Dealing with Infertility

Posted on January 11, 2017 by Alisa Hafkin

As a NYC psychotherapist I have a particular focus on helping individuals and couples deal with infertility.  Often new patients seek out therapy to get help with developing a plan to get through this challenging time.  They may have just found out there is an issue or they have been struggling with infertility for quite some time.  Each session is an opportunity to talk about the struggle and emotional upheaval of dealing with infertility and its treatments but it is also an opportunity to develop coping methods and plans of action.   Inevitably, this is the question that gets asked:

How I am going to get through infertility?

I create a safe space to feel whatever it is you are feeling and that, in an of itself is a way to get some relief from anxiety, stress, depression and fear about your infertility. It may feel hard to keep going and act normal at work and with friends, but sometimes that gives your mind a break from focusing solely on your infertility. Here are some suggestions to get you started down a path of accepting where your body and mind are right now.

  1. Acknowledge your disappointment.  A diagnosis of infertility is shocking and you should expect to feel a wide range of emotions.  Discussing these difficult feelings will allow us to deal with them in a positive manner.
  2. Turn toward your partner or a trusted friend or family member.  Whether the issue sits with you or your partner or does not have an immediately understandable source, it is time to turn toward someone for support.  If you are in a relationship, blaming, giving the cold shoulder or acting aloof can creep in and you want to get a hold on that before it becomes destructive.
  3. Do your research.  Do not sit confused with unanswered questions that can lead to more anxiety.  Use your support team to get the information you need on treatments and for developing your plan.
  4. Try to get some space from thinking about your infertility.  This might be a good time to think about getting in to something that can fully absorb you, even if it’s for a very short time. That will give your brain and heart some rest.

Individuals and couples who seek therapy during this very difficult time hope to find a way to ultimately get pregnant. Therapy is part of a holistic approach to the problem of infertility along with a strong medical team, good nutrition, rest, socializing and exercise.  All of these things need attention to promote balance and as much wellbeing as possible while going through stressful treatments and wait times.  No matter where you are in the process of dealing with your infertility, make sure you have a confidential support team in place to help you through.

 

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What are the Warning Signs We Need Couples Therapy?

Posted on December 19, 2016 by Alisa Hafkin

Relationships are dynamic. We all have our ups and downs. Every relationship will hit some bumps in the road but you should get help before your relationship gets out of control and feels hopeless.

Sometimes it takes one partner realizing there is a problem and convincing the other partner that help is needed.  When there is resistance, it might be helpful to talk to your partner about how you are feeling.

Here are some things to consider when thinking about couples therapy.

  • Do you feel like your partner isn’t seeing or hearing you? Is he or she too busy with the demands of life, leaving you feeling isolated?
  • Are you having sex? Almost 12% of marriages are considered sexless or nearly sexless, according to one survey. There could be a physical issue in the way and caring for children and stressing about work doesn’t help. If you’re not interested in sex for a prolonged period of time or are no longer physically attracted to your partner, a deeper issue, like a lack of emotional intimacy or romance, might be a factor.
  • Are you thinking about or talking to ex-lovers or spouses? Do you want to get back together or have an experience with someone other than your spouse?
  • Do you enjoy time with others more than with your spouse? Are you looking forward to time with friends or family, but not with your partner?
  • Have you become so apathetic about your relationship that even arguing about issues doesn’t seem to be worth the effort? Bickering represents more of a connection than apathy because apathy is a sign you’ve given up and there’s no longer something holding you together.
  • Are you overcompensating? When asked by others how things are going, do you paint an overly rosy picture about your spouse and your relationship?
  • Are you empowering one another or spending a lot of time nitpicking and criticizing, pointing out flaws or thinking your spouse can’t do anything right? Are you verbally lifting each other up or knocking each other down?

I help couples re-build their relationships and enable them to take down the emotional walls between them. We all need help from time to time and getting help with a relationship can be an investment in time and energy that could result in a lifetime of rewards. Learn more about what I can do for you and your relationship by contacting our office.

