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Постнатальный период

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Postnatal Depression - Self-help Exercises

Постнатальная депрессия - помоги себе сам

     Anxiety and depression can be completely overwhelming and it's often hard to know where to turn. There is treatment available in the form of counselling, anti-depressants and anti-anxiety medication so if you feel overly anxious or depressed, do please see your doctor. There are also some self-help exercises and activities that you can try. Although they sound simple, they are rooted in basic therapeutic principles and there are reasons why they help.

Self-help exercises

     Here are some basic self-help principles. Read through each of these pages, print them out if you want to, and perhaps try one or two that you think might be particularly useful to you. Get used to doing the exercises and perhaps move on to another one in a week's time. You are developing the skills that will help you to cope and to work through your condition.

An exercise in reducing anxiety
A compassionate mind
A comfort box
A grab jar
Making time for you
Mindful relaxation

1. Reducing anxiety

     One of the most debilitating symptoms of postnatal depression is anxiety. Sometimes we find ourselves worrying about something, and for some reason the worry takes on enormous proportions and starts to pre-occupy our mind. It gets in the way of concentration and/or sleep, and in some cases undermines our self confidence.
     This page offers support for those showing signs of post natal depression, and includes a questionnaire to help you assess your symptoms. In addition we have more self-help exercises to help you cope with the symptoms of postnatal depression.

Mind over Mood - Help to beat depression

     Christine Padesky and her colleague Dennis Greenberger have devised a way of finding out what it is that's concerning us, and then to find a more helpful way of thinking about it. We have adapted their work for self-use, but you can see the whole exercise in their book 'Mind over Mood: change how you feel by changing the way you think' (1995); they call it a 'thought record'.
     You may find this exercise upsetting as you are going to take yourself into your anxiety. So find a good time and place to do this, e.g. half-an-hour before your favourite TV programme. If you have someone who you trust and feel you could do the exercise with - then ask them to help.

Write down what it is that is causing your anxious feelings: be specific, e.g. who you were with, what were you doing and where you were.
Then name your feeling - anxiety, fear, dread or panic.
How big is the feeling? Rate it on a scale of 1% (not much), to 100% (at its worst).
Jot down all the thoughts that come into your mind as you become aware of this feeling.

Ask yourself 2 questions and write the answers:

What am I afraid might happen?
What is the worst thing that could happen to me?

      Hopefully, these 2 questions will help you get to the root of your anxiety/fear. Once you have done this, read over what you have written down and pick out the one thought that really pushes the feeling.

Then ask yourself questions like:

When did this actually happen? What were the circumstances?

When you have exhausted this list, ask yourself:

When did it not happen (even though you were worried that it might happen)?

Again, once you have written everything down, read over both of your lists and ask yourself:

Is there a more helpful way that I could think about my anxiety/fear?

Write it down, and then reconsider your initial feeling and how you rated it (1-100%). And see if you have been able to bring your rating down. If you have - then well done. If you haven't - then you might have to go over it again to see if you missed something out that would have been helpful to you. It might be best if you gave yourself time to think about it before you do the exercise again.

Mind over Mood: change how you feel by changing the way you think Ссылка
by Dennis Greenberger PhD, Christine A. Padesky PhD,
Publisher: The Guildford Press, New York (1995),
ISBN: 0-89862-128-3




2. Developing a Compassionate Mind

     For many reasons, when we are growing up, we sometimes find that a negative, self-critical part of our brain develops. It nags us and tells us we are no good, worthless beings that deserve very little in life; and over the course of time this inevitably affects the way we feel about ourselves. It lowers self-esteem, and possibly contributes to anxious and depressive thoughts and feelings.
     This then becomes a familiar well worn path that is easy to access and probably underpins how we live our lives. However, it does not have to be like this. Just as we learnt how to criticise ourselves, we can learn how to be kind to ourselves.
     The concept of the 'compassionate mind' comes from Professor Paul Gilbert's book called 'Overcoming Depression' (2000). Here, we share with you some ideas for developing your own compassionate mind as a way of taking care of ourselves which we totally attribute to Professor Gilbert.

