Coping with Infertility

Posted on December 27, 2017 by Alisa Hafkin

Recently, Giuliana Rancic shared her very private struggle with infertility with readers of USA Today.  Stories by people in the public eye who struggle with anxiety, depression and infertility can bring comfort to many who read their words. We realize that no amount of fame or fortune can protect someone from life’s challenges .

You may know of Giuliana and her husband Bill (both of reality TV fame).  Their path of dealing with infertility has been well documented and discussed over the years including several other health issues they have had to contend with.  I applaud their willingness to share their stories and connect with others who are struggling.  Their infertility journey did bring them to surrogacy and their son Duke.

When you read about Giuliana’s struggle with infertility, you realize one theme that kept them going – hope.  Hope carried Giuliana through when she realized that what was so “normal” for other people was not going to happen for her – the idea of conceiving a child herself.  Her strong sense of hope helped her manage IVF, which for many couples can be an unbearable time filled with uncertainty and expense.

How can you manage to find and then maintain some hope when going through IVF?  It can be difficult but I can help.  When clients approach me for help, they often come in frightened, ashamed, confused, tired, angry and depressed.  They have been struggling with issues of infertility for some time and have hit the emotional wall.

We often start by examining the full range of emotions that occur, and there are many.  You may feel scared that you will never be able to conceive a child, angry that your body is not working as it should, jealous of your friends and family members who seem to easily get pregnant, and dread the idea of dealing with the doctors, tests and medications.

Validation is a key component in the beginning of our work – you have the right to feel exactly as you do. When someone is struggling with infertility, they often keep their deepest feelings to themselves. Our task is to help you manage the negative emotions so that they don’t dominate your perspective on what you are going through. I provide a safe space to fully experience whatever emotion you may be feeling and expressing your emotions can bring about a sense of relief.

As Giuliana states, research can help alleviate your anxiety by providing you with a greater understanding of what types of treatment options are available.  The science behind fertility treatment is constantly evolving so it is helpful to try and find out what is most current so that you can make educated choices. It is critical to find good doctors to work with who have good success rates.  I would add that finding a great therapist who can help you stay positive is also a vital part of your journey toward having a child.

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Communication and Infertility

Posted on December 22, 2017 by Alisa Hafkin

You’ve been trying to conceive a baby for some time and still you are not pregnant. You worry that something may be wrong.  Sometimes, this is the most difficult stage in the process of dealing with infertility – just admitting there could be a problem.

Sometimes admitting the problem, even to yourself, is just plain scary.  It means you have to face the reality that this might be difficult…and not natural.  You may be wondering “will I ever have a child?”  When you walk down the street in NYC you see other new moms pushing baby strollers and you just cringe on the inside…and you also cry, out of fear and frustration.

The first thing to do is work together with your partner, doctor and a therapist to come to a place of acceptance that you might have an issue. This comes with helping you gently forgive your body for not cooperating and living with some fear about the future – both in terms of what you will go through and also if you will ever conceive.

How you talk to yourself:  Clear and positive messages to yourself will help you ride the storm or infertility.  You can certainly get angry and sad, but also be loving and gentle.  Setting a positive attitude does not guarantee success but it will enable you to carry on and bear the weight of decisions you and your partner will be facing as you try to make plans for having a baby.

Communicate with your spouse:  Couples experience infertility at the same time but they process it in different ways.  For instance, a woman who feels like a pin cushion needs a sensitive partner.  When a man goes through testing he may feel as if his “manhood” is being called into question.  It is important to know that this is not about one of you, it is about both.  It does not matter where the medical obstacles lie, it is just critical that you face them together.

Discussions with your doctor:  There are so many things that can be medically corrected these days, but you have to find a doctor who meets your needs.  Your medical history may play a part in what is going on, and your doctor is only going to have that information if you share it.  Your entire medical history, including your reproductive history, should be fully discussed.

Bring it all to therapy:  all of these discussions can be exhausting and mixed with the myriad of emotions you are having, it can sometimes feel like it is too much to handle.  If you find yourself getting bitter, resentful or depressed it is best to see a therapist.  Sometimes a impartial and caring person can help you sort through emotions and options and give you the clarity you need to move forward.