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Don’t Get Overwhelmed Over the Holidays

Posted on December 19, 2016 by Alisa Hafkin

The holidays are supposed to be idyllic times for friends, family and children. For many people the holidays are stressful with overloaded schedules and high expectations that can’t reasonably be met. Spending time with family members who you may not have a great relationship with or being surrounded by children while you are dealing with fertility issues may not be a recipe for happy holidays.

The Mayo Clinic has suggestions for things you should plan on doing to help you through the holidays.

  • Maintaining all the holiday traditions every year may be an impossible task. Families and times change and traditions and rituals change as well. Choose some to maintain and think about creating new ones. If adult children can’t be with you try to schedule time together in January when schedules aren’t as tight and time demands are lower.
  • Accept family members and friends as they are, don’t wish they could be as you would like them to be. Set aside differences until they can be discussed some other time. If someone else gets upset or stressed by something it might be because they’re feeling the effects of holiday stress or depression.
  • Stick to a budget. Don’t try to spend your way to happiness or show how much you love someone by how much money you spend on them. Set a budget and stick to it.
  • Set aside specific days for holiday tasks like shopping, baking, visiting friends and other activities. If you’re hosting, plan your menus and make shopping lists. Avoid last minute scrambling that can multiply holiday stress. Ask for help for party prep and cleanup.
  • Say no when you need or want to. You can’t be in more than one place at a time and you’ll need some down time for yourself, especially if your job entails a lot of demands at the end of the year.
  • Don’t go overboard with food and drink. Many people try to treat holiday stress or depression with alcohol or over eating which is especially easy to do this time of year when we seem to be surrounded by food and drink. You’ll just have the inevitable food or alcohol hangover the next day, making you feel worse.

Seek professional help if you need it. If despite your best efforts, you’re feeling persistently sad or anxious, have difficulty sleeping, are irritable and feeling hopeless and unable to face routine chores, then get help. Contact our office so we can talk about what you’re going through this time of year and how we can help you.

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What are the Signs of PostPartum Depression?

Posted on November 14, 2016 by Alisa Hafkin

Mood swings and feeling blue are not uncommon in new mothers during the first six weeks after a baby is born, but for some mothers these depressed feelings don’t go away. These ongoing feeling can be a sign of a more severe, longer term condition known as postpartum depression. Postpartum depression is not your fault, nor is it a character flaw or a weakness. It is a complication that can occur after giving birth. Symptoms of postpartum depression vary and can range from mild to severe. It is important for both members of a couple to know the signs and provide support.  

Postpartum “baby blues” may last a few days to a up to around six weeks after birth. Some symptoms include,

  • Mood swings
  • Feeling anxious
  • Feeling sad
  • Being irritable
  • Feeling overwhelmed
  • Crying
  • Difficulty concentrating
  • Appetite problems
  • Insomnia

Postpartum depression may be seen as the “baby blues” initially but symptoms are more intense and last beyond the six week time frame with little or no signs of abating. They can interfere with taking care of yourself, your child and other daily tasks. Symptoms can develop from a few weeks to months after giving birth.

  • Feeling depressed
  • Severe mood swings
  • Extreme crying
  • Feeling disconnected to your newborn
  • Withdrawal from family and friends
  • Eating much less or eating much more than usual
  • Insomnia or excessive sleeping
  • Severe fatigue or loss of energy
  • Less interest and pleasure in activities you previously enjoyed
  • Extreme irritability and anger
  • Fearing you are not a good mother
  • Feelings of worthlessness and inadequacy
  • Less able to think clearly, concentrate or make decisions
  • Anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

I focus on helping new parents after the birth of their baby. Many new mothers and fathers go through a challenging time after their baby is born and may not realize that they need help coping, especially if this is their first child. If untreated, postpartum depression can last many months or longer. There is help for you so if you believe you are suffering with this contact our office so we can help.

