Author: Dr. Linda

  • Postpartum Mood Disorders

    Postpartum mood disorders are treatable–Support, medications, hormones, other helps are available.

    Dr Linda Helps – If you’ve ever dealt with a postpartum mood disorder, you know what a frightening and sometimes shameful experience it can be. One moment, you are happy, the next crying. Some days are great. Other days are met with confusion and hopelessness. You may have thoughts about hurting your baby or have panic attacks that feel like you are dying. You may have bizarre fantasies like throwing your baby out the window or toasting her in the oven. Maybe you feel obsessed and check your baby’s crib every 15 minutes.

    Symptoms vary and range from mild blues to a severe form of the disorder called postpartum psychosis. It is rare but occurs in about one in a thousand women. Symptoms include hallucinations and delusions that sometimes place the safety of a baby in danger. Therefore, quick intervention is needed.

    Since the disorder has a psychological component as well as hormonal and biochemical ones, what should a mother do who finds when gripped by this condition? In the past, women have suffered in silence, feeling horrible and ashamed. Others have been given advice like, “Drink a glass of wine or take a tranquilizer.” Today, although we don’t completely understand the causes of this disorder, we have treatment options.

    Support groups can help women deal with the psychological issues related to the disorder and possibly prevent recurrence. Group meeting provide a place for women to tell their stories and discharge guilt related to feeling less than ideal mothers. Hearing other women talk who experience similar symptoms is reassuring. You soon realize you are not alone. Group members usually share strategies to cope with negative thoughts, depression and anxious feelings.

    Physicians can offer antidepressants and mood stabilizers. According to Dr. Rex Gentry, a Bellevue hospital psychiatrist, research has not found any heightened risks for birth defects when pregnant women take Prozac, Paxil or older tricyclic antidepressants. He believes that if you weigh the developmental risks of a mother’s depression on the fetus, careful drug prescription used to stabilize mood disorder during pregnancy may be a safe prevention strategy.

    But breast-feeding women are not usually prescribed Prozac because it is metabolized more slowly and can accumulate in the baby’s liver. Also Lithium, often prescribed for bipolar disorder, is not prescribed for nursing women.

    A group of English and now American doctors are experimenting with progesterone and /or estrogen treatments given immediately following birth. The intent is to stabilize hormonal changes that might precipitate the disorder. Estrogen and progesterone rise to many times their normal levels before birth and then drop after delivery.

    Hormones changes are not the only explanation for these mood disorders since fathers and adoptive parents can also develop them. Researchers continue to look at factors like sleep deprivation, lack of social support, family history of depression, expectations and attitudes about new parenting and the baby’s temperament. The more we know, the better we can prevent the problem.

  • Marriage: What We Learn from Hosea

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    Couple unhappiness can be remedied!

    Dr Linda Helps – Too many couples divorce over fixable problems. When I talk about fixable problems I am referring to couples who stop liking each other, grow apart and refuse to work on their marriages. Today, Christian couples have allowed their unhappiness to become an acceptable reason for divorce.

    After seeing hundreds of couples in marital therapy over my 20 years in clinical practice, I can’t deny the growing numbers of people dissatisfied with their relationships and even hostile towards their once chosen mates. Relationship pain is real and hurts. However, an escape plan is not the answer. Couple unhappiness can be remedied. But, it takes work, perhaps even counseling.

    The Bible clearly establishes God in covenant with His people. He then uses this covenant as a model for marriage. Both are defined as an unbreakable promise. The Bible is full of difficult covenant relationships in need of reconciliation. In fact, the most unusual is Hosea and Gomer. God instructs His prophet, Hosea to marry Gomer, “a wife of harlotry” (Hosea 1:2). During this period in history, God is disgusted with His people for their unfaithfulness and idolatry. The marriage of Gomer and Hosea, a symbolic and real act, deals with broken covenant and God’s desire to restore. Hosea endures the emotional pain of spouse betrayal, works through the restoration process and redeems the woman who has wronged him.

    More couples could learn from the Hosea story. Sin is acknowledged, repentance happens, emotional pain is embraced and the couple eventually transformed. The power of God’s redemption is once again revealed.

