Mental Health

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Author: Anxiety Canada

 

"I want to feel more balanced and more like “myself” again. I find things that help my anxiety for a while, but I seem to get overwhelmed so easily."

Tools for self-care: The importance of self-care Setting yourself as a priority Healthy eating Exercise Engaging in life Relaxation Mindfulness Sleep Things to remember

Luckily, there are many things you can do to feel more resilient and able to cope, even over the long term. The key is to build a tool kit of multiple strategies. The tricky part is that some of the most valuable strategies might actually increase distress in the short term (see Facing Fears), but are essential for making us feel better over time.

Tool 1: The importance of self-care

An important anxiety-management strategy is to take care of the basics. Think of it as making sure your tank stays closer to “full” so you have more energy and focus to take care of your mental health. Read on for information and practical tips.

Taking care of yourself is an important step for managing anxiety

We all know that we need to aim for a healthy balanced diet and regular exercise to maintain our physical health. It’s easy to forget that these steps are ALSO important for our mental health and well-being. If you struggle with high anxiety, it’s especially important to make self-care a priority in your life. This can include:

• soothing activities (e.g., massages, bath)

• relaxation

• getting adequate sleep (or as much as possible!)

• spending time with friends and family

• making time for pleasurable activities (what do YOU like to do?)

I do take care of myself but I still feel anxious

Sometimes we haven’t been taking care of ourselves long enough to see a difference yet. Or sometime we are focused on one area of self-care and not enough on other areas (e.g., eating well but not seeing our friends). We are periodically "filling up" our tank, but still running too close to empty. Also, self-care strategies alone might not be enough to reduce our anxiety. They can still be really useful, however, as they can give us the energy to make other fundamental changes in our lives. Please browse through the website to learn more about other strategies you can use to change the way you feel and experience the world (What Is Anxiety?; Healthy and Flexible Thinking; Facing Fears).

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Tool 2: Setting myself as a priority

Let's admit it—with a new baby, sometimes it seems like getting out of our housecoat is too much work. With all of the challenges of being a new mom, "self-care" might seem like an impossible demand. We are so busy looking after the baby, and perhaps several other people in our lives, that we neglect ourselves. And although we are doing something very important, we run the risk of burning out.

So although it is wonderful to help others, we won't be able to do so if we don't first look after ourselves. Remember what flight attendants always say: "You need to put on your own oxygen mask before you can help anyone else." Being a mom takes a lot of energy, and we need to remember to also nourish ourselves.

Looking after the baby is taking all of my energy. I don’t have time to take care of myself!

Some days are going to be especially challenging: the baby is sick, the washing machine breaks, our older child suddenly "remembers" an assignment that is due today. We have so many balls in the air, we don't even notice that we are not attending to our own basic needs very well. The important thing is that over time we do what we can to look after ourselves. Self-care doesn't need to involve a huge change or lots of time. It can be something easy to do. For example, we can decide to eat a sandwich or take a well-deserved nap instead of running around cleaning when the baby is asleep. These small acts of self-care throughout the day help us stay mentally balanced and energized—so we can keep doing all the important things in our lives.

For more ideas, Treat Yourself Kindly.

I find it difficult to ask for help

With a new baby, sometimes we need extra help. It's very important to ask for what we need and receive support during this time. In many places in the world, a new mom would be helped by an army of supporters. As many of us are on our own, we may need to be creative about getting extra help (such as asking a friend to pick up some groceries, arranging child care during exercise classes, switching off with another mom, sharing a babysitter, or hiring a high school student to help out).

And as if we were not busy enough with our new baby, sometimes we say "yes" to other people's requests for help and we are left with very little time for ourselves. It can be hard to say no, and we may not be sure how others may react. But we have to weigh this against knowing how we will feel if we are overwhelmed and not taking care of ourselves.

For tips on assertiveness, see Effective Communication.

More information on how to say "no" and other assertiveness techniques is also available at the Centre for Clinical Interventions' Assert Yourself.

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Tool 3: Healthy eating

How does healthy eating help me manage my anxiety?

