While I rarely share the same post twice, the topics herein are so very relevant at this time of year for many parents that I felt compelled to share it again. 

In a 2011 issue of the Pennsylvania Psychological Association Public Newsletter, the article "Working Women: Take Care of Yourselves" by Rachel Milner, Psy.D., caught my attention as being particularly important any time of year. As children go back to school, working moms are often faced with not only the demanding daily responsibilities of their jobs and housework, but now children's class selections, teachers, specialized learning programs, various therapies, sports, clubs, high school or college applications and other social activities are once again begging for mom's finite time and attention.

According to the article, while the number of  women in the workforce has increased from one in three in the 1950's to more than half of the current workforce in the US, "women continue to have primary responsibility for home and family matters, [and] many forget to take care of themselves and many run the risk of exhaustion, burnout or becoming ill". (Milner, 2011) In order to decrease the likelihood of these negative outcomes,  Dr. Milner suggests taking the following steps:

• Learn to set limits - You cannot accomplish every- thing yourself. Know your limit and set it.
• Take breaks - It is important to take short beaks during the day. Get up and take a short walk, speak with a co-worker, or do some relaxation exercises at your desk.
• Say no - It may be difficult to say no for fear that you will be negatively evaluated. However, if you take on too much you will not be able to give sufficient attention to anything.
• Take days off - It is important to take time away from the office to rest and regain your energy.
• Give adequate attention to your life outside the office. - If you are having problems in your personal life, your work may suffer.
• Work reasonable hours - Everybody needs to come in early or stay late sometimes, but avoid this becoming a pattern.
• Communicate - It is important to communicate with your supervisors and co-workers so that they know what your needs are and when you may need extra support on a project. 
• Recognize signs of burnout - Know the symptoms of burning out, such as having a short attention span, getting annoyed easily, and feeling unmotivated. When you recognize that you are burning out, make some of the changes mentioned in this article. 

Learning how to recognize our needs and learning to take care of ourselves is not only important for our own self-preservation, thus giving us more energy and resources to tackle more of life's difficulties, but it also models to our children the importance of self-awareness, limit-setting, and balance.

After recently reading this NYT magazine article about the over-prescription of antidepressant medications in the U.S., I thought it might be helpful to expand on this often-debated issue. Being a psychologist, it is not my job, nor my wish, to prescribe medication. However, it is very much my responsibility to notice when an appropriate medication consultation may be necessary. For example, if a client's presenting symptoms are significantly interfering with their daily life, making it nearly impossible for them to initiate change, it may be a good idea to obtain a medication consultation.

I often hear the fear that once begun, one will have to remain on the given medication indefinitely. While people with certain diagnoses, such as bipolar and psychotic disorders, are proven to fare much better if continually medicated, others may have a different course. For example, some individuals, particularly those with presenting symptoms of anxiety, adjustment disorders and mild depression, may initially need a little extra pharmaceutical help in alleviating the severity of their symptoms in order to be able to make the necessary changes in their lives. However, once these folks are able to make and maintain certain behavioral, cognitive and even affective changes, they may be able to lower the dose of their medication or ever discontinue its use, advisably, with the consent of the prescribing medical doctor.

It is important to keep in mind that there are a number of highly effective and non-invasive options to treat symptoms of depression, adjustment and anxiety that have nothing to do with pharmaceutical intervention. For example, while exercise certainly has not received as much press and endorsements as psychopharmacological treatments for depression and anxiety, studies show that regular exercise may be a viable medicine against certain psychological problems. Likewise, regular meditation, yoga and mindfulness approaches may be extremely helpful in reduce symptoms of anxiety and  depression. Finally, while talk therapy can sometimes be a difficult and time-intensive process, it often results in lasting, sustainable change that rarely has the kinds of side effects that are unfortunately all too common with pharmaceutical interventions.

In his recent NYT article about the popular perception on grief and mourning, Mark Epstein made a powerful point about our country's constant cultural pull toward "normalizing" everything. In this poignant article, Dr. Epstein points out the omnipresent expectation that even the pain associated with life events that are inherently deeply painful and traumatic are subjected to external, arbitrary timelines to disappear without a trace. This cultural expectation to "move on" from grief, loss and trauma sets up a difficult paradox for the individual who is already going through a tough time, imposing a constant judgment on the efficiency and general nature of a very personal and individual process. 

This tendency to normalize our lives and put on a certain expected facade is at the very foundation of our culture. Take a look at the superficial nature of our personal greeting process. When asked the question "how are you?" how many people habitually answer the question honestly, and tell the greeter how they really feel? I am willing to bet that even when most of us are internally suffering,  we nevertheless dutifully utter a socially acceptable, if not meaningless platitude, that makes the person asking the question feel better. However, this social "nicety" may come with a price to those of us who are already struggling with grief, trauma or loss by contributing to feelings of alienation, as well as feelings of guilt for not coping or healing in an appropriate and timely manner.

As Dr. Epstein so eloquently states, "the willingness to face traumas -- be they large, small, primitive or fresh --is the key to healing from them. They may never disappear in the way we think they should, but maybe they don't need to. Trauma is an ineradicable aspect of life. We are human as a result of it, not in spite of it."