    An application of this powerful story is that healing is possible even when couples have a “biblical out.” Restoration and reconciliation are repeated biblical themes. Through out history God goes to extreme measures to woo his chosen and win back their hearts.
    Sadly God’s covenant, whether in relationship with Him or marriage, is constantly challenged by our idolatry, adultery and rejection. We easily complain, feel abandoned when prayer isn’t immediately answered and become distracted by things that pull us away from intimacy. Then, like in our marriages, we stare into space, feeling numb and wonder, “What happened? I don’t feel intimate or connected.” Emotional distance ensues, a predictor of relationship breakup.

    In my book Divorce Proofing Your Marriage, I expose ten common lies people embrace that eventually leads to divorce. This book confronts our thoughts, beliefs and assumptions that influence how we behave and the choices we make. So if you want to strengthen your marriage or stop the slippery slide to divorce, first check your thoughts and ask, “Are my thoughts reflective of the secular culture or the Bible?” You may be surprised how far your thinking has strayed from the Bible’s restorative theme.

    Here’s a brief overview of the 10 lies that lead to divorce. Do your own self-check.

    Lie #1: Marriage is a contract. Yes marriage is a legal contract but in God’s eyes it is much more. The truth is marriage is a covenant, an unbreakable promise. It is life commitment. It means “for better or worse, richer or poorer, in sickness and in health.” It means loving someone when you don’t feel like it, staying faithful and working through difficulty and bad times.

    Lie #2: I married you, not your family. The truth is you don’t marry just your spouse; you get her family as a package deal! Don’t kid yourself and think the outlawed in-laws don’t matter. Your spouse grew up in a family that taught her how to be who she is today. Yes, there are other influences and people can change, but family is a primary force in the development of any individual.

    Lie #3: I can change my spouse. Wrong! The fact that she’s continually late or her apartment is a mess is not likely to change because of your undying love. Pay attention to the red flags you see during the dating relationship, especially the more serious ones like drinking too much, violent temper, promise breaking, etc. Chances are these things won’t improve but worsen after the honeymoon is over. The truth–all you have control over is your reaction to your spouse–that’s the only part you can change.

    Lies #4: We are too different. Differences are not a major problem as long as the differences are not about life values and morals. Incompatibility doesn’t kill a relationship. The real issue is how you handle your differences. You need compatible styles that work for both people. Some differences are unsolvable and couples need to learn to accept those. And the Bible gives clear guidelines on how to deal with conflict in a Christ-like way.

    Lie #5: I’ve lost that loving feeling and it’s gone, gone, gone! Intense passion doesn’t last forever but love can stay for a lifetime. You may not always feel love but you must determine to love your partner as yourself. The loving feeling dwindles when couples lock into negative patterns that lead them away from each other. Criticism moves to contempt and highly defensive behavior that eventually leads to emotional distance. The truth is you can restore that loving feeling with a number of changes. One is to make five positive statements to your spouse for every negative one. Other changes focus on building friendship and support. I don’t doubt when men tell me they no longer feel love for their wives. I just want them to understand that loving feelings can be rekindled.

    Lie #6: A more traditional marriage will save us. Out of frustration, many men feel that if their relationship could be more like the Brady Bunch couple, life would be happier. They are confused about gender roles and responsibilities. Submission is a misunderstood and often abused concept. God’s intention for marriage is gender equality. On two occasions, God revealed His will on earth concerning gender–in the Garden and in the life of Christ. Look to those examples of how men and women should interact. You will find that no matter how you negotiate the relationship, you need mutual submission, respect, honor, empowerment and empathy.

    Lie #7: I can’t change–this is who I am: take it or leave it. An unwillingness to change is rooted in rebellion. It’s doing things your way versus God’s. To say you can’t change obviates the entire Christian experience of salvation and change of heart. Yes, we are always striving for perfection but the operative phrase is that we should be striving. This requires a willingness to look at your behavior and work towards being more like Christ. If both spouses in marriage would do this regularly, divorce would be less prevalent. Change doesn’t happen when you don’t embrace it. You can change but it requires desire, obedience and Holy Spirit driven power.

    Lie #8: There’s been an affair. We need to divorce. Affairs are serious and damaging but they are not beyond repair if both spouses agree to try. There must be a commitment to cut off the affair, a time of repentance, forgiveness and a rebuilding of the relationship. The covenant has been broken but can be restored if a couple chooses to do so. It’s not easy but possible.

    Lie #9: It doesn’t matter what I do: God will forgive me. God will forgive you if you repent but it does matter what you do. Your behavior has natural, as well as spiritual consequences so don’t cheapen God’s grace.

