"​While parents may be feeling unsure about school options this fall, there are ways to feel better as you make the tough decision."

"A combination of dread, panic and sheer exhaustion. This is what I see on the faces of patients (and friends and colleagues) when the conversation turns to the most pressing topic on every parent’s mind: what to do about school in the fall. I’m a psychiatrist specializing in women’s mental health, and I have yet to speak to anyone who feels satisfied with the options presented to them, or who feels particularly confident in the choices they’ve made.

The information on children and the coronavirus has been evolving since March, with the most recent data suggesting that children are less likely to become infected by the virus and less likely to have a severe course when infected. But, those words “less likely” suggest that children are at some, albeit smaller, risk. And, the United States still has not come up with an adequate solution to protect teachers, many of whom are high risk.

As I see it, school stress for parents boils down to two main points: Deciding what to do, and then what to do with the uncomfortable feelings that could arise after that decision. As a psychiatrist, I’m admittedly not so helpful when it comes to the decision of whether or not to send your kids to in-classroom learning this fall. Where I can help is how to deal with the uncertainty and difficult feelings that accompany this process.

A risk assessment system, like the one described by Emily Oster, Ph.D., a professor of economics and public policy at Brown University, can be a useful guide when making decisions with scarce data. Instead of focusing on the illusion of “one right answer,” this framework can give you a reliable process for making hard parenting decisions by focusing on evaluating and mitigating risks, and assessing benefits. While no parent is feeling particularly confident about the school options available to them, it is possible to feel good about the process you use to make those decisions.

In an interview, Dr. Oster wrote, “By making clear the choices, the costs and benefits, we can reason our way to better decisions. But I really think even more important is the fact that we can make our way to more confidence in these decisions by articulating a good process.”

Once you’ve delineated a plan, then you’re faced with the task of coping with the onslaught of feelings, like worry, guilt, fear and uncertainty. For this, here are some strategies, many of which come from acceptance and commitment therapy, a form of behavioral therapy that teaches people to accept their difficult thoughts and feelings as opposed to struggling against them, and to prioritize taking actions that are in line with their values."

Elliot Aronson and Carol Tavris|Social Psychologists| July 12, 2020

"​The minute we make any decision--I think COVID-19 is serious; no, I’m sure it is a hoax—we begin to justify the wisdom of our choice and find reasons to dismiss the alternative."

By: LULU GARCIA-NAVARRO

​"So many of us do it: You get into bed, turn off the lights, and look at your phone to check Twitter one more time.

You see that coronavirus infections are up. Maybe your kids can't go back to school. The economy is cratering.

Still, you incessantly scroll though bottomless doom-and-gloom news for hours as you sink into a pool of despair.

This self-destructive behavior has become so common that a new word for it has entered our lexicon: "doomscrolling."

The recent onslaught of dystopian stories related to the coronavirus pandemic, combined with stay-at-home orders, have enabled our penchant for binging on bad news. But the habit is eroding our mental health, experts say.

Karen Ho, a finance reporter for Quartz, has been tweeting about doomscrolling every day over the past few months, often alongside a gentle nudge to stop and engage in healthier alternatives.

Ho first saw the term in a Twitter post from October 2018, although the word may very well have much earlier origins.

"The practice of doomscrolling is almost a normalized behavior for a lot of journalists, so once I saw the term I was like, 'Oh, this is a behavior I've been doing for several years,' " she says.

​If Ho's daily reminders aren't enough to break the habit, clinical psychologist Dr. Amelia Aldao warns that doomscrolling traps us in a "vicious cycle of negativity" that fuels our anxiety.

​"Our minds are wired to look out for threats," she says. "The more time we spend scrolling, the more we find those dangers, the more we get sucked into them, the more anxious we get."

By: Cassie Shortsleeve| July 07, 2020

"​Black maternal health providers share the advice they give their own patients that any Black expectant or new mom can learn from."

"Pregnancy is a life-changing event. But for Black women, this time in their lives comes with uniquely concerning health issues and added layers of struggle.

In the U.S., Black women are two to three times more likely to die from pregnancy-related causes than white women. That figure is even larger in metro areas such as New York City where Black women are up to 12 times more likely to die during pregnancy and childbirth. And while about one in seven women in this country experience a perinatal mood and anxiety disorder (PMAD), Black women suffer at higher rates—and are less likely to receive treatment.

