s autonomy) Whether in the workplace, at school, or at home with your kids, employing motivational interviewing techniques can lead to more productive interactions. If you haven’t listened to the full podcast episode on MI, I recommend you start there, but then check out MI role play videos on YouTube—I find those to be a helpful way to see it in action and to learn more.

Are you struggling with some big life changes or decisions? Find a therapist at Ellie that specializes in Motivational Interviewing.

The post Motivational Interviewing: A Guide for Anyone appeared first on Ellie Mental Health, PLLP.

The Science of Solitude: Understanding Loneliness and Mental Health

Recent neuroscientific research has revealed that loneliness operates much like physical pain in our brains. When we feel socially isolated, the same neural circuits that process physical injuries become activated, highlighting why this emotional state can feel so genuinely painful. This biological response serves an evolutionary purpose – throughout human history, social connection has been crucial for survival.

Studies published in the Journal of Clinical Psychology Studies have demonstrated that chronic loneliness can initiate a cascade of neurobiological changes. The brain’s stress response system becomes hyperactive, flooding our bodies with cortisol and other stress hormones. This physiological state can manifest in various ways:

The impact extends beyond our emotional state. Longitudinal studies have shown that sustained loneliness can alter gene expression in ways that suppress our immune system’s functioning. The relationship between mind and body becomes particularly evident as chronic loneliness correlates with increased inflammation markers, potentially contributing to various health conditions.

Nurturing Connection: Evidence-Based Approaches to Reducing Loneliness

Rather than viewing loneliness as a personal failing, contemporary psychology encourages us to recognize it as a natural signal – much like hunger or thirst – that alerts us to our fundamental need for meaningful connection. Here are research-supported strategies for nurturing social bonds during the holiday season:

Cultivate Meaningful Interactions

The quality of our social interactions often matters more than their quantity. Research from the Harvard University Study of Adult Development, which has tracked participants for over 80 years, suggests that deep, authentic connections contribute more significantly to emotional well-being than numerous superficial interactions. Consider:

• Engaging in “active-constructive responding” when others share good news, showing genuine enthusiasm and asking questions
• Practicing vulnerability by sharing your own experiences and emotions with trusted friends or family members
• Creating opportunities for shared experiences, even in small ways, like having a virtual coffee date or taking a winter walk with a neighbor

Embrace Community Engagement

Participation in community activities can provide what sociologists call “social scaffolding” – structures that naturally support the development of connections. Research published in the Journal of Happiness and Health Studies has shown that volunteering not only reduces loneliness but also increases overall life satisfaction. Consider:

• Joining local interest groups that align with your passions
• Participating in community service projects
• Attending cultural events or workshops in your area

Practice Self-Compassionate Solitude

While addressing loneliness is crucial, learning to find peace in solitude can be equally important. Mindfulness research suggests that cultivating a kind, accepting relationship with ourselves can help transform moments of aloneness into opportunities for growth and reflection. Consider:

• Developing a gentle self-care routine that honors your emotional needs
• Engaging in creative activities that bring you joy
• Maintaining a gratitude journal to notice and appreciate life’s small pleasures

Seek Professional Support

Sometimes, loneliness can become entangled with deeper psychological challenges. Mental health professionals, like those Ellie Mental Health, can provide valuable support in understanding and addressing these complex emotions. Research indicates that cognitive-behavioral therapy can be particularly effective in helping individuals develop healthier thought patterns and coping strategies among other methodologies that are catered to the unique needs of the person seeking help.

Building Resilience Through Connection

As we navigate the holiday season, it’s essential to remember that experiencing loneliness doesn’t reflect a personal shortcoming but rather speaks to our fundamental human need for connection. By understanding the science behind loneliness and approaching it with self-compassion, we can begin to build more resilient social connections and nurture our mental health.

Remember that healing from loneliness is often a gradual process, much like tending to a garden. Some days may feel more challenging than others, but each small step toward connection – whether reaching out to an old friend, joining a community group, or simply practicing self-compassion – contributes to our emotional well-being.

In this season of reflection and renewal, let us approach our experiences of loneliness not with judgment but with understanding, knowing that our yearning for connection reflects one of the most fundamental and beautiful aspects of our humanity.

The post The Hidden Burden of Loneliness: Understanding and Nurturing Mental Health During the Holidays appeared first on Ellie Mental Health, PLLP.

If you’re dreading this year’s holiday gatherings or looking for ways to better navigate the complex web of family relationships, here are some key takeaways and actionable steps to make for a more joyous and peaceful season.

Understanding Expectations and Setting Boundaries

Listen– It’s all about managing expectations and setting appropriate boundaries. Whether it’s the high pressure to have the perfect holiday or family expectations that don’t align with your reality, setting boundaries can be crucial.

Identify and Communicate Expectations

Start by understanding both your external and internal expectations. Evaluate what expectations are realistic and ones that might need to be adjusted or thrown to the wayside. Communicate with family members to preempt confusion and stress (i.e. “We’ll be coming into town on Friday morning, but we need to leave by Sunday at 4pm” or “I’m really hoping that we can decorate cookies when we’re together”).