    Lie #10: It’s too broken. Nothing can fix this relationship. If you’ve given up, the future looks hopeless, you’ve grown apart, can’t manage conflict, made a mistake or whatever the problem, believe that God can work when you can’t. He can change hearts, do miracles and work in the most difficult circumstances. He is the God of the possible. Draw close to Him, intercede for your marriage, do battle with your true enemy (Satan) and expect God to work on your behalf.

    If you and your partner stay intimately connected to God, your marriage will reflect that intimacy. Divorce doesn’t have to happen. Recognize the cultural lies that influence you and counteract them with biblical truth. No marriage is beyond the probability of divorce but you can be proactive in preventing it. It’s time to improve on the divorce statistics and divorce proof your marriage.

  • After the Admission of an Affair

    Admission of infidelity is a first step towards reconciliation.

    Dr Linda Helps – Susan was devastated. Her husband Dan was supposed to be in Cleveland on business. Instead he was seen vacationing in the Virgin Islands with a female co-worker. The betrayal took her by surprise. She couldn’t believe Dan would risk the ten-year marriage for another woman.

    Susan called a therapist. Dan admitted to the affair. He apologized profusely and cut off all contact with the other woman. The hurt and anger in Susan’s face was hard to bear. Dan hoped that by apologizing and admitting his sin that Susan would get over the affair. He felt his apology and cut off from the other woman was enough to reconcile the relationship.

    But Susan couldn’t stop thinking of the betrayal. She found herself obsessing on thoughts of the other woman. She worried Dan would be unfaithful again. She felt guilty. Dan had apologized and promised not to ever have an affair again. Dan went back to church, talked to the minister and put himself under the accountability of a men’s group. But Susan couldn’t sleep and was anxious.

    Susan sensed Dan was mad at her for not “getting over” the affair. Dan said, “Forget it ever happened. Why are you still talking about it when it’s over?” He was frustrated with her nervous anxiety whenever the phone rang late at night. He resented her constant questioning about late business meetings.

    Dan and Susan represent many couples stuck in the aftermath of an affair. They think because the affair is acknowledged, things should go back to the way they were before. They don’t recognize the traumatizing effects of the affair.

    Susan never really talked at length about her feelings regarding the infidelity. She was too afraid Dan would leave the marriage and felt vulnerable due to her financial dependence on him. All through her marriage she avoided conflict. She pretended to believe everything was great when it wasn’t.

    Dan apologized but showed little remorse. He broke the marital covenant and expected Susan to be over it much too quickly. He didn’t understand the trauma his wife experienced. The apology wasn’t enough.

    Dan needed to:

    · Share his feelings of remorse more than once
    · Allow Susan to question him and give reassurance
    · Be empathetic for the pain his actions caused Susan
    · Understand Susan’s reactions were typical
    · Learn to share his emotions including his fear that Susan may leave
    · Be patient. His wife needed time

    Susan needed to:

    · Have time to process, talk and explore her feelings more deeply
    · Understand that the injured spouse usually has post -traumatic stress like symptoms (difficulty sleeping and concentrating, hyper-vigilance and intolerance for things that brought up memories of the affair)
    · Be allowed to question Dan whenever she needed reassurance
    · Not feel guilty when she needed to talk more about what happened

    Admission of infidelity is just the first step of reconciliation. The betrayal raises complicated emotions that don’t usually fade away without additional work. A one-time apology is not enough to cover the reactions of the partner. Your partner needs to forgive but also process his/her reactions over time. The one who committed the offense needs to be patient and humble.

  • Emotional Reaction to Affairs

    What’s normal when it comes to reacting to a marital affair?

    Dr Linda Helps – Kathy had never seen a therapist before her husband announced he was having an affair with another woman. The shock of his disclosure was enormous. She repeatedly asked herself, “How could I have missed the signs and been so naïve? Have I been in denial of our marital problems?”

    Kathy didn’t consider herself prone to anxiety. However, since the disclosure, she has had several anxiety attacks. She could be doing laundry and suddenly feel short of breath. Or she might be reading a book and feel her heart pounding and palms sweat. Watching TV could send her into an agitated state, especially if the show contained reference to a marital affair. Sleep seemed to elude her. She had no appetite and was rapidly losing weight.

