This story is one of the many that I encounter. Even with a healthy pregnancy, many expectant mothers experience anxiety bordering on panic. She could be overjoyed and looking forward to the arrival of her newborn and yet be riddled with doubt about her ability as a mother. The timing of the pregnancy may have an impact, too. It could mean cutting down on work or even resigning, financial setbacks and not to mention the frustration of lagging behind in your career.

It is natural that pregnant women will be concerned about the safety of their unborn child. And we would think that cutting edge medical imagery should help calm the nerves. Yet, paradoxically, in many cases the aggressive and often mandatory testing throws up more doubts about the health of the child. Ultrasounds and 3D imaging have an important role to play in managing the complications of pregnancy. But, they also increase the stress in parents. I often come across pregnant women who have whipped themselves into a panic over test results which showed only a modicum of deviation from normal. No amount of explanation will calm them down. One woman repeatedly ran to her obstetrician the moment she felt that she could not sense the baby’s movements.

In many cases the aggressive and often mandatory testing throws up more doubts about the health of the child

Otherwise stable and intelligent women seem to become puddles of anxious anticipation during pregnancy. I don’t blame them. Being responsible for a little being within you without having consistent and continuous access to what’s happening inside can be scary. However if this is not addressed during pregnancy, the depression may continue even after delivery and take the form of post partum depression.

Do we blame it on the hormones?

A lot of these emotional reactions are often a result of increasing levels of oestrogen and progesterone. Pregnancy is a hormonal circus. Hormones work their magic to help us conceive, keep the baby healthy, aid in labour, delivery and in nursing our child. The downside is that they also make us moody… very moody. A pregnant woman could wake up happy and, in a matter of minutes, could get downright cranky because the tea that was lovingly made by her partner did not turn out to her liking. Hormones can make us more prone to anxiety and panic.

Hormonal changes during pregnancy may also cause fluid retention, weight gain and hyperpigmentation of the face, neck and inner thighs. These unsightly changes can further have a depressing effect on a woman’s mood. To add to it, if the husband is unaware of what changes to expect and how to respond to his wife, she could wrongly perceive it as lack of support. Pregnancy jokes made by insensitive friends don’t help matters either—and the expectant mother ends up with the perfect recipe for depression.

Otherwise stable and intelligent women seem to become puddles of anxious anticipation during pregnancy

Feeling overwhelmed

Depression could be physiological, brought on by the hormonal variations or could be a result of feeling overwhelmed with the whole gamut of changes brought on by the pregnancy with no access to coping techniques. Some of the other precipitating factors could be complications in the previous pregnancy or even a previous miscarriage, physical or emotional abuse, infertility, low income, stressful life events such as death, moving homes, work pressure or divorce.

Whatever the cause, depression during pregnancy is common and unfortunately very easily dismissed by doctors and family members alike. Often, the pregnant lady is told that it will go away after she takes one look at the baby. The truth is far from it. If the depression is not managed well, it can continue even after the baby arrives. Depression during pregnancy is characterised by crying spells, restlessness, preoccupation with negative thoughts, mood swings, trouble concentrating, poor or excessive sleep and appetite and constant and extreme fatigue which may continue well after the baby is born.

If the depression is not managed well, it can continue even after the baby arrives

So what can you do?

Here are nine tips that can help you prevent or manage the emotional upheavals associated with pregnancy.

1. Assess your readiness as a couple to have the child. Is your marriage on sound footing? Have both of you spoken about and found a resolution/compromise to the issues you have with each other? Are you having a baby because you want one or is it family pressure that you are yielding to? Having this conversation with yourself and with your spouse can clarify the thoughts behind you seeking or going ahead with parenthood. The more ready you are, the more accepting you will be of the changes involved and the more motivated you will be to seek solutions to the accompanying emotional upheaval.
2. Become part of a pre-natal class. It will make you more aware about the different issues involved in pregnancy—physical, emotional and medical. The pre-natal class will also equip you with skills to cope with the changes during gestation.
3. Make sure you plan your day in a way that allows you to get adequate sleep and rest. Packing your day from daybreak till bedtime will only tire you physically and mentally. Remember that ‘You come first’.
4. Exercise regularly. Not only does it keep you physically fit but also releases endorphins which are happy hormones that work to elevate your mood. Meditate regularly.
5. Plan at least one activity every day that gives you pleasure. It could be gardening, reading, going for a drive, watching a favourite show or listening to your favourite music. Or some music specially suited to pregnancy.
6. Avoid seeking information about pregnancy related complications on the Internet. Have minimal contact with people who foster negativity in you.
7. Do household chores as a couple. Doing things together with the father of your child can be an enjoyable and wonderful bonding process.
8. Share your feelings of anxiety, fear or sadness with a trusted friend or family member. Join a support group. It helps to spend time with other expecting moms who might be going through feelings similar to yours. The solutions that come out of these discussions can help calm you down.
9. Do not hesitate to seek professional help to ascertain how serious your depression is and if it will require medication and/or counselling support.

