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There are many things that might impact a woman’s mental health. Some of these worries might be related to gender stereotyping or assumptions and concerns related to women’s health, but they can also include other challenges faced by women. It is best to avoid making assumptions based on gender as a person’s identity is multifaceted and no single aspect defines a person entirely. Women may experience particular biological, environmental and psychosocial challenges related to gender and these anxieties may have a significant impact on mental health and well-being.

Understanding Mental Health in Women

Some mental and physical health fears women face may be related to gender. Not only are women more likely to experience mental health concerns such as depression or anxiety, women may also experience mental distress at a higher rate than men do. Challenges faced by women may occur more as a result of gender-based stereotypes, assumptions or some other cause. Biological, environmental and psychosocial factors may at least partially contribute to the development of certain mental and physical health concerns. These may be somewhat impacted by gender but a woman may easily develop concerns that have nothing to do with gender. Issues such as gender socialization, prevalence of domestic violence and lower socioeconomic status can all contribute to health disparities. A single mother who has a full time job but still finds it a challenge to pay her bills each month may be at a greater risk for depression, anxiety and stress. Pressure to succeed both at home and work often has a negative impact on mental health.

Mental Health Care in History

In terms of mental health, women have historically faced disproportioned scrutiny for thousands of years. Terms such as crazy, hysterical and mad have been used for generations, stigmatizing and diminishing the experiences of women facing both mental and physical health challenges. In the late 1800’s, when psychology was in its infancy, mental health treatment for women was not widely practiced. Often referred to as the “weaker sex”, women were considered to be fragile and more emotional than men. Hysteria, a label used to diagnose a number of “symptoms” women may exhibit, was considered to be a disease, experienced exclusively by women. Women who behaved in ways and held beliefs not according with the social norms of the time were often diagnosed with hysteria and a wide array of protocols were employed to treat hysteria and other similar problems. These “treatments” often included involuntary commitments (sometimes for life), sexual interventions, lobotomies, hydrotherapy and electroshock therapy.

Mental Health Care Today

Today, mental health care in women has vastly improved, but additional improvements may further support the effective treatment of mental health concerns among women. Woman are more likely than men to develop a mental illness as women tend to view themselves more negatively than men and that is a vulnerability factor for many health problems.While research indicates women may be more likely to experience a mental health concern, not all women will experience a health challenge, and a mental or physical health concern may be experienced in different ways. Some mental health concerns commonly experienced by women include:

• Depression
• Anxiety
• Postpartum Depression
• Postpartum Psychosis
• Posttraumatic Stress
• Eating Disorders
• Borderline Personality
• Mood-Related Challenges
• Self-Harming Behaviours

Social and Cultural Issues

Both mental health professionals and those seeking treatment may wish to maintain an awareness of the various social and cultural constraints woman may experience. Traditionally, women were typically assigned the roles of caretakers and nurturers, while in reality they are capable of being caretakers, providers, nurturers, professionals and holding any number of roles. Evolving roles and less emphasis on identity based on gender have helped some challenges in these assigned roles, but women often still face a sociocultural challenge that contribute to a greater risk of mental and physical health concern.

Sexism/Oppression: Women have experienced some degree of oppression in many cultures across history. This discrimination, which still happens today, can stifle the growth, development and general well being of women around the world. Women may be forced into marriage, be denied basic rights, and excluded from certain professions. Even today, women are still underrepresented in many fields and are often paid a lower wage than men.

Abuse/Intimate Partner Violence: Women are statistically more likely to be victims of abuse and intimate partner violence. Surviving these types of abuse may influence the development of depression, posttraumatic stress or anxiety.

• Adverse Portrayal in Society and The Media: Media portrayals of women may skew expectations of what women “should” look like. Many studies have explored the link between self-esteem/self-worth and exposure to media’s representation of the “ideal” female. The frequent media depiction of women as sex symbols can be problematic as women may often be socially expected to maintain both the image of chasteness but be available to men who pursue them. The clothing choices and sexual behaviour of women and young girls are often both policed by society in general.

Motherhood

Another major issue unique to women is the complexity and significance of motherhood. The ability to reproduce and carry a child may bring joy and satisfaction, but the prospect of motherhood also delivers a number of potential health risks. Pregnancy, childbirth, menopause and aging sometimes bring emotional challenges with them. Challenges also arise when women encounter problems with infertility, postpartum depression and a range if concerns to sex and sexuality. In addition to the effects of mental health, these concerns can have a lasting effect on both mother and child. A mother’s mental health can impact the mental health of a child. If the child develops behavioural and emotional problems, this can place added stress on the mother, thus establishing a cycle of challenges for the entire family

Laurian Ward Psychologist Pretoria East Coping With Anticipatory Grief

Let Children Express Their Grief

Children can also experience anticipatory grief. It is important for kids to work through their grief. Children often have fewer chances to express themselves. Studies have shown that children who do not have the opportunity to grieve are more likely to struggle with anxiety and depression later on in life.

