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Taking Care of Yourself: A Parents Guide to Mental Health, Stress Reduction & Parental Guilt

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Taking Care of Yourself: A Parents Guide to Mental Health, Stress Reduction & Parental Guilt

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Taking Care of Yourself: A Parents Guide to Mental Health, Stress Reduction & Parental Guilt

  1. 1. Taking Care of Yourself: A ParentsGuide to Mental Health, StressReduction & Parental GuiltTina Drossos, Ph.D.Assistant ProfessorDepartment of Psychiatry andBehavioral NeuroscienceUniversity of Chicago
  2. 2. Rates for pediatric chronic illness 20 million children suffering from one chronic health problem 3 in every 10 children in the US  For JIA:294,000 children under the age of 18 It is important to know that you are not alone
  3. 3. Response to pediatric chronic illness Initial diagnosis  Overwhelmed/fear/worry  ANGER  Denial (“This cannot be happening to me, to my child, to my family.”)  Grief  Feel that you do not have all/enough information  Confusion  Feelings of isolation  Powerlessness  Blame/guilt*
  4. 4. Blame/Guilt “Did I do something to cause this?” “ Am I being punished for something I have done?” “Did I take care of myself when I was pregnant?” Can transform into religious or spiritual blame It is normal but you must find a way to let go of the blame
  5. 5. Long-term consequences Long-term consequences  Financial problems  Marital problems  Work problems  Continued uncertainty and fear/worry  Hospitalizations etc. “Rollercoaster”
  6. 6. Responses (cont’d) “You can’t make it better. I think that’s the hardest thing I found: that Mommy couldn’t make it better.” Struggle for control over their lives Strain of not being able to help a child in pain Changed life (unplanned and unexpected) Burden of needing to follow a treatment regimen Increased parental distress Increased negative affect  Most of these responses are NORMAL
  7. 7.  Taking care of a chronically ill child is one of the most draining and difficult tasks a parent can face
  8. 8. Effects of parental mental health onchildren Greater emotional distress (in mothers) -> higher levels of reported pain More psychological distress -> greater pain related disability in youth Parental reports of mental and physical health is related to the psychological adjustment and functional status of children
  9. 9. What to look out for Depressed mood Diminished interest or pleasure in activities you used to enjoy Decreased appetite/weight loss Sleep problems Fatigue/loss of energy Increased tearfulness Feeling hopeless and helpless Problems with attention/concentration Excessive worry/nervousness Intrusive thoughts/worries Increased irritability *thoughts of death
  10. 10. Rates of mental health problems Lifetime Prevalence rates for adults (in the general population)  10%-20% depression  16%-20% for anxiety Lifetime Prevalence rates for adults with chronically ill children  Approx 30% for depression  Up to 55% for anxiety
  11. 11. Mental health in parents of childrenwith JIA Parents (specifically mothers) are at heightened risk for mental health problems Association between perceived impact of JIA on the family and mothers’ mental health Association with medications the child is prescribed
  12. 12. Our working model • Biology cannot be separated from other experiences • Social context is essential to consider • Change is part of each level of experience
  13. 13. What can you do? Educate yourself Talk openly with your child Do NOT neglect your relationship with your significant other  Set aside time to spend together  Communicate openly with your partner  Respect your partners’ opinions  Have a “game plan” for working together  Be on the same page as much as you can  Counseling, if necessary
  14. 14. What can you do? (cont’d) Identify positive coping strategies  Respect individual differences in coping Social support  VERY IMPORTANT  “In order to receive help, you have to ask for it.”  Friends and family  Parent-to-parent support groups  JIA professionally led peer support groups  Internet based support groups  Religious support groups
  15. 15. What can you do? (cont’d) Focus on the joys and accomplishments of today—a smile, interest in a favorite toy, contagious laughter —not on what tomorrow may or may not bring. Your feelings are valid, so be easy on yourself to not feel guilty when you have had a bad day. Find a way to release your anger, sadness, jealousy and elation.
  16. 16. Stress reduction strategies Take time out for yourself  Walk  Exercise  Read  Cook  Warm bath
  17. 17. Stress reduction strategies (cont’d) Scripted Relaxation strategies  Deep breathing  Progressive Muscle Relaxation  Guided visual imagery techniques  Hypnosis
  18. 18. Deep Breathing Lie down or sit in a comfortable chair, maintaining good posture. Your body should be as relaxed as possible. Close your eyes. Scan your body for tension. Pay attention to your breathing. Place one hand on the part of your chest or abdomen that seems to rise and fall the most with each breath. If this spot is in your chest you are not utilizing the lower part of your lungs. Place both hands on your abdomen and follow your breathing, noticing how your abdomen rises and falls. Breathe through your nose. Notice if your chest is moving in harmony with your abdomen. Now place one hand on your abdomen and one on your chest. Inhale deeply and slowly through your nose into your abdomen. You should feel your abdomen rise with this inhalation and your chest should move only a little. Exhale through your mouth, keeping your mouth, tongue, and jaw relaxed. Relax as you focus on the sound and feeling of long, slow, deep breaths.
