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Miscarriage is more common than one would think, but this information may be cold comfort if you are coping with a recent loss. Many women are surprised by the intensity of their emotions after a miscarriage. The feelings can range from shock and sadness to irrational guilt and anxiety about future pregnancies. Men may also struggle with feelings of loss and inadequacy and this is especially true if they are not sure about how to help their partner through this difficult period.

These feelings are normal, and the emotional healing process after a miscarriage may take some time. It very often takes much longer than the physical healing. Allowing yourself to grieve the loss can help you come to terms with the loss in the long run.

Dealing with Feelings

Technically speaking, a miscarriage is a pregnancy lost before 20 weeks. Unfortunately, 15-20% of known or diagnosed pregnancies miscarry, most before 12 weeks. Most miscarriages are caused by a genetic abnormality that keeps the foetus from developing normally. Everyday activities such as exercising, working and having sex do not cause a miscarriage. Yet many women still blame themselves.

In the weeks after a miscarriage, many women experience a roller coaster of emotions and at the same time, a woman who just had a miscarriage is going through a hormonal shift as her body readjusts to not being pregnant. Her changing hormones can intensify the emotions she is feeling.

Grieving your Loss

Some friends and family may tell women they should not be feeling such a sense of loss. This attitude is common when the miscarriage occurs early in the pregnancy. But an early loss is not necessarily easier to handle than one later in the pregnancy. Even if a woman was pregnant for only a short time, she may have been planning the pregnancy for many years.

If you have been through a miscarriage, remember that your feelings are normal. Some women are hit harder than others. Allow yourself to experience the grieving process in your own way and at your own pace. It is common to feel fine one day, and terrible the next.

Sharing experiences with other women who have been through the same thing is often reassuring. You will be surprised to find out how many women have been through a miscarriage. Joining a support group may help. If your feelings start to interfere with your ability to get along in daily life, or if your sadness does not lessen after a couple of months, talk with your counsellor. You might benefit from talking to a mental health specialist.

Coping as a Couple

Men and women respond to a miscarriage in different ways. Men often shift into problem-solving mode when faced with a crisis. They may end up feeling helpless when they are not able to “fix” their partner’s grief. Miscommunication is also a common problem. Often a man sees his partner cry when he talks about the baby, so he learns not to bring up the subject. And because he does not bring it up, the woman might feel he does not care, when he really does.

Experts advise men to show how much they care and to open up and share their feelings. For example, they can watch their other children and let the woman take time to rest or self-care, do the dishes, or take their partner out for a special dinner.

Ready to Try Again?

A common question many women have is when they will be able to try again. Talk to your health care provider as to what is best for you. In general, the first menstrual period occurs four to six weeks after a miscarriage. It is usually safe to conceive after one normal menstrual cycle. At times you may be advised to have medical tests first to determine the cause of your miscarriage. Also, your emotions may need a little more healing time than your body. It is best to wait until you are ready physically and emotionally before getting pregnant again.

Fears about suffering another pregnancy loss are common after a miscarriage. The reality is that many women who miscarry go on to have a healthy pregnancy the next time around. Don’t hesitate to talk to your health care provider and counsellor of any concerns you may have.

Laurian Ward Psychologist Pretoria East Panic Attack Anxiety Attack

With a panic attack or an anxiety attack, it is near impossible for the sufferer to know which of the mental health conditions they are experiencing since the symptoms of anxiety and panic attacks present in a similar way.

Symptoms Associated with Panic and Anxiety Attacks

  • Shortness of breath
  • Dizziness
  • Rapid heartbeat
  • Numbness and tingling sensations felt in the body
  • Rapid heart rate
  • Trembling or shaking
  • Hot flashes

What is the Difference Between a Panic Attack and an Anxiety Attack

People struggle to understand the difference between panic disorder and anxiety disorder, which means they often get interchangeable. In clinical practice, anxiety and panic disorders get identified as having different features, and mental health professionals use these terms to diagnose specific conditions and symptoms.

Panic Disorder

The diagnostic and statistical manual classifies panic attacks under an umbrella term known as panic disorder. A panic disorder gets observed in other psychiatric conditions too, however a person can experience panic attacks without any other mental health disorders present.

Anxiety Disorder

Anxiety attacks are currently not classified as a disorder under the statistical manual or mental health. However, anxiety is a term used to describe a set of features of several mental health illnesses under the umbrella term: Anxiety Disorder

Some of the anxiety disorders include:

  • Trauma Disorder
  • Stressor-related Disorder
  • Obsessive-Compulsive Disorder (OCD)

Panic Attack vs. Anxiety Attack

The differences between anxiety attacks and panic attacks are the intensity of the symptoms experienced and how long the symptoms occur

Panic Attacks

When someone experiences a panic attack, they usually experience sudden and intense feelings of discomfort, terror or fear. Other physical and mental symptoms accompany all of this.  The unpleasant signs and symptoms associated with panic attacks cause severe unease and dispruption in a person’s life.

