Mya Fonarov, LICSW                                   Psychotherapy for Adults & Adolescents
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Advice for Women Coping with an Early Pregnancy Loss

1/9/2013

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From the moment of conception, most women start fantasizing about how their lives will change following the birth of their baby.  They begin to wonder about whether they will have a son or daughter, what their baby will look like, what kind of personality their baby will have, and what kind of toddler, child, and adult their baby will grow up to become.  When a baby dies before birth, the intensity of grief that some women experience can be surprising—these women not only have lost a baby but they have also lost a part of their dream for the future.

When pregnancy loss occurs early during pregnancy, most women feel like they should not talk about their loss with others.  As a society, we feel uncomfortable talking about death to begin with.  There is also a cultural expectation not to announce a new pregnancy until the end of the first semester due to the high rate of miscarriage during the first trimester.  As a result, many women who experience an early pregnancy loss believe they must grieve privately.  However, many women report that sharing their feelings of loss with other women helps them heal.  Women who share their loss with others begin to very quickly find other women who have gone through a similar experience.  These women are able to validate feelings of loss and provide hope about future pregnancy success.

When I experienced a second trimester pregnancy loss, I felt damaged.  I was ashamed that I was incapable of reproducing.  I felt like a biological failure.  As I shared my story with friends, I discovered that I had just become a newly initiated member of a secret club with many members.  I was shocked to learn how many women had had a similar experience and then went on to have successful pregnancies.  I realized I was not in fact damaged and my feelings of loss were not out of proportion to my circumstances.

As a therapist, I of course believe in the power of talking to feel better.  In the case of unexpected pregnancy loss, I also believe in the power of talking with others to help you cope.  I promise you have a friend out there who has been in your shoes and can help relieve your pain.  It is not necessary to grieve privately unless you want to.  Friends, family, clergy, doctors, and therapists will understand that pregnancy loss often leads to a serious grief reaction which can include depression and anxiety.


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Dr. Google, Health Anxiety, and Cyberchondria

1/9/2013

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According to Wikipedia, cyberchondria refers to the unfounded escalation of concerns about common symptomology based on review of search results and literature online.  Cyberchondria is a growing concern among many healthcare practitioners as patients can now research any and all symptoms of a rare disease, illness or condition, and manifest a state of medical anxiety.

When my baby was recently diagnosed with an infantile hemangioma (vascular birthmark), I found myself doing exactly what I tell my clients not to do when they have anxiety about a health issue.  I started “googling” uncontrollably.  I spent weeks looking at horrific google images of hemangiomas and reading about brain disorders that rarely are associated with hemangiomas.  After weeks of incessantly and obsessively googling, I was convinced that I knew more than my pediatrician.  Rationally, I knew that googling was magnifying my anxiety, yet, I could not stop myself. 

What I discovered online both hurt me and helped me.  I convinced myself that his birthmark would permanently disfigure his face and that his cerebellum was damaged.  This realization led to total panic, loss of appetite, and sleepless nights.  Fortunately, my “google diagnosis” turned out to be wrong and I had unnecessarily and prematurely spent weeks worrying endlessly.

My “google diagnosis” and elevated anxiety did eventually lead me to seek expert advice from hemangioma specialists and away from the virtual world of terror.  Seeking such consultation was not an option my pediatrician presented for my son, and, it turned out such consultation was necessary to determine an appropriate course of treatment.

If your guts tells you that your primary care physician may not have all the answers, please trust your instinct and do your own research.  However, if you decide to research your concerns online, do so knowing that what you find can easily be misinterpreted and seek a second opinion from a specialist.

If you have a lot of health anxiety, I recommend staying off google entirely if you can control your impulses.  If not, here are some tips on how to google medical concerns responsibly:
  • Information published on the internet is not regulated. Please check the source and the date of the information you find.  
  • Remember that blogs are often based on anecdote rather than the scientific method.
  • Ask medical professionals to recommend credible web sites.
  • Use the internet to educate yourself and gather more information but do not to self-diagnose.

Mya Fonarov, LICSW

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Postpartum Depression(PPD)

1/9/2013

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Just about everyone expects that the birth of a child automatically fosters feelings of happiness and joy in the mother.  However, most people do not realize that about 10 to 15 percent of women develop Postpartum Depression (PPD).  PPD usually emerges in the first 2 to 3 months following childbirth but can also develop anytime after delivery.  If left untreated, PPD can affect the mental health of the entire family.  However, with proper care including therapy and/or medication, mothers can make a full recovery from PPD. 

Symptoms of PPD include:
  • Depressed or sad mood
  • Tearfulness
  • Loss of interest in usual activities
  • Feelings of guilt
  • Feelings of worthlessness or incompetence
  • Fatigue
  • Sleep disturbance
  • Change in appetite
  • Poor concentration
  • Suicidal thoughts
  • Anxiety and constant worry
  • Irritability
  • Difficulty bonding with your baby
  • Terrified of being alone with your baby
  • Thoughts of wanting to “send your baby back”
  • Doubting your decision to become a mother

If you think that you may have PPD, take the following quiz:
  • The Edinburgh Postnatal Depression Scale
    • If you score 12 or higher or if you answer “yes” to question number 10, please seek a more thorough evaluation from a mental health provider.

Treatment

In addition to psychotherapy and medication, I recommend the following to mothers struggling with PPD:
  • Get as much sleep as you can to restore your biorhythms.  Allow your partner, family, friends, or someone you hire help with night feedings.  Getting sleep is vital to your recovery!
  • Join a new mothers group.  Becoming a mother can be a very isolating experience and it is essential to be able to share your new trials and tribulations with other mothers in the same boat.
  • Have someone you trust (a friend, relative, or hired help) care for your baby so you can get some relief—time away from your baby will restore and rejuvenate you.
  • Accept help from others!  When friends and family ask how they can help, say yes and tell them what you need.
  • Make sure to find time to take care of yourself (have dinner with a friend, take a yoga class, go for a walk, get a massage, take a nap, take a long shower).
  • Communicate how you feel to people you love and trust.  Talk to other mothers who have experienced PPD. You have nothing to be ashamed of.  Having PPD does not make you a bad mother!

Local Resources

PPD Support Group:
  • This Isn’t What I Expected
New Mothers Support Groups:
  • Jewish Family & Children’s Service
  • Isis Parenting
  • WarmLines The Freedman Center at MSPP
Home Visiting Program for New Mothers:
  • Visiting Moms
Massachusetts General Hospital:
  • Center For Women’s Health

Books on PPD
  • It Sucked and Then I Cried: How I had a Baby, a Breakdown and a Much Needed Margarita by Heather Armstrong
  • This Isn’t What I Expected: Overcoming Postpartum Depression by Karen Kleiman and Valerie Raskin
  • Sleepless Days by Susan Kushner Resnick
  • Down Came the Rain by Brooke Shields


Mya Fonarov, LICSW

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