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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5111
Experience:  Dr. Mark is a PhD in psychology in private practice
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Hello. I need help. I am a mom of four children (two teenagers,

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Hello. I need help. I am a mom of four children (two teenagers, one toddler and a preschooler). All boys... I have a part job that I love and I spend a lot of time with my family. I know that I am very lucky to have what I have. However, I cannot help but feel very stressful and irritated most days. Little things can send me over the edge... I do have my hands full with cooking, laundry, kids activities etc. My husband works long hours so it is mostly me who is stick with all household duties. But as I said, I work p/t, and I also have a cleaning lady who comes in biweekly to help out. I understand that most women would kill to have this kind if lifestyle and flexibility and I feel horrible and ungrateful, but what can I do? I yell at my kids all the time, I feel stressed, I cannot fully enjoy anything and most of the time I feel like I am in the wrong place. What would you suggest? I am so desperate to try anything at this point!!! I really want to change and be a calm mom and wife, somebody my family can enjoy being with...
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! I believe I can be of help with this issue.



First let me say that I can imagine how confusing and distressing this situation must be for you. You are clearly a very loving, caring, and competent person. But you don't feel very strong in yourself right now, it's clear. I therefore want to begin by telling you that this is not a contradiction: that you do not feel strong right now does not negate the truth that you are indeed a strong, loving and caring person.


What has happened appears to be that you have had to be so strong and competent for so long and you're "suddenly" finding it hard to maintain this. I put suddenly in quotes because it doesn't happen suddenly. It's that we compensate and compensate until finally the lack of taking care of our emotional selves catches up with us.



Emotions and personal needs don't just disappear: they store up and the pressure builds up. And then they begin to leak out if you don't let them express themselves in healthy ways. And that appears to be what's happening at this time now. What the triggers might be at this time can be varied. A common trigger as we leave our 30s is hormones. Not just menopause, but perimenopause or even earlier hormonal changes. This isn't shameful or an excuse; it's a reality. And by the way, men also have hormonal changes, sometimes at this time or a few years later than women. But they also can begin to question their lives, feel empty, anxious, and unsettled.



So hormonal changes may be one possible trigger. Another trigger, you may be surprised, is when children reach a certain age of adolescence. This is often very hard for fathers even more than mothers. And you may be reacting to some of your husband's triggers as well as your own. When children reach 15-16 or so, they become independent in ways that are very challenging. They need to be different than they were before; it's healthy and vital. But it puts the accent on change as exciting, on adventure, on growth, development, etc. They tend to put down things that are "the same", old, etc. And parents find themselves left out. Parents aren't changing, their lives are the same, they are the ones getting older. It is one of the bigger life triggers I see in my private practice.


Therefore, we have to get you to a situation where you can deal with your feelings in a healthy ways. That means a combination of work on your own and possibly psychotherapy.

Psychotherapy may be important because anxiety and depression are often the result of these unexpressed emotions. So therapy is an important way to manage the emotions. I will also at the end of the posting give you a technique you can use on your own as well for when you are feeling anxiety and working on avoiding the anger outbursts, etc.


Let's work on the six ways you can begin to build a healthy life program for yourself: conferring with your doctor, diet, exercise, spiritual life, motivational reading and psychotherapy. The first four are to help you feel more involved and in control of yourself and what's going on inside. The psychotherapy can actually teach you skills and give you tools for managing your symptoms.

Conferring with your doctor: you may want to have testing for hormonal levels and nutritional deficiencies. These also occur, by the way, as we become more adult with our hurried diets. Your doctor may want to head straight toward antidepressants or anxiety medications. This is up to you. I tend to avoid medicating as a first choice because it's a lifelong rollercoaster with medications. But I don't negate its ability to help if truly needed.


Diet: cut out coffee, sugar, white flour. That may be tough. But you will see results as some of the newer research shows. And lean meats only. No fast food restaurants, no fatty foods. See what I mean about getting involved in controlling what's happening? With diet changes you are treating your problem with respect: you are acknowledging you need to make changes to get your body feeling better. It will help you feel more in control again.


Vitamins can be useful for moods. A good quality daily vitamin, for example. One of the most important supplements is Omega 3 fatty acids, either in fish oil or capsules or in flax seed oil. Buy good quality. The clinical dosage is 1,600-3,000 mg daily. There are herbal preparations available to promote calm and those are worth a try if not too expensive. All these things you should get at the biggest and most frequented health food store and ask them for the best brands they trust in terms of quality.