Panic attacks usually happen suddenly, and without an exact trigger or external stimulus. They typically last a few minutes before subsiding, although some panic attacks may last longer. A person may also experience a succession of panic attacks that occur one after the other. Once the panic attack comes to an end, it is not uncommon for a person to feel shaken up, upset, emotional, and tired.

Physical  symptoms of a panic attack can include:

  • Dizziness, feeling faint or lightheaded, and unstable on the feet
  • Stomach trouble and nausea
  • Rapid heart rate and heart palpitations
  • Trembling and shaking
  • Chills and hot flashes
  • Excessive sweating
  • Shortness of breath and difficulty breathing
  • A choking sensation
  • Numbness or tingling in the body
  • Felling as though you might be having a heart attack or other life-threatening disease
  • Chest pain

Mental symptoms of a panic attack can include

  • Feeling as though you are losing control
  • Feelings of panic or dread
  • Feelings of unreality
  • Fearing that you are going crazy or dying
  • Feeling detached from yourself or your surroundings

Anxiety Attacks

Anxiety attacks operate differently from panic attacks and are a cumulative mental health condition that develops over time. Panic attacks happen suddenly, where anxiety intensifies over a long period and gets connected to excessive worry and long-term exposure to stress.

Anxiety symptoms vary and may feel like a panic attack at times, especially if a person’s stress levels become overwhelming to the point that they feel they are unable to cope.

Physical symptoms of an anxiety attack include:

  • Dizziness
  • Sleep patterns that are disturbed
  • Increased heart rate
  • Fatigue
  • Aches and pains in the body and muscle tension

Mental symptoms of an anxiety attack include:

  • Feeling restless
  • Difficulty concentrating
  • Irritability

Risk Factors

Anxiety is a prevalent mental disorder that affects many individuals. It is a fact while many people suffer from feelings of anxiety and panic, few people seek help and treatment from a mental health professional.

People must seek treatment for coping with anxiety and panic disorders, particularly as the intense fear (such as fear of dying) caused by anxiety and panic attacks, are conducive to a persons well being. Health information is helpful for people to understand the impact that anxiety and stress have on the body.

When a person experiences anxiety in the long-term, they are likely to be in a state of constant alertness, all of which triggers a fight or flight response making the anxiety symptoms worse.

Treatment Options

There are plenty of treatment options available to those experiencing anxiety and panic attack symptoms. Treatment may include various techniques such as mindfulness and meditation and other forms of therapy such as:

  • Self-help techniques. This may include breath work and various breathing exercises, all of which promote symptom management and a way to manage your feelings and take control
  • Therapy. This is beneficial for anxiety management and controlling the symptoms of anxiety. Therapy challenges any unhelpful thoughts that may lead to self-destructive thoughts, feelings, and behaviours, allowing a person to adopt a healthier coping mechanism
  • Medication. Is useful in controlling anxiety symptoms and may be used in the short term combined with other therapies
Narcissistic Personality Disorder Relationships

Loving someone who has narcissistic traits is not easy. The key traits of the narcissist may include a constant need for approval from others and an impaired ability to recognize the needs of others.  With long term treatments, narcissists and their loved ones can find help.

Being in a relationship with someone with this personality style can be very challenging. Narcissists tend to have an inflated sense of ego and entitlement, put themselves first, lack empathy and can become abusive to others.

It may be difficult for narcissists to recognize the distorted and unhealthy patterns of their thinking and behaviours. This can then make getting treatment especially difficult, although not impossible.

Seeking professional assistance is the start of any treatment. After taking this first difficult step and recognizing there is a problem, both of you can begin making progress towards a healthier relationship.

Relationship Patterns

Many narcissists are unable to accept themselves and others as integrated whole selves, complete with both good and bad qualities. Narcissists tend to judge others as either perfect or flawed, based on the treatment they are receiving. These traits manifest themselves in three fairly predictable patterns:

Idealizing Phase: Loving a narcissist is quite easy at the beginning of the relationship. People with narcissistic traits are charming in the courtship stage, largely due to their romanticized idea of the “perfect relationship”. For you, this may feel like the typical honeymoon phase that many couples experience early on in their relationship. For narcissists, this phase is much more extreme. It involves living out romantic fantasies, showing you and the rest of the world all their good parts without revealing any vulnerabilities.