Black moms and moms-to-be also face the biases of a mostly-white medical field, not to mention systemic racism, and stigma in and out of doctors' offices, say experts. But there are ways to prioritize yourself and protect your mental wellness (or help an expectant friend) in the journey to motherhood.

Here, Black doctors, therapists, doulas, and other maternal health experts share the words of wisdom they'd give to Black moms everywhere.

1. Prioritize emotional wellness.
"Given that Black women are at higher risk for pregnancy-associated mortality when compared to non-Black pregnant women, it is important that Black women empower themselves with knowledge about the importance of maintaining emotional wellness so that they take the steps necessary to advocate for their mental health needs during their pregnancy. If you're experiencing significant anxiety, disclose your distress to friends and family. If social support is not sufficient, talk to your healthcare provider about different treatment options."—Christine Crawford, M.D., M.P.H., an assistant professor of psychiatry at Boston University School of Medicine and an adult, child, and adolescent psychiatrist at Boston Medical Center.

2. Find the mental health support you need (even if it's virtual).
​"Mental health support during the prenatal period is important especially during a time like this when women have the extra stress of the consequences of COVID-19 and racial injustice and protests. Black women are less likely to receive care for depressive symptoms and are often under-diagnosed. If you have symptoms, find a provider that you feel comfortable with, whether on a mental health app, one-to-one talk-therapy, or group therapy. Another great tool I love for moms is meditation apps. They can help with grounding during times of great stress. If the new mother has access to mental health support during the prenatal period, the risks for postpartum depression decrease."—Latham Thomas, founder Mama"

"Soon after her first baby was born in 2014, Crystal McAuley started having catastrophic thoughts about her infant’s health. Throughout the day, random thoughts popped up like tiny speech balloons, each one filled with a newfound fear: “What if the baby overheats?” “What if he stops breathing?” “What if he falls out the window?”

McAuley, 38, shared her concerns with her husband, who told her the baby was healthy. His reassurance, however, didn’t shut down the worry-filled thoughts that looped over and over in her mind. “It was hard to make them stop,” McAuley recalled. And then they changed course: “I started having visions of pulling my car into the opposite lane of traffic, but I didn’t want to die or harm my infant.” 

McAuley was experiencing intrusive thoughts, which are unwelcome, negative thoughts, or images that seem to come out of nowhere and are highly upsetting, psychologists say.

“Occasionally, everyone experiences senseless intrusive thoughts,” said Jonathan Abramowitz, Ph.D., a professor of clinical psychology and an anxiety researcher at the University of North Carolina at Chapel Hill. On a turbulent flight, for example, we may see images of the plane crashing, even if we’re not afraid of flying. If we’re driving a friend’s new car, we may have thoughts about getting into an accident.

Most times, we don’t give those thoughts much attention, but when stress arises and responsibilities mount, it can be harder to ignore them, Dr. Abramowitz explained. And with the added strain of the Covid-19 pandemic, many parents are preoccupied with worries about their children becoming ill and dying from the virus, he said.
McAuley said the pandemic has sent her anxiety into a tailspin. “I feel like a new mom again. At unpredictable times, I imagine one of my children falling down a steep ravine or dying in a violent accident.”

While intrusive thoughts can be a sign of a perinatal mood disorder, such as postpartum anxiety or postpartum obsessive-compulsive disorder, a 2006 study conducted by Dr. Abramowitz and his colleagues followed 85 participants (43 mothers and 42 fathers) from the second trimester of pregnancy to three months postpartum. Of those who participated in the study, 91 percent of mothers and 88 percent of fathers experienced upsetting intrusive thoughts about their newborn.

According to Dr. Abramowitz, it’s not uncommon for new parents to think of the baby falling down the stairs, choking or drowning in the bathtub. One parent told Dr. Abramowitz he imagined “sticking a pencil in the soft spot of his baby’s head.” 

Disturbing thoughts and images like these can bewilder new parents. Not to mention, mothers who envision harming their babies may misinterpret their thoughts as ominous signs about their mothering abilities. “I felt like a prisoner inside my own mind,” said McAuley, who worried that if she told her doctor what she was thinking, her baby would be taken away.

While intrusive thoughts can be terrifying, the problem lies in how we interpret them, Dr. Abramowitz said. Labeling such notions as “negative” causes the brain to give them more weight, which is why parents who judge their invasive thoughts often struggle to let them go.