Motherhood is so consuming, we can forget to eat until we are extremely hungry.

Not only will this low blood sugar make us more cranky and irritable, it can also increase anxiety levels. Eating small meals throughout the day stabilizes our blood sugar and helps us concentrate and think more clearly.

To ensure you're eating regularly, try to eat by the clock (scheduling in meals and snacks), rather than waiting until you notice the symptoms of not eating.

When we eat irregularly or skip meals, our blood sugar will be less consistent and more likely to dip. This can cause many different symptoms, many of which overlap with anxiety:

• fatigue

• hunger

• irritability

• lightheadedness

• mental cloudiness

• nervousness

• shakiness

• sweating

Being a new mom may add some extra challenges to eating well

It is hard to think of regular, balanced eating when even getting dressed in the morning might be a challenge. Give yourself a break and just make it easy.

• Have prepared meals on hand.

• Stock up on lots of easy to eat food.

• Order in.

• Say "yes" when anyone offers to cook for you.

Food on the go ideas for the busy mom:

• meal replacement bars and drinks

• easy veggies (baby carrots, precut packages)

• trail mix

• granola bars

• easy to carry fruit (bananas, apples)

• fruit cups or other packaged snacks

• wraps

• shakes (add some protein powder)

You might be eating out of a can over the kitchen sink, but the important thing is that you are providing your body with needed fuel!

A resource for ideas for healthy eating is the Dietitian Services at HealthlinkBC: visit Healthy Eating for information and to email a dietitian.

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Tool 4: Exercise

Exercise can improve our mental health

Research shows that exercise has a positive impact on mood: exercisers often report less anxiety, and exercise can help improve feelings of mild to moderate depression. Physical activity can also regulating stress hormones and decrease overall stress levels. (Note: Your health care provider can help you choose appropriate exercise ideas.)

One way our body gets rid of extra stress hormones is through our tears and our sweat. Sometimes a good cry or sweaty exertion is just what we need to get back in balance.

It is hard to exercise when I need to care for a baby

Luckily, to get this positive impact on our mood, we don't have to do high-intensity exercise. It is actually more effective to stay within our comfort zone and slowly increase our activity levels. Anything active counts. Take advantage of Baby and Me exercise classes or yoga, use child-minding services at the gym, or trade off with another mom.

"Walking is man’s best medicine. —Hippocrates."

If you are looking for a little extra motivation for getting active, watch 23 and 1/2 hours: What is the single best thing we can do for our health?

Ideas for getting your body moving other than the gym

• Take the baby out for a stroll. You can experiment with different types of baby carriers/strollers to find a good fit for yourself and your baby.

• Find a bit of nature to walk in.

• Hold your baby while doing squats.

• Get a baby and me exercise or yoga exercise DVD (often available through your library).

• Find other moms to exercise with.

• Park a block from an appointment and walk the rest.

• Dance with your new dance partner (or have a dance party if you have older kids).

• Do household activities with the baby in a carrier; it is exercising with special weights.

• Give yourself credit for the extra exercise lugging around a baby and supplies!

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Finding it hard to exercise?

Even when I didn’t have a baby, I found it hard to exercise

You are not alone in finding this difficult. Approximately 50% of people who begin an exercise program stop within six months.

Although exercise has many positive effects on our mood, you may only experience these benefits after you finish exercising, or in the long term. Let's be honest—some of us do not find the actual exercising enjoyable, so it's hard to feel motivated. Keep reminding yourself that if you keep at it, both your body and your mind will feel better.

Ideas to set yourself up for success

• Start with small, realistic goals.

• Try to find an exercise buddy—people are more likely to exercise when they have a friend or partner to do it with. Do you have a friend with a new baby you can meet?

• Splurge for a few hours of babysitting and go for a quiet walk.

• Look for community centre drop-in classes to get you going. Baby and me yoga or exercise classes can be quite social and a good place to meet other moms.

For ideas on setting effective goals, see Guide for Goal Setting.

Can you exercise too much?