Set Realistic Boundaries

It’s important to establish what you are comfortable with this holiday season. Whether it’s deciding to stay at a hotel instead of with family or limiting the length of stay, understand your limits and communicate them thoughtfully. (i.e. “We are looking forward to seeing everyone, but I’d rather not talk about [insert stressor] while we’re in town.”).

Be Comfortable with Discomfort

Recognize that some level of discomfort may be unavoidable. Embrace it as part of the process and focus on maintaining your peace and happiness. Have some go-to responses if you notice they’re crossing the line (i.e. “I thought we agreed not to talk about that this week” or “I’d rather not get into that today”).

Holidays can be stressful! We’re here to help you navigate the madness. Find an Ellie location near you and get matched with a therapist today.

5 Practical Tips for the Holidays from Therapists

• Talk with your partner and family about what traditions hold meaning for you and which ones you wish to carry forward or ones that you should perhaps let go.
• Allow for new traditions to emerge, which may mean breaking away from old ones. This flexibility can ease stress and foster a more enjoyable experience.
• Prioritize your holiday time with those that lift you up and decrease your stress.
• Focus on the current holiday season without worrying too much about future gatherings. Try to be present.
• Incorporate activities that ground you, such as daily walks or quiet coffee breaks, to manage stress levels… And maybe make a preemptive therapy appointment for when you get back.
• If you’re dealing with grief or loss around this holiday season, take it extra easy this year. Consider ways to involve your loved one’s memory into celebrations or traditions.

Effective Communication with In-Laws and Extended Family

In-laws and extended family can often add another layer of complexity to holiday gatherings.

Open the Dialogue

Encourage open communication and address any underlying tensions. This could involve having direct conversations that may feel risky but are necessary for long-term peace.

Involve Your Partner in Communication

When interacting with your partner’s family, ensure that your partner is an active participant in any challenging conversations to prevent miscommunication and foster united decision-making. In fact, we often recommend that you are primary communicator with your family and your partner is the primary communicator for their family.

Maintain a Sense of Humor

Find humor in the chaos and the absurdity of the holidays. Lightheartedness can be a powerful tool in defusing tension.

Final Thoughts

The holidays can be a wonderful yet challenging time. By taking these tips, reflecting on your own holiday experiences, and setting clear expectations and boundaries, you can transform stress into joy and create meaningful connections with your family. Remember, the goal isn’t to have a perfect, Hallmark-Christmas-movie of a holiday… it’s to have a holiday season that reflects your desires and values.

Holidays can be stressful! We’re here to help you navigate the madness. Find an Ellie location near you and get matched with a therapist today.

The post Make This Holiday Season Stress-Free: Tips From Our Therapists appeared first on Ellie Mental Health, PLLP.

In this article, we’ll dive into simple, practical ways to help kids understand their emotions, calm down when they’re upset, and handle challenges without feeling overwhelmed. Whether you’re a parent, teacher, or just someone who cares about kids, these tips will help you support them as they learn to manage their feelings.

What is Emotional Regulation?

Emotional regulation is being able to calm ourselves when we’re upset, express emotions in healthy ways, and use problem-solving skills to handle challenges. For kids, this process can feel overwhelming, as their brains are still developing the tools needed to regulate intense feelings like anger, frustration, or sadness.

In the brain, emotional regulation involves a balance between two important areas: the emotional side and the rational side. The emotional side, led by the amygdala, acts as the brain’s alarm system. It jumps into action when we feel threatened or overwhelmed, triggering instinctive responses like fight, flight, or freeze. For kids, this part of the brain often takes charge, which can lead to outbursts, meltdowns, or shutting down during emotional moments.

The rational side, controlled by the prefrontal cortex, helps with thinking things through calmy, making decisions, and staying cool under pressure. This is the part of the brain that can pause and consider better ways to respond. But in kids, the prefrontal cortex is still maturing—it won’t fully develop well into our twenties. Because of this, kids and adolescents often struggle to pause and think before reacting, especially when emotions are running high.

This is where grown-ups come in. Children learn how to manage their emotions by watching and interacting with important adults around them. When adults model skills like taking a deep breath, naming feelings, or calmly solving problems, kids start to pick up on these behaviors. Over time, these interactions help strengthen the brain’s pathways between the emotional and rational sides, giving kids the tools they need to manage their feelings and reactions more effectively.

Identifying Coping Styles in Adults

Below are four ways you may respond to a difficult situation. As you read through the list, is there one that resonates with you?

1. Run away from or ignore the situation
2. Cry about it
3. Complain or yell
4. Look for ways to solve or provide tools for resolution

Choosing to run away from or ignore a situation indicates a deflection mindset. It is likely this person would rather pretend the conflict doesn’t exist and not deal with it. People who deflect may believe if they ignore the conflict, it will just go away or someone else will resolve it.

Someone who immediately cries about a situation has an emotional breakdown mindset. This person would rather breakdown and leave the conflict or issue for another person. The underlying belief is if they cry about the situation, someone else will fix it.

A person who turns to complaining and yelling likely uses a victim or blaming mentality. They would rather spend time blaming other people for the conflict than find ways to resolve it. Believing if they complain about it enough, someone else will eventually make the changes.