Dr. Abramowitz and his colleague, Nichole Fairbrother, Ph.D., a psychologist and researcher at the University of British Columbia, said intrusive thoughts pop up in new parenthood for a reason. In their research, the psychologists found that the immense responsibility parents feel for keeping their newborns alive can bring on disturbing thoughts about harm striking their babies, especially during the first six months of their children’s lives.

Dr. Fairbrother said: “I remember gazing at my baby’s delicate hands and thinking, ‘I could just cut those right off with the garden clippers,’ but because I’m an anxiety researcher, I wasn’t upset by it.”

Even though intrusive thoughts might seem puzzling, Dr. Fairbrother said, they’re often adaptive. “If a mother worries about the stroller rolling into traffic, she’s going to grip the handle more tightly,” she explained.

For parents bothered by their intrusive thoughts, certain exercises and steps can reduce the anxiety they create. A few suggestions:

Distance yourself from the emotions

One way to disarm intrusive thoughts is to recognize that they don’t define who you are. Repeating the bothersome thought in a singsong voice or saying it aloud, over and over again can help, said Stefan Hofmann, Ph.D., a clinical psychologist and anxiety researcher at Boston University. This behavioral technique, known as distancing, can unhook thoughts from emotions, helping the mind to change direction. No longer seeing the thoughts as a threat, parents begin to realize that “thoughts are nothing more than just thoughts,” Dr. Hofmann explained.
​
“A mother may think about pushing the stroller down the stairs, but that doesn’t mean she’ll act on it,” he said."

"​Our struggle is not an emotional concern. We are not burned out. We are being crushed by an economy that has bafflingly declared working parents inessential."

By: Deb Perelman

"Last week, I received an email from my children’s principal, sharing some of the first details about plans to reopen New York City schools this fall. The message explained that the city’s Department of Education, following federal guidelines, will require each student to have 65 square feet of classroom space. Not everyone will be allowed in the building at once. The upshot is that my children will be able to physically attend school one out of every three weeks.At the same time, many adults — at least the lucky ones that have held onto their jobs — are supposed to be back at work as the economy reopens. What is confusing to me is that these two plans are moving forward apace without any consideration of the working parents who will be ground up in the gears when they collide.

Let me say the quiet part loud: In the Covid-19 economy, you’re allowed only a kid or a job.
Why isn’t anyone talking about this? Why are we not hearing a primal scream so deafening that no plodding policy can be implemented without addressing the people buried by it? Why am I, a food blogger best known for such hits as the All-Butter Really Flaky Pie Dough and The ‘I Want Chocolate Cake’ Cake, sounding the alarm on this? I think it’s because when you’re home schooling all day, and not performing the work you were hired to do until the wee hours of the morning, and do it on repeat for 106 days (not that anyone is counting), you might be a bit too fried to funnel your rage effectively.

For months, I’ve been muttering about this — in group texts, in secret Facebook groups for moms, in masked encounters when I bump into a parent friend on the street. We all ask one another why we aren’t making more noise. The consensus is that everyone agrees this is a catastrophe, but we are too bone-tired to raise our voices above a groan, let alone scream through a megaphone. Every single person confesses burnout, despair, feeling like they are losing their minds, knowing in their guts that this is untenable.

It should be obvious, but a nonnegotiable precondition of “getting back to normal” is that families need a normal to return to as well. But as soon as you express this, the conversation quickly gets clouded with tangential and irrelevant arguments that would get you kicked off any school debate team.

“But we don’t even know if it’s safe to send kids back to school,” is absolutely correct, but it’s not the central issue here. The sadder flip side — the friend who told me that if their school reopens, her children are going back whether it’s safe or not because she cannot afford to not work — edges closer.

​Why do you want teachers to get sick?” isn’t my agenda either, but it’s hard to imagine that a system in which each child will spend two weeks out of every three being handed off among various caretakers only to reconvene in a classroom, infinitely increasing the number of potential virus-carrying interactions, protects a teacher more than a consistent pod of students week in and out with minimized external interactions.
​
“You shouldn’t have had kids if you can’t take care of them,” is comically troll-like, but has come up so often, one might wonder if you’re supposed to educate your children at night. Or perhaps you should have been paying for some all-age day care backup that sat empty while kids were at school in case the school you were paying taxes to keep open and that requires, by law, that your child attend abruptly closed for the year."

By Cassie Shortsleeve| June 08, 2020

"Last month, one random morning while breastfeeding my 11-month-old daughter Sunday, she bit down (and laughed) then tried to latch back on. It was an unexpected snag in an otherwise smooth breastfeeding journey, but after some bleeding (ugh), a prescription antibiotic ointment, and shedding some tears, I decided it was also the end.