    Even though her husband claimed to have stopped seeing the “other” woman, Kathy felt uneasy and deeply betrayed. She found herself obsessively thinking about the other woman having intimate conversations with her husband. When she closed her eyes, she envisioned him holding her hand and caressing her.

    Kathy found herself monitoring her husband’s every movement. Little things upset her and she was highly suspicious. She couldn’t shake the mental picture of her husband in bed with another woman. Intrusive thoughts flooded her mind. Kathy felt like she was losing it. She needed to bounce all this off of a therapist to see if she was going crazy.

    When an affair has been found out, it is common to have reactions like Kathy’s. Anxiety attacks and grief-like symptoms are normal reactions to the breach of marital covenant. In many ways, the reactions of the non-involved spouse are similar to post traumatic stress symptoms for those who have been emotionally, physically and sexually abused. The reality of an affair awakens a deep sense of loss. You may feel you are going crazy. This is normal.

    Couples that deal with an extramarital affair do have higher rates of depression than couples who come to marital therapy for other reasons. 1 Some partners are even suicidal. It’s also not uncommon to hear homicidal rage towards the lover.

    Given this emotional instability and intensity, the safety of people involved must always be considered. While not all people will act out their intense feelings of betrayal and rage, the risk is there and does happen. Turn on the nightly news and you’ll get a glimpse of what betrayed people can do!

    It’s important to know that you won’t feel like this forever and that what you feel is valid given the circumstances. The intensity is strongest when the affair is found out because you realize that you have been deceived and that your marital vows were broken. The goal is to mange those feelings so that you don’t become incapacitated by them.

    · Allow yourself to feel whatever comes.

    · Don’t deny the intensity of your emotions.

    · Work with a therapist who can help you express what you feel and help you manage those feelings.

    · Pour your heart out to God. He hears your pain and promises to comfort you even in difficult times.

  • Weight Loss: Looking for the Magic Pill

    Are you searching for the magic pill that will make pounds melt away?

    Dr Linda Helps – We are a pill-popping society. When we feel bad, we take something to feel better. Americans are in love with drug solutions to anything. Pill popping is easy, convenient and doesn’t make us deal with the complicated issues of life. Temporary relief is the goal.

    This pill-popping mentality is all around us. On the one hand we tell our children and teens not to take illegal drugs or misuse medications. On the other hand, we model the opposite by popping a pill for every ache and pain. Nowhere is the quick-fix mentality more evident than when you look at weight loss products. The number of products on the market claiming to make you lose weight is staggering. I am amazed at what people will swallow to reach the thin ideal of American beauty. Billions of dollars are wasted on elusive promises to melt away pounds. We covet the magic pill and we’ll try anything in an effort to find it.

    At present there is no magic pill. We are still searching for a better understanding of the molecular biology of obesity. If we truly understood the causes of obesity we could do more than treat the symptoms. But until that happens, pharmacological solutions for obesity remain hopeful but not yet proven.

    Science continues to bring us new treatments but we need to wait for proof of their effectiveness. Remember the fenfluramine hydrochloride and dexfenfluramine hydrochloride fiascos. Wyeth-Ayerst Laboratories in Philadelphia, PA., the American distributor of fenfluramine and dexfenfluramine, voluntarily withdrew these meds from the market in September 1997 at the request of the Food and Drug Administration.

    Then there was phen-fen (phentermine and fenfluramine). Obese patients were flocking to physicians for phen-fen prescriptions. They were desperate to find the right combination of drugs to make those pounds drop.

    At the height of the phen-fen popularity, I was working with an internist who studied the research of Michael Weintraub and colleagues at the University of Rochester in New York. The results indicated these medications were less than exciting in the long run. Then, national concern about possible serious side effects related to valvular heart disease surfaced. People who jumped on the phen-fen bandwagon were left wondering what damage they may have done to their physical bodies and over time, gained back most of their weight loss.

    Since that time, newer agents have been approved–sibutramine and orlistat. Again, time and research will tell if long-term results can be maintained without significant risks. The question continues to be, what amount of sustained weight loss is considered successful and worth the risks? Is a 5% reduction in weight worth the long-term effects of continued drug use?

    The search goes on as we learn more about genetic influences after the 1994 discovery of the ob gene and its protein product leptin. The hope is that pharmacology will eventually cure obesity. The wish of many is that a magic pill will be discovered and our obesity problems solved. In the meantime, keep doing the sensible things we know to do: eat healthy, exercise, and change your lifestyle. It may be awhile.