How to start...

     To begin with we need to learn how to value compassion - as it can make us stronger and more confident. For some people compassion is akin to being weak and lacking in energy and drive, and as such is not something to strive for. Yet in reality, it is quite the opposite.
     Nelson Mandela and Gandhi are examples of people who are strong and compassionate, and they are known for their energy, drive and strength. Can you think of someone you know, or a personality in the media, who you would consider to be a compassionate and strong role model?

Compassionate qualities include empathy and sympathy

     Empathy is about being in touch with how others feel, and in turn being more able to accept and understand our own feelings. It may be a feeling of disappointment or joy, but it is not about telling ourselves that we should be coping and not feeling these things.
     Sympathy moves us away from understanding, towards wanting to help to put things right. If we can learn to be sympathetic towards ourselves, we can learn to be sad and not necessarily become depressed or to think that there must be something wrong about feeling sad. It helps us to focus on feeling kind towards ourselves, rather than being hard on ourselves.

Forgiveness and acceptance

     Forgiveness recognises that we make mistakes and can learn from them. It allows us to change, as opposed to criticising ourselves at every opportunity and thereby keeping ourselves in a negative and unpleasant place that is difficult to escape.
     Acceptance and self awareness allows us to recognise ourselves for who we are. It's about getting to know and like ourselves and using our differences as information we know about ourselves. This is more helpful than wishing we were something else.
     Developing feelings of warmth for yourself may feel scary at first, and will probably require some practice. Start by imagining warmth coming towards you, and gradually build up to being able to generate your own warmth.


     Compassion is about personal growth, change and development. It is based on self recognition warts and all, and facing all our foibles no matter how painful. It requires us to commit to taking responsibility for this change through training and perseverance. As with any new skill it will take time, and there will be some setbacks.
     The next step is to build a compassionate image, and to do this we need to practice giving it the necessary qualities. So these are some questions to help you start to build up your own compassionate mind:

So these are some questions to help you start to build up your own compassionate mind:

  What would you like your compassionate image to look like?
  What would s/he or it sound like?
  What would it feel or smell like?
  How would you like your image to relate/talk to you?
  How would you like to be able to relate/talk to your image?

     Once you have built up a good image of something or someone that would be able to be kind and compassionate with you, try to start communicating with your image to help you think more favourably about your concerns, fears etc. You can also use your image to prevent you from returning to old self-critical habits by reminding yourself of your new forgiving and accepting self.

Overcoming Depression: a self-help guide using cognitive behavioural techniques Ссылка
by Paul Gilbert,
Publisher: Robinson, London (2000),
ISBN: 1-84119-125-6




3. A comfort box

     There are times in our lives when for many reasons we may feel depressed, alone, anxious, unloved or unsupported. There may be others around us, but they are unable to comfort us in the way we need, or we may be too distressed to tell them what we need. When this happens - a 'comfort box' can be very helpful to cherish and nurture you through your time. Find out more about how comfort boxes can help below...

The comfort box principle

     When your child is feeling sad or down or worried, your instinct is to wrap them up, give them a warm milky drink and a favourite teddy and settle them down with a book, or favourite DVD. This helps make them feel loved and safe and warm. You may have heard of the expression "the inner child" - the theory is that inside each of us is our own inner child who needs some attention and love. A comfort box is a useful way of helping you to give yourself the care that your inner child needs... just as you would to your own children.
     The idea is that you find a box, bag or something big enough to put what you need into it. Then sit and think what are the things that would generally bring you comfort? Ideally, you will put your box together when you are feeling reasonably ok - in readiness for those more difficult times. Store it somewhere safe. All is not lost if you are not able to do that, as some suggestions follow.

Here are some ideas to start you off, but the best box will be of you own making...