The person who identifies most with the fourth option displays a resolution-based mindset to coping. They see the issue and look for ways to resolve it, as well as to use the situation to learn and grow from it.

Coping with difficult situations is not just tied to learning to handle them, but also in how we resolve them. 

Need someone to talk to? Find a therapist near you today!

Behavior Modeling and Emotional Regulation in Children

Children learn how to express emotions from adults. To understand this a bit more, let’s imagine a group of children playing at a playground with their adults nearby. Remember, children are learning their coping skills from the adults in their lives!

In this scenario, two kids are playing, and run over to a slide. One child gets there faster than the other. The second child is bothered that they are now second to go down the slide and tries to push the other child out of the way. Nearby, the adults are watching this play out and their coping skills go into effect.

From our example above, the ignoring parent probably pretends to miss the whole thing, hoping another parent will step in. When their child brings it to them, they may just brush off their feelings about the story. They are modeling their belief that if you ignore something, it will eventually go away.

The parent who copes with an emotional breakdown may be hovering nearby and when their child gets pushed, rush over and over-react to them being pushed. They are modeling that you can expect someone else to step in and fix your problem.

A parent who subscribes to a victim or blaming-mentality will start ‘pointing the finger’ at the child who got their first, blaming them instead of helping the other child to cope with being second. They are modeling to the children that someone is always to blame, rather than teaching them to take accountability.

Fourth, we have the overseer, who copes from a resolution-based mindset. When involving themselves, they will ask questions of both the children, and help them come to an understanding. They are modeling that a calm, rational approach will help find a resolution to the difficult situation.

How to Help a Child Regulate Their Emotions

Regulating emotions can be difficult for children, primarily because it involves the emotional response of their adults. When a child has BIG emotions, we can help them process through them by focusing on the following:

Demonstrating Good Behavior

Modeling how to cope is one of the most effective ways to teach children how to regulate their emotions. When adults demonstrate patience, stay calm in stressful situations, and approach problems thoughtfully, kids learn by example. Kids are always watching and observing, and this consistent modeling helps them understand not just what to do, but how to do it. By showing them how to think rationally, consider others’ perspectives, and respond calmly, we provide a framework for managing their own emotions and reactions in a healthy, constructive way. It also shows kids that it’s okay to feel and manage emotions without hiding them.

Connecting and Validating

Research consistently shows that secure, trusting relationships with their parents or caregivers lead to stronger emotional regulation skills. This is deeply rooted in attachment theory, which emphasizes the importance of early bonds in shaping a child’s emotional and social development. ^Resource

Identifying Emotions

As a therapist, some of the first things I’ll do with a new kid client is work on naming and identifying emotions.  When kids can put a name to what they’re experiencing—whether it’s anger, sadness, excitement, or worry—they gain a sense of control over those emotions. Naming feelings helps children understand that emotions are normal and temporary, rather than overwhelming or scary. It also gives them the vocabulary to express themselves, reducing the likelihood of acting out in frustration or confusion. It’s the foundation for learning how to cope and communicate effectively.

This might look like narrating your own emotions, asking kids how they’re feeling about certain things, or using an emotion wheel. 

Enacting Coping Strategies

The next step after teaching kids how to name and identify their emotions is to help them learn coping skills. Coping skills provide kids with practical tools to calm themselves, process their feelings, and respond to stress in healthy ways. Here’s a handy-dandy list you might use.

Emotional Regulation Activities for Kids

Teaching kids about identifying feelings and emotional regulation works best when it’s fun and engaging, which is why play and activities are so effective. Games, storytelling, role-playing, and art give children a safe, creative way to explore emotions and practice coping skills. These activities help make abstract concepts more understandable and relatable. Through play, kids are more likely to connect with the material. Here are some activity ideas:

Sit in the Emotion

Provide children with the opportunity to sit in their emotions. This is also known as ‘the calm down’. A great example of this is when a child is sad… let them be sad! While it can be hard, do not attempt to fix the sadness for them but be present so they feel safe and comfortable to talk about what has caused them to be sad. The ability to identify emotions helps us cope with them. 

Emotional Mood Cards

Help the child with their big emotions with emotion cards (think flashcards for feelings). By using the emotion cards, you are giving the child language or images to help them express the emotions they feel. You can create your own emotion cards or find a set online. This will help the child learn what emotion they are feeling. When they recognize the emotion, they can then work on coping with it and making the big emotion small.

Narrate the Emotions

Talk them through the emotion; observe and state what you are seeing and validate it for them. For a frustrated child, an example could be, “I can see you are really having a hard time and it is causing you to feel frustrated. Everyone gets frustrated sometimes.” Leave space for them to talk about what happened that may have caused their frustration, while continuing to validate their feelings. You can also encourage them to take a moment to breathe and reset. This will help them develop skills to recognize when emotions feel too big. 

Exhausting Emotional Energy

Physical activity helps release nervous energy that can build up when kids feel overwhelmed, anxious, or restless, making it easier for them to return to a calmer, more focused state. Simple exercises like running around the block, jumping rope, or doing jumping jacks not only engage the body but also help the brain produce endorphins, which improve mood and reduce stress. 

