Mental Health During Pregnancy and Postpartum

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Pregnancy is a life changing condition.  Physically and mentally, there are many changes that happen with new life growing within.  These changes during the perinatal and postnatal periods often put new mothers and mothers-to-be at high risk for developing anxiety and depression.  Less common but worse conditions may include bipolar disorder and postpartum psychosis.

Women may develop a mental health problem during pregnancy or may have a recurrence of such a problem if she had such issue before pregnancy.  Women on medication for some mental disorder may have to stop taking their prescriptions when they get pregnant.  Unfortunately, they form a high risk group for recurring symptoms.  Seven out of ten women who stop their antidepressant medication for instance fall back into depression or anxiety during their pregnancy.

In the U.K., about 10-15 out of 100 pregnant women become clinically depressed or anxious.  The cause is not singular but it is usually a mix of factors and it can happen to anyone.  These factors may depend on:

  • Degree of recent or ongoing stress in one’s life such as a death of a loved one, divorce or separation, etc.
  • Attitude toward pregnancy.  The thought of raising a child, for instance, may put undue worry on a person especially one with a difficult childhood.  Changes in weight and shape may take an emotional toll especially if the mother has an eating disorder.
  • Whether one is on treatment or medication.  Stopping treatment could make one fall ill again.
  • Type of mental illness one has experienced

Postpartum Depression and Anxiety

As pregnancy and post pregnancy are times of great changes, depression symptoms may not be so easy to identify.  Depression signals may come when there are big changes in everyday routines or habits such as short sleeping hours, increase in appetite, etc.

If you are experiencing some of these symptoms for more than two weeks, get some help:

  • Feelings of hopelessness, worthlessness, emptiness, sadness, and other feelings of inadequacy
  • Very low moods; extreme sadness
  • Feeling numb
  • Easily irritated, angry, or resentful
  • Unfounded fears for the baby or of motherhood
  • Loss of interest in things that were normally enjoyable
  • Withdrawal from social contact
  • Not taking care of self
  • Insomnia
  • Poor concentration and decision making
  • Harbouring thoughts of harming the baby or one’s self; thoughts of suicide
  • Decreased energy; extreme lethargy

Anxiety is a common partner of depression.  When experiencing these symptoms, you need to see your GP or health professional who may test your degree of depression and anxiety using the Edinburgh Postnatal Depression Scale (EPDS).  The EPDS is a questionnaire which assesses your feelings if these fall outside the normal range and into the depression/anxiety scope.  This test may be conducted twice during pregnancy and once after childbirth.

Seeking Help

A pregnant woman, who has had prior history of mental illness such as schizophrenia, bipolar disorder, anorexia, or severe depression, must make a wise decision to talk to her GP.  Consultation with a specialist, even if she feels very good about herself and her pregnancy at the moment, is important because there is a high enough risk for her mental illness to recur during pregnancy or after childbirth.  One needs a care plan drawn up by a GP in order to head off or at least lessen the effects of the illness.

Medication During Pregnancy

Since many pregnancies are usually unplanned, some women may be under medication at the time of conception.  If you are under medication but suspect a pregnancy, do not stop medication suddenly but go see your doctor immediately.  He will assess whether to change or gradually take you off your medicines.  Stopping medications suddenly can quickly cause a relapse of your symptoms or cause undesirable side-effects.  If the doctor sees no harm to the foetus with the drugs you were prescribed with, he may insist that you continue with your medicated treatment.

While many medications are unsafe for pregnancy, selected antidepressants such as a few serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are considered safe for pregnant women.  These few have not been associated with birth defects and pass at very low levels through breast milk.

The decision of your doctor on whether to continue or not to continue medication may rest on the ff. factors:

  • the likelihood that you may not be able to take care of yourself when off medication
  • your tendency to turn to drugs or alcohol because you feel unwell without medication.  This tendency is harmful for both you and the developing foetus.
  • your tendency to develop postpartum depression which will affect your nurture and care for your baby
  • you are at a high risk for a relapse.  A relapse may require more medication, usually a higher dose or a supplementary drug, both situations that can be very harmful to the baby.
  • if talking therapies are not enough to mitigate your mental health issues.  Mental health problems like depression must be addressed because these can cause a host of problems from low birth weight to infant development.