Action, self-care and a hefty does of communication will help you navigate the often uncertain and scary path you will walk when attempting to conceive a child.  Make it about you and your partner taking on the goal of getting pregnant- together – and you will find yourself better prepared to handle what comes your way.

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The Importance of Self-Care

Posted on December 4, 2017 by Alisa Hafkin

In the last few years we have seen a significant up-tick in amount of importance placed on self-care.  What was once viewed as a self-indulgence is now being viewed as critical for emotional health and overall contentment.  For those of us who live in NYC, self-care is essential to leading a balanced life.   How you practice self-care is entirely up to you as long as you enjoy it, it enhances your life in some way, recharges your mind, body and soul and it helps you tackle the stress of every day life.

If you are dealing with anxiety, stress, or depression, Manhattan can provide an abundance of opportunities for self care.  Sometimes it is hard to find time outside of work, family and other commitments so here are a few great suggestions for taking care of yourself.    Here are some general guidelines to help you find the self-care activity that you need.

  1. Self-care is not about getting things done so you feel better.  While you may have a “things to do list” a mile long, spending an entire Saturday sloughing through holiday shopping or cleaning is not self-care.  I acknowledge that reducing stress is important, but driving people around to their appointments is not self-care for you.
  2. Self-care does not have to be expensive.  You do not need to book a spa suite at a fancy salon to give yourself a bit of time to destress.  In fact, spending too much money on self-care can cause your anxiety to increase.
  3. Self-care is about taking care of you and it should be planned.  You can plan on going into an evening or weekend with a commitment to carve out time.  It helps to discuss this with your family or significant other so they understand the importance and can get on board.

So what does self-care look like?  Well it certainly can be a spa treatment but here are a few great examples that you can start practicing today without much effort or expense.

  1. Read a book
  2. Meditate
  3. Take a walk without your phone.
  4. Unplug
  5. Exercise
  6. Go to lunch with a friend.
  7. See a movie
  8. Work on your hobby

Many times clients are confused about what self-care really means to them.  During our discussions we explore the things that are overwhelming and stressful and then we sort out what they do not like to do. We collaborate on developing a list of simple things they can do to take care of themselves. Not being able to fulfill the goal of self-care can be stressful so we come up with ideas that are reasonable and doable. Making a commitment to taking care of yourself should not be a source of stress!

 

 

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Creating Healthy Habits in 2018

Posted on November 29, 2017 by Alisa Hafkin

With the new year just beginning, it is time to start thinking about how you are going to build the best you in 2018.  January 1 is a great time to start and with some planning you can be prepared for a successful kick-off to the year that will enable you to achieve your goals.  I work with clients to develop goals that they can commit to and here are my best tips for success.

When clients come into my office they are often looking for help to navigate current problems. Usually something has derailed their plans or thinking and helping clients refocus their thought process is a good first step.  For couples who are having relationship problems or are struggling with infertility, or individuals who suffer from anxiety and depression, coming up with a good plan on how to unpack the complexities of the problem while trying to embrace life and move forward can be helpful.

Exercise:  With the consultation of your medical doctor, exercise can be one of the best ways to combat an emotional rollercoaster.   Clearing your mind, sweating it all out, and focusing on your health can help relieve anxiety, help you deal with depression and bring a healthier connection in your relationship.

Big goals start with small steps:  While you can have long-term goals of improving your marriage or losing 50 pounds, it is best to break these down into small steps.  Remember, each step can be a milestone worthy of  celebration and an impetus to continue, so you can to reward yourself for hard work.  Having a 10+ marriage can just start with 2 dates a month or a nightly 15 minute check-in.

Habits will help:  Let’s say you want to start exercising because you know you will feel better about your self and it will help reduce your anxiety and depression.  Having a regular routine to get you to the gym and also maximizing your time while at the gym will be advantageous to sticking to your plan.  Pack your gym bag the night before, plan your workout, and carve out time during your day.  Going to the gym at the same time of day will also help.

Do this with a buddy:  Sometimes the support, and accountability, from another person is enough to keep us focused.  It can be a friend or a co-worker whom you check in with on a regular basis to make sure you are staying on track.  Maybe this person has goals similar to yours!