Provide Steps for Resolution

Walk them through some resolutions for dealing with the emotion. Children often get very upset or frustrated with tasks they are still learning. A great example of this, especially for young children, is difficulty putting on their shoes. Talking through the steps one at a time can help the child work through the emotions that come up around the difficult task. Provide them with different tips and tools to help navigate through the process. You can say things like “it might help if we loosen your strings”, or “it’s frustrating when we put the wrong shoe on the wrong foot!” or even, “let’s take a break, breathe, and try again”. The act of slowing down to process through each step will strengthen their coping skills.

Learning to Better Manage our Emotions

Our emotions are how we interact with the outside world. When we learn how to cope, we learn how to emotionally connect with the world around us. For children, learning the importance of emotions and healthy ways to cope is vital. Helping them develop these skills can give them words to express how they are feeling when they don’t know how. It is integral to how they will handle conflict, rejection, and emotional challenges throughout their lives.

As we learn to cope, we learn to better manage our emotions. We as parents and guardians, teachers, childcare providers, friends, and even other family members can help facilitate these emotional skills and help children to know that, while big feelings are inevitable, they are something we can control and manage.

Things to Remember…

As a parent, guardian, teacher, or adult in a child’s life… you got this! Your support will be everything to them. Additionally, we can always learn more effective or healthy coping styles to model for the children in our lives. There is no shame in seeing a therapist for yourself or your child if this is something you are struggling with.

Need someone to talk to? Find a therapist near you today!

The post Emotional Regulation for Kids: How to Help Children Manage Their Feelings appeared first on Ellie Mental Health, PLLP.

In this blog post, I’m excited to share a list of children’s books that tackle many of these topics head-on. Whether you’re a parent looking to support your little one or a fellow therapist seeking resources for your practice, these stories are perfect for guiding kids in navigating their emotions and learning to manage them in a healthy way.

Please note that many of these books are affiliate links if you click on the title!

Kids Books About Anxiety

Worries and anxiety can be tough for kids to handle, but the good news is that there are some fantastic books out there to help them navigate these feelings! This list features stories and guides designed to support children ages 3 to 12 as they learn to manage their worries and understand their emotions. Each book offers relatable characters and situations that show kids they’re not alone in their feelings and provide practical tips for coping.

• “The Worrysaurus” by Rachel Bright
  Age Range: 3-7 years
  A story about a little dinosaur who learns to manage his worries by focusing on the present moment.

• “What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety” by Dawn Huebner
  Age Range: 6-12 years
  A workbook-style guide that helps children understand and work through their anxiety.

• “Ruby Finds a Worry” by Tom Percival
  Age Range: 3-7 years
  This book follows Ruby, a little girl who learns to talk about her worries and find ways to manage them.

• “Hey Warrior” by Karen Young
  Age Range: 5-12 years
  Explains anxiety to children in a simple way, encouraging them to see anxiety as something they can understand and manage.

• “Don’t Feed the WorryBug” by Andi Green
  Age Range: 4-8 years
  A story that helps children understand how feeding their worries can make them grow and how to manage them.

•  “A Little Spot of Anxiety: A Story About Calming Your Worries” by Diane Alber
  Age Range: 4-10 years
  A book that introduces kids to the concept of anxiety and provides practical tips for managing it. Personally, this is my favorite book about anxiety for preschoolers and elementary aged kids and they have more books on more feelings!

• “The Invisible String” by Patrice Karst
  Age Range: 3-8 years
  Though not specifically about anxiety, this book is often used to help children deal with separation anxiety and other worries.

• “Scaredy Squirrel” by Mélanie Watt
  Age Range: 4-8 years
  A humorous story about a squirrel who learns to face his fears and discover new things outside his comfort zone.

• “Wilma Jean the Worry Machine” by Julia Cook
  Age Range: 5-8 years
  This book explains worry in a way that children can understand, offering solutions for managing it.

• “I’m Worried” by Michael Ian Black and Debbie Ridpath Ohi
  Age Range: 4-8 years
  A lighthearted approach to worry, showing kids that it’s okay to feel anxious and that they can talk about it with friends. This book is also a part of a set with other feelings!

• “Breathe Like a Bear: 30 Mindful Moments for Kids to Feel Calm and Focused Anytime, Anywhere” by Kira Willey
  Age Range: 4-8 years
  This is an awesome book to help with anxiety! It’s a collection of short, guided breathing and mindfulness exercises to help kids manage anxiety and stress.

Books About Emotions for Kids

Helping kids recognize and understand their emotions is super important as they grow up, and this list of books is here to make that journey a little easier and a lot more fun! Each of these titles dives into different feelings—whether it’s joy, silliness, sadness, or even anger—showing young readers that it’s completely normal to experience a whole range of emotions.

• “In My Heart: A Book of Feelings” by Jo Witek
  Age Range: 2-6 years
  A beautifully illustrated book that explores different emotions, helping children articulate how they feel in various situations.

