Coping With Perimenopausal Depression by Kara N. Bradford, BS, LCDC, LMSW

As if being a woman wasn’t full of body and hormonal shifts already, but there’s such a thing as perimenopause? What exactly does perimenopause mean? The literal translation of perimenopause is “around menopause,” and is defined as a period in a woman’s life shortly before menopause when her body is beginning to prepare itself for menopause, which typically begins at the age of 40 to 50, but in some women as early as 35! During perimenopause, the woman’s body is beginning to produce less of the hormone estrogen and the level of the hormone rises and falls inconsistently, which can make women experience physical symptoms such as hot flashes, interrupted sleep patterns, and vaginal dryness. The irregular rise and fall of estrogen causing hot flashes–which interrupt sleep patterns–are likely to cause mood swings and irritability, increasing the likelihood of women experiencing depression. We know that interrupted sleep can be a reason why someone may experience depression, then add in suddenly painful sexual experiences due to vaginal dryness and menses that can sometimes last longer than 7 days–makes sense how women are more inclined to experience depression during perimenopause, right? 

Know that you’re not alone.
Though every woman’s body and experience is different, studies show us that as many as 33% of women in the United States experience depression during perimenopause. Try searching for support groups on Google or Facebook formed by women who are experiencing similar things that you are experiencing. 

Decrease or alleviate stressors. 
Decreasing stressors in life is sometimes unrealistic (i.e. COVID-19 pandemic), so being creative with ways to alleviate stress is important to help with irritability and inconsistent sleep. Yoga is a great way to practice mindfulness and enjoy exercise, which is also important in combating depression.  Another way to alleviate stress is to meditate. If you have never practiced meditation before, try a guided meditation–there are many free ones on the internet! Even a quick walk or jog around the block can help alleviate stress.

See your gynecologist or primary care physician.
Being open with your doctor about any symptoms that you are experiencing during this transition may help you find some relief. There are many pharmacological options to discuss with your doctor that may help alleviate depression symptoms, such as Zoloft, Prozac, or other selective serotonin reuptake inhibitors (SSRIs). Additionally, there are many options to help treat the physical symptoms of perimenopause as well, often referred to as hormone replacement therapy (HRT). HRT can be many different things such as oral tablets taken daily to regulate the rise and fall of estrogen and there are even creams applied vaginally to combat painful intercourse. For some women, HRT may not be an option if they have had certain cancers or other medical conditions, so always see your doctor to help you select a treatment plan that is right for you. 

See a therapist.
If you are experiencing symptoms that have caused disruption in your life at work or home, try reaching out to a therapist to support you and help you develop a plan to cope with your experiences in a healthy way. Studies show that cognitive behavioral therapy (CBT) can have a lasting positive impact on women struggling with depression during perimenopause by targeting mood swings. CBT is a therapeutic modality that helps to shift negative thought patterns toward more neutral or positive thought patterns, combating irritability. Many therapists at Niyyah utilize CBT and can help - reach out today if you need help.

How to Cope If Your At-Home COVID Test Comes Back Positive, by Nabiha Hasan, LMSW

Covid has inevitably become a part of our everyday lives over the span of the past two years. Nonetheless, a positive Covid test can be a marker for a reaction of a variety of different emotions, including fear, anxiety, and/or heightened stress. If your test comes back positive, what should you do? Likewise, what should you not do? Here are some useful tips and tricks for coping with a positive at-home test. 

Verify. Before you get worried or emotionally worked up, verify that your result is indeed positive. Go ahead and double check your test result at a testing center so that you can find out for sure whether or not you have tested positive for Covid. The situation has become a bit tricky and confusing, so it’s best to ensure first and foremost that the test result is indeed accurate. Quite frankly, I’ve personally heard of numerous cases in which one test comes out positive, and then another following it results in being negative. If your second result is positive, do follow the remaining steps that are highlighted below. 

Don’t panic. Much easier said than done, this is potentially the most important yet most difficult step to implement if your Covid test comes back positive. Upon seeing that positive result, it is natural for thoughts to go in about a hundred different directions, for quite valid reasons. Remain calm, remember that Covid is becoming normalized, and consider how the vast majority of Covid-positive cases turn out just fine. Think and focus more on the ones who test positive and recover with no issues, rather than focusing on the cases which do result in being more severe. 

