If you are anxious, you most likely have been advised not to “blow things out of proportion.” That probably seems easier said than done. CBT teaches you how to stop magnifying the odds of something that you fear will happen. When you magnify, you overestimate the likelihood of something happening, losing track of the difference between possible (which is just about anything) vs. probable vs. likely vs. certain.
Typically you are exaggerating the likelihood or risk of something happening. You might also exaggerate the importance of your problems and shortcomings. The other side of that coin is minimization, wherein you minimize the importance of your desirable qualities. Typically, you also will minimize your ability to cope with or withstand your own anxiety. For example:
“I am afraid of being paralyzed by the epidural. My doctor says the risk is “practically zero.” That still means there is some chance.” (Magnification) “On the other hand, I have no tolerance for pain. I practically rush to the ER if I have a papercut. I will never be able to withstand an unmedicated birth.” (Minimization)
In most cases, you will find that there is some evidence to substantiate a potential problem or threat; however, the likelihood, actual degree of risk, or magnitude of the problem is blown out of proportion.While others might agree that some evidence exists, they do not agree with the conclusion you have jumped to. While the problem or threat is possible, it is extremely unlikely. Often the feared outcome requires a chain of events to occur and those events are not occurring. Or, the feared outcome is impossible and cannot occur, or cannot occur in the way you are imagining.
Rather than magnifying:
● Acknowledge the difference between possible vs. probable vs. likely vs. certain.
● Research the real odds?
● Try to imagine what is most likely to happen. What are the likely consequences or outcomes?
● Create a plan to take action. What would you do if the most likely thing occurred?
The final step is to ask yourself: “What could you say that would be more fair or helpful in this situation?” If you follow these steps, you will feel much less anxious and you will be more effective in whatever course of action you take.
Many of us turn to the internet for information that might help us "diagnose" symptoms we are experiencing. Because pregnancy produces many physical sensations that overlap with the physical symptoms of anxiety, symptom checklists that are used with the general public might not be the best tools for assessing pregnant women. This new research examines the worries and unique concerns of women experiencing anxiety during pregnancy. Appropriate assessment is an important first step in getting the help you may need.
“Counselor” or “therapist” are general terms. If you are referred to a mental health professional, you might meet with a licensed clinical counselor, a social worker, a psychologist, psychiatric nurse, or psychiatrist. Differences among these professionals include the amount of education they have, what type of program they completed, and the type of services they provide. The list below includes only licensed professionals who assess, diagnose, and treat those with mental health conditions.
All of these individuals can provide therapy; in most states, only psychiatrists and advance practice nurses can prescribe medication. In addition to the training described above, mental health professionals may have a chosen specialty for which they have pursued additional training. If possible, I recommend that pregnant women ask for a referral to a Women’s Health specialist. If the approaches utilized in this series resonate with you, look for a specialist in cognitive behavioral therapy.
Sometimes only one form of treatment is used, or both therapy and medication can be combined. Picking the right person to help you overcome any emotional or mental troubles is important. Remember that finding the “right” mental health professional can involve trial-and-error. In addition to specialty and training, you will need to consider scheduling, convenience, cost, etc. Overall, your goal is to find someone who can help you with your current symptoms and with whom you can collaborate effectively to find better ways of thinking, feeling, and living.
“It’s cold. The roads might be bad. It may snow or sleet later. I don’t really know if I’ll enjoy myself anyway. Maybe no one else will be there. I’ll probably just stay in.”
Sound familiar? People tend to be less socially active during the winter months--think of it as “social hibernation.” While you might be cozier at home, loneliness and isolation can quickly set in.
“But, I’m pregnant and tired and trying to save money.”
I know. I’ve been there myself! But it’s particularly important to remain socially active during pregnancy. Why? Because socializing is not only fun, it also helps you build and maintain your support system.
Lack of social support is a well-established risk factor for postpartum depression. It’s important to have people in your life who can offer support, share information, listen to you when you share your thoughts and feelings, and help you feel less alone. In addition, social activities are deposits into your self-care account.
Humans are social creatures. Extroverts need quite a bit of interaction—they feel recharged by others. Introverts need less interaction, but they still need some.