• “A Little SPOT of Emotion Box Set” by Diane Alber
  Age Range: 4-10 years
  A set of books that personifies various emotions (anger, anxiety, happiness, etc.) to help children understand and manage their feelings.

• “Today I Feel Silly: And Other Moods That Make My Day” by Jamie Lee Curtis
  Age Range: 4-8 years
  This book introduces kids to a range of emotions, from silly to sad, and helps them recognize their own feelings. Ps. I had this book when I was little and I now read it to my daughter!

• “The Color Monster: A Pop-Up Book of Feelings” by Anna Llenas
  Age Range: 3-7 years
  This book is great for when we’re feeling all jumbled up and we have a hard time articulating how we’re feeling.

• “The Way I Feel” by Janan Cain
  Age Range: 3-7 years
  A colorful book that explores different emotions, including anger, helping children recognize and express their feelings.

• “The Boy with Big, Big Feelings” by Britney Winn Lee
  Age Range: 4-8 years
  A book about a boy who feels emotions intensely, including anger, and learns to express and manage those feelings with the help of others. (Also really beautifully illustrated if you’re a fan of that sort of thing like me!)

• “Tough Guys Have Feelings Too” by Keith Negley
  Age Range: 4-9 years
  A funny book with illustrations of tough guys having feelings to normalize feeling all sorts of different ways.

Kids Books About Anger

Understanding and managing anger is a crucial skill for kids. This list of books offers a variety of engaging stories aimed at helping young readers recognize, express, and cope with their feelings of anger in healthy ways. From exploring the roots of their frustrations to learning techniques for calming down, these age-appropriate books provide valuable insights and strategies for kids of all ages.

•  “When Sophie Gets Angry—Really, Really Angry…” by Molly Bang
  Age Range: 3-7 years
  A story about a girl named Sophie who learns to calm down after feeling angry, highlighting healthy ways to process strong emotions.

•  “Anh’s Anger” by Gail Silver
  Age Range: 4-8 years
  This book introduces mindfulness techniques to help children understand and manage their anger.

• “I Am Angry” by Michael Rosen
  Age Range: 3-6 years
  A simple yet expressive story that shows children how it feels to be angry and ways to manage those feelings.

• “The Red Beast: Helping Children Understand and Manage Anger“ by K.I. Al-Ghani
  Age Range: 5-9 years
  This book uses the metaphor of a red beast to represent anger, teaching children ways to calm the “beast” when it wakes up.

• “When I Feel Angry” by Cornelia Maude Spelman
  Age Range: 3-6 years
  This book explores what it feels like to be angry and offers young children simple ways to deal with their emotions.

• “Hands Are Not for Hitting” by Martine Agassi
  Age Range: 3-6 years
  This book teaches children alternatives to using their hands when they are angry, promoting positive ways to express their feelings.

Kids’ Books for Dealing with Change (New school, moving homes, separation etc.)

Change can be daunting for young children, whether it’s starting school, moving to a new home, or adjusting to new situations. This list of books provides gentle, engaging stories to help children understand and manage their feelings around transitions. From familiar first-day-of-school jitters to moving homes, these books offer relatable characters and reassuring messages that can empower kids to face new experiences with courage and resilience.

• “The Kissing Hand” by Audrey Penn
  Age Range: 3-8 years
  A classic story about a young raccoon dealing with separation anxiety on the first day of school, with a comforting message about love and security. As an anxious child, I loved when my momread this book to me.

• “First Day Jitters” by Julie Danneberg
  Age Range: 5-8 years
  A fun twist on the nervous feelings of starting school, where the character experiencing the jitters turns out to be the teacher.

• “Wemberly Worried” by Kevin Henkes
  Age Range: 4-8 years
  A story about a little mouse who worries about everything, especially her first day of school, and how she learns to manage her anxiety.

•  “Llama Llama Misses Mama” by Anna Dewdney
  Age Range: 3-5 years
  An easy-to-read book about a young llama’s first day at school and how he adjusts to being away from his mother. My preschooler LOVES all of these books!

• “The Invisible String” by Patrice Karst
  Age Range: 3-8 years
  Obviously I love this book, since it’s on this list a few times! Though often used for dealing with separation anxiety, this book is also great for kids facing changes like moving or starting school, emphasizing the connection with loved ones no matter where they are.

• “Moving Day!” by Jess Stockham
  Age Range: 3-6 years
  This book is targeted towards really young children and to help them understand and process the feelings associated with moving to a new home.

• “Alexander, Who’s Not (Do You Hear Me? I Mean It!) Going to Move” by Judith Viorst
  Age Range: 5-8 years
  A relatable story about a boy who is upset about moving and learns to cope with the change.

• “A House for Hermit Crab” by Eric Carle
  Age Range: 4-8 years
  This story follows a hermit crab who must find a new shell and learns to adapt to change, making it a great metaphor for moving or starting something new. This book is great for kids that are just learning how to read.

• “The Pigeon Has to Go to School!” by Mo Willems
  Age Range: 3-6 years
  A humorous book about a pigeon who doesn’t want to go to school, exploring feelings of apprehension and fear of the unknown.