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How Do I Find the Right Fertility Clinic?

Posted on November 9, 2016 by Alisa Hafkin

If you’ve decided it’s time to contact a fertility specialist in order to become pregnant, start by doing some thinking and homework. It is important to spend the time and energy to find a clinic that’s a good fit and gives you the best chances of becoming pregnant.  There are many options here in NYC, from clinics to doctors offices.  While the goal of each is the same, to achieve a pregnancy, there are differences that may be important to you.  

Before you start your doctor or clinic search, consider the following:

  • Infertility treatments can be very expensive, as they may or may not be covered by insurance.
  • The use of hormone drugs can produce varying physical and emotional side effects.
  • Be mindful of your emotional, practical and financial limits as there are many options to engage in that can occur over months and years.

Two resources you can use to find information on a clinic near you is a database maintained by the federal Centers for Disease Control and Prevention (CDC) and the American Society for Reproductive Medicine.

  • They contain the success rates of fertility centers throughout the U.S.
  • Look for the most updated outcome statistics.
  • Explore the history of the clinic and look for any major changes that may have affected the functioning of the facility.
  • The database and ASRM are good places to start but don’t make decisions based strictly on the statistics. It is important to honor how you feel during your review process.

If you schedule a visit, prepared yourself with a list of questions. You need to find a place with good quality control and strong ethics.

  • How long has the medical director, doctors and technicians worked there? 
  • Which procedures do they perform? How often? Find a clinic with a range of infertility practices and techniques using the latest technology.
  • Do they limit treatment based on age? If so, find out their rationale.
  • Fertilization outside the body involves making a choice as to how many eggs get fertilized and how many get placed back in the body. Find out if there are limitations and if you are able to collaborate on the amount.
  • What are the costs? You may not want to choose strictly on cost but be aware of the costs before starting so that you can make an educated decision.

Undergoing fertility treatments can be a long and stressful process. I help couples and individuals who find themselves on this journey, develop the skills and coping mechanisms that are necessary as they try to conceive a child. If you’re in the New York City area and have any questions or want help contact our office today.

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Preparing for Holiday Anxiety

Posted on October 17, 2016 by Alisa Hafkin

If you suffer from depression and/or anxiety, the onset of colder weather may make you feel nervous.  The recent arrival of fall may trigger an additional stressor – the upcoming holidays.  For many, the holiday season is a time of joy with family and friends coming together.  But for some, it can be a time of great stress that can lead to depression and anxiety.  If you have suffered from anxiety and depression in the past and know the holidays can be a trigger, then use the following information as a guide to help you gain insight and learn coping mechanisms.

  1.  Talk with a therapist now.  There is no better way to deal with depression and anxiety than before it begins.  We can work together to build your coping skills now so that when you are presented with a stressful or uncomfortable situation you do not slip down a darker path.
  2. Acknowledge the signs as they present themselves.  Colder weather, an invitation to a holiday party, the thought of gift shopping, your mother calling to confirm you are attending dinner.  These scenarios have the potential to raise your stress level, leaving you more vulnerable to depression and anxiety.
  3. When you feel the triggers stick to the action plan we put in place.  For some people it is a positive affirmation or mantra they repeat to themselves, for others it might be a call to a friend, walk in the park, or a specific relaxation technique.  For some of my patients the best course of action is to schedule an appointment with me to talk through what is bothering them.
  4. Staying healthy can really help you avoid stress and anxiety at the holiday time.  Eating right and getting a regular dose of exercise will help clear your mind.  When you make the commitment to take care of your physical self, the added benefit is that it positively feeds your emotional self.

Holidays can be stressful for many people.  But if you dread the thought of going through the season because of anxiety and depression then take care of yourself.  Having a plan and booking regular appointments with a therapist can build you up to ensure you not only survive the season but actually enjoy it.

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“When Are You Starting Your Family?”