Talking Therapies

Talking therapies or psychological treatments may be imperative treatments for pregnant women afflicted with depression or anxiety.  Cognitive behavioural therapy (CBT) for one can help you cope with your feelings by changing the way you think and behave.  Talking therapies help people identify the problem and ways to change their thinking and behavioural patterns so that the effects of the triggers are significantly lessened.  Some people may do away with medication and get by very well with talking therapy alone.

Talking therapy may be done as a one-on-one consultation or as a group event.  This type of therapy may also be conducted online as e-therapy through e-mail or video sessions.

postpartum blues

Arts Therapy

art therapy session

Arts therapies are constructive non-verbal approaches that allow mental health patients to adequately express themselves through the creative process.  Painting, composing music, and writing a poem are different artistic ways through which patients may communicate feelings when verbal expression just seems too inadequate or just not preferable at the moment.

Arts therapy is also known as expressive therapy or creative arts therapy.  The emphasis of this therapy is on the creative process rather than on the resulting work of art.  This is why people with no artistic background can still benefit from arts therapy because the final artwork is not judged by its aesthetic value.  Instead, the therapist helps the patient find his voice about his personal issues by letting him go through the creative process, one which gradually helps him understand himself better.

How Is Arts Therapy Conducted?

After completing your project, your therapist will help you think about your creation and about how it relates to your feelings and experiences.  For some people though, the mere exercise of creating art somehow is enough therapy in itself.  The artistic activity allows them to discover many things about themselves and helps them process these revelations as well.

Art therapy may be conducted in a group session or on a one-on-one basis.  This type of therapy lends itself well to many forms of mental illnesses.  It is often used in conjunction with other kinds of therapy like talking therapies.

Art therapy has proven to be a successful form of treatment because it has helped many learn to deal with, and in some cases even bounce back, from their mental health issues.

Who is Best Suited for Arts Therapy?

Arts therapy is recommended as treatment for many behavioural, emotional, and mental problems.  They have proven to be particularly helpful with patients experiencing:

  • detachment from their feelings
  • resistance to talking therapies because relating their experiences may be too painful at the moment

People with these mental problems may benefit from art therapy:

  • Schizophrenia
  • Schizoaffective disorder
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • Eating disorders (i.e. bulimia, anorexia)
  • PTSD (Post Traumatic Stress Disorder)
  • Depression
  • Anxiety
  • Stress-related issues
  • Traumatic brain injury
  • Developmental disabilities
  • Social challenges

Types of Arts Therapy

Art Therapy has varied modalities:

Music Therapy

Communication with one’s therapist or group members is through playing, listening, or singing a musical piece.  It may involve playing instruments such as the drums, maracas, chimes, bells, and wood blocks.

During a music therapy session, the therapist listens to the music you create or present and tries to understand the emotions you are trying to convey.  In response, they play their own music which is geared toward making positive changes in the way you feel.  Music is the medium the therapist uses to help you explore your feelings and think about the way you relate to people and your environment.

Dance Therapy

When body movements are a more comfortable mode of expression for a patient, then dance therapy is recommended.  Dancing can help a patient express emotions he may find difficult to talk about.

Dance therapy is also beneficial for those who:

  • are feel disconnected from their emotions and from things in daily life
  • have been sexually or physically abused as the experiences show in the way a person holds and moves his or her body
  • have a difficult time with physical contact
  • have physical symptoms from their mental illness.  Ex. Depression manifests as pain
  • have negative perception of their body and therefore have eating disorders such as anorexia or bulimia

Dramatherapy

Dramatherapy involves participating or creating skits or plays in which one needs to act out, use body movements, facial expressions, role play, or mime to express what one feels or wants to convey.  For those who are not particular about acting, dramatherapy also offers behind-the-scenes roles such as lighting, directing, costume or scenery creation, or even being the audience.