Not only did I beat myself up—I didn't make it to the (albeit self-imposed) one-year marker that I had set—but within days, those teary, dark moments that had been with me in the early postpartum period crept back up. I could almost feel my hormones changing.

If you just had a baby (or have new mom friends), you're likely aware of some of the mood changes that can accompany new parenthood, namely the "baby blues" (which impact some 80 percent of women in the weeks following delivery) and perinatal mood and anxiety disorders (PMADs), which impact some 1 in 7, according to Postpartum Support International. But mood issues related to weaning—or transitioning your baby from breastfeeding to formula or food—are less talked about.

In part, that's because they're less common than PMADs, such as postpartum depression. And not everyone experiences them. "All transitions in parenthood can be bittersweet and there is a wide array of experiences associated with weaning," explains Samantha Meltzer-Brody, M.D., M.P.H., director of the UNC Center for Women's Mood Disorders and a principal investigator in the Mom Genes Fight PPD research study on postpartum depression. "Some women find breastfeeding very satisfying and do experience emotional difficulty at the time of weaning," she says. "Other women do not experience emotional difficulty or they find weaning to be a relief." (See also: Serena Williams Opens Up About Her Difficult Decision to Stop Breastfeeding)

But mood changes related to weaning (and *everything* breastfeeding, TBH) make sense. After all, there are hormonal, social, physical, and psychological changes that take place when you stop nursing. If symptoms crop up, they can also be surprising, confusing, and occur at a time when you may have *just* thought that you were out of the woods with any postpartum woes.

Here, what's going on in your body and how to ease the transition for you.

The Physiological Effects of Breastfeeding
​
"There are basically three stages of hormonal and physiological changes that allow women to produce breastmilk," explains Lauren M. Osborne, M.D., assistant director of the Women's Mood Disorders Center at The Johns Hopkins University School of Medicine. 

The first stage happens in the second half of pregnancy when the mammary glands in your breasts (which are responsible for lactation) begin to produce small amounts of milk. While you're pregnant, super high levels of a hormone called progesterone produced by the placenta inhibit the secretion of said milk. After delivery, when the placenta is removed, progesterone levels plummet and levels of three other hormones—prolactin, cortisol, and insulin—rise, stimulating milk secretion, she says. Then, as your baby eats, the stimulation on your nipples triggers the release of the hormones prolactin and oxytocin, explains Dr. Osborne.

"Prolactin brings a feeling of relaxation and calmness to mom and baby and oxytocin—known as 'the love hormone'—helps with attachment and connection," adds Robyn Alagona Cutler, a licensed marriage, and family therapist who specializes in perinatal mental health.

Of course, the feel-good effects of breastfeeding are not just physical. Nursing is an extremely emotional act in which attachment, connection, and bonding can be cultivated, says Alagona Cutler. It's an intimate act where you're likely snuggled up, skin-to-skin, making eye contact."

By Anna Medaris Miller| June 19, 2020

"Pregnant women and new moms are experiencing higher rates of depression and anxiety amid the coronavirus pandemic, a new study suggests.

In the study, researchers asked 900 women – 520 of whom were pregnant and 380 of whom had given birth in the past year – about their depression and anxiety symptoms before and during the pandemic. They found that the crisis elevated depression symptoms from 15% to 41%. Moderate- to high-anxiety symptoms went from 29% to 72%. 

Pre-pandemic, about one in seven, or just under 15%, of women experienced such symptoms during the perinatal period.
 
"I was pretty shocked at the magnitude of the increases," said Margie Davenport, a co-author of the study and associate professor of the pregnancy and postpartum health program at the University of Alberta, Canada. 

A number of factors – like physical isolation, increased household and childcare duties, and fears about the state of the world – have contributed to the higher rates of mental health issues among pregnant women and new mothers, a demographic that was already susceptible to developing perinatal and postpartum depression disorder.

Davenport suspects the rates are even higher in people who already face healthcare and social disparities.
"I'm worried that this [data] is potentially underestimating the effects on women who've lost their jobs, and women who don't have secure housing and secure healthcare," she said. 
​
Most participants were white, employed, partnered, and living in a single-family home — in other words, had the types of supports that would typically put them at a lower risk for perinatal mental-health issues. Davenport fears the effects of the pandemic, and now racial justice issues, on pregnant women and new moms in more marginalized communities may be even worse."