<![CDATA[SHANA AVERBACH, LMFT, PMH-C: Therapy for Women, Moms, & Moms-to-Be in S.F + CA - Blog]]>Mon, 29 Apr 2024 12:47:37 -0700Weebly<![CDATA[Expert Feature: Women's Hormones and Mood]]>Sat, 07 Sep 2019 16:33:56 GMThttp://shanaaverbach.com/blog/expert-feature-womens-hormones-and-moodHi again! I was featured in Romper talking about a topic I LOVE to nerd out on - monthly mood changes around ovulation and menstruation. Check it out here!

Yours in wellness, self-care and compassion,

Shana



Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[Expert Feature: Am I Ready to Have Another Baby?]]>Wed, 28 Aug 2019 07:00:00 GMThttp://shanaaverbach.com/blog/expert-feature-am-i-ready-to-have-another-babyInterested in questions to ask yourself before having another baby? I weighed in on this, along with other specialists in maternal mental health to generate a list of questions you can ask yourself along the way. Check it out in Romper here!

Yours in wellness, self-care and compassion,

Shana



Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.
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<![CDATA[Why Maternal Mental Health Is Everyone's Business: A Letter to Clinicians]]>Wed, 01 May 2019 21:45:21 GMThttp://shanaaverbach.com/blog/why-maternal-mental-health-is-everyones-business-a-letter-to-clinicians

(This essay first appeared in the May/June SFCAMFT Newsletter)

Maternal Mental Health is everyone’s business.

Although specialized in nature with a specific clinical focus, maternal and perinatal (the pregnancy through postpartum period) mental health touches all of our work.

Untreated perinatal mood and anxiety disorders (PMADS) negatively impacts a mother’s quality of life and increases her risk for suicide. PMADS are linked to cognitive and behavioral issues in children, the same children with whom you sit eye to eye - talking, playing, and helping them process their worlds.

PMADS intersect with eating disorders, substance abuse, grief and loss, domestic violence, and severe mental illness. Actually we’d be stretched to find a therapeutic area with which it doesn’t collide.

Perinatal mental health can be improved or hindered depending on the level of supportive relationships within couples, families, and communities. And since each of us has a different understanding of what it means to be a ‘mother,’ perinatal mental health will be part of our countertransference experience. Whether our relationship with ‘mother’ is simple or complex, it is still often rife with strong and complicated feelings, and thus therapists must be aware of their responses.

Since knowledge is power and protection, the more we collectively know the better. What follows are a few myths and truths that will improve our understanding and support of our moms.

- Myth: Postpartum depression is the only mental health issue that arises in the perinatal period.

+ Truth: Depression, anxiety, OCD, PTSD, and Psychosis are all perinatal mental health concerns.

The ‘M” in PMAD refers to mood disorders, namely unipolar and bipolar depression. 50% of women with bipolar mood disorder are first diagnosed in the postpartum period.

The ‘A’ refers to a spectrum of anxiety disorders, including generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and post traumatic stress disorder.

Postpartum psychosis is very rare (1-2 in 1000) and must be treated as an emergency.

While defining these disorders is out of the scope of this article, simply knowing there’s a spectrum can be a starting point for clinical considerations.

If you remember one thing only, it’s that each of these disorders is highly treatable.

- Myth: Postpartum Depression is a normal part of the motherhood experience.

+ Truth: Postpartum Depression is a common (estimated at 15%) and (again) highly treatable disorder.

When talking about depression in pregnancy and postpartum, well meaning clinicians will often say that this experience is “normal,’ presumably to help women feel at ease.

Unfortunately, this can lead to moms keeping symptoms private and not getting the help they need. This is an especially problematic message in pregnancy as being depressed or anxious in this phase is predictive of being depressed postpartum.

Overwhelm, ambivalence, fatigue, and transient crying spells are normal. About 80% of postpartum moms have the “baby blues” within the first couple weeks of having a baby, largely connected to sudden and intense hormonal changes.

A pervasive sense of sadness, guilt, irritability, and hopelessness, and even rage - which may show up anytime within the first year postpartum, and peaks around month three - may be signs of something more concerning and should be tended to with therapy and/or medication.