Art Therapy

Art therapy involves using art materials and other physical objects to help the patient connect with the world around them.  Clay, paint, pebbles, and crayons are just a small portion of art materials a patient may use to express himself through artwork.  A camera may also be used to take photos as glimpses to your past emotions and memories.

Finding an Arts Therapist

Arts Therapy is regulated and therefore has certain regulations about how this type of therapy must be conducted.  Make sure that your art therapist is registered with the Health and Care Professions Council (HCPC).

art therapy

Safety and Support When Going Online

online support

For many seeking help for mental illness, the web is a complex goldmine of information.  With a wealth of facts just a mouse click away, it is but natural for those seeking to understand their type of mental illness to turn to online for answers and later for support.  Unfortunately, the net is also a vat of disinformation and a playground for hostile individuals and groups.  In this regard, the internet user must know what sites to trust and what social networks, support groups, and chat rooms to be on the lookout for questionable members and activities.

When trawling the net, one must look after his privacy and his well-being especially when using the internet to look for support.  One must learn to deal with cyber abuse and be cautious with online advice from just any support group.  Not everything published on websites are a hundred percent reliable either because anyone, whether they be experts in their field or a common Joe just giving his two cents worth, can post just about anything they want online.

Where to Go For Reliable Information?

If you want to understand more about your mental issue, go to sites that have been certified to carry reliable content.  Ask yourself these questions before deeming any content you read as factual:

  1. Does the content have verifiable factual information or is the content written from just someone’s personal opinion or experience?
  2. Is the content written by an expert in the field?  Are they certified professionals?
  3. Is the content current?  When was it written?
  4. Is the content relevant to your mental health issue or circumstances?

It may be difficult to discern the legitimacy or illegitimacy of many sites.  Fortunately some sites have been certified as reliable by the Information Standard, a mark of accreditation by the National Health Service (NHS England) that certifies the content reliability of certain websites concerned with health and care.  A site marked with the following logo ensures trustworthy information for your guidance:

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Mind and NHS are good examples of sites that host very dependable, informative health content.

Finding Support Online

If you are thinking of finding a therapist online, it pays to do a little background search on his or her qualifications first?  The mental health therapist, psychologist, or psychiatrist must be accredited by a professional body such as the BACP (British Association for Counselling & Psychotherapy).

Chat groups or forums also exist that deal with specific mental health issues.  There are forums for bipolar patients and support groups for depressed people.  These are online communities with the ideal goals of providing as much factual information and as much support to their members.  Being part of these groups may help you discover new coping strategies and give you a sense of belongingness.  Sometimes, knowing that you are not alone can be a big help.

As much as support groups are beneficial, bear in mind the following:

  • Not all information you glean may be applicable to you.  If a group member swears by a certain medication, it does not mean this medication will work or will have fewer side effects for you as well, even if you and that member share the same diagnosis.  It is always wise to refer the information you get with your GP instead of acting on it on your own.
  • Other people’s comments can trigger some emotional issues.  Your comments may trigger theirs as well.  For example, if someone is saying that he feels like harming himself, you start feeling the same because of the suggestion.  If you feel this is happening, don’t pursue the thread.  Go to some other site.
  • Manage your online relationships.  People you have met online are not ones you have built a relationship with face-to-face; so be careful about giving personal information.  In addition, respect other people’s feelings and opinions even if you don’t agree with them.  Moreover, do not tolerate online mistreatment such as bullying by nipping any first attempts in the bud.
  • Manage expectations.  Do not believe what people write about 100% because it could just be their opinion, not fact.  Furthermore, other people’s experiences are circumstantial to them and may not be relevant to your own situation.

As much as the internet is a great tool for helping you manage your illness, there is still no substitute for face-to-face therapy or consultation with your psychiatrist or general practitioner (GP).  Having said that, online support from a licensed mental health professional through webcam talking therapies or email therapy is the next best thing.  Just be fastidious in establishing your online therapist’s credentials with the BACP, BPS (British Psychological Society), or other accrediting bodies.