Children need to be included in the grieving process; they need a safe place to express themselves. There are some myths that children do not feel an impending loss as deeply and a study has shown that parents with a terminal illness are not aware of how deeply distressed their children are. But on the other hand, the same study also found that these children learned to value other family relationships much more than children who do not have parents with a terminal illness

Talking about death with a child who has a very ill parent has been shown to help. It can help to decrease anxiety, depression, and behavioural problems. Children need to know they are cared for and will be cared for after death, they need to understand they are not being abandoned.

Consider Journaling

Keeping a journal can be healing as it can help you express things you would not normally feel comfortable sharing with a friend. Some people prefer a private journal or may want to use an online blog to share their experiences with others going through a similar situation.

You may also want to try writing letters to your dying loved one as it might help you say all the things you wanted to say.

If you are the person who is dying, consider writing letters to your children or other family members. Letters are a great way to express emotions and can be a gift to those left behind.

Nurture Your Spirituality

Spirituality is very important for those who are dying and for their caregivers. This can come in many forms:
• Religion and Prayer
• Meditation
• Communing with nature
• Listening to music that is meaningful to you

It has shown that people have a better quality of life in their last days if they have an active spiritual life. Caregivers may also experience less depression if their loved one has an active spiritual life. What is good for the dying person may also be good for their loved ones.

Maintain a Sense of Humour

There is not always much room for humour when someone is dying, but in the right setting, humour can sometimes be healing. It may take some thought and time to bring humour to your loved one as it is helpful in many ways, but it is also important to not trivialize your loved one's situation. Do not make jokes about pain as an example.

One person might enjoy funny emails and memes, others may enjoy comedy movies or series. Laughter may not always be helpful, but sometimes it can lighten a heavy mood a bit.

Practice Forgiveness

Forgiveness is healing. Learning to forgive yourself is just as important as forgiving others. The time before death is extremely emotional. There may be anger and resentment among family members but this is the time to resolve differences.

Listening is an important step toward forgiveness. People often say the same things but in different ways. But sometimes there are clear differences. When you are irritated with another family member, ask yourself “is it more important to love or to be right?”

Give Your Loved One Permission to Die

A dying person may remain until a specific moment, for example. They may wait for a graduation, a birthday or a visit from a loved one. Some people seem to wait to die until a loved one says goodbye. This goodbye can act as permission to die. This can be helpful for the dying person and for loved ones. A goodbye can be a beautiful gift.

Summary

Anticipatory grief is the grief you feel before a person has died and it is a common experience. There are many ways to cope, but everyone grieves in different ways. It is important to let yourself grieve. It may be helpful to find a friend or a counselor to talk to who will not judge you or offer unwanted advice. Try spending time with your dying loved one, even if it is hard. Talk to children about death and grief and let them express themselves.

How to Cope With Terminal Illness

Dealing with the news of a terminal illness can be a long process. When you find out about a terminal illness, whether it affects you or a close friend or family member, is difficult. There are many complex emotions and challenges that will need to be navigated during this period and you may feel overwhelmed or incapable of handling it all. The most important thing is to be kind and patient with yourself and your support system as you manage an illness and what steps it might bring.

If You Have Received a Diagnosis

When you receive the news, you will likely feel overwhelmed with many different emotions and with what the diagnosis truly means. Over the course of this journey, there are a few steps you may want to take.

Educate and Inform

Many things are going to feel out of your control after receiving a terminal illness diagnosis. One of the steps you can take to feel empowered and to make the right decisions for your personal needs is self-education and staying informed. You should be aware of potential complications. Speak to your doctor about options in order to make informed choices about your personal health and well-being.

Speak With a Grief Professional

Friends and family members can be amazing support systems, but there is a benefit to seeking the counsel of a grief professional after receiving a diagnosis. It can be difficult to be honest with the people we love for fear of upsetting them, and counselors have resources and training specifically for your needs.

Find a Group

In addition to the support of a grief counselor, you may wish to look for the support of individuals sharing the same experience as you. Support groups can give you the opportunity to be candid and honest about your experiences with others who genuinely understand, and they can provide a sense of community and support that can be important after a difficult diagnosis.