A significant part of a successful 2018 is believing you can do this.  You can build the life you want to live and meet all of the goals you set by starting small and building on top each goal you achieve.

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Michael Phelps and His Anxiety

Posted on November 6, 2017 by Alisa Hafkin

Major sports figures and celebrities often appear to have perfect lives.  But over the years a few have been brave enough to come forward and share personal stories about their anxiety and depression.  Michael Phelps is the latest to come forward and he talks about his anxiety in a new film.  http://people.com/sports/michael-phelps-talks-anxiety-new-film-angst/

Like many people, Michael has admitted to simply ignoring his anxiety.  When he felt anger, depressed, or upset he would ignore it, burying his emotions and not dealing with them until that strategy no longer worked.  

This was not a healthy plan and eventually the problems he was dealing with got too big for him to handle privately.  Michael was arrested for drunk driving and marijuana possession, and he isolated himself by sitting in his room for days on end.  He knew that the anxiety was manifesting in unhealthy ways and he ultimately came to the conclusion that he needed to make a change.  

Phelps message was clear – he didn’t want to recover alone, and you should not suffer alone either.  Phelps mentioned the importance of opening up and talking about his feelings.  He explained that for him, he finally got to the point where he realized it is “ok, not to be ok.”  

When you work with a therapist here in NYC, you develop a partnership with someone who will listen to everything you have to say.  When patients visit my office they know I am there to ensure they are heard in a safe environment that they can trust.  We work to unravel the often confusing and upsetting emotions and then find ways to build up healthy coping mechanisms to help you when you feel anxious.

How can you start to feel more empowered when you feel anxious?  If you are going through an anxious period in your life, it is critical that you develop methods to help you deal with stressful situations.

  1. Breathe – Taking a deep breath in and out can help you relax. There are very specific ways to breathe that can maximize its stress reducing capabilities.
  2. Start to write about your stressors.  Some form of journaling can be very therapeutic and gives you a list that exists outside of yourself of what is making you feel anxious.  There is no right or wrong way to journal so just start writing to find your comfort level.  
  3. Get outside. There is a tremendous benefit to just getting outside and walking around.  It could be interacting with nature, seeing other people or just the physical exercise that makes you feel a bit better.
  4. Exercise.  There are many individuals who feel that regular exercise keeps their mind in balance.  So, with your doctor’s approval, get over to the gym and start sweating.
  5. Talk.  Just like Michael Phelps, talking with a trusted person is important.  We can put in place strategies to ensure that when anxiety creeps up you have a plan on how to handle it.  

Here in Manhattan we live in a very busy environment and it seems that everyone else is doing fine and getting ahead.  The truth is, just like Michael Phelps, many struggle to find some balance.  Just like Michael, find help for yourself so that when you hit bumps in the road you can handle them and succeed.  

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Anxiety When There is a Tragedy

Posted on November 6, 2017 by Alisa Hafkin

Managing anxiety on a daily basis can be a struggle.  In these last few months the news has reported on several tragedies that can give us each pause and trigger anxiety.  The hurricanes in Florida, Houston, the Virgin Islands and Puerto Rico as well as the mass shootings in Las Vegas and Texas and the terror attack in New York City are very hard to process in an already anxious mind.  If you find yourself endlessly worrying about these recent events, is critical to acknowledge your fears but also make a plan to help you deal with your anxiety.

Initial panic over a horrific event is of course completely normal.  You may be concerned about friends and family who are involved in or live in that area.  If the incident is close to you it may be overwhelming to think that something bad could happen.  You may have thoughts and questions for yourself like “could a storm like that hit where I live?”  “What would we do if we lost power and didn’t have clean water for an extended period of time like in Puerto Rico.”  “How safe are we from more terror attacks here in NYC.”  

These anxious feelings that you are having and questions you are asking are normal when there is a crisis, even far away.  Do not feel that your thought of “could this happen to me” is unfounded.  Acknowledge the reality of what you are thinking as important.  The problem occurs when your thoughts start to spiral.  It is important to recognize the direction your feelings are headed before they cause debilitating anxiety which can create a kind of psychic paralysis that keeps you from living your life.  