Dialectical Behaviour Therapy (DBT)

dbt

Dialectical Behaviour Therapy is a specialized type of talking therapy under the general category of Cognitive Behavioural Therapy (CBT).  This kind of CBT was developed by psychologist, Marsha M. Linehan, in the 1980’s  to especially focus on treating Borderline Personality Disorder (BPD) and has since proven to be a valuable treatment for this particular mental illness.

What does “Dialectic” in DBT mean?

The word dialectic in the term Dialectical Behaviour Therapy refers to the unification or synthesis of two opposing positions, concepts, or realities.  DBT seeks to meld two key concepts that naturally oppose each other:  acceptance and change.

Acceptance refers to coming to terms with who you are—your emotions, experiences, and natural responses.  Change means altering your responses and thoughts toward more positive behaviour and coping strategies in order to reach personal and social goals in becoming a more integrated individual.

People with Borderline Personality Disorder have very heightened negative emotions.  As a result, they are often acutely emotionally unstable and have a tendency toward inflicting self harm and attempting suicide.  DBT seeks to help BPD patients accept their personal liabilities and to help them acquire new behavioural skills to replace their ineffective and damaging responses for achieving emotional stability and personal goals.

Four Stages of Treatment with Dialectic Behaviour Therapy

The end goal of all four stages is to mould the patient toward making their own paradigm shift from feelings of worthlessness to:  I am worth as much as everyone else; life is worth living.

Stage 1:  Achieving Behavioural Control

At the start of therapy, the patient’s condition may be dangerously low—in psychological misery, out of control, and therefore may be self-destructive with drug and alcohol use, sexual promiscuity, or binge eating.  They may also be suicidal with a history of attempts or still at the contemplation stage.  The objective of Stage 1 therapy is to assist the patient into gaining command of his spiralling out-of-control thoughts and behaviour.

Stage 1 is all about setting and achieving three main goals:

  1. Stop suicidal or self-harming behaviour
  1. Rid the patient of obstacles or behaviour that prevent or interfere with therapy — the patient may justify to himself why he does not need to go on with therapy or his family may be embarrassed about his condition and prevent him from getting needed treatment.
  1. Addressing issues that lower patient’s quality of life — Problems like depression, unstable relationships, or being expelled from school may be issues distressing the patient to a volatile degree.

At this stage, the therapist tries to equip the patient with emotion-managing skills so that the patient can disengage from dangerous behaviour and gain some mastery over his negative thought patterns.

Stage 2:  Emotional Experiencing

Although Stage 1 behaviour control has been achieved, the patient continues to suffer quietly.  Their emotional turmoil is usually due to past trauma and invalidated feelings.  For those with Post Traumatic Stress Disorder (PTSD), past trauma is explored and analysed and its accompanying negative beliefs and behaviours, verified.  PTSD is treated at this stage.

The goal of stage 2 is to move the patient past suffering with inhibited emotions and on to a level where they experience their emotions in full.  At this second stage, the therapy involves the following:

  1. The patient is encouraged to remember and accept the traumatic event.
  2. Reduction of stigmatization
  3. Reduction of self-blame
  4. Lowering incidences of negative intrusive and denial syndromes

Stage 2 goals can only be achieved once negative behaviour is under control.

Stage 3:  Learning to Live

Stage 3 focuses on building self-esteem, owning one’s behaviour, creating trust and value for one’s self, and goal setting.  The patient is gradually led toward coming to terms with happy and unhappy events in life, thus enabling him to live life normally.

Stage 4:  Building Capacity for Joy

Some people stop at stage 3 but for others, stage 4 is an important part of recovery.  Stage 4 is all about spiritual fulfilment which helps the patient feel connected to humanity as a whole.  The goal at this stage is to help the patient go beyond just living day to day and be able to incorporate the ability to experience joy and freedom.

DBT-Skills

Scientific evidence has proven Dialectical Behaviour Therapy to be effective in lowering rates of suicides, self-harm, dropouts in treatment, depression, hospitalization, and substance abuse.  DBT has indeed helped many patients to improve functioning and relationships in their personal and social lives.