Yes you can. Check with your health care provider before dramatically changing your exercise routine.

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Tool 5: Engaging in life

Spending time with family and friends

Sometimes when we are anxious we tend to isolate ourselves, especially if we want others to see only our best and "happy" side. We can start thinking that we don't have the energy to fake it anymore. Isolating ourselves can give us a bit of relief in the short term, but we are depriving ourselves of one of the most powerful tools for managing stress—spending time with people we care about.

It is important not to underestimate how vital it is to spend time with people to whom we feel attached. Research consistently tells us that the support we get from others is one of the strongest predictors of overall well-being. But sometimes we need to push ourselves to reach out to others or let them in. Even a five-minute phone chat can help. You can do quick check-ins with friends while the baby is nursing or taking a bottle. If you are worried it will take too long, start by saying, "I just have five minutes to chat but I really wanted to catch up." You can also meet new friends through baby-oriented group activities (e.g., well baby, parenting, and play groups). Some places to look for these are your community centre, local health unit, or organizations such as Family Place.

If fear is getting in the way of being around others, visit Facing Fears for ideas on building confidence.

What we want to avoid, however, is asking others for reassurance over and over about our worries. See Resisting the Quick Fix for more details.

For our mental health, sometimes the best time to be social is when we "feel" like doing it the least!

Scheduling pleasurable activities

We schedule our to-do lists full of appointments, errands, and tasks. We sometimes forget to schedule in some fun and pampering. Being a new mom is one of the most energy-intensive jobs we will ever have. We need to help recharge our minds and bodies with interesting activities and interactions with others.

Plan some activities involving getting out of the house with the baby. Even if this takes extra effort and planning, daylight and sunshine can be great mood lifters. It’s important to still feel part of the world if you are feeling isolated and trapped.

We also can have microbreaks within the house. This can be having a nice cup of tea or coffee while watching the baby in the exercise saucer, lying down with the baby under a hanging toy and doing a mini-relaxation, taking a nice bath with the baby, or putting on a favourite piece of music and dancing.

It's also nice to have some time away from the baby once in a while. Even very short amounts of time can help. It does not have to be terribly exciting; you can start by curling up with a hot cup of tea when the baby is asleep. When you have someone to give you a small break, go out to do a bit of gardening in the backyard, take a short walk by yourself, or watch a TV show at a friend's house down the street.

Microbreaks from being on-duty can make a huge difference and allow us to recharge. It can be particularly helpful sometimes to have a change of scenery, away from parenting triggers. You want to try making some breaks a routine, since if you plan for it, it is more likely to happen. We are so good at scheduling routines for our children, but often forget about the advantages for ourselves.

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Tool 6: Relaxation

"People sometimes tell me to "just relax"...but I don’t know how to. Is that really all I have to learn how to do?"

Relaxation can help us cope with anxiety, but it will not be enough on its own. Although it would be nice to say "just relax" and have our anxiety magically disappear, it simply doesn’t work that way. Relaxation, however, is a great general stress management strategy and can help keep our body calmer and more resilient over time.

What counts as a true relaxation exercise?

People often count watching TV and other similar activities as relaxation. Although activities like watching TV might be enjoyable, it does not bring about the mental and physical response that makes it count as a relaxation technique. What we want is to bring on the relaxation response, a state of calmness that is the opposite of the stress response.

Our stress response is activated when our mind and body are preparing us for a threat. This "fight or flight" response can be lifesaving in emergency situations where we have to act quickly. When you don't need the stress response, relaxation techniques tell your mind and body "the coast is clear"—and that this response is not needed.

The relaxation response is not just lying on the couch and channel surfing, but a mentally active process that leaves the body relaxed and the mind calm and focused. Learning relaxation techniques isn’t difficult, but it does take practice. You might even find yourself feeling more anxious when you first try relaxation techniques. At the beginning, schedule a time in your day that will be easiest for you and find a place to practice that is conducive to relaxation, such as in bed before going to sleep or in a comfy chair. Over time, you can practice in more varied locations, such as at your desk during a break or on the bus during your commute to work.