Avoid the news and searching the web. No matter what happens, refrain from looking up symptoms because that can cause more anxiety than anticipated. Seek the advice solely of a medical professional, as websites and web searches are not aimed to describe symptoms and provide treatment on a case-by-case basis; rather, they give a one-size-fits-all approach which is not ideal to follow. Additionally, watching and following the news will also simply trigger added stress due to the news outlets highlighting and magnifying the number of cases, deaths, and lack of mask mandates around the country. After testing positive, the last thing you’d want to do is read more about how Covid has overtaken the world…that would be the least bit helpful!

All in all, if your at-home Covid test results in being positive, do your best to remain calm and avoid panicking. If you feel that your mental health is being adversely affected, don’t hesitate to reach out to us at Niyyah Counseling for support and to make an appointment to speak to one of our highly qualified and experienced therapists. We are a click away and would be more than happy to help you walk through your thoughts. The pandemic is far from over, but remember that you are not alone in feeling these emotions - talking about them and seeking guidance on how to manage them is the first step.

Managing Anxiety With the 3-3-3 Rule by Connor Cohen, LMSW

Anxiety feels like it doesn’t play by the rules. It’s like that loose cannon that does what it wants, when it wants and because it wants to. Anxiety thrives in the what ifs and the oh no's. It exists in the space between moments. Anxiety has us worried about what is to come and worried about all that has passed. Will this person like me? Did that person like me? Will something go wrong? Did I make a mistake? Anxiety can be a lot to handle. It can be tiring and create a sense of dread and panic. So how do we handle something that makes us anxious and feel as though life is out of control?

As we have discussed, anxiety doesn’t feel like it plays by the rules. So what if we spent time training our response to anxiety to have rules? One helpful rule is the 3-3-3 rule. This rule helps take you from that space between moments, into being aware of the moment you are in. So what is the 3-3-3 rule? Well it’s a strategy to combat anxiety and recenter yourself in the present moment. 

Step one: Name three things that you hear: When anxiety takes hold, we can be quick to block out the world. The thoughts in our head get louder and louder, to the point where we may not notice the little things around us. By taking time to name the sounds we are hearing in the midst of an anxiety attack, we are taking back our power of attention. Anxiety creeps in and directs us where to point the spotlight but by focusing on the present moment of what we can hear, we can take back control of our attention and focus and thus we are the ones directing the spotlight. Anxiety may say “hey look at this scary thought over here” but we can remind ourselves of our power to shift our focus and change our thoughts by purposefully engaging with the present moment.

Step two: Move three parts of your body: This could be fingers, toes, arms, legs, anything that gets you moving. Anxiety can often present as bodily sensations such as tension. Scientifically speaking, energy can not be created nor destroyed, now scientists may not have originally had the human body in mind when studying the law of thermodynamics, but I believe that as beings in and of this world and universe, we are subject to its laws as well. Anxiety builds up tension and energy within that body and according to science, it has to go somewhere. By moving your body, you are giving that energy a different purpose. 

Step three: Point out three things you see: Much like the step where we point out things that we hear, our visual surroundings can help remind us to be present in the moment. It’s almost like an anxiety relief sandwich. We engage with our surroundings in the beginning and at the end of the 3-3-3 rule, like the bread of the sandwich, and moving the body or finding ways to disperse the anxious energy is the meat or veggies. By ground yourself in the present moment, we take back control from anxiety and move from the what ifs and oh no’s to right now.

If you or a loved one struggle with anxiety, our team here at Niyyah understands that anxiety can be difficult to overcome and live with. Feel free to reach out to us, we are more than happy to help! 

Depression Is Unique for Everyone, So Treatment Should Be Unique For You, by Nabiha Hasan, LMSW

Depression affects a significant number of individuals worldwide, and can be unique in the way it impacts person to person. Some people may have loss of appetite, others may have increased appetite, and sleep patterns can vary as well; some may sleep excessively and others may not be able to sleep at all. At times, people suffering from depression may have difficulty concentrating or may experience recurring thoughts of death. With depression being unique for everyone, it would make sense to say that treatment should be unique as well. Take a look at the following tips and suggestions in reference to seeking therapy for depression. 