Depression: When Sadness Becomes More Than Itself

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Clinical depression is a growing concern in the Western World.  It has become a common debilitating mental disease with one in five persons in the U.K. having had depression at some point in their lives.  It hits all age groups, income levels, and communities.  Its growth is accelerating to the point that it could become one of the most incapacitating conditions in the developed world by 2020, second only to heart disease.

Normal bouts of sadness are natural occurrences.  Death of a loved one, for instance, may cause one, grief.  In a mentally healthy individual, the intensity may last for a short time and taper off eventually to a steady acceptance.  Grief that spirals into clinical depression however will stay with the individual for the long haul and could disrupt his daily functions.

Depression Is a Real Illness

A person with a depressive disorder is truly sick.  Much like a physical illness in which an organ or its system is weakened, so it is with depression of which its compromised organ is the brain.  Diabetes, for instance, is a physical disease that involves the impaired function of the metabolic system to handle the hormone, insulin.  Likewise, the condition of depression involves an impairment of the nervous system manifesting with the imbalance of certain brain chemicals; low production of neurons and nerve cell connections; and impaired nerve cell growth and nerve circuit functions.

Many factors can trigger depression.  Life events can traumatize people into a depression.  Our biological makeup such as genetics and brain chemistry are major factors as well.  Serious medical illnesses such as cancer and Parkinson’s disease can also lead a person into a depressive state.  Some medications used to treat physical illnesses may have depression as its side effect.

The State of Depression Varies for Each Person

The degree, frequency, and length of depressive symptoms are as individualized as the person afflicted by it.  Symptoms vary from person to person with the variety dependent on age, gender, culture, and other factors.  Some people feel only a few symptoms while others are burdened by many.  In addition, there are people, especially children and adolescents, who do not even recognize the symptoms of depression.  Men feel it differently than women and have different coping strategies as well.

Symptoms of Depression

The tell-tale signs of depression include but are not limited to the following:

  • Sad or anxious mood that does not go away for a long time
  • Chronic empty feeling
  • Thoughts of suicide; attempts at suicide
  • Increased pessimism; hopelessness
  • Restlessness
  • Irritability
  • Insomnia or oversleeping
  • Decreased cognitive functions.  Depressed person has trouble remembering or making sound judgements or decisions.
  • Physical aches, pains, and other symptoms, such as headaches, palpitations, and stomach aches which do not test positive for any physical illness
  • Feelings of very low self-worth, inferiority, and guilt
  • Chronic reduced energy levels; exhaustion; fatigue
  • Fast weight changes and appetite changes
  • Loss of interest in things previously enjoyed; loss of interest in anything and anyone
  • Markedly reduced libido

Some people may not be aware of their depressed state because symptoms can come gradually to them.  They may have kept themselves busy to avoid feeling sad or hurt.  Eventually the strain does catch up to them and they start to exhibit some of the above symptoms.  Physical pains however without any physical cause may also signal that a person has a psychological issue.

Treatment for Depression

The good news is that depression, even severe cases, can be treated; however, diagnosis and treatment is best at the early stages where recovery is faster.  When you suspect yourself of being depressed, seek professional help as soon as possible.  Expect treatment to include talking therapies with your psychiatrist.  Antidepressant medication may also be prescribed if your situation warrants it.

What You Can Do to Help Yourself

Aside from seeking professional help, there are a number of ways by which you can help yourself feel better.  First thing you can do is take charge of your physical health.  As the mind and body are tied together, whatever affects the body affects the mind and vice-versa.  You can start by:

  • Eating a well balanced diet everyday
  • Beginning and sticking seriously to an exercise program
  • Avoid alcohol, caffeine, smoking, and illicit drugs.  These substances just worsen depression.
  • Fixing your sleeping patterns.  Getting a good night’s rest everyday is crucial to your recovery.

Your emotional state needs nurturing as well:

  • Find a trusted friend or family member you can talk to about your issues and emotional condition.
  • Approach depression with a plan.  Write down what you think is causing the problem and the positive ways you can fight your negative state.
  • Join a support group of people with the same problem.
  • Avoid making any major life decisions until you can handle big changes.
  • Avoid piling up more work to perpetually take your mind away from your issue.  You need to set aside time to go over the problem so you can eventually come to terms with it.

stronger than depression

Learn all you can about depression in order to understand the condition better.  The road to recovery may be a shorter path if you simply work positively toward achieving that healing goal.