There are many different relaxation techniques, so experiment to see which ones work the best for you. Here are two techniques to try:

• How to do calm breathing

• How to do gradual muscle relaxation

Additional resources for relaxation techniques:

• The relaxation and stress reduction workbook, fifth edition. 2000. Eshelman, E.R., McKay, M., & Davis, M. Oakland, CA: New Harbinger Publications.

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Tool 7: Mindfulness

"I've heard that mindfulness can help with anxiety. What is mindfulness?"

Being mindful means paying attention to the present moment, exactly as it is. It's a lot harder to be anxious if you are completely focused on the present moment (that is, what you are doing and sensing right now). Mindfulness also means paying attention to current experiences, without making judgments or evaluations about them: for example, if you were in front of a tree and were going to look at it mindfully, you could notice how tall it was, that the leaves were lime green, the way the sun sparkles between the leaves, and how the bark on the trunk is rough, rather than evaluating whether the tree is beautiful or ugly.

Being in the present moment is very different than what we usually do when we are anxious: live in our heads and think about all the things that could go wrong in the future, or ruminate and dwell on regrets from the past. Our brain is very creative, and can come up with the most amazing worst-case scenarios and the harshest criticisms.

"Mindfulness means paying attention in a particular way; on purpose, in the present moment, and non-judgmentally." —Jon Kabat-Zinn

Important: It is completely normal that your mind will drift when you are trying to be mindful. Imagine a leaf floating on a pond; it will naturally drift. Part of the practice of mindfulness is noticing when your mind is drifting and learning how to gently bring your attention back to the present moment. When you catch yourself being caught up in worries about the future, or guilt or regret about the past, non-judgmentally notice that it is happening and gently guide your attention back. Take a calm breath and focus on what you are doing right now. For more information on letting thoughts be, see R.O.L.L with Anxious Thoughts.

We have included some mindfulness exercises that you can try. You can also find audio and video resources on Mindfulness at UCLA’s Mindful Awareness Research Center’s Free Meditation Podcasts.

Mindfulness exercises

Using your senses

A simple mindfulness exercise is to notice what you are experiencing right now through any or all of your five senses: sound, sight, touch, taste, and smell.

Take a few slow breaths and ask yourself:

• What are three things I can hear? (for example, my baby’s breath, the clock on the wall, music in the next room)

• What are three things I can see? (for example, my baby, a receiving blanket, a red and orange toy)

• What are three things I can feel? (for example, my baby’s soft skin, the chair under me, the floor under my feet)

• What are three things that I can smell?(for example, the new baby smell, flowers in the room, the soap on my hands)

• What are three things I can taste? (for example, my tea, a cracker, smooth cheese)

Think of these answers to yourself slowly, one sense at a time. It is impossible to do this exercise and not be mindful in the present moment.

Fully participating in an activity

The next time you go for a walk in the park, practice doing it mindfully.

As you are walking, you might find that your mind is creating its usual array of worries. You are pulled into your head and away from experiencing the walk. Trying to push the worries away just seems to make them stronger.

Instead of fighting them, acknowledge they are there ("Oh, there's that worry thought again"), let the thoughts be (not suppressing them or trying to fix things in your head), and then consciously bring your focus back to the present moment. You could notice the warm sun on your face and the cool breeze on your cheeks. You could look up and watch the birds flying above you or look down at the plants below you. You could notice the scents of nature in the air and the feel of the earth under your feet.

Every time your worries try to pull you away (and this might be every 20 seconds at first), gently let them go and return to being aware of the world around you. This is walking in a mindful way.

This is in contrast to how we often do things mindlessly. We may go for a walk, but we are caught up in our thoughts and are not really being aware of our surroundings. Luckily, we can practice being in the moment and develop much richer experiences of life. Any activity can become an opportunity to practice mindfulness: taking a shower, washing dishes, preparing and drinking tea, eating a meal.

Loving kindness

This type of mindfulness is used to help people be kinder to themselves as well as more compassionate to others.