- Myth: You can tell by looking whether someone has postpartum depression or anxiety.

+ Truth: you can tell by screening whether someone has a postpartum depression or anxiety.

We all know that stigma is a huge barrier to mental health treatment overall. But being depressed or anxious during pregnancy or postpartum feels especially taboo for many, thanks to messaging around how glowing, joyful, and happy moms and moms-to-be are supposed to feel.

Women are often using energy they don’t have trying to hide their scary and painful internal experiences. Many women who have a PMAD present as outwardly put together, with bright smiles, not a hair out of place.

All healthcare clinicians can overestimate their ability to informally assess how someone is doing. And since early detection of a PMAD can significantly reduce the severity and duration, we need to deliberately look for depression and anxiety symptoms.

There are accessible and reliable screening tools that can truly help pick up the hidden data. The Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) are two such tools, and both are free and available online.

Resources:

So what do we do when we identify that a PMAD may be at play?

If you were to have one resource in your back pocket, I would highly recommend Postpartum Support International. You can learn more about all the PMADS on their website and you can find local perinatal trained providers by calling their area coordinators: https://www.postpartum.net/locations/california/

Other great local resources include:

UCSF Pregnancy and Postpartum Mood Clinic
CPMC Perinatal Health and Wellness Program
Homeless Prenatal

Whether through direct service or linking someone with the best resource, together we can weave a web of support for moms.


Yours in wellness, self-care and compassion,

Shana



Are you a mental health or perinatal provider who wants to learn more or consult about perinatal mental health? Or think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[Resources For New and Expecting Mamas: Books]]>Wed, 01 May 2019 21:31:30 GMThttp://shanaaverbach.com/blog/resources-for-new-and-expecting-mamas-books
One of the toughest things about perinatal mood and anxiety disorders is that you can’t always tell by looking who has one. Among the many mama superpowers is the uncanny ability to hid a struggle (hey, not all powers are used for good).

And of course, therapy can help. But not everyone is interested in that as a next step, nor is it the only option for wellness whatsever..

Below is a smattering if books that can be helpful in different ways, along with a short-attention-span-honoring one-sentence book review.


From the bottom up.

1. The Pregnancy & Postpartum Anxiety Workbook: Provides basic, CBT-falvored (No, not CBD - Cognitive Behavioral Therapy) easily digestible education about perinatal anxiety, as well as DIY tools and practices.

2. Ina May's Guide to Childbirth: Provides empowered birth stories and childbirth education that can helpful no matter what type of setting you’re planning to give birth.

3. This Isn’t What I Expected: Overcoming Postpartum Depression: Informative, readable, validating information about postpartum depression, and what you can do to help.

4. Dropping The Baby and Other Scary Thoughts: Informative, readable, validating information about postpartum anxiety, and what you can do to help. 
5. Expecting Better: Not your average “what to expect book” - illuminates some of the data about what you can and cannot eat and do during pregnancy (spoiler alert: coffee is not evil). 6. Parenting From The Inside Out: A kinda dense, but super important read for parents of kids of all ages sharing one major take home message: When we make meaning of our own experiences, we are less likely to repeat unhealthy patterns with our own children.

Okay, that's it for now. I imagine this list will g r o w! Share with a mom or mom-t0-be in your life. It just may be the exact things she needs (bring her some food while you're at it ;)


​Yours in wellness, self-care and compassion,


Shana




Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[A Roundup of Resources for New Moms]]>Mon, 29 Apr 2019 02:09:27 GMThttp://shanaaverbach.com/blog/a-roundup-of-resources-for-new-moms
One of my favorite observations about being in a helping profession and being a person who taps into all sorts of different healing mediums is that there are SO MANY WAYS TO HELP AND BE HELPED.

This is lucky for all of us, as needs differ form person to person, day to day, sometimes minute to minute.

Below are some new mom resources of different kinds that you can check out, depending you your needs in this moment in time. The list will grow in time.