Cognitive Behavioural Therapy (CBT)

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Mental problems are varied and individualistic in most and therefore the approaches to addressing these dysfunctions are also diverse and may be tweaked to suit each individual patient.  One such therapy that has proven to it merit through the decades is Cognitive Behavioural Therapy or CBT.

CBT and its History

Cognitive Behavioural Therapy is also known by its shortened name, cognitive therapy, and by its initials, CBT.  Cognitive theory is a type of therapy that focuses on a person’s thinking patterns as the source of his dysfunctional emotions and behaviours.  The aim of CBT is to change how people think for the better so that this positivity may improve how they feel or how they choose to behave.

The Greek philosopher, Epictetus, taught that:  “It’s not things that upset us, it’s our view of things.”  Psychoanalyst and psychiatrist, Aaron Beck drew from this philosophy to develop cognitive therapy in the U.S. in the 1960’s.

Albert Ellis is another proponent of CBT who developed a slightly different approach known as Rational Emotive Behaviour Therapy (REBT).  This therapy looks into a person’s basic irrational assumptions about themselves which often lead them to compromise their chances for happiness and success.  Thoughts like “I can’t be that sexy; I’m not smart enough to make the grade; my parents don’t like me ” reflect a typical negativity that persists even when faced with contrary evidence.

A Case in Point

Some of us do not realize that our thought patterns and behaviour stem from negative assumptions.  Take this case:   Tom thinks of himself as inferior to his colleagues; as such, any small incidents at the workplace may upset him.  If he happens to greet a co-worker who fails to reply in turn, Tom starts to think that:

  1. He has not been deemed worthy of the person’s time for a reply.
  2. He is not liked by this person.

Out of these assumptions, he goes on to infer more negative conclusions:

  1.   My colleagues think I’m not good enough.
  2.   I really am not good enough.
  3.   It’s only a matter of time before I lose my job.

Tom then goes into a low mood without considering that there may be other factors why his greeting was not returned.  His colleague may not have heard him or must have been preoccupied with something that he missed Tom’s greeting.  More incidents like these and Tom begins to solidify his negative thoughts.  These bad thoughts then influence Tom’s behaviour and he:

  1. becomes withdrawn                                                                    cognitive-behavioural-therapy
  2. becomes timid or less assertive
  3. highly sensitive to constructive criticism

All these behaviours work against Tom’s ability to further his career.  Indeed, he may lose his job if his behaviour is not corrected.  This is where cognitive behavioural therapy can help.  CBT sessions with a mental health professional may help Tom realize that his negative thoughts are compromising his workplace situation.

How CBT is Carried Out

Cognitive Behavioural Therapy involves a “talking it out” type of treatment that is concerned with making the patient realize that his inherent tendencies toward negative thoughts have a strong influence on his behaviours and emotional state.

A cognitive-behavioural therapist employs four phases in the treatment:

  • Assessment stage

At the beginning, you and your therapist get to know each other.  This is how your therapist can draft a treatment plan which can include an estimate of how long treatment is likely to take.

  • Cognitive stage

In this stage, your therapist will help you identify what’s causing your negative behaviours.  Expect to delve into past events that helped shape negative thought patterns.  Your therapist       means to help you to understand how your perceptions have brought about your maladjusted behaviours.  Although this stage may prove difficult especially for people who grapple with introspection, patients must fully cooperate at this stage if they are to gain vital insights and make crucial discoveries about their psyche.

  • Behaviour stage

Once the roots of the problem have been fleshed out,  you and your therapist find new patterns of thinking and behaving.  These new skills must be applicable to real life situations.

  • Learning stage

The patient starts to learn and practice new behaviour.  This may include dealing with situations that could contribute to a relapse.  Here, the goal is to establish permanent positive changes so that the psychological problem may be eliminated for good.