Posted on October 17, 2016 by Alisa Hafkin

With the holiday season upon us, many people are planning to spend time with family and friends.  If you are married/partnered/single and in your child bearing years, you may be ready to start a family of your own.  You may have friends and relatives your age who have babies and toddlers, and you have yet to conceive.  Your may be contemplating your options around the idea of having children or you may be starting infertility treatment.  And you know an interested relative at a family gathering is going to ask…

“When are you going to start your family?  When are you going to have a baby?”

And just the thought of this question brings dread and feelings of frustration, shame, anger and confusion. You know you want to scream “It’s none of your business!” You are not ready for the uncomfortable silence that may follow nor are you about to discuss your struggle with infertility with your relatives.

How do I know you may have these feelings?  Well, one of my specialties is helping individuals like you deal with the emotional side of infertility and my patients have shared the many challenges they faced during their time of trying to conceive.

So, here are some tips to help get you through the awkwardness.

  1.  Know it is coming.  If your aunt, cousin, grandmother, friend has asked before then they may ask again.  Be ready for it; do not feel blindsided or hurt.  Cough it up to being a bit nosy, concerned and curious.
  2. Have a plan to respond.  The phrase “we just aren’t ready yet” is a great response and then have a follow-up to turn the conversation back to them.  For instance, offer them a drink, ask them about a current event, or inquire as to what they have been up to since the last time you saw them.
  3. You can feel ok about trying to avoid those difficult questions from people you suspect are prone to ask you personal questions. Limit your exposure to people who make you uncomfortable to reduce the risk of being caught in a painful situation.
  4. Enlist the support of your partner or close relative to either stay with you during the event or at least when dealing with certain relatives.  You can even ask to be surrounded by a safe group at the dinner table.

I do not recommend your sitting home pretending to be sick just because you do not want to face your relatives who will notice and comment that you do not yet have a baby.  Nor do I suggest you feel obligated to disclose or discuss anything that is private and sensitive. Sit confidently in your current situation knowing that at some point you will start your family.

The emotional side of dealing with infertility can be painful.  It is normal for you to be uncomfortable when others are having babies or asking questions.  Go home, have a good cry on your partner’s shoulder and make sure to spend some time talking with a therapist who can help you.

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Beating the Baby Blues – Why Walking in NYC Can Help

Posted on September 7, 2016 by Alisa Hafkin

A common occurrence after having a baby is experiencing the baby blues. Your hormones are trying to get back to normal and during this regulation process, you may feel sad, depressed, anxious and just plain all over the place emotionally. This process usually lasts around three to four weeks after having a baby. If you are physically able, one way to try to cope is by walking or doing other mild exercise. It’s been clinically shown that regular, moderate exercise is beneficial for the mind and body.

Studies going back to 1981 show that regular exercise can improve mood in those with mild to moderate depression and may also help those with severe depression according to the Harvard Medical School. A study published in the Archives of Internal Medicine in 1999 involved looking at 156 men and women with depression who were divided into three groups. One group was involved in an aerobic exercise program, another took a medication (Zoloft) and a third did both. After sixteen weeks, depression had eased in all three groups with about 60%–70% of the groups no longer meeting the definition of major depression.

Why would walking help with the baby blues? Exercise increases the action of endorphins; chemicals circulating through your body that improve natural immunity, reduce the perception of pain and may improve your mood. Another theory is that exercise stimulates the neurotransmitter norepinephrine, which may directly improve mood.

Regular walking has other physical benefits including lowering blood pressure and providing some protection against heart disease and cancer. How frequently and intensely you exercise is up to you and what you feel you can do after having a baby. For long term overall health, experts suggest a half an hour to an hour of moderate exercise, including brisk walking to improve your health and your mood.

If you want to talk about the baby blues or other postpartum issues contact us today so you can discuss what you’re going through and what we can do to help.