Make Plans

There are many important plans you will need to put into place after your diagnosis. You will want to discuss your medical needs and possibilities with your healthcare team and decide what the next steps for pain management and care are going to be so that you can have control at the end of life.

Be Kind to Yourself

A diagnosis may come with many conflicting emotions and fears, but it is essential to work toward peace and patience with yourself. When you feel guilty for things you may have done or not done, that you believe contributed to this outcome, it takes energy and time away that could have been spent with loved ones or doing the things you enjoy the most. You will experience changes and frustrations. Every emotion is valid and deserves consideration. When you are kind to yourself, you can reduce the amount of added stress, which leaves you with more time and energy to be with people and engage in joyful things.

Acknowledge It

Communication after a diagnosis is very important. Not only will these conversations help you complete any necessary tasks, it will also make it easier to say the important things. It is difficult to acknowledge an illness head-on, but there are many tools for starting those difficult discussions and it will also make space for your friends and family to tell you how they are feeling as well. If something is affecting you, tiptoeing around the topic can feel uncomfortable. Find a method for discussing the situation puts you at ease and allows you to say the important things.

Be Honest

If you have someone in your life whom you love very much, let them know. Even if you say the words all the time, it can give them joy and peace to keep those memories of your love with them in the future. If you are struggling to say something important, this can be the opportunity to open up and share what needs to be said. Alternatively, you can write it in a letter to them.

Do the Things You Want To Do

Do you want to watch the sunrise? Binge-read a favourite author and meet them for a signed copy of a new book? Take time to be with and enjoy the things you love and the things you feel you never had enough time to do. That can mean morning walks with a partner or trying new types of foods. If it makes you feel happy and gives you a sense of joy or peace, embrace the moment.

Conclusion

There is no one way to deal with news of a terminal diagnosis. Finding a support system, asking important questions, and learning what you can do to best advocate for your own or a family member’s needs are all very important. There are logistical and medical steps that should be taken as part of the end-of-life planning process to protect a person’s interests and wishes.

It is very important to respect the emotional journey and the many feelings that come along with such a diagnosis as they change over time.

Laurian Ward is here to offer guidance and resources so you do not have to do it all alone.

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Anticipatory Grief is different than your conventional grief. Anticipatory grief generally happens before someone dies, and conventional grief afterwards. This type of grief can be experienced by both the loved ones of someone who is nearing death and the person who is dying.

You may have different feelings when a loved one is dying. You may hold on to hope while also beginning to let go and these emotions can be deeply painful. People are less likely to get support for their grief in this time. People who have not been through this experience may react poorly, they may think  you are giving up on the dying person.

There are things you can do to help you cope with the grief you are feeling for the person who is still here.

Understanding Anticipatory Grief

This type of grief is a deep sadness that is felt during the last days of life. Grief before death gives you a chance to say goodbye, which you don’t have when a loved one dies suddenly. But grief before death doesn’t replace or even shorten the period of grieving that follows death.

People sometimes use words like “battle” and “fight” to describe terminal illness. These metaphors incorrectly suggest that patients can “beat” their illness with enough effort. This alone can make it hard for the dying person and their loved ones to express their grief before death.

Not everyone feels anticipatory grief, but it is common.

Feeling grief while your loved one is still alive does not mean you are abandoning your loved one or giving up. Instead, this may give you a chance to gain meaning and closure you might not have had otherwise. You may feel like you are somewhere between holding on and letting go. Some people find this extremely painful as they may feel like they are betraying their loved one if they are leaning towards letting go.

The truth is it is possible to live with both holding on and letting go at the same time, you do not have to choose.

Allow Yourself To Feel And Grieve

Let yourself feel the pain as this helps you be honest and true with yourself. Anticipatory grief is not just grief for the coming death of a loved one, it is also grief for the other losses that go along with death, such as:
• The loss of a companion
• The loss of shared memories
• The loss of dreams for the future

Sometimes, past grief may resurface during this time. Denying the pain you feel now may prolong grief later on. Grief serves a purpose, whether it occurs before death or after death.

Researchers have identified four phases and tasks of grief. The tasks include:
• Accepting the coming loss
• Working though the pain
• Adjusting to a new reality where your loved one is absent
• Connecting to your loved one in a different way as you move forward

This does not mean you should give up on your loved one or forget about them. These tasks help you hold onto the joy and love you once shared. They can also help you cope with deep sadness that may make remembering painful.