Waning Phase: Over-time (even overnight), the honeymoon phase comes to an end. Instead of growing closer to authenticity, this is the time when narcissists’ resistance to vulnerability starts to come through. Your partner starts to notice your less-than-perfect qualities and may make frequent comments about necessary improvements. If you reject these suggestions, your partner feels insulted. Because narcissists view any slight to themselves as a flaw in others' behaviour, they may begin to distance themselves at this point.

Discarding Phase: Many relationships with narcissists end in disregard for the other partner. Even if they look back on the relationship with fondness, they typically will not accept any of the blame for how things turned out. If there is abuse involved, sometimes the partner will be the one to end the relationship.

Loving a Narcissist

One of the most difficult things about loving a narcissist is their lack of empathy, which can give you the feeling that they aren’t really present even if they are with you. People with narcissism struggle to understand the feelings of others and often use people to meet their own needs.

While the lack of empathy can seem cold and manipulative, it is a symptom of an inability to show empathy and does not necessarily signify wilful hatred on the part of your loved one. Learning how to understand a narcissist without judging them is an important step in gaining their trust, which may make seeking treatment easier. Although more research is needed on this topic, studies have shown that it can be possible to reduce narcissistic tendencies and increase empathy among narcissists.

Treatment for narcissists is important, as those people are more likely than others to experience substance abuse as well as anxiety, mood and personality disorders.

Finding Support for Yourself

Abuse is a real possibility for those in a relationship with a narcissist. For a narcissist’ loved ones, it can be difficult to differentiate between the acceptance of the behaviour of a narcissist and tolerance of abusive behaviour.

While it is healthy to accept that your loved one is a possible narcissist and in need of some compassion, it is unacceptable to endure abusive behaviour. Be on guard for any abuse or mistreatment, whether it is physical, mental, emotional, sexual or financial, and seek help as soon as you can.

If you are in a non-abusive relationship with someone who has narcissistic traits, it is still important to set firm boundaries and look after yourself first and foremost. Consider seeking therapy for yourself and the support of others who are in similar situations. By building up your own resilience and sense of self-worth, you will be better equipped to support your partner.

Does your relationship add or remove from your overall happiness and self-esteem? If you find yourself losing self-esteem, voice, and value, you may be in a toxic environment. Reflecting for a bit on the health of our relationships, from intimate partners through to friends and employers, we would most likely be able to identify a few that are not as healthy as they can be, some that we have outgrown and maybe one, in particular, that seems to have a consistent and negative impact on us.

What Is A Toxic Relationship?

Toxic relationships may include violence, abuse, and coercive control, but they may also be more subtle, leaving us unhappy, drained, and feeling bad about ourselves. Psychological terms such as “gaslighting” and “narcissism” have become part of our lives and these concepts have helped us become more aware of relationship patterns that leave us hurt. It can be a revelation when we realize how a relationship is not working for us and has a negative impact on our mental health.

Possibly a woman realises she has been a puppet to the manipulations of her mother or a man who begins to recognise that his partner is forever criticising and belittling him. If we find ourselves losing our self-esteem, voice, and value in a relationship, chances are you are in a “toxic” environment.

How to Identify a Toxic Relationship

  • Persistent unhappiness, feelings of sadness, anger, anxiety or resignation
  • Lack of respect and constant conflict
  • Competitiveness and jealousy
  • Financial and social control
  • Raising concerns and having them minimised or dismissed
  • One person having to sacrifice their needs to keep the other happy

A relationship can begin by seeming “healthy” but end up being toxic over time. In some cases, one partner is more committed to pleasing the other and works hard to meet their partner’s needs while sacrificing their own. They continue to believe that their partner loves them and wants the best for them, but instead, their partner has become controlling, withholds love, and uses criticism to undermine their confidence. The partner who wants to please could have endured the situation for so long, that they can be blind to how the power balance in the relationship is uneven.

What to Do When You Realise Your Relationship Is Toxic

It can be shocking to realise you have been living in an emotionally abusive relationship. Once you realise it is toxic and that it is more than just a “bad patch”, you may be confronted with many uncomfortable, distressing, and frightening considerations about whether to stay or to go.

Here Are Some Steps to Take

  • Reach out to friends or family who can listen or support you without judgement. Some may have been trying to tell you that you are not being treated well and it is worth listening to their perspective.
  • Be honest with yourself and ask what it will really take for the situation to change. Acknowledge to yourself if you have realistically done all you can try to improve things.
  • Reflect on your levels of happiness and self-confidence, compared to an earlier version of yourself. How has your confidence grown or diminished?
  • Start to develop healthy boundaries that convey to others that you expect to be treated well.
  • Don’t be too hard on yourself. It is understandable to hold on to hope, or to be afraid of being alone, or to fear no one else will love you. Take it one step at a time.
  • Focus on yourself. If you continue to blame your partner, you keep on giving them all the power to rob yourself of the energy you need to move forward.
  • To move forward, you must understand how you got into the position where you gave up your control. Then take the time you need to strengthen yourself to ensure it does not happen again.