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Date Nights in NYC in the Fall

Posted on August 30, 2016 by Alisa Hafkin

You and your spouse or partner lead busy lives. If on top of that if you’re having difficulty with your relationship, infertility or feel frazzled due to a newborn baby it might help to take some time out to relax and get reacquainted with each other. Dating was the way you originally got to know one another and it’s a good way to learn more about your partner as the relationship progresses.

Maybe it’s been a while since your last date, maybe too long.  But continual dating, well into a marriage, is an important way to stay connected through busy times.  You get to relax without the distractions of your home (including children) and can spend a bit of time just focused on one another.

There are limitless date options in New York City in the fall or any time of year. Get out and make at least one a date and it doesn’t have to be going out for dinner. Sometimes talking over a meal can lead to heavy discussions and that, in and of itself is ok, but maybe not what you need right now. You may need a date where you don’t talk but just play.

Don’t underestimate the value of playing with your spouse. Children engage in play all the time and it builds their sense of self and solidifies their relationships. As adults, we often don’t have time to just play and that cuts us off from experiencing joy, freedom and the life affirming feeling we get from a good laugh.

When I with couples who are experiencing stress in their relationship I encourage them to seek out adventures they can do together. It is very important to experience and view your partner through a new lens and when you try something new, you get to feel and see your partner in a new light. This broadens the scope of knowledge you gain about your partner and highlights aspects of them you didn’t know were there or had forgotten about.

There are many things you can do to improve your relationship and reduce the stress and tension that’s building between the two of you.  One of them is to get help by contacting me so we can talk about your situation, uncover your challenges and develop ways to improve the quality of your relationship.

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How to Avoid the Winter Blues

Posted on July 25, 2016 by Alisa Hafkin

At this time of year many people who suffer from depression have a bit of a reprieve.  They are able to get out and about in NYC, enjoy activities, and see friends.  But, just like in Game of Thrones, the knowledge that “winter is coming” is always looming.

Why?  Winter brings with it less daylight, more darkness and colder temperatures. The world becomes less colorful and more black, white and gray. The change to a colder season affects many people’s moods, some of who experience bouts of depression. Winter doesn’t have to mean getting the blues.

If you are someone who has a tendency to experience depression during the winter, there is no better time than the present to start preparing.  Real Simple has some suggestions on how to avoid seasonal affective disorder (or SAD, a form of depression that usually starts in late fall or early winter and improves as the weather warms up) including,

  • Brighten your environment. If your body hungers more daylight try sitting next to a light box for thirty minutes each day. It may help alleviate some depressive symptoms including lethargy, sadness and loss of motivation. Open blinds and curtains to give you an extra dose of sunshine.
  • Eat better. Certain foods, such as nuts, dark leafy vegetables, omega-3 fatty acids, berries and foods rich in vitamin D, help boost the body’s immune system but they also support and improve your mood. Other foods that are high in sugary carbohydrates may temporarily make you feel better but they ultimately increase feelings of anxiety and depression. Don’t stay away from all carbs, just choose ones that have good health benefits.
  • Simulate dawn. Those with SAD may feel depressed, irritable, lack energy and have difficulty waking up, especially if it’s still dark out. Studies have shown a dawn simulator, which has its own light or causes the lights in a room to gradually brighten over a period of time, can lessen the depressive effects of waking up in the dark and make it easier to get out of bed.
  • Exercise.  A Harvard University study from 2005 suggests quickly walking for about 35 minutes a day five times a week or 60 minutes a day three times a week improved symptoms of mild to moderate depression. Exercising under bright lights can boost those results in the winter.
  • Listen to music. A 2013 study showed that hearing upbeat or cheerful music significantly improved test subjects’ mood in the short and long term.
  • Plan or go on a vacation. Life can seem overwhelming with longs days at work during the dark days of winter. It is important to take a break and shut your mind down for a while. Research has shown that just planning a vacation can improve your mood. An actual vacation can work even better.

If you have questions about seasonal mood disorders or feel you need professional help contact me today. We can talk about your situation and work together to find ways to alleviate some of your depression and improve your overall functioning.

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