Anxiety that is brought about by a sense of impending doom is not uncommon in uncertain times.  And in a bustling city like ours there are certainly many big issues to worry about.  I completely understand and know how are scary these very real threats seem to be.  Over the years NYC has had some tragedies hit close to home and being able to weather these, and other storms, is critical.  

When you work with a psychotherapist, you can start to build a plan so that when fear and panic set in you can deal with the emotions in a positive way.  Isolated incidents that cause panic can be dealt with in a positive way, and I am here to help you figure out the best plan for you.  

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When Anxiety Runs Your Family

Posted on September 18, 2017 by Alisa Hafkin

If you talk with the loved one of an addict, you know that the addiction tends to dominate the family dynamic.  The same can be true for those suffering from anxiety.  Their anxiety can be driving the dysfunction in your family and you don’t even know it.  Here in New York City we live in tight spaces and family members are around often.  Our living environments can be cramped with few ways to escape the chaos.

Does it ever seem to you like one member of your family is on edge most of the time? The presentation of anxiety can vary greatly but it becomes clear when you sense tension and fear from that family member.  Maybe they want the chores done a certain way in order to feel in control.  Maybe it is a child who constantly panics about homework and the entire family must be quiet and/or available to help.

In these situations, family members often feel that they are walking on eggshells as they try to be very careful of what they say or do so that they do not trigger the anxious person.  They want calm but wind up creating strain.  They give space, but that space, when too big can become unhealthy and create an unwanted sense of distance.

It is important that you do not try to fight the anxiety that seems to be controlling your home.  Sure, you can have quiet hours, and follow certain cleaning procedures.  However, you also need to live a normal life and not feel under scrutiny.  If your family member has a significant problem, they are not going to react well to conflict and will not snap out of it.

It is important that you validate the feelings of the anxious person but not sacrifice the household.  “I’m sorry you feel that way, let’s talk,” can diffuse the situation and show that you care.  They need to understand you are on their side but that they can not run everyone’s lives.  If your child is anxious then maybe they need to go to a local library to do homework or start an exercise program to relieve stress.  There are many options we can explore.

All families experience stress, especially when there are many people, activities and noise.  If you have the feeling that the stress is overwhelming, take a good look at the issues.  Maybe one family member is having some difficulty managing stress and their anxiety is starting to take over your home.  A therapist can work with you and your loved one to ensure that the stress is appropriately managed.

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Is Depression Hereditary?

Posted on September 18, 2017 by Alisa Hafkin

Depression is a serious mood disorder that can impact every single area of an individual’s life.  Here in New York City we see depression caused by many external factors.  The question has always remained whether or not depression runs in families from one generation to the next. Studies have shown that a child who has parents who are depressed is two to three times more likely to be depressed themselves.  In fact, there’s a forty percent chance that someone suffering from depression can trace it to a member of their family.  

Depression runs in families just like allergies, blood pressure and cancer.  Not everyone in a family needs have suffered with depression to make it a factor in your own depression.  Your uncle, grandmother or sister may have depression while everyone else does not.  Even with the same genetic pool, certain factors for depression are not necessarily found in all family members.  Additionally personality and life events can have a significant impact on if and how depression can manifest.

Members of your family who have struggled with depression may enable you to better understand the signs and symptoms.  Knowing what to look for can spur you on to get help before depression starts to cause significant problems in your life.  However, if there is depression in your family that caused serious problems, you may feel scared about acknowledging your own depression.  Maybe you feel a bit blue one day but do not think it is as bad as your father who stayed in bed for weeks on end.  You decide not to check in with your therapist (or find one).  So, it continues and you struggle.

If you know that it’s possible for the feelings of depression to originate from within you, know that it is never too early to learn ways to manage the stressors that trigger depression.  Practicing techniques such as breathing, meditating as well as finding ways for support will help you feel like you have some sense of control over slipping in to a depressed state.  

When you are depressed, a therapist can make the difference by helping you learn to manage your depression or struggling with it.  I am always available to help you and your loved ones deal with depression to enable you to live as full a life as is uniquely possible for you.

 

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How Do Men Deal with Infertility?