Therapy is not a one-size-fits-all, a cookie cutter, or a magic wand. Nonetheless, each therapist has a different approach to treatment and is unique in her or his course of study, experience, and modality. Not every therapist will be a good fit for every client either, and that is ok to acknowledge and accept. Therapists come from all walks of life with various experiences, and are of differing backgrounds, socioeconomic statuses, and cultures; nonetheless, therapists are trained to be culturally competent, open and willing to work with a diverse set of clients, and know when to refer out when a client's situation is not in her or his scope. As a therapist myself, I remember having my first appointment as a student at the university counseling enter, and absolutely hating it. I felt like I was talking to a wall, and the therapist was of a different background than me, so I felt as if she didn't understand my struggles. I acknowledge that she must have been a great therapist, but just wasn't a good fit for me. I did successfully move on to another therapist who was the perfect fit.

Even within one therapist’s practice, each client who is treated will not and should not be treated in the same way. Some clients do very well with homework, as in journaling, for example, and others do much better when they journal in session. Some clients thrive on CBT, and others may despise it completely. EMDR has become a popular and well-researched form of therapy, which also may not be a good fit for every single person. 

All in all, it's a great idea to research your therapist before seeking services. Check out what your therapist's specialties are, what population you fall under, and what modalities are used in that practice. Additionally, researching different types of modalities would be helpful to take into consideration, particularly because there are so many out there and it will give a feel for various types of treatment methods in psychotherapy. 

If you feel that you are experiencing symptoms of depression, remember to seek help as soon as you can if you aren't able to manage your symptoms otherwise. At Niyyah Counseling, we have a spectrum of therapists with years of experiences who come from all walks of life and are familiar with a variety of mental health concerns. They are well versed in a number of different modalities and participate in case consultation regularly. Remember that you can reach our highly qualified therapists with just a click.

Why Validation is Important in Relationships, by Kara N. Bradford, LCDC, B.S., LMSW

Validation is one of the many important communication skills that build strong, long lasting relationships. Validating is a way to communicate your understanding and acceptance of someone else’s emotional experience, despite whether you view the situation the same way as they do. If you choose to validate your partner’s/spouse’s experiences and accept their perspective, you may find that trust and emotional safety in the relationship increase, resulting in less arguments and more intimacy. Research tells us that couples who use validating language in their relationship experience higher levels of relationship satisfaction, increased intimacy, and greater feelings of support.

What is an example of validating vs. non-validating language? 

Scenario: Partner A works remotely from home, Partner B works outside of the home in a more physical labor-intensive type of job. One of their children becomes ill and has to be home for a few days. Partner A is able to make arrangements with their employer to care for their child during the day and try to catch up on important work projects during nap times and in the evenings. Partner B is experiencing mechanical issues at work and is short-staffed due to illness of co-workers, resulting in them having to work longer hours.

After a couple of days, Partner A tells Partner B: “The baby has been so clingy the past couple of days and I’m feeling like I’m behind at work, I’m just exhausted!” 

Partner B Non-validating response: “Shoot, at least you get to be at home. I’ll trade yah!”

Partner B Validating response: “I know these past couple of days have been rough, I’m sorry you’re exhausted.”

Partner B’s non-validating response does not show emotional understanding of Partner A’s perspective and could send the message that Partner A’s situation is somehow less exhausting than theirs due to Partner A’s job being able to be done at home. The comparison game would likely start and soon comes the argument that could last all night when all they both want to do is SLEEP! Consistently not being validated by a partner/spouse can eventually activate one or more of Gottman’s four horsemen of the apocalypse in a relationship: criticism, contempt, defensiveness, and stonewalling. 

Partner B’s validating response to Partner A’s emotional experience in this scenario lets Partner A know that they were heard by Partner B acknowledging understanding of the situation from Partner A’s perspective and letting them know that it’s okay to feel exhausted with this temporary change in family need. With the validating language being used in this scenario, it is likely that the couple could continue to communicate from there on how to help each other out during this exhausting time.

In summary, validation is a way to let your partner know that they are being heard, understood, and that they are valued. Validation is a way to avoid passive-aggressive behaviors that lead to unnecessary arguments and build trust in your relationship. Give it a try! If you and your partner need help developing this skill, consider reaching out to Niyyah Counseling for help!