How to Help Others Who Might Be In a Toxic Relationship

  • Listen and let them know you believe in them and care about them
  • Reassure them they are not selfish, bad or any of the negative things that they have been told
  • Take care that efforts to help do not become toxic too. Avoid taking over or being critical
  • Watch how much they can take in, and stop when it seems too much
  • Give them room and time to find their own way
  • Offer suggestions for external help, if they choose to do so. Laurian Ward is able to assist.

Moving Away From A Toxic Relationship Will Take Work

Deciding on where to put your energy, what realistic hope you have for change and the workability of the situation need some objective consideration. You might become stuck in your thinking or fearful about change, so getting external help from a professional can be valuable for finding new ways forward. Seeing a couples therapist together could help you both to look at change (if both have the same investment in staying together). It can also be valuable to see a professional alone to find your own feet in the discussions ahead.

Back To School

Returning to school after living through the COVID-19 pandemic can be very stressful for any child. Remote learning has taken an emotional, mental, and developmental toll. Many children have fallen behind on their studies, missed out on important milestones, and suffered from a lack of peer interaction that helps develop important social skills.

With declining rates of COVID-19, children are going back to normal classroom schedules, with safety provisions such as masking and physical distancing. Although the return to in-person schooling is more stable, with an interactive learning environment, the transition also presents new mental health challenges.

Even though in-person learning is usually the best for physical and mental health overall, it could take children a while to adapt back. Kids are resilient, but they also have emotions without the maturity to process these emotions the healthy way. Families are also fearful about safety and anxious over the potential illness in the event a classmate tests positive for COVID-19.

Here are some tips to support your children during a return to an in-person school, and how to cope with your own fear and anxieties, to ensure a more successful transition.

Know the Facts and Know What To Expect

Be informed about the real risks and benefits of returning to school during an ongoing pandemic. Consult reputable sources about how the virus that causes COVID-19 is transmitted and requirements for schools to re-open safely.

Be prepared for increased caution over your children's health, especially younger children. Children with runny noses coughs, and fevers, despite the cause, will be required to stay home until they are feeling well. If a peer tests positive, schools may need to be shut down for a period in the hopes of avoiding an outbreak.

Closing down often can be very hard emotionally, kids can be in school one day doing great, and then out for 10 days for a quarantine. Children get stressed about falling behind on classwork and not being able to keep up.

Observe Your Child’s Behaviour

Whether you feel your child will thrive in the classroom or you worry about a tough re-entry, pay attention to their behaviours.

While some kids will be excited to meet their peers and teachers, other children who’ve adjusted to isolation may feel overwhelmed in a new social environment.

Watch for signs of depression. Children may become withdrawn, develop eating disorders or anxiety around food, and their stress may manifest in abdominal or other physical pain. Children who have been cyberbullied during virtual learning especially, will undergo strain in social settings. These problems can affect learning.

Communicate Openly

No matter how your child reacts to going back to school, foster open conversations. Keep checking in, ask them how they are doing, and let them know how you are feeling as well. If they express fear and anxiety, validate their feelings, your support can help them to continue to be honest with you so that you are aware of and address any issues. At the same time, reassure your kids that schools are following health guidelines.

Sometimes parents are excited to get kids back in school, but the kids are not. If your child is reluctant to return, even if you have different views, try to make them feel confident you are doing everything in your power to keep them safe and comfortable.

If possible, stay in touch with the teachers as well, especially if your child is comparing themselves to their peers and worrying they are not performing at their best. More important, listen and know that your child is listening to you. Kids are going to hear what their parents are saying about politics and policies. Kids talk about this and it can add stress for them too. It is good to just let them know the facts.

Make the Right Decision for your Family

Some kids may not be ready for school, like children with ADHD may be flourishing in-home learning, away from distractions. Other children who live in a multigenerational housing with at-risk family members are worried about contracting the virus at school and infecting parents and grandparents.

For families that are not sure they are ready, they can weigh the risks and benefits and determine if virtual learning is still the best model for them. A lot of people are anticipating in-person learning with open arms and can’t get back fast enough. It is disheartening that the kids who need support are falling behind, and those families will really benefit from having those services again.

Rely On You Psychologist

Remember that your Child's psychologist is there to support them and you. They will check on your kid’s mental health during each visit. Many kids have lost loved ones, or their living situations are changing, and they are worried about the future, not just school, but their personal mental health as well.