It is the goal of CBT to help people come to terms with the fact that while they always cannot control their environment,  they alone can control how they perceive things and react to them. Therapy is a gradual process, one that helps a person take small steps toward thought and behavioural change.

Where CBT is Most Effective

Cognitive Behavioural Therapy has been used to treat patients afflicted with a wide range of problems.  These include anxiety, addiction, phobia, and depression.  In much serious mental health dysfunctions, CBT may only be a component of a main therapy plan.

Cognitive therapy is best suited to people who are comfortable with self-analysis and introspection.  CBT will prove effective especially with those who are truly committed to finding the root cause of the problem and making the necessary behavioural changes.

Manage Your Anger: Why You Should

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Is Anger Bad?

Just as joy, sadness, fear, and envy are emotions that define our humanity, anger is a human ingredient integral to experiencing life. Anger is also a survival mechanism, without which we will all be ill-equipped to deal with danger or threats to our physical and psychological health. In this context, anger is a good thing. Anything good, however, can turn bad; it simply depends how you use it.

Anger can range from simple annoyance to rage. Anger at any point on the emotional scale does serve as a defence mechanism to perceived personal or sociological threats. Anger, however, becomes a debilitating problem when it is:
• chronic
• unresolved
• harmful to one’s self
• harmful to others

Anger is a very strong emotion that can threaten to overwhelm one if he does not know how to express or channel it. It is imperative that we learn to manage our anger if we want to live normally, at peace and harmony with one’s self and with others. Our ill-expressed tempers often cripple us socially and psychologically. Simmering, unresolved tempers often worm their way into verbal abuse, constant criticism, and even self-destructive behaviour such as alcoholism and substance abuse. Rage may manifest into physical violence.

Are Some People Angrier Than Others?

People whose tempers flare stronger and linger longer than normal have anger management issues. Not all of these types readily erupt in a full-blown tantrums, however. Some exhibit chronic irritation or crankiness, social withdrawal tendencies, and even physical illness.

People whose anger is out of control usually have low tolerance for frustration and stress. They may not have the mental strength to take things in stride and the emotional intelligence to know how to pick their battles. Because of this, constantly overwrought people tend to overreact to situations they perceive to be unreasonable. For instance, a person with anger problems may respond with verbal abuse when faced with constructive criticism from a friend or colleague. An overly angry person may perceive friendly critical advice as an attack to his integrity, triggering intense feelings an average person would normally not possess when faced with a similar situation.

Do You Feel You Need Counselling?

Although venting anger is important and emotionally healthy, it is its manner of expression that has to be controlled or managed. Your happiness is at stake if you cannot learn to manage a volatile temper well. It is time to seek professional help when you find yourself having problems in these aspects of your life:

Your Anger is Hurting Your Relationships  Angry-Couple
People get hurt or afraid when you lash out at them, whether you do so by being loud and demanding or by being indifferent and cynical. When you realize that people have to walk on eggshells around you, it is time to make a critical assessment of yourself before relationships become irreparably damaged. You owe yourself an honest appraisal if you have lost friends, the respect of colleagues, or are experiencing an emotional distancing from your family because of your temper or volatile moods. It is essential to get a grip on your anger before it destroys your social and personal life. Children are particularly damaged by misplaced and excessive parental anger.

Your Anger is Hurting Your Career  fired!
Excessive anger that morphs into hostility and disrespect in the workplace often gains the abnormally angry person nothing but the very same reactions he dishes out. Indiscriminately lashing out simply alienates you from people around you. Remember, it is people that help you advance your career; it is also people that can hamper it.

Your Anger is Hurting Your Psychological Health
Anger raises your “fight or flight” hormones such as adrenaline, cortisol, and norepinephrine. These hormones regulate our survival responses when faced with a stressor and are therefore necessities to life; but, when chronic anger compels these hormones to stay in our bloodstream indefinitely, it takes a toll on our mental health. We begin to be more susceptible to anxiety and depression and feel the pressures of stress more acutely than normal people would.