How to Cope With Anxiety If You Can't Attend Therapy Immediately by Connor Cohen, LMSW

Anxiety is..well..anxiety inducing. At points it can appear due to known triggers and stimuli. In other moments anxiety can feel unknown, scary and random. Let’s face it, if anxiety followed a road map, it would probably be less anxiety inducing. The thing about anxiety is, it can kind of come up when we least expect it. 

So what do we do if anxiety strikes in between our therapy sessions?

Step one: Breathe. Take a big breath in and out in an effort to center yourself. It’s amazing how much of our anxiety can be rooted in our automatic processes. It makes sense if we think about it though. Anxiety often creates an increased heart rate, and we counter that with reducing our heart rate through calm, controlled breathing. 

Step two: Ground yourself. Grounding is a wonderful technique to further combat anxiety. Grounding is the act of centering yourself in the environment that you are currently in. The thing about anxiety is that our brain can often send our thoughts elsewhere. Sometimes anxiety sends our mind into the unknowns of the future, at other times, anxiety has us focusing on the past in a way that our thought process can get stuck in the notion of past mistakes. Grounding techniques take you from future or past to present minded. A great way to ground yourself is to be aware of the little things in your surroundings. For example, try making note of the things around you, count what you see, pay attention to what you can hear and feel around you.

Step three: Go outside. Outside can be helpful for several reasons as it relates to anxiety. One key reason is that changing your physical environment and surroundings can be great to break the cycle of anxious thoughts by forcing your brain into a new safe situation. Another way that it is helpful is that going outside can give you plenty of fresh air to breath (see step one) and plenty of things to see, hear and experience (see step 2). 

Step four: Write it out. Writing out our thoughts and feelings can be a wonderful way to again break from the cycle of anxious thoughts. Writing these anxious thoughts down can help bring the feelings from the cycle out of our mind into the practical world. By writing down your thoughts, we can basically put the thoughts on trial and examine critically if the thoughts are true or simply our perceptions masked in anxiety. Bonus points for this one because writing out the thoughts can be helpful for your therapy sessions especially if at times you are unsure what to talk about in sessions. 

Step five: Seek help. If you have tried all of these steps and strategies and the anxiety still feels as though it has a strong grip on you, don’t be afraid to reach out for help. Our team here at Niyyah understands that anxiety doesn’t just pop up while we are talking about it. Your friendly neighborhood Niyyah counselor can help connect you with resources to be used in the event that anxiety peaks outside of therapy. 

Coping with Seasonal Depression During COVID Isolation by Nabiha Hasan, LMSW

Covid isolation, unfortunately, seems to be never-ending. Right when we think that all is well and good, and begin to stop hearing about an influx of hospitalizations or an uptick in cases, there comes a new variant and we are told to isolate all over again. Isolation is enough to trigger seasonal depression in many individuals, but the constant back and forth can be even more triggersome. Stay tuned to take note of some tips and techniques to cope with seasonal depression while we endure this pandemic.

Remember that it’s temporary. Even though the pandemic seems to go on forever, and as cliche as it sounds, it is in fact temporary. It will not go on forever; Covid will eventually cease just like swine flu, bird flu, and ebola did, and we will be a world free of isolation once again. While we live in the pandemic on a day-to-day basis, it can seem as if this is what we’re destined to for the rest of eternity. Whatever you do, don’t let the current situation let you feel that this is what is meant to be until the end of time.

Focus on what’s in your control. Although we may continue to be isolated, which can lead to a whirlwind of emotions, try to focus on what you can do, rather than focus on what you can’t do (leave the house, associate with large gatherings, etc.). Utilize this time to virtually connect with family and friends, take a relaxing bath, splurge into your favorite show on Netflix, or cook your favorite meal. If you have children, use this opportunity to spend time with them either by playing, participating in something educational, or having them help you around the house. Thankfully, technology has become very useful particularly during this time; imagine being in this situation 50 years ago!

Avoid the news outlets. If watching the news causes your seasonal depression to get even worse, take a moment to detox yourself from being engrossed in the world’s current events and happenings. Chances are, you will feel your symptoms exacerbate upon reading, hearing, or seeing more of the news reports. The news is aimed to heighten your emotions, and taking yourself away from following it constantly may be just what you need. If you find yourself wanting to know more about the number of cases, increase in hospitalizations, or presence in your area, remember that this can trigger your depression to spiral…ignorance really is bliss in this situation.