Posted on August 2, 2017 by Alisa Hafkin

Remember the old saying, men are from Mars and women are from Venus?  In many ways, men and women are emotionally wired a bit differently.  When dealing with infertility, it is important to understand the different coping mechanisms men and women use as they navigate the highs and lows of an infertility diagnosis and treatment.

Being given a diagnosis of infertility is an extremely significant stressor in your life.  From an early age, both men and women develop ideas around family and parenting that gets derailed when infertility is uncovered. There are many reasons for infertility and testing to determine what is going on affects men and women differently. Male infertility is more common that is typically known so when a man is diagnosed with infertility, it is important to understand the depth of his emotional response.

If you have a low sperm count it may feel like your manhood is in question and that can be a struggle for even the most confident man.  Take note to work through all of the causes with a doctor and then follow the suggestions you are given.  Touch base often with a therapist during this time – we can help you process the feelings that arise from finding out that your body is not doing what it is supposed to do.

Intimacy becomes scheduled and controlled and the sexual relationship you have with your partner is is now something that doctors want and need to know about.  Doctors may have to put your sex life on a schedule for optimal times for conception. Erection problems are not uncommon when a man is told that the reason for infertility lies with him.

Managing your partners emotions during times when she feels like a pin cushion and she herself is extremely anxious can be very stressful for men.  She is watching her friends and relatives start their families and she just wants to have a baby already!  She may try to be strong and she may crumble in tears and you may not know what to do to help her. If infertility drugs are involved then you will most likely see your partner experience a wide range of emotions that she cannot control.

There is no way to just “solve” this problem and this may make you feel helpless. Some men love to fix a problem but this is not a scenario where solutions are immediately available.   Learning to let go and trust nature and doctors may be difficult.  We can work closely together to help you process the emotions you may be feeling such as fear, shame, depression and anxiety.

How to make it through?  Regular communication is the key to your success in managing this emotional situation.  Acknowledge that you want to connect with one another as a couple and give yourselves some space to not talk about making a baby.  Couples therapy can be a great resource for you so together you can learn to build a strong relationship during this incredibly stressful time.

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Dealing with Depression in the Summer

Posted on August 2, 2017 by Alisa Hafkin

Great weather, lots of fun outside and so much to do. It seems as though most of your friends are at the beach…taking the train down to Belmar or hopping a ride out to Jones Beach and the Hamptons.  And all you want to do is sit inside.  How is this even possible?  Your friends and family are concerned…and you might be as well.

When you think you may be suffering from depression in the summer time – it’s a good idea to schedule a few therapy sessions to help you uncover what is making you feel so sad. Sometimes just talking about your feelings and collaborating with your therapist on what you can do to help yourself can bring about relief. Therapy can help you cope with your feelings and hopefully enable you to take part in enjoyable summer activities.

What can cause summer depression?  New schedules can certainly be a problem for someone who likes routine.  Your colleagues may be on vacation, children are home from school, or maybe your children are all off at summer camp and you really miss them!  The thought of spending time in a bathing suit might cause anxiety and depression for you.  You may have issues about money as summer activities can be more expensive.

All of these are feelings are normal.  The question is, how can you cope with your summer depression so that you don’t shut down during this time of year?

The best thing you can do for yourself is to schedule a therapy appointment. We can spend some time together working through what is holding you back from engaging in life.  As we work through your issues, we will develop the tools you can use to manage your emotions when life becomes stressful.

It may also be a good idea for you to do something you absolutely love that is outside of the house.  Visit a museum, a favorite restaurant, or take a walk through a park.  Getting out and about a bit can help you experience the world beyond what is going on inside your head and it may help ease some of your depression.

Lastly, practice self-care.  Attend a yoga class, get a massage, read a good book or spend some time relaxing and deep breathing.  Take time to sit with and acknowledge all that you are grateful for in your life.  Counter some of your negative thoughts with positive affirmations about what you currently have and are working toward in your life.

It is often hard to process summer depression because it just doesn’t seem like the right season to feel depressed – that seems to happen more in the winter when you are stuck inside.  But being sad during this time is completely normal.  The most important thing is to work through your issues so you can catch the depression early on before it becomes too overwhelming.

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