  A soothing smell, such as vanilla or cinnamon or lavender.
  A new candle or tea light in a small holder.
  A favourite CD of relaxing or uplifting music.
  Something to wrap around your shoulders to hold you tight, like a shawl, blanket or pashmina.
  A favourite book, such as a novel, book of poems, or something from your childhood.
  You may also have your old teddy bear, doll or cuddly.
  Family videos or photos of good, happy times.
  Some find chocolate helps; if so a small good quality bar of your favourite brand.
  Some soft men's hankies.

     If there is space in your home - you might like to designate a comfort corner or room that has a generally more relaxing atmosphere about it.

You don't have to wait until you are feeling dreadful before you use your 'comfort box' - you can use it to nurture yourself whenever you feel like a bit of care and attention.




4. A Grab jar

     When depression has set in - it is sometimes difficult to get motivated to do anything; with the result that long periods of time pass and nothing has been done or accomplished. This sometimes adds to the sense of hopelessness and despair that so often accompanies depression. So it is with this in mind that the concept of the 'grab jar' was developed...

Creating a grab jar

     If you feel fearful or anxious and find your mind whizzing round and round going over the same thing - distraction may help you to put your fears or anxieties to one side. The grab jar may help to take your mind off your worries.
     You really need to make your grab jar on a good day, so that it is ready for you if a bad moment hits. You will need a large jar, box, bag or something that you can put lots of pieces of folded paper into, a pen and paper, scissors. Then you need to think about creating two lists of things to do that fall into either of these categories:

Pleasure or achievement

     There will inevitably be some cross over, as some things are both pleasurable and give you a sense of achievement. Here are some ideas to get you going, but it is best if you make up your own list - as only you will know what gives you pleasure and/or a sense of achievement. Keep the tasks simple and achievable.


  A soak in the bath;
  Hand massage / face pack;
  Reading a chapter of a book, or a magazine if concentration is poor (also achievement);
  Going out for a walk;
  Sitting in the garden;
  Gardening (also achievement): a particular task you had in mind eg cutting back a hedge;
  Painting your nails;
  Telephoning an old friend (also achievement).


  Tidy up your underwear draw, or perhaps a kitchen cupboard;
  Write a letter to a friend or relative;
  Bake a cake or biscuits (also pleasurable);
  Hoover a room, wash kitchen floor;
  Do a jigsaw or sudoku puzzle (also pleasurable).

     As you can see, the lists are endless. If you find it difficult to think of things yourself, you could ask others what they do for pleasure or achievement. Once you have made your list - cut out each activity and fold the paper over, then put them in your jar.
     Alternatively, instead of bits of paper put actual things into your grab jar: eg a new nail polish, a little book of sudoku, a pair of clean gardening gloves, a little paint box, a set of labels (for files/school uniforms), a packet of seeds, a CD with some happy songs that you could dance to, a cake or bread mix...

You must always adhere to your personal safety. Therefore, if it is night or not safe for you to go out or do any particular activity - then do not do it, just put it back into the jar and pick another one.

The 'Five Minute Rule'

     The thing about depression is that you will probably not want to do any of these things. If this is so - then you need to bring in the '5-minute rule'. This means that whatever you pick out of your jar you only have to do it for 5 minutes. If you would like to do it for longer, then of course you can - so long as you remember you only have to do it for 5 minutes.
     The other thing that you may notice is that ordinarily you might expect to gain a great deal of pleasure or sense of achievement out of your activity. However, when you are depressed this may not be so. On the whole it will probably take time to start enjoying life as you knew it; the real purpose of this is to help get you back into the swing again.

Other applications for the grab jar

     If you have small children you may want to add in things that you could do with them, such as go to the park, finger paint, play football etc. Especially for those days when the day is stretching ahead, and you feel yourself getting anxious or despondent about how you'll cope with the children.
     You could have an Activities Grab Bag for your children with a collection of crafts stuff, paints, playdough, colouring book, dot to dot, puzzles...teaching children about the grab jar could be done as a life skill for them - helping them through 'boring times' like wet afternoons and long holidays.