Chronic anger also clouds your thinking and impairs judgement which reduces your cognitive abilities. Your decision-making capacity, thinking patterns, and perceptions may be significantly warped because of unresolved anger.

heart-attackYour Anger is Hurting Your Physical Health
Unresolved anger can be dangerous to your body’s health. High emotional stress can cause the immune system to weaken and subsequently contribute to a variety of health issues ranging from skin ailments (dandruff, eczema, psoriasis) to cardiovascular problems (high blood pressure, heart attack, stroke).

Your Anger Has Taken On A Violent Turn
When you have physically hurt your spouse, child, or a friend in a fit of anger, it is urgently vital to seek professional help. Violence is inexcusable unless one is faced with a life-threatening situation.

The Goal of Anger Management

Anger management is not about getting rid of anger. It is a process by which one is taught how to identify his personal anger triggers, how to control his responses when faced with angry feelings, and how to handle a stressful situation with constructive and positive reactions.

When you seek to manage your anger issues, you not only seek to significantly improve your life but also the life of others you live and work with on a daily basis. Most of us do not realize how much our words and actions affect other people, especially those who are dependent on us.

Should you feel the need for help on your anger issues, seek a professional therapist. It is best to consult one who is accredited at a recognized organization such as the British Association for Counselling & Psychotherapy (BACP).

Relationships and counselling

4Just like all relationships, marriages do face challenges of all sorts; small, big, simple, complex. What one may call small is what usually causes strain and stress in a marriage hence instability. However, when a partner is willing to find a solution to an impending problem and participate in problem solving, then most problems affecting relationships will not cause major hiccups, but when problems are left unattended to, bad habits develop, health problems arise as tension is also on a rise.

Stress and strain in a marriage may be faced by one partner or by both people in the marriage and problems such as poor communication, differences in parenting skills, financial problems, differences in political ideas, chronic or terminal illness of a partner and infidelity are some of the causes of this tension.

For one to identify that some problems in a relationship have been swept under the rug, there will be an increasing frequency in arguments.

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When problems are swept under the rug, there might also be mental health problems such as depression for one or both people in the marriage, self esteem will be dented. Addictive behaviours such as the abuse of drugs may also occur when partners do not want to get to the root of the problem in their marriage.

It is at such times that couples seek marriage counselling since the problems in their relationship are starting to interfere with their daily lives or they are not sure if they want or can continue with their relationship. When the couple approaches a counsellor, they will need assistance but they have no idea how this help will come and how it will solve their present problem. While some couple may need to develop or better their communication skills, improve intimacy or learn how to sail through the new wave that their lives have presented, others will need the therapist to help in mediating their argument, declare which partner is more logical and the like.

There are several ways that relationship counselling or therapy for married will be done for example the Imago relationship therapy where couples are equipped with tools needed to relate with one another in healthier ways. This therapy also helps to uncover the emotional pathway that one has formed all the way from childhood to now. This is a combination of behavioural and spiritual techniques plus western psychological methods that are used to help couples unravel what their unconscious components are. Other therapies include: family therapy, couple therapy, group counselling, individual therapy.

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However, all these therapies are aimed at resolving relationship problems.

Some couples address problems in their marriages using individual therapy and they apply what they have learned about themselves to their partners. Furthermore, family therapy is also good for families where the children have also been affected by the tension brought on by the strain and stress in their parents’ relationship.


What every couple or family needs to know is that counsellors are not going to take sides or advise a couple to put a halt to their relationship but will advise the couple or family to allow the therapy carry on and unfold in a natural manner without any predetermined relationship saving goal.

Through relationship therapies, couples and families are assisted by supporting the goals that they have set and also helping everyone communicate their needs, emotions, and thoughts in a clearer manner as well as to listen to the other party with a little more care.

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For amazing results to be actualized during and after counselling, every involved party must at least be committed to the counselling while it lasts. There should also be a level of honesty, interest in applying what was advised during the therapy session as well as personal accountability.

In as much as starting any counselling more so relationship counselling is a very daunting task because baring your soul out before a person that already knows you in and out may make one feel naked, then saying the truth about some incidences may bring more hurt than already present. However, if couples or families can let go of that lump in their throats that causes them to trample upon the idea of relationship therapy, the rewards they will get will be greater than the fears.