Social activities might include direct or indirect contact with others. For example, calling a friend, sending email, spending time on social media, etc. During the winter, put some extra effort into activities that connect you with others.
Here are some suggestions:
Making time for friends during pregnancy not only can help you prevent feelings of isolation that could lead to postpartum depression, it also helps you maintain the habit of making plans for yourself. Set yourself up for success by prioritizing your individual interests and friendships now—a healthy habit you can continue after your baby arrives.
Happy holidays, and welcome to the AFP Blog! In my first post, I’d like to offer 12 tips (one for each day of Christmas...) for dealing with anxiety around the holidays. But first a disclaimer: In the title of this post, I put men in parentheses--not because anxiety is any less uncomfortable or disruptive for them, but because holiday planning and stress often fall disproportionately on women. That said, these tips can help everyone reduce feelings of worry, stress, and anxiety that are often an unfortunate part of spending time with family and friends.
1. Use a relaxation app to keep your anxiety thermometer as low as possible. Relaxation techniques help your body reabsorb cortisol and adrenaline (stress hormones) more quickly and efficiently. Relaxation is the antidote to stress.
2. Take a walk. Actually, any form of physical exercise will help reduce stress. It gets you out of your house and away from stressful people, pumps your endorphins, and carves out a little time for yourself.
3. Find 30 minutes to recharge. Soak in a tub, read a book, work on a puzzle, take a nap, listen to music, be “mindless.” A small amount of time when you think of nothing and no one else can feel like a luxury at this time of year.
4. Connect with someone who makes you laugh. Laughter reduces cortisol and strengthens your emotional immune system.
5. Incorporate super snacks (e.g., berries, nuts, kale chips, yogurt, a hard boiled egg, or avocado). Going long periods without eating causes the release of adrenaline. If you are stressed, your body burns off blood sugar at a much higher rate than when you are relaxed. Hypoglycemia can mimic stress with irritability, shaking, and apprehension.
6. Examine the cost and benefits of options that are available to you. We don’t just pay for things financially; we also pay with our time and our emotional energy. Some tasks might be worth paying others to do if it makes you feel less stressed overall. Be sure that you are considering all of the potential “costs” when making a decision.
7. Rather than running through your “to do” list over and over, use visualization to change your focus to a scene or a setting that you find neutral or relaxing. Use your five senses as a guide. Visualization helps manage the mind-body connection; if you can channel your mind to neutral or calming scenes, your body follows suit.
8. Practice finding the positive. Your mind is pre-programmed to find potential problems or difficulties. This makes you vulnerable to a negative or pessimistic outlook. Make an effort to record at least three positive aspects of your day. These can include: things you accomplished, interactions with others, pleasure or satisfaction you experienced, something that “went right,” a break you caught, a compliment or kindness you received, feelings of gratitude, etc.
9. Power nap for 20 minutes in a cool, dark room that’s free from distractions. An hour or two after lunch is the ideal time, since that is when blood sugar and energy levels drop, and it is early enough that it will not disrupt your nighttime sleep.
10. Write it out. Journaling (or writing the email or letter that you are not going to send) helps you express your feelings, examine your thinking, and get distance that allows you to think differently about a situation or stressors.
11. Notice your shoulders. Are they up near your ears? Do you feel tension radiating across your shoulders and up your neck? This is where most people experience muscle tension. Release tension in that area by pulling your shoulders up toward your ears. Then roll your shoulders down your back. Next, roll them forward and back into their natural position. Repeat 5-7 times.
12. Let one “should” go. Skip a non-essential errand. Eliminate one stop on your holiday route. Buy cookies rather than making them. One year, I printed 100 copies of a photo of my new baby, only to realize when I went to stuff the envelopes that the insert needed to go the other way. Dilemma: buy 100 new cards or 100 new photos. Solution: insert baby the wrong way and send cards anyway. (I actually received compliments from several friends who recognized my attempt to let go of perfectionism—which is always hard, especially at the holidays when everything must be picture perfect!)
Dr. Jill Sullivan is a licensed clinical psychologist with more than fifteen years of specialized training and expertise in Cognitive Behavioral Therapy (CBT). She is a co-founder of CBT Specialists of Chicago, and creator of Anxiety-Free Pregnancy.