Carly Snyder

I’m sorry to hear about your mother’s health issues - it is a hard situation for everyone. It’s so nice that you want to help your mom - have you asked what she thinks might help? Is she eating a healthy diet? Can you bring her out for lunch or dinner and can you go out for walks with her? Making healthy food choices and regular exercise help with mood. Sleep is also very important - if she isn’t sleeping well, a meditation app may help. You can help her find one and download to her phone if needed. Knowing you have someone who cares and a shoulder to cry on can be reassuring. However, while you can and should be supportive, you cannot act as her therapist - being her child means you cannot be objective (this is why physicians and therapists don’t treat family members). If she is struggling emotionally, it never hurts to see a professional. Offer to bring her to the first therapy visit if she is nervous or unsure about it. Having a chronic disease is very hard and she deserves a therapist who can help her cope with the many feelings that come with such a diagnosis. Best of luck to both of you.

Carly Snyder, M.D.

I’m sorry to hear about your father’s recent passing. Your mom is likely grieving, and she may also be suffering from depression. There are different forms of grief, ranging from appropriate and expected, to ‘pathological’ grief, where someone may hear their loved one or see the person and struggle to cope with the loss. Sometimes while grieving people may have a reduced appetite, they may sleep less or more and may be very sad. If these symptoms are prolonged and/or impair a person’s ability to function, then it is a good idea to see a psychiatrist and/or a therapist for treatment. Engaging in treatment will not change the magnitude of the loss, but can help with processing and coping now and in the future. Sending best wishes and condolences to you and your entire family.

Carly Snyder, M.D.

A psychiatrist is a medical doctor and can prescribe medications if needed. A psychiatrist completed four years of medical school, four years of psychiatry residency and possibly additional fellowship training. Some psychiatrists see patients for various forms of therapy as well as medication management, and some may instead focus on treatment with medication as needed.

Psychologists are not medical doctors, but some may have their doctorates in psychotherapy. Psychologists can have differing amounts of post-graduate education, but all had to complete an accredited training program. Psychologists do different forms of psychotherapy, but cannot prescribe medications.

Carly Snyder, M.D.

Congratulations on your pregnancy! Given your history of postpartum depression, you are at an increased risk for experiencing antepartum (during pregnancy) and postpartum mood symptoms. This does not mean that you inherently will again suffer, but there is a definite possibility. I would connect with a perinatal/reproductive psychiatrist and/or a therapist now to help monitor your symptoms and to begin treatment if needed. If you don't have a provider, please go to http://www.postpartum.net/get-help/locations/united-states/ <http://www.postpartum.net/get-help/locations/united-states/> and find a local coordinator who can help.

Yes, please speak to her. Open up a non-confrontational, non- judgmental dialogue, express your concerns, and go from there.

Carly Snyder, M.D.

Hi,

You sound like you’re having a very hard time and I am so sorry that you are hurting so much. Please, please know that your life is so important - you can do amazing things in the future and be incredibly happy. The first step is getting proper treatment. Talk to your parents and tell them how you are feeling and also ask to see your pediatrician. Tell your doctor what is going on and ask him or her to help find you a child/adolescent psychiatrist who can help you to feel better. Feeling this way is awful and you deserve to be well - please be your own advocate and ask for help and don’t give up until you get it. And remember, suicide is never the answer - truly. If you’re feeling like hurting yourself, call 1-800-273-8255.

Sending you lots of strength and love,

CS

You’re not alone - up to 20% of new mothers suffer from postpartum depression, and more than 10% suffer from postpartum anxiety. These numbers are likely actually much higher, but many women keep their symptoms a secret and struggle in silence unnecessarily. The exact reason why women experience a postpartum mood and/or anxiety disorder is still being explored, but we do know it is never a mom’s fault - no mom wants to feel like you are unfortunately feeling. Please speak to those close to you about your feelings and ask for help when needed. Many women take on much of or all the responsibility for caring for their kids and this can be overwhelming and often leads to profound exhaustion. Sleep deprivation is a literal form of torture, and no one should expect to enjoy anything if they are profoundly tired. Brainstorm ways to improve your sleep quality and the amount of sleep you get regularly - ask for your partner's or mom's or a friend's help at night if your little one isn’t sleeping through the night and keep this help on a consistent basis. Also, please strongly consider working with a therapist trained in perinatal mental health and if needed also speak to a reproductive and perinatal psychiatrist. Asking for and receiving help is the strongest thing a mom can do - it’s saying you want to feel and be the best mom possible for your little one. Your mental health and wellbeing is not just vital for you, but also for your entire family. You are needed and loved and deserve to enjoy motherhood. Having a child isn’t easy but it should not be painful and you deserve to get treatment so you can start feeling like yourself again. Please go to the Postpartum Support International (PSI) website Postpartum.net and search for a local coordinator in your area who can help connect you with a well trained professional. I’m so sorry you’re feeling like this, but know that you can and will feel better with the necessary support and treatment you deserve.

Carly Snyder, M.D.

Be honest and express your concern to your friend with your willingness to help. Suggesting your friend consider mental healthcare is a compassionate suggestion that shows how much you care. If your friend does not want to hear you and feels offended, reinforce how much your impulse is to help and that there is no shame in seeking and obtaining support in times of stress. Even if your friend is mad now, he will hopefully appreciate your efforts in the future once he feels better.


Carly Snyder, M.D.

Negative thinking is not specifically a disease, but is often a component of some mood disorders like depression or obsessive compulsive disorder. Your awareness of the negative thoughts is a great first step towards feeling better - CBT or cognitive behavioral therapy can be very effective to address and squash negative thoughts and general negative thinking. You may also want to consider why you feel so negative, if there are any stressors that can be easily modified such that you will feel more
positive.

I am sorry to hear you are struggling to fall asleep. Some things that can help are to
1. try to give yourself time to unwind before going to sleep - rather than using an iPad or watching tv before bed, consider reading a book outside of bed and returning to bed only to sleep.
2. Limit emails, facebook, twitter and other interactive activities before bed - this way you won't have new information to ponder before going to sleep.
3. meditation can be very useful to help you fall asleep - meditation apps like Headspace or Om can be very helpful to reduce unnecessary distractions and reduce anxiety before bed, and to lull you to sleep.
4. limit caffeine intake overall and stop drinking caffeinated beverages after 2 or 3 pm.
5. If there are many issues weighing on your mind, try writing them down to 'purge' your mind.
6. Therapy can be helpful to explore the reasons for your anxiety and work towards resolutions.

Drinking a glass of wine while taking an SSRI like sertraline (Zoloft) is relatively safe, however your blood alcohol level will increase faster than if you were not taking the medication. You may feel as if you drank two glasses of wine after drinking only one, and you may become drunk faster than usual. Be careful and drink slowly to understand how your body responds to alcohol while on an SSRI like sertraline.