All in all, seasonal depression during Covid isolation has become very common. There are numerous members of society who have found themselves struggling to stay emotionally afloat during the pandemic, and have sought mental health support during this time. If you feel that you need additional support and have tried to cope on your own, but haven’t been able to resolve your emotional state, remember that you are not alone in your feelings, and can lean on any of our wonderful therapists at Niyyah Counseling for guidance. We are a click, call, or message away.

Parenting Tips During Difficult Times by Amanda Young, LCSW

Parenting during difficult times has seemed to be never ending as of late. We would like to believe that all parents have encountered moments where our kids have had meltdowns in the store, tantrums in restaurants, screaming competitions when not wanting to leave play areas, negative attitudes, back talk, criticizing us as parents when they can’t do what they want or simply just shutting down when they can’t get their way. Well these last couple of years have expanded the definition of “parenting during difficult times.” due to the pandemic which made our entire world stop and struggle to get back to whatever normal is. 

With this new set of difficult times, we are not only seeing the behaviors mentioned above, we are seeing more isolation, acting out behaviors, high risk behaviors, and the list goes on and on. Not only are we struggling to mentally stay afloat, we are also struggling trying to figure out what is wrong with our kids as well as connect with them. When parents are faced with difficult times that are intensified by uncharted waters, they become helpless and missing signs that might prompt them to intervene when they need to.

Having some direction can definitely help the process. Below are a few tips that parents can keep in mind when difficult times arise. This is not an exhaustive list but some things that might help.

Tips for parenting through difficult times:

Be patient and calm

When approaching a child who is obviously upset, remain calm and show patience to gain an understanding of what the issue is according to their perception. If parents are calm and don’t show patience, they can shut down the communication lines and never be able to know what the issue is.

Be empathetic

Try to understand the issue from their standpoint and walk in their shoes. Encourage them to ask questions.

Listen with interrupting

There are times, as parents might have something we want to say right then or want to correct the child. If we interrupt, it can affect their thought process. So listen attentively so the child can know they are heard.

Check your emotions and practice self care

Consistently evaluating our emotions is important and making sure we are taking care of ourselves to decrease stress.

Be open and honest

It important to be honest but open with information, just making sure it is age appropriate.

Love/hug on your child

Comforting and showing/telling your child you love them during difficult times tell them they are safe and that you care about what is happening with them.

Being consistent

Keeping a schedule can provide a sense of predictability and comfort.

Giving praises and positive feedback

Praising them for talking about their feelings and being able to calm down is important. It shows them they did the right thing by being open and that you are proud of them.

Keeping these simple tips in mind, could help turn a difficult time to a pleasant one. Remember parenting is trial and error. Sometimes we need a little help to overcome some challenging times. If you need further assistance, Niyyah professionals are always here to help. WE are a phone call away.

Brain Fog and Anxiety by Kara Bradford, LMSW, LCDC

What is brain fog?

Brain fog is when you have difficulty concentrating or forming clear thoughts. Much like driving a car in the fog, you can only see a few feet in front of your car and cannot fully prepare for what lies ahead. Although brain fog is commonly experienced, it is not a condition on it’s own, it’s usually a symptom of something else.

How is brain fog associated with anxiety?

Brain fog is usually a symptom of ongoing, unmanaged, anxiety. When you’re continuously anxious or worried about so many things going on in your life, the overload of thoughts does not allow the mind to rest. Though you may not be actively having anxious thoughts, they can remain in the subconscious and continue to play in the background, causing physical symptoms such as upset stomach, increased heart rate, and fatigue. 

5 tips for addressing brain fog from anxiety:

Identify the source of anxiety
In recent times–especially during the pandemic–the source of anxiety may be easily identified. Maybe you have a huge work project that you are now having to work on from your home office and you have your entire family home in quarantine due to a positive case in the family. However, in some cases, it could be more difficult to identify the source of anxiety if you have a long history of recurring anxiety. In this case, you should try speaking with a mental health professional to help identify the source. 