  1. Groups
  2. Podcasts
  3. Yoga, Pilates, & Beyond.
  4. Books


Yours in wellness, self-care and compassion,

Shana




Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.
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<![CDATA[Shana Averbach quoted in Washington Post on PPD]]>Mon, 22 Apr 2019 16:00:05 GMThttp://shanaaverbach.com/blog/shana-averbach-quoted-in-washington-post-on-ppd
I was honored to be quoted in a recent article in The Washington Post that discussed screening and treatment of Postpartum Depression. You can read the article here!

Yours in wellness, self-care and compassion,

Shana



Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[Shana Averbach & Associates Now On Instagram]]>Fri, 19 Apr 2019 01:55:48 GMThttp://shanaaverbach.com/blog/shana-averbach-associates-now-on-instagramHi there. You can now find me here on Instagram obsessively spreading information and inspiration.

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<![CDATA[Reflections on Becoming (a Certified Perinatal Mental Health Professional)]]>Mon, 01 Apr 2019 17:44:26 GMThttp://shanaaverbach.com/blog/reflections-on-becoming-a-certified-perinatal-mental-health-professional

Good morning from my kitchen, where there is bright light absorbing, hot tea and pesto pizza consuming, and sweet bits of reflection happening.

Thought I'd share with you. Not the pizza. That's gone. But some thoughts.

This past Saturday I woke up at the crack of dawn and drove across the Bay Bridge to Oakland to sit for an exam. The (positive) outcome (phew!) was being certified as a Perinatal Mental Health Professional (PMH-C, that's me!).

I'm not sure I knew how much this thing mattered to me until I was done. Not passing would have bruised my ego, but work life would have remained the same.

In practical terms it means I've had both fundamental and approved advanced training, at least two years experience, and have passed an exam measuring cumulative and up-to-date knowledge on the subject.

But it's more than that.

As soon as finished and grabbed the quiet space to notice how light my body felt, up floated a montage of memories about this journey.

Sitting at 38 weeks pregnant in an intensive training hearing dozens of voices whispering about the impact of their mothers and thinking, almost as though a commandment: We MUST support the moms. If we are to give them so much power and oftentimes blame, we MUST support the moms.

Hearing the stories of women around me who felt lost, disconnected, traumatized, anxious, disempowered, and sad during their motherhood journey and it not quite making sense to me...yet.


Attempting to piece together the story of my grandmother, hospitalized postpartum at age 19, properly diagnosed at age 82, months before her death. Wishing I knew more directly about her lived experience, filling in the gaps with educated guesses.

Joining this community of providers who are the fiercest, most curious, smart, and supportive group of people I've ever encountered en mass. Helping each other hold the heaviest of experiences, forming a net - with clinicians who were strangers just moments before - to help catch those terrifying feelings of free-fall that Our moms are having. Feeling like I had arrived, truly arrived, in the company of this group.

And every. single, mama who has sat on my couch. Her and her and her and her and her. These souls who felt anything but brave and yet showed up anyway, sharing such difficult private experiences and availing themselves to whatever came next.

Relearning the lifelong lesson that even though there are common and predictable manifestations of anxiety, depression, and trauma, that each mama is different and her uniqueness holds healing wisdom. Watching these mamas soar even when they felt they were merely stumbling (a sincere feat in its own right at times). 


I could go on.

And I realized then that this exam served as a ritual of sorts, one that honored the meaningful experiences leading up to it, and one that instills more confidence for what's to come. 

So anyway, it's now Shana Averbach, LMFT, PMH-C. Thanks for reading :)


Yours in wellness, self-care and compassion,

Shana




Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[Shana Averbach, LMFT featured as Postpartum Depression Expert on Pure Healthy Living]]>Tue, 22 Jan 2019 18:34:14 GMThttp://shanaaverbach.com/blog/shana-averbach-lmft-featured-as-postpartum-depression-expert-on-pure-healthy-livingI recently had the opportunity to answer some common questions about postpartum depression. Check them out here!

Yours in wellness, self-care and compassion,

Shana




Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

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<![CDATA[Kindness is Queen: Three Research-Based Reasons to Practice Self-Compassion After Having a Baby]]>Fri, 01 Jun 2018 02:34:53 GMThttp://shanaaverbach.com/blog/kindness-is-queen-three-research-based-reasons-to-practice-self-compassion-after-having-a-baby
The postpartum period is challenging by any reasonable standard -  long hours, few breaks, a steep learning curve, physical recovery, predictable relationship distress (or that which comes with single parenthood), just to name a few factors. I wish this was compelling enough to get mamas to be gentler on themselves during this short, but oh-so-long-feeling phase.

