"When your mind races"

Dealing with scary thoughts in the peripartum can be really challenging.  Much thanks to Karen Kleiman for this extract from her book Dropping the Baby and Other Scary Thoughts, with ideas on how to manage those scary intrusive thoughts.

Dealing with scary thoughts is not just a matter of willpower, as some claim. Although willpower may indeed be part of the solution, it is more complicated than simply wishing thoughts away.  We’ve all heard the truism that we should think positively, and we’ll feel better. Sounds good, doesn’t it? One of the most significant attributions for recovery from anxiety or depression seems to be the person’s belief in her ability to take control and be successful. In other words, if you believe you will be successful, you are more likely to succeed.

Surely it is easier said than done, but great personal power can come from shifting the focus of your energy from fear (negative) to acceptance (positive). For mild to moderate degrees of distress, women report that they feel more in control of their lives when they take responsibility for how they are feeling and identify the specific actions they can take to feel better.

Here are some specific self-help strategies you can rely on to ease the impact of your anxiety, depression, and scary thoughts.

Keep these points in mind:

• Denying the feelings and thoughts will not make them go away.
• Panicking will make them worse.
• Resistance creates persistence.
• Distraction will help for a while.
• Enhancing awareness might feel counterintuitive, but it is meaningful.
• Acceptance is hard but essential.

SO WHAT HELPS? Here are a couple of ideas for short-term relief:

1. First, acknowledge your current state 

This is hard, but there is power in acknowledging one’s powerlessness. Great resiliency can be achieved when one is able to surrender, to some extent, and let go of secondary panic. It is natural to react with alarm when thoughts and feelings are scary and unsettling, but it is well-established that when one fears the fear, distress escalates. Straightforward affirmations reflecting the current state can be a self-compassionate way to regain some control.

• I am having scary thoughts. I might not understand why this is happening, but I know it is common and it happens to many mothers.
• My scary thoughts are not me. They are either a symptom of OCD or PPD or they are just a function of my anxiety right now. They will not always be here.
• I don’t like the way it feels, but I am doing what I need to do to feel better.
• I understand that my anxiety is a natural part of becoming a mother and even though it makes me feel terrible at times, I can endure it because I know I will not always feel this way

2.  Distraction works!

Distraction has actually been shown to temporarily interrupt the loop of negative thinking. This is not the same thing as avoidance or denial. Rather, it is a way for you to remain in the stressful situation by coping with it.

If you are terrified of your own scary thoughts, can you really distract yourself from this uncomfortable mental state?

Yes.

When you feel fear taking hold, do something that feels manageable. When you engage in work or activity that feels manageable in the present, you minimize your involvement with anxiety-generating thoughts and images and keep the mind actively focused. Your body, in response, is able to settle down a bit allowing you to feel more in control. Once you acknowlege that you are currently suffering from the scary thoughts and want to feel better, your brain will be going: I’m feeling bad right now, (acceptance) but maybe I’ll go for a walk, or call my sister (self-care) so I can feel better (self-compassion).

Here are just a few examples of distracting activities:

It can be pleasing:

• Listening to music.
• Watching TV
• Sitting outside in a relaxing environment with nature sounds/ocean waves/birds singing/warm sunshine
• Making a phone call to a friend.

It can be absorbing:

• Engaging in work-related projects.
• Planting in the garden.
• Helping a neighbor.
• Making a scrapbook with baby pictures.
• Playing computer/phone games.
• Reading a novel by your favorite author.

It can be detailed-oriented:

• Doing puzzles or playing games.
• Counting the tiles in the ceiling.
• Writing
• Organizing
• Counting backward by 3’s from 100.

It can be physical/bodily: (It is helpful to simultaneously insert a cognitive association, like “It’s okay” or a gentle “stoooop” or “everything is good” as you use these)

• Snapping a rubber band on wrist.
• Visualizing and repeating the word STOP.
• Splashing ice cold water on face.
• Gently slapping cheek.
• Talking or reading aloud.
• Use and say your name as you comfort yourself in the third person (“you’ll be okay, Karen. Let’s go outside for a walk.”)

It can be energizing:

• Exercising
• Taking a brisk walk in the sunshine.
• Dancing

At first, this may appear ridiculously insufficient, or fleeting, at best. Sometimes, it’s even tempting to resist the distraction, almost as if it feels important to STAY WITH THE ANXIOUS THOUGHT; A sort of inertia sets in and it feels almost easier to remain anxious. But while your body may fight this, you might be surprised to discover that it really works if you stick with something and keep your mind focused on whatever you are doing.

These distraction techniques work to temporarily take the mind away from the worrisome thought and redirect it to something that feels different. This is based on the principle that there is a limited amount of functions that one’s brain can perform at one time. By keeping your brain busy as much as you can, you are less able to accommodate the anxiety. This is not as easy as it might sound. Keeping your brain busy requires a dedicated effort; it will not be enough to turn on the television and let your brain wander.  Before you know it, it will meander right back to the object of your obsession. It requires a deliberate desire to absorb yourself in an activity.  Count, read, paint, design, clean.  Teach your brain how good it can feel to focus on something other than your scary thought. Your thinking is getting in your way right now. Give yourself permission to play and not to think.

Don’t forget to:

• Eat frequent small meals to help stabilize blood sugar. Swings in blood sugar can cause symptoms that mimic anxiety, such as lightheadedness.
• Drink lots of water.
• Eat complex carbohydrates (whole grains) can increase serotonin, which is associated with feelings of calmness.
• Restrict simple carbohydrates (sugar).
• Avoid alcohol.
• Avoid caffeine.

 

Adapted from “Dropping the Baby and Other Scary Thoughts” by Kleiman and Wenzel (Routledge, 2010)