Express Your Pain: Don’t Do It Alone

It is important to let yourself feel pain. Many people find it hard to express grief before death. They may feel they are not feeling supportive of their dying loved one. Talking to a trusted friend is a good way to cope with these feelings. Nobody should have to face this grief alone. Keeping these feelings to yourself can lead to loneliness and isolation.

Anticipatory grief is similar to the grief you feel after someone dies. The one big difference is that there is often more anger and you may find it much harder to control your emotions.

Someone who does not have a loved one facing death has little understanding on how you feel. Even if someone who has been through the death of a loved one will have experienced it differently. It can be upsetting when someone tries to tell you what to do or how to feel. Some people react to this advice with anger, others simply shut down. Neither will help you cope.

Find a friend who does not judge and will let you express anger. This person should be a good listener and should not try to “fix things” or tell you how you should feel. If your friend does try to share unwanted advice, speak up. Let your friend know you want someone who will listen and not try and fix things.

There is no easy fix for your emotions but a good listener can help you feel less alone.

Spend Time With Your Loved One

People often talk about how hard it is to spend time with a dying loved one. They may not want to remember their loved one as they were dying, they want to remember how the person was before their illness.

Spending time with a loved one is important. This is true not just for the person who is dying but also for close loved ones. If you decide not to visit, you may regret your choice later.

Find meaningful ways to spend your time together. Share old photographs or memorabilia. Ask your loved one to share stories about family heirlooms and other possessions like jewellery. You may find that reminiscing can be cleansing. Consider making videos of your loved one sharing stories. These recordings can be shared with children, friends and other family members. You can even give your loved one a foot massage as this can help reduce pain or relax the person and it provides the needed touch. Reading your loved one’s favourite book out loud is another way to spend time together.

Everyone finds meaning in different things, in the end the activities you choose are not important. What is important is the time you spend together, even if it is in silence.

You may feel nervous about visiting your loved one, many people fear that they will break down and make their loved one’s grief even worse. Keep in mind that your loved one prefers to see you, even if there are tears. You may be scared your loved one will want to talk about their death. If you do feel anxious, take some time to think about and face your own fears. It is possible that you will upset your loved one more by avoiding the subject than talking about it.

Many studies have found that gendered role expectations in women have a disadvantage, but the same can be harmful to men too.

In a society where gender roles are still being challenged, most men still see themselves to be the breadwinners. Even as children, men are encouraged to be “strong and not cry”. Showing emotions, and seeking support or help in males are all seen as a sign of weakness. The image that men are taught to portray is that of a strong, silent, and dependable kind who is always in control and ready to be the savior. However, not every man lives up to these heightened and exaggerated concepts of masculinity. Some concepts are so ingrained in males that they may linger, even unconsciously.

Men are expected to be breadwinners and make a greater contribution financially towards the family than women in a traditional role. If for whatever reason men are not able to do that, it has a great impact on their mental health.

Men who make a lot more money than their partners may approach breadwinning with a sense of obligation and worry about maintaining the breadwinner status. Women on the other hand, may approach breadwinning as an opportunity of choice. Women may feel a sense of pride, without worrying about what others will say if they can’t or don’t maintain it. Study shows that men with negative psychological well-being are those who made significantly more than their partners.

Ass to this fact is that men are expected by society to not ask for help or to always be in control and the consequences can be dire. While serious mental illnesses may be more common in women than in men, men are much more likely to commit suicide. Men are more likely to abuse alcohol and drugs, something often intimately interlinked with mental wellbeing. Men are much more likely to suffer in silence and not seek help.

With more families having both partners working and contributing toward the financial burden, the social image is changing for the better. Men do not need to feel the sole burden of being the breadwinner or constantly worrying about losing their job and livelihood. It becomes more complex when the woman starts earning more than her partner and ego clashes start happening if not handled sensitively. Signs to look out for in your male partner that the pay cut/ laying off/ or wife being promoted is not having a positive effect on him, maybe irritability, anger outbursts, lack of motivation, sleep or appetite disturbances, and social isolation to name a few.

As society changes, so does the gender role definition. More males opt for paternity breaks and haring of the financial burden is not such a rarity but more of a norm. When women go on maternity breaks, men tend to be more stressed as the role change of becoming a father along with the pressure of being the sole earner in the family with added expenses of having a baby all play a part.

As we bring up a new generation, allow the boys to cry and say it is okay to have emotions and show them too. As they grow up watching their parents share not only financial burdens but also the responsibilities at home. Here is hoping that breadwinners and homemakers are no longer associated with one gender.