Exercise: 5 days a week moderate exercise, to include 3 days of strength training as you get more used to it. Pretty amazing isn't it? I told you it would require work, but what you put in to it you will get out of it. Your doctor will verify the research results showing the benefit.


Spiritual life: the medical literature is now rather overwhelming about the benefits to so many different areas of physical health of regular religious and spiritual practice. Going to church, meditation, etc. are all shown to produce benefits to the physical body. What about our mental health? Well, you will see that meditation is now a regular part of psychotherapy interventions. I don't know if you're a religious person or not. But if not, this may be a good time in your life to tune up your spiritual life. If you do not believe in G-d, that's not a barrier to your own spiritual life. Just thinking about the meaning of your life, of life in general, and studying spiritual texts and practices will help with the anxiety and depression, all those unexpressed emotions.


Then along with exploring the spiritual part of life, I want you to get really into motivational videos and books. Here's a simple YouTube search I put together for you on "motivational speakers":


http://www.youtube.com/results?search_query=motivational+speakers&aq=f



Some like Tony Robbins are the classic big guys. Some are newer. Watch them all. There are wonderful women speakers as well. Get inspired. Buy a book or two. Let yourself add some new dimensions to your thinking about who you are in the world.


This book is by Anthony Robbins. He's one of those speakers who fills up huge auditoriums. For a reason. He's a terrific speaker and writer. The particular book (if you like it, try his others): Awaken the Giant Within.

Which brings us to psychotherapy. I'll add it here in case you find that talking through the problems is a good choice for you. You will want to find a psychologist or psychotherapist to help you manage the anxiety and depression from these unexpressed emotions. And the therapies today are very effective. The preferred form of treatment today is Cognitive Behavioral Therapy to learn skills but you need someone who also practices psychodynamic therapy as well so you have a place to express all your frustrations, etc.

I'm not familiar with the directories for finding a psychologist or therapist in Ireland. Perhaps your doctor can help. But make sure to interview the person first to feel comfortable with him/her. You're looking first and foremost for someone who provides you with a place that's safe to express all those stored feelings.

Okay, that should help you get working on these symptoms and get some relief. I wish you the very best!

Now, I want to give you a tool to use for when the anxiety is present. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 1 year ago.
Thank you so much for such a comprehensive response. I don't know if that's the anxiety that plagues me though... What happens on a daily basis is I yell at my kids for no reason (I mean, there is always a reason, my reaction is blown out if proportion. For examoke, unmade bed can easily set me off...) and then I regret it and apologize to them and feel horrible. But next day it happens all over again. So, do you think it us a sign of anxiety? What kind of natural supplants can I try other than vitamins and fish oil?
Expert:  Dr. Mark replied 1 year ago.
I do think it is a sign of anxiety in your case. You didn't describe yourself as someone who had an internal anger issue. You describe yourself as someone who's life has snowballed into a lot of frustration that explodes out of you. But, if you feel that this doesn't really describe the situation, then let me know and we'll discuss anger issues and handling anger issues. Because I am seeing from what you've told me that you're overwhelmed by the daily demands and the lack of self outlet.


As for supplements for anxiety, I'll make two herbal recommendations. This is because I know there is SOME research evidence for these two herbs. However, it is not that conclusive or even impressive. But it is some and they have the following going for them: in the cultures they come from, they are traditionally used for anxiety. That's encouraging. The first is Black Cohosh, the root of which was used by Indians in our country. The second is Kava, sometimes called Kava Kava, which is from the Pacific Islands.



It would be good for you to have Vitamin D levels tested. There's been a lot of recent research excitement about the value of this as Americans seem to be chronically deficient. But you would be best off to know clinically how much to take rather than just guessing.


Don't be surprised by how much fish oil can help just on its own...with daily exercise, you may be very surprised.


You may want to start reading Dr. Andrew Weil's books if you're interested in a more natural eating lifestyle. He's been working at it for decades! He's just now becoming famous in the mainstream of medicine.


I wish you the very best!


My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5111
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Thank you
Expert:  Dr. Mark replied 1 year ago.
You are very welcome. I wish you the very best!

Dr. Mark

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