Perinatal Mood and Anxiety Disorders (PMADS)

Pregnancy and childbirth are often thought of as times of joy, yet mental health issues can complicate this experience. One of the most famous modern cases centered around a Houston woman named Andrea Yates, who a judge convicted of murder in 2002 after she drowned her five children. Yates was later found not guilty by reason of insanity. She was also diagnosed with postpartum psychosis. The 2023 news story of  Lindsay Clancy is another example of the devastating consequences of pregnancy-related mental health disturbances. Lindsay was a normal mom regularly sharing photos of herself happily smiling and hugging her three kids. Yet Clancy was charged with murdering her children before attempting to take her own life. It is difficult to comprehend what led to this mother to lose her grip on reality and harm her children. At her trial, Clancy’s legal defense emphasized that since her youngest child was still a baby, this mother may have been suffering from undiagnosed postpartum psychosis. When reviewing this case in hindsight, it is clear that appropriate intervention may have prevented tragedy. This lawsuit has sparked a nationwide conversation regarding the importance of post-partum mental health education.

The Power of Curative Connections

What if you could be prescribed a trip to a nature preserve, a watercolor class or walking group to treat mental health issues? Social prescribing is an alternative model of care that recognizes the social, emotional and practical needs that impact people’s overall health. Our wellbeing is strongly determined by our environment. These social determinants of health are the nonmedical aspects in which we are born, grow up, work, live and age that influence our health outcomes. We all need basics to survive, such as clean air, nutritious food, decent shelter and adequate money. However to truly flourish, we need to focus on whole-person care by finding meaning in our lives, sources of joy and beneficial relationships.

Boundaries: A Form of Self-Respect

The process of setting boundaries has three steps: identify your needs, clearly communicate the limits and reinforce your intentions. Self-awareness is paramount here. Boundaries should be flexible, as your needs change. For instance, your stress levels may increase your requirement for personal time or your limits may flux with a maturing long-term relationship. While it is never required to justify your boundaries to others, at times this practice can be beneficial. For example, perhaps you have allowed an old friend to repeatedly call to vent problems, but you have realized that their oversharing is affecting your peace of mind. This friend’s lack of self-awareness requires the need to be more direct by setting a threshold on the content and length of the calls. Will that hurt your friend’s feelings; probably! But for you to live an authentic life, you may have to get used to disappointing others. Boundaries are a form of self-respect. Being too much of a ‘yes-person’ creates barriers to setting healthy limits for one’s own self-care. Hopefully, the friend will appreciate your candor rather than being offended. Communicating your thoughts to the other person should serve to strengthen trust in strong relationships. In truly stable companionships, establishing boundaries openly indicates that your friendship is important enough to save. A fair-weather friend is more likely to tolerate the encroachment quietly and then sacrifice the alliance instead of trying to mend it. A friend that sees your boundaries as an attack is likely not a desirable attachment in the first place.

Incivility in our Society

From small insults to more serious forms of aggression, acts of disrespect have consequences on our health, wellbeing and confidence. Take the example of being cut off in traffic, an experience that leaves one seething miles later or perhaps you have been rudely interrupted by a colleague in an important meeting. The magnitude of the effect it has on your decision making is not surprising, as most people replay the threatening scene repeatedly in their mind. When a person is rude to us, we feel targeted. The nervous system interprets these events as life-threatening and our ability to problem solve is compromised. ‘Anchoring’ is a term for cognitive bias describing the human tendency to rely too heavily on a first piece of information when solving a problem. For example, our outrage creates an overfocus (or anchor) on our initial interpretation ofwhat happened and ignores mediating information. The anchoring effect keeps us from logical solutions because of our judgment errors related to skewed expectations and dismissed information.

Cultivating Self-Esteem

The foundation of self-esteem is rooted in the relationship you have with yourself. According to Schiraldi (2016,) self-esteem is “a deep, quiet inner security that is not easily shaken under duress or after a disappointing performance.” Often we measure self-worth by comparing ourself to others. This practice can alter the respect we hold for ourselves. Decision making, assertiveness, risk taking and letting go of past mistakes are areas of our lives that can be disrupted when our self-respect is in question.

The Power of Journaling

A journal is a personal diary that encourages one to practice self-love, which is cultivated through a regular mindful ritual. Jotting down your views without a critical voice allows you to connect to ‘the Self’ and tune into your honest truths. By shifting our focus inward for a new perspective, we have a chance to change the negative stories we tell ourselves defined by others’ actions and words. Rigid expectations we may hold are illuminated and positively altered through fresh viewpoints created by insightful exploration.