• “My New Friend Is So Fun!” by Mo Willems
  Age Range: 4-8 years
  Part of the Elephant & Piggie series (also by the same author has the book above this one), this book is great for kids who are adjusting to new friendships, a common part of starting school or moving.

• “When You Are Brave” by Pat Zietlow Miller
  Age Range: 4-8 years
  This story encourages children to find courage when facing new situations, such as moving to a new place or starting school. This is one I use regularly with kids in my practice.

•  “School’s First Day of School” by Adam Rex
  Age Range: 4-8 years
  A unique story told from the perspective of a new school building experiencing its first day, reflecting the feelings of children attending school for the first time.

•  “Goodbye, Friend! Hello, Friend!” by Cori Doerrfeld
  Age Range: 3-7 years
  A gentle book that explores the idea that with every goodbye, there’s a new hello, helping children deal with transitions and change.

• “How to Get Your Octopus to School” by Cori Doerrfeld
  Age Range: 3-9 years
  A funny book about a child trying to get their anxious octopus out the door for their first day of school.

Books About Sadness, Grief, and Loss for Kids

From illustrated picture books to insightful guides for older readers, these book recommendations are crafted to gently guide children through their grief journey, fostering empathy, resilience, and hope along the way.

• “The Grief Rock: A Book to Understand Grief and Love” by Natasha Daniels
  Age Range: 3-7 years
  This gentle story uses the concept of a “grief rock” to help young children understand and carry feelings of grief.

• “I Miss You: A First Look at Death” by Pat Thomas and Lesley Harker
  Age Range: 3-7 years
  A straightforward guide that helps children process the loss of a loved one by explaining death in age-appropriate terms.

• “When Someone Dies: A Children’s Mindful How-To Guide on Grief and Loss” by Andrea Dorn
  Age Range: 4-10 years
  This book provides mindful practices and compassionate guidance for children working through feelings of loss and grief.

• “Lacie’s Moon: A Children’s Story About Grief” by Natcole Staskiewicz
  Age Range: 6-18 years
  A comforting tale about a child who finds solace in the moon, connecting it to memories of a loved one who has passed.

• “The Invisible String” by Patrice Karst
  Age Range: 3-7 years
  This book reassures children that love connects them to those they miss, no matter where they are.

• “The Invisible Leash: A Story Celebrating Love After the Loss of a Pet”
  Age Range: 5-10 years
  Specifically for pet loss, this story shows children that a pet’s love and connection remain even after they’re gone.

• “Old Coyote” by Nancy Wood
  Age Range: 5-8 years
  A heartfelt story about an old coyote who accepts the natural cycle of life, making it easier for children to understand loss.

• “How I Feel: Grief Journal for Kids: Guided Prompts to Explore Your Feelings and Find Peace” by Mia Roldan LCSW LCDC
  Age Range: 8-13 years
  A guided journal with prompts to help children navigate their feelings of grief and find emotional healing.

• “Tear Soup” by Pat Schwiebert
  Age Range: 13+ years
  This metaphorical book illustrates grief as “making soup,” where each ingredient represents a different stage and feeling in the healing process.

• “A Grieving Teen: A Guide for Teens and Friends” by Helen Fitzgerald
  Age Range: 13+ years
  A comprehensive guide for teens, addressing the complex feelings and challenges they face after a loss.

• “Chill & Spill” by Art With Heart
  Age Range: 13+ years
  An interactive art journal that allows teens to express and process their grief through creative exercises.

• “Healing Your Grieving Heart for Teens: 100 Practical Ideas” by Alan D Wolfelt
  Age Range: 13+ years
  A practical guide offering teens 100 ways to cope with grief and find comfort after losing a loved one.

Looking for more tips on helping your kids cope with loss? Check out this blog post with specific ideas and tools.

When to Find a Therapist for Your Child

While these books are invaluable resources for helping children navigate their emotions, it’s important to remember that therapy can provide additional support during challenging times. Working with a therapist can offer kids a safe space to explore their feelings and develop coping strategies tailored to their unique experiences. Whether they’re facing big changes like moving to a new home or grappling with feelings of anger or sadness, therapy can help them build resilience and emotional intelligence. By combining the power of storytelling with the guidance of a professional, you can empower your child to face life’s ups and downs with confidence and understanding.

Find children’s therapy at an Ellie Mental Health near you.

The post Therapists’ Top Children’s Books to Help Kids Navigate Emotions: Anger, Sadness, Anxiety, and More appeared first on Ellie Mental Health, PLLP.

The Experts:

Alice Mills Mai

Dr. Lucas Volini

What is Internal Family Systems Therapy?

Internal Family Systems, developed by Richard “Dick” Schwartz, is a therapeutic approach that is based on Schwartz’s book, “No Bad Parts.” This modality views the mind as naturally multiple with various ‘parts,’ each with its own perspectives and roles. These parts can either work together harmoniously or conflict with one another, affecting our inner and outer lives.

The guests break down IFS as, “Internal means inside us, our brain. And the systems or the parts of us all come together to make us whole.” This intricate system aims to bring these parts together, fostering unity and healing through what is known as the ‘self.’