Mind over Mood: change how you feel by changing the way you think  Ссылка
by Dennis Greenberger PhD, Christine A. Padesky PhD,
Publisher: The Guildford Press, New York (1995),
ISBN: 0-89862-128-3




5. Making time for you

     When a new baby comes into a family - all sorts of emotions come bubbling up to the surface for the new parents; and on top of all these feelings there are all the additional demands that having a new baby brings. Amongst all this change and possible confusion - personal time disappears as the continual round of demands of family life replace it.
     Exhaustion and depression can creep in if there is no break in the pattern of constant care, and before you know it everything just gets that much more difficult. If you own a car - just think of all the care that goes into keeping it roadworthy. You have to regularly fill up with petrol, and check and maintain the battery, washers and tyre pressures. We may resent all the time, money and care we spend on the car, but it is considered necessary. In truth though, it's just a lump of metal! So considering you are worth much more than a car - there are lots of things you can do to try and redress your time deficit and to take care of yourself.
     It doesn't mean you stop loving your baby, or that you are a bad wife or mother. It means you need some tender loving care for yourself.

The first thing to consider is what you think about caring for yourself?

     If you were starting a new job - would you be expected to know all about the job before you started, or would there be a settling in period, support and some training? You would also be entitled to meal breaks, days off and holidays. Could you be kind to yourself - to get used to being a new parent? (Whether it is your first or fifth child - each time it will be different!)

Ask yourself - what have you done for yourself today?

     Probably nothing: time was short, the baby needed your constant attention and the housework was piling up. If that is the case - it might be helpful for you to consider the difference between what is important, and what is urgent?
     Everything to do with children and family life seems to come under urgent, because if we don't do it we feel it will get worse and think it will prove the "I'm a useless and bad mother" theory.
However, although urgent tasks will always keep piling up on us - the fact is that 'we' as mothers are much more 'important' than 'urgent'. In order to manage urgent - we have to be fit enough, or like the car - roadworthy.
     Have you ever wondered why on an aeroplane, we are advised than in the event of an emergency, mothers should put the oxygen mask on themselves first, before their children.
There is a need to be able to take care of and cherish ourselves in order to nurture and cherish those around us. And it is necessary to build in some personal time each day that is just for you. Find a time of day that suits you as a family, then it is more likely that it will happen.
     If you have a regular time slot you will be able to plan for it, and look forward to it - to do whatever you would like or need to do for yourself. It will probably become known as mum's time. If for some reason your time looks like it is not going to happen - negotiate with yourself, and/or your partner, another time slot straight away so that it becomes the norm that you need time for yourself, just as much as you need the air that you breathe and the food that you eat.




6. Mindful relaxation

     For those of us who are not practised in transcendental meditation, and are short on time, this exercise can help to create a relaxing interlude that does not take extra time, nor does it leave your mind empty and thus open to scary thoughts.
     Traditionally, relaxation and meditation have required you to find time and space to practice a combination of breathing, relaxing techniques and emptying your mind of thoughts. This takes practice and discipline, and above all it takes time - which for busy new parents is rarely there. Also, when you clear a space in your mind, if you are worried about something - this can leave you vulnerable to negative and/or anxious thoughts filling the void.

     What you are going to do is to use your everyday activities as rest and relaxation opportunities. You could use washing up, making a cup of tea using a teapot, ironing, vacuuming, bathing, gardening, or walking as mindfulness exercises. (You may have noticed men do this automatically whilst hand-washing their cars!)

For safety it is important that you do not do this exercise whilst operating potentially dangerous machinery or driving etc.

Here is what you are going to do - whilst, say, washing up:

     You are going to bring in as many of your senses as possible. So you will feel your feet on the ground, your body pressed against the drainer, your hands in the water. You will see the dishes, the water, the kitchen, and perhaps what's going on outside the kitchen window. You will hear the noise of the water from the taps, the clinking of the plates. And you will smell the washing-up liquid.
     It is important to be in the present moment. So don't have the radio on and don't go over what has happened, or plan what you have to do. Just be involved in the washing up. If your mind wanders - create more noise in the washing up bowl to bring you back to the present.
     If you can do the washing up several times a day - all the better as it will allow you to have a rest from an over busy mind, and that is generally helpful.



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