Then there’s the hormonal rollercoaster, any genetic predisposition toward worry or sadness (on overdrive anxiety and depression), the repercussions of a labor experience that may not have gone as planned, life stressors, and the fact that - if you’re reading this - you’re likely parenting in the United States, which doesn’t have a system in place to support new moms, as many other cultures do. Those seem like enough reasons to be kind to yourself along the way.


And then there’s the part where most of us in the face of distress - due to how our brains work - quite naturally try to will, criticize or even berate ourselves into feeling differently (oh you thought it was just you? Nope). That seems just unfair enough to justify finding ways to balance the scales by steering some compassion inward.


But since these reasons don’t always convince mamas to go the self-compassion route (make no mistake about it, I am aiming to sway you!), I offer you three pieces of research that support the benefits of inclining kindly towards self. All of these come from Kristin Neff, who has a generous spread of research, tools, and meditations on her website. If you're visual, here's an infographic with a couple bonus research points.


1. Self compassion is linked to positive emotions such as happiness, optimism, gratitude, and positive affect.


Let’s go back to the part about life as a new mom being hard. There's nothing wrong with feeling challenged by it, but when we add in the critical white noise that often sounds something like - I should be enjoying every moment of this. I'm not cut out for this job. A better mom would know and do all the things it adds a layer of suffering.


Finding a way to talk to yourself that includes messaging like – Oh hon, this is so hard right now, you are doubting yourself while trying to learn this new job. That's tough. You are not alone in your doubt or frustrationyou will actually have a greater chance at being present for the sweet moments and the not-so-hard parts.


2. Self compassion fosters resilience in the face of adversity.


A sad truth about the journey to motherhood is that it sometimes comes with larger challenges. Some experience loss along the way, others have difficult, if not traumatizing, labors, and still others have devastating life circumstances rolling alongside the transition to motherhood – natural disasters, loss of parent(s), and community violence to name a few.
Finally, about 15% of new moms experience depression and 10% anxiety in the postpartum phase, increasing the difficulty of adjustment and enjoyment.


Enter again this extra layer of hurt with the inner response to these experiences. We have a way of yelling at ourselves to get back up that doesn't exactly, A) work, or B) foster the desire to reach out for a hand.


What if the next words we heard from within were:


You have made it through so much, and it's hard to muster the energy to even slog through the day. You are not alone in your struggle, even on your darkest day. Anyone would be having a hard time in your shoes. This hurts now, but won't last forever.


What the research suggests is that from this place – learning and practicing the skills of self compassion - we are better able to stand back up when pushed around and/or knocked over by adversity.


3. Self compassionate people feel less emotional upheaval when faced with relationship conflicts


Research shows that two out of three couples experience relationship distress in the first few years of parenting. Said another way, you can expect to have some degree of relationship conflicts after having a baby (and that's not even to speak of parental and in-law ones!).


Considering that fact that, as mentioned above, most people in this culture are parenting largely in isolation, having conflict with a partner is really tough – you are each other's third and fourth hands!


I don't know about you, but when I'm in a heated conflict I kind of emotionally spin out far away from my kind and reasonable parts. But when I can soothe myself through compassionate words (You're feeling misunderstood, you just wanted to enjoy this rare time together, oof. It's okay, it happens to most of us) and warm touch (hand on heart, hand on belly) I am able to come back to myself quicker, and then back to my partner.


My experience aligns with the research that says if you can find a way through with self-compassion, you will be able to find your footing more easily when swept up by conflict.


There is a simple and profound Buddhist concept that says Suffering = Pain x Resistance. When we are in the middle of the pain points that come in the postpartum phase and beyond, one way we resist is by listening to our inner critic, believing the tough parts will last forever, and, most concerning, thinking we are alone in our experience. Compassion is like a salve for the pain, thus lessening the suffering. And mama, you deserve to be soothed.


Yours in wellness, self-care and compassion,

Shana




Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.




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