Make sure to get enough sleep
Not getting enough sleep in itself can make it difficult to concentrate, whether you’re dealing with anxiety or not–anyone with children can tell you this is true! Honestly, a few nights of not getting enough sleep may make you irritable or sleepy during the day, but will likely not have a long-lasting impact on your mental health. Consistently not getting enough sleep can cause a variety of physical health symptoms, but also have a long-lasting impact on your mental health. Everyone should get at least 7 hours of sleep per night, but most studies conclude that 9 hours of sleep per night is optimal. 

Set firm boundaries
Once you have identified the source of your anxiety, set firm boundaries to protect yourself from feeling anxious. A few examples of this may look like: only working a set number of hours extra per day, no more and no less; asking your partner or spouse for help with specific tasks around the house; limiting yourself a set amount of time to scroll through social media.

Create protective factors
To help yourself hold firm to boundaries, create safeguards to help you. Some examples of this from boundary examples before might look like: setting a daily alarm on your phone labeled “a good days’ work!” or something to remind you that you have put in plenty of extra time for your work project; give your partner or spouse specific things that they can do daily such as unload the dishwasher, move laundry to the dryer if the washer is complete, don’t expect them to read your mind; set parental controls on your phone to block access to social media at a certain time or when you have reached a certain amount of time per day.

Take a mental break
Taking a mental break could be going for a walk around the block, lying down for 15-20 minutes, or just closing your eyes for a few minutes. Another great option for taking a mental break is to meditate. If you have never meditated before, there are many free guided meditations out there to help you through it, or if you have a therapist already, have your therapist walk you through how to meditate in your next session. 

How Much Fighting is Normal and How Much Is Too Much? By Connor Cohen, LMSW

Fighting has been a part of our human existence for millenia. In the past, we would fight for land, for freedom and for love. Nowadays, we may not individually fight for land or our freedoms but we still hold a soft spot in our hearts about fighting for love. It can get confusing though when fighting for love looks more like fighting with those we are in love with. So is this normal? Is my relationship doomed to fail if we fight? Short answer: YES IT IS NORMAL and NO fighting with your significant other does not mean that the relationship is doomed. 

Firstly, what does it mean to fight with your significant other? I feel as though I should not have to say this but fighting with your significant other should NEVER look like physically putting hands on one another out of frustration, anger, or to “get your point across”. That is not a fight, that is abuse. While we are on the topic, abuse can take a lot of different shapes between you and your partner. Abuse does not have to only be physical or sexual in nature, it can be emotional, verbal, or even financial. To learn more about abuse and to find resources.  Follow this link. 

Fighting is a very normal product of life. Think back to when you were young and would live with your caregivers and possibly siblings. Any time we spend in close proximity with another person over a period of time, it is only natural for tempers to flair and for buttons to get pushed. A relationship with your significant other is no different. Buttons will get pushed and emotions will be felt and felt strongly. A fight can look different depending on your relationship. For some couples, it is a mild disagreement, for others it involves yelling, possibly screaming and maybe even a few tears. 

So how do we know if our fighting is abnormal or a problem? Well we can attack this issue from a few points. 

1. How often are the fights/disagreements? If you and your significant other are fighting more often than not, it may be time to address some underlying issues.

2. How intense are the fights? As I said above, some couples fight intensely with words and yell and scream. Just because it is normal for some couples to do, does not mean that there is no improvement to be made. If the intensity of the fights are mentally, physically and emotionally draining then it may be time to address the issues at hand in another way or with professional help.

3. Are the fights you vs. your significant other or you and your partner vs. the issue or disagreement? There is a big difference between being angry at your partner and being frustrated at a lack of communication or a misunderstanding.

4. Are the arguments/fights leading to change or a shift in perspective? Fighting for the sake of fighting is not a healthy way to fight. Fighting to be understood or heard is arguably a healthy fight to have. If at the end of your fights, everything remains the exact same, it may be time to try a new approach. 

As we discussed, fights are very normal. If you have had them with your partner, chances are more will pop up from time to time. Just because you and your significant other can have a fight from time to time, does not mean that you are doomed to fail in your relationship. If you and your partner notice a trend in fights, it may be time to address the fights with professional help. Our team here at Niyyah would love to help you navigate these issues and help turn fighting from you vs. them to us vs. the problem.