Key Components of Internal Family Systems

IFS identifies three primary types of parts:

1. Managers

Managers are proactive parts. They try to control the environment to protect the person from getting hurt. For instance, a manager might employ perfectionism as a defense mechanism. As Alice, a clinic director and IFS practitioner, explains, “A manager could be a perfectionist…but as a result, it may also be causing you anxiety or depression.”

2. Firefighters

Firefighters are reactive parts that emerge when exiles threaten to break out. They attempt to distract or numb us, potentially through behaviors like substance abuse or overeating. A firefighter part’s job, in Alice’s words, is to “save the day” when our usual defenses (managers) fail.

3. Exiles

Exiles are parts that have been hurt and are often buried deep within us. They hold the pain and trauma that our managers and firefighters try to keep at bay. The goal of therapy, as explained by Alice, is to heal more of these exiled parts to promote inner harmony: “So maybe five-year-old you can take a seat now. I am an adult. I am here. I can take care of you.”

Using the “8 C’s of Self ” in IFS

To truly heal and bring harmony among your parts, IFS practitioners have you approach them with these qualities, often known as the “8 C’s of Self-Leadership”:

• Calmness: Find a quiet space to sit with your thoughts and feelings.
• Curiosity: Explore your parts without judgment. Ask, “Why is this part acting out?”
• Clarity: Try to clearly identify which part is activated at any given moment.
• Compassion: Treat your parts with kindness and understanding.
• Confidence: Trust in your ability to manage and heal your inner world.
• Creativity: Use imaginative methods like art or storytelling to connect with your parts.
• Courage: Confront the more challenging parts and feelings you’ve been avoiding.
• Connectedness: Build a sense of internal harmony and cooperation among your parts.

Tips for Practicing IFS

Journaling: Write down daily reflections, identifying and naming the parts involved in your feelings and actions.

Meditation: Spend a few minutes each day in guided imagery, focusing on calming and understanding your parts.

Self-talk: When feeling stressed or triggered, take a moment to internally talk to the part of you that’s activated.

Therapy: If possible, consult a professional trained in IFS to guide you through the deeper layers of your internal system. Find one at Ellie here!

Criticisms of Internal Family Systems Work

When asked about problems with IFS, Alice shares: “Some of the criticisms are about IFS not fully accounting for external factors such as race, socioeconomic, religion, and other sociopolitical factors. Deran Young does a beautiful job when it comes to IFS and race.”

Lucas shares, “Gestalt therapists have essentially been doing IFS for decades”

It should be noted that not every therapy modality works for each person. Everyone is different and will connect with different ways of connecting and processing. This underscores the importance of asking your therapist questions and continually revisiting your therapy goals.

Conclusion

Understanding and integrating the principles of Internal Family Systems can lead to greater self-awareness and emotional healing. By identifying your parts, practicing self-compassion, engaging in guided imagery, and applying the 8 C’s of self, IFS believes that you can move towards a more harmonious and balanced life.

Listen to the full podcast here:

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The post Understanding Internal Family Systems: Expert Interview appeared first on Ellie Mental Health, PLLP.

They say it takes a village to raise a child, but it also takes a village to raise a parent. It’s hard work. It’s wonderful, terrifying, beautiful, stressful, awe-inspiring, and anxiety-inducing all at once. On top of those wild emotions, it also comes with serious sleep deprivation and significant life changes. And the truth is, when we welcome new babies into the world, none of us have a clue what we’re doing.

Want to talk to someone who gets it? Get matched with a therapist near you today!

What Is Parent Counseling?

New parent counseling provides a supportive space where you can gain valuable insights, learn effective parenting strategies, and build confidence in your new role. Imagine having a trusted ally to help you navigate sleepless nights, nurture your bond with your little one, and embrace the incredible changes in your life. This can offer emotional support, practical advice, and a sense of community, ensuring you’re never alone in this adventure. 

7 Ways Parent Counseling Can Help New Parents

It’s okay if you’re not okay. New parents need emotional support, and you don’t have to undertake this journey alone. Your partner might be able to help you, your family might be able to help you, your friends might be able to help you, and a therapist might be able to help you too.

1. Baby Blues or Postpartum Depression

Let’s start with the period immediately after your bundle of joy arrives. POW! HORMONES!

Anyone who has given birth knows that what it does to your body – before, during, and after – is wild. It’s very common to experience the “baby blues” while you’re adjusting to parenthood, which is characterized by symptoms such as anxiety, overwhelm, sadness, irritability, crying, reduced appetite, and inability to sleep. It typically starts after delivery and can last up to two weeks.

However, in some people it can develop into a more severe and long-lasting condition known as postpartum depression (or PPD). This can pop-up during pregnancy or even up to a year after your baby arrives. It can present with symptoms such as severe mood swings, difficulty bonding with your baby, fear, guilt, shame, anger, feelings of worthlessness, overwhelming fatigue, and more. These symptoms are most common in new mothers, but it can actually affect new fathers as well.

Parent counseling for postpartum depression is available. A therapist can support you while you’re processing all of these thoughts and feelings. They can also help you develop a treatment plan – which may include medication management – that will help keep your head above water.