Below is a simple script to give you an introduction to this type of mindfulness. Any one of the following sections also can be done separately. More detailed scripts can be easily found, such as UCLA's Mindful Awareness Research Center's Free Meditation Podcasts.

1. Contemplate kindness from others: Gently bring up a memory of a person for whom you already feel warm, tender, and compassionate feelings, such as someone who has been very kind and loving to you in the past (this could be a parent, your child, a close loved one, a pet) or a situation when you felt warm feelings. Focus on this memory and remember feeling warmed by the presence of this person.

2. Extend warm feelings to yourself: Place your hand on yourself (such as over your heart or on your belly) and imagine that this is the hand of someone very kind and caring (or being hugged by a loved one or having a beloved dog on your feet). You can feel the warmth flow from your palm to your body. Let your palm rest gently and let the kindness flow from your fingers. You can also speak kindly to yourself, saying something caring to express concern or affection (for example, you can simply say words like "gentle" or "kindness" or express thoughts such as "I know this hurts, but I can do this" or "For this moment, may I find peace").

3. Extend warm feelings to the world around you: Expand your presence and radiate these warm, tender, and compassionate feelings to others; first to a few people you well, then to all your friends and family; then to all people with whom you have a connection, and finally to all people and creatures of the earth.

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Tool 8: Sleep

How do I get a good night's sleep?

Motherhood does certainly add challenges for our sleep.

Our sleep schedule is, at least temporarily, in very small hands. If this is your first baby, follow the old rule of sleeping while the baby is sleeping. This may mean loosening your standards on such things as housework to make sleep the highest priority. When you have older children, it may be harder to find extra sleep times, but take advantage of opportunities when they come up. Sometimes you can get someone to watch the children, just so you can have a rest.

Some ideas that can help you get a better sleep:

• Don’t spend a lot of time in bed not sleeping. Try to get up before you are feeling very antsy about not sleeping (approximately 20–30 minutes, not watching the clock).

• Use your bed for sleep or sex, but try to avoid other activities such as watching TV.

• If you have a partner or close relative, ask him or her to take a shift and be "on call" for a part of the night. Or you can alternate nights so you have a chance to catch up a bit.

• Sleep in a separate room from your baby for a night (or part of a night) while your partner or close relative is "on call." If you find it hard not to listen for your baby (even when someone else is monitoring), try using earplugs or a white noise machine.

• If you are breastfeeding, ask someone else to bring you the baby for a feed.

• If you are bottle feeding, ask someone else to do one of the feeds.

• Dim the lights at least 30 minutes before you want to sleep. Late-night exposure to the light emitted from TV and computer screens can also interfere with sleep.

• Deflate the worry about not sleeping. Remind yourself that human beings can function with disrupted sleep. We are biologically built to cope with the impact of a baby on our sleep. For ideas on challenging your worries, see Tools for Healthy and Flexible Thinking.

• Develop some coping statements. Instead of worrying about how terrible it is that you aren’t sleeping, try saying things to yourself like, "I will be tired tomorrow but I won't completely fall apart" or "It's not fun but I can still function on a little sleep" or "I'll get through it."

• Practice a relaxation technique.

• Avoid caffeine.

For more ideas, see Getting a Good Night’s Sleep (PDF).

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Things to remember

Self care is all about moderation, balance, and flexibility.

There will be some days when life gets in the way of our good intentions and plans.

That's okay. Try to take a long-term perspective and think about what you are doing over the week or month. Start with planning small changes that will be easier to try out and keep going.

• Nourish your body throughout the day and don’t skip meals.

• Eat a variety of foods and aim for a balanced diet over the month.

• Slowly increase your physical activity level.

• Use exercise as a way to help deal with stress.

• Spend time with family and friends.

• Make time for pleasurable and meaningful activities.

• Practice relaxation.

• Use a mindfulness exercise.

• Try sleep promoting strategies.

• Put energy and focus into healthy behaviours.

You don’t have to make big changes to improve your wellness and help you manage your anxiety. The good news about practising self-care is that every little bit counts!

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