  19. 19. Deep Breathing (cont’d)Complete Natural Breathing Sit or stand with good posture. Breathe through your nose. Inhale, filling first the lower part of your lungs then the middle part, then the upper part. Hold your breath for a few seconds. Exhale slowly. Relax your abdomen and chest. Practice these two exercises, in whatever combination feels best for you, for ten minutes, twice a day. (Taken from Davis, Eshelman, and McKay; The Relaxation and Stress Reduction Workbook, 2nd edition; New Harbringer Publications, 1982.)
  20. 20. Progressive Muscle Relaxation (PMR) Progressive muscle relaxation is an exercise that relaxes your mind and body by progressively tensing and relaxation muscle groups throughout your entire body. You will tense each muscle group vigorously, but without straining, and then suddenly release the tension and feel the muscle relax. You will tense each muscle for about 5 seconds. If you have any pain or discomfort at any of the targeted muscle groups feel free to omit that step. Throughout this exercise you may visualize the muscles tensing and a wave of relaxation flowing over them as you release that tension. It is important that you keep breathing throughout the exercise.
  21. 21. PMR (Cont’d) Begin by finding a comfortable position either sitting or lying down in a location where you will not be interrupted. Allow your attention to focus only on your body. If you begin to notice your mind wandering, bring it back to the muscle you are working on. Take a deep breath through your abdomen, hold for a few second, and exhale slowly. Again, as you breathe notice your stomach rising and your lungs filling with air. As you exhale, imagine the tension in your body being released and flowing out of your body. And again inhale…..and exhale. Feel your body already relaxing. As you go through each step, remember to keep breathing . Now let’s begin. Tighten the muscles in your forehead by raising your eyebrows as high as you can. Hold for about five seconds. And abruptly release feeling that tension fall away. Pause for about 10 seconds.
  22. 22. PMR (cont’d) Now smile widely, feeling your mouth and cheeks tense. Hold for about 5 seconds, and release, appreciating the softness in your face. Pause for about 10 seconds. Next, tighten your eye muscles by squinting your eyelids tightly shut. Hold for about 5 seconds, and release. Pause for about 10 seconds. Gently pull your head back as if to look at the ceiling. Hold for about 5 seconds, and release, feeling the tension melting away. Pause for about 10 seconds. Now feel the weight of your relaxed head and neck sink. Breath in…and out.
  23. 23. PMR (cont’d) In…and out. Let go of all the stress In…and out. Now, tightly, but without straining, clench your fists and hold this position until I say stop. Hold for about 5 seconds, and release. Pause for about 10 seconds. Now, flex your biceps. Feel that buildup of tension. You may even visualize that muscle tightening. Hold for about 5 seconds, and release, enjoying that feeling of limpness. Breath in...and out. Now tighten your triceps by extending your arms out and locking your elbows. Hold for about 5 seconds, and release. Pause for about 10 seconds.
  24. 24. PMR (cont’d) Now lift your shoulders up as if they could touch your ears. Hold for about 5 seconds, and quickly release, feeling their heaviness. Pause for about 10 seconds. Tense your upper back by pulling your shoulders back trying to make your shoulder blades touch. Hold for about 5 seconds, and release. Pause for about 10 seconds. Tighten your chest by taking a deep breath in, hold for about 5 seconds, and exhale, blowing out all the tension. Now tighten the muscles in your stomach by sucking in. Hold for about 5 seconds, and release. Pause for about 10 seconds. Gently arch your lower back. Hold for about 5 seconds, relax. Pause for about 10 seconds.
  25. 25. Guided Visual Imagery Visual imagery is a process that affects every aspect of your body. During guided imagery, you control your breathing and relax your muscles. You focus on something specific – such as a therapist’s voice or the instructions on a DVD or audio tape. You enter into a state of deep relaxation, success, and wholeness – similar to meditation.
  26. 26. Hypnosis Hypnosis is the induction of a deeply relaxed state, with increased suggestibility and suspension of critical faculties. Once in this state, sometimes called a hypnotic trance, patients are given therapeutic suggestions to encourage changes in behavior or relief of symptoms. Hypnosis for a patient with arthritis might include a suggestion that the pain can be turned down like the volume of a radio.
  27. 27. Self Help Books Depression  Burns, D.D. (1999) The feeling good handbook: New York, NY: Penguin Group (USA)  Pettit, J., Joiner Jr., T.E., & Rehm, L.P. (2005). The interpersonal solution to depression. Oakland, CA: New Harbinger  Addis, M.E. & Martell, C.R. (2004) Overcoming depression one step at a time. Oakland, CA: New Harbinger  Strosahl, K.D. & Robinson, P.J. (2008) The mindfulness and acceptance workbook for depression. Oakland, CA: New Harbinger
  28. 28. Self Help Books (cont’d) Anxiety  Zeurcher-White, E. (2998). An end to panic. Oakland, CA: New Harbinger  Greenberger, D. & Padesky, C.A. (1995)Mind over mood. New York, NY: Guilford Press Insomnia  Hauri, P. & Linde, S. (2996). No more sleepless nights, Revised Edition. Hoboken, NJ: Wiley
  29. 29. Self Help Books (cont’d) Stress  Davis, M., Eshelmen, E.R. & McKay, M. (2008). The relaxation and stress reduction workbook. Oakland, CA: New Harbinger
  30. 30. Quote “I have learned, and grown, moresince Johnny’s birth than any othertime in my life. You learnpatience, and you get to witnessmiracles that you otherwisewould have been too busy to havenoticed... You learn acceptance,you realize you have been wrongto judge, and you learn that thereis a thing called unconditionallove.”
  31. 31. Thank you Contact Information Tina Drossos, Ph.D. University of Chicago 773.702.5887 tdrossos@yoda.bsd.uchicago.edu

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