2. Missing Parental Instinct

Some people seem to take to parenting like ducks to water. They seem to thrive on raising a little one, cherishing every moment, every memory, and every minute spent with their child. Others find themselves staring at the small and mysterious creature in their arms, feeling absolutely bewildered and searching desperately for something – anything – that will stop the seemingly endless crying.

Right off the bat, we’re going to remind you that social media is not real life, and if you’re looking enviously at a cute photo of a cute baby in a cute outfit, it probably took multiple tries and resulted in a huge pile of teeny-tiny baby laundry covered in spit-up. One a serious note, however, if you feel like you’re missing the parenting instinct, you’re definitely not alone. Were you actually meant to be a parent? Or did you just start a family because it seemed like the next logical step in your life? Are you ever going to be any good at it? Will your child miss out because this isn’t coming naturally?

That’s a lot to process! The fact that these questions are keeping you up at night is a sign that you’re already a great parent – you’re doing everything you can to give your new baby an amazing life. That said, counseling can help you work through your fears and get into the groove.

3. Insomnia and Anxiety

When was the last time you got a full night of sleep? If you’re in the trenches of late-night feeds and constant diaper changes, it’s probably been a while. Even if your baby sleeps well, you might find that your struggle to switch your brain off. And the more you think about how little sleep you’ve had, the more elusive it becomes. You know you need to get some rest, but you don’t know how.

A lack of sleep can severely impact your mental health. There are a lot of things that can contribute to insomnia, but it’s likely that anxiety is playing a big part, resulting in an unending train of thoughts you can’t control. If this is you, talking to a therapist can help you work through the things that are on your mind, learn to let go of the things you can’t control, and find some new strategies to channel Sleeping Beauty.

4. Career Remorse

Choo choo! The career train is departing… and is it leaving without you? This is a huge issue for many new parents and it disproportionately affects the one who has given birth. First you have to tell your workplace that you’re pregnant, then your need time off for labor and delivery, then you may take a few days/weeks/months/years away from work to care for your new arrival. If you want to give your baby a sibling, you’ll have to rinse and repeat the entire process, leaving another gap in your career.

We’ve all seen the statistics around women in the workplace. We know that time out of the labor market impacts their careers. We know there is stigma around hiring women of child-bearing age. We know that women earn less than men. We know that when mothers return to the workforce their careers and earning potential often plateau or even diminish. It’s a lot to process. What have you done? Will you ever catch up? Why do you find yourself blaming your partner or your kids?

These are some very fertile fields for discussion and one of the reasons counseling for new parents is so important. Many people struggle with a changing sense of identity after becoming parents, and therapy can help as you redefine who you are and what you want out of life and work.

5. Parental Guilt

Parenting and guilt go hand-in-hand. You might feel guilty about what your baby is eating. Guilty about how your baby is sleeping. Guilty about how you’re spending time with your baby. Guilty about not being as present as you’d like. Guilty about not knowing as much as you wish you did. Guilty about going back to work. Guilty for lying to your child to get them to do something that will ultimately benefit them. Guilty about asking for help. Guilty for abandoning your partner.

That’s heavy. Even if you tell yourself that what you’re doing is totally normal and talk yourself around to feeling okay again, a different form of guilty can rear its ugly head and weigh you down again. Truthfully, you have enough on your plate without having to divert valuable mental energy to the guilt monster. Talk therapy is a great way to process this because it provides you with a safe environment to unload all of the guilt and shame you’re carrying around.

6. Restoring Intimacy

If you’ve had a baby, there’s a reasonable chance you can’t even think about this yet. All of your energy is going towards keeping your child alive, so you just might not have the bandwidth. When intimacy does eventually make its way back into the realm of possibility, things will have changed. Pregnancy changes your body. Exhaustion changes your brain. Parenting changes your priorities.

If you’re freaking out, you’re not feeling ready, you’re worried that you can’t give your partner what they need, or you have other concerns, reach out to a therapist. Counseling for new parents isn’t limited to talking about your baby – it can also include couple’s therapy, which is a really effective way to reconnect with your partner and find some ways to reignite the sparks between you.

7. Unpacking Childhood Baggage

Finally, lots of us are still carrying some baggage from our own childhoods. That’s just part of being human: we all inevitably fall and have to get back up again. The trouble is it’s really easy to transfer the insecurities we pick up along the way onto our kids, which is another reason why counseling for new parents is so important. As you start unpacking your own baggage, your therapist will be able to help you the identify behaviors and thought patterns you’ve developed that aren’t serving you well, so you can develop the strategies you need to replace them with healthier alternatives.

If you want to raise healthy kids, it’s important to demonstrate healthy behaviors. For example, if they see you eat fresh fruit, they’re more likely to eat fresh fruit. If they see you exercise, they’re more likely to exercise. If they see you engage in self-care, they’re more likely to engage in self-care. It’s the circle of life (*cue The Lion King*): a process of learning, unlearning, and relearning.

Parental counseling is a great way to set your kids (and yourself) up for success.

The team of experts from Ellie Mental Health can guide you in your parenting journey. Find a therapist near you today.

The post How Parent Counseling Can Help First Time Parents 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.

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