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Types of play

It all begins in early childhood as we sit next to another child in the sand pit or in the park. We play alone, seemingly oblivious to the child next to us, but in reality we mimic the actions of that child. This is parallel play, the first step towards socialisation and friendships. Then comes associative play followed by cooperative play, which slowly and surely pushes us towards more complex interactions with other children and eventually towards building the deep bonds that affect us to the core.

Effective social skill trainers

Friendships not only serve to provide children with playmates but also teaches them the larger purpose of social and emotional development. Kids learn how to relate to different people through making friends. Interacting with diverse people allows your child to understand what socially acceptable behaviour is and isn’t. Solving problems, weighing alternative solutions, implementing social plans and making rules are all skills that a child learns as he navigates his way through friendships. He also learns about team spirit, accountability, social reciprocity, responsibility towards self and others and loyalty. It is through friendships and playmates that your child understands that individuals react differently to different situations. He learns that there are diverse perspectives to a situation and that unusual situations call upon singularly distinctive ways of dealing with them. Friendships also encourage healthy competition and foster high achievement goals.

Companionship a survival necessity

A child’s self-esteem is inextricably linked to his peer group. His playmates set the standard for age appropriate performance and it is against this standard that the child measures himself. His friends help him cope with difficult times like parents’ divorce, illness, academic disappointments as well as supporting him through the transition phases of adolescence. Research shows that children with friends have a healthier sense of self, higher levels of self-confidence and greater feelings of wellbeing. They fare better academically and have better social skills when compared to children with few or no friends. Lack of friends or rejection by peers can cause significant amounts of distress and even lead to childhood depression. Friendships are an important factor for the healthy psychological development of a child. Friendships serve a purpose that is different and complementary to the one served by family. Family gives one a sense of belonging, satisfies some of our biological needs and gives us a sense of intimacy. On the other hand, friendship is our training ground; it provides us with the luxury of trial and error and the cushion to make mistakes before we venture out into the adult world.

Friendship at different life stages

Childhood friendships are focussed on rudimentary play behaviours and a preference for certain playmates. Elementary school children tend to focus on kids with similar likes and dislikes and become part of groups with those inherent hallmarks of inclusion/exclusion, fear of rejection, conformity and independence. The focus here is on companionship. But, it is tweens and adolescents that spend almost a third of their day with friends. Friendships now become more intimate and a big part of their identity. Validation, acceptance, care and trust are the other features of friendships at this age. It is at this life stage that peer friendships influence an adolescent at a deeper level. They can either lead him towards delinquent behaviour or foster resilience, higher adaptability, conflict resolution skills and collaborative learning. I remember seeing two children, Anil and Pritam, both aged 10 years, going through a tough time adjusting to their new school. Both had relocated to India recently. Anil and his parents lived in a retirement-haven neighbourhood, where he had a limited opportunity to meet kids of his age. Pritam on the other hand, stayed in an apartment complex and had a lot of peers in the area. He would meet them every evening to play. At the end of six months, Pritam had adjusted well to his new school and new surroundings as a result of the friends he made, while Anil continued to struggle for a few more months before adapting to his new routine. Pritam’s friends helped him to feel at home in his new surroundings, they had modelled the local lingo and shaped his school behaviour, thus aiding the process of Pritam’s settling down.

Encouraging your children to build friendships

As parents, it is important for us to understand the value of friendships for our kids and work towards providing them the opportunities to socialise and form bonds with peers. A visit to the neighbourhood park, organised sport activities, play-dates and sleepovers can provide your child with occasions to develop peer attachments. Setting clear, acceptable rules for social behaviours, teaching the child how to deal with different social situations, coaching them to deal with negative emotions and seeking resolution to peer conflicts will encourage your child to seek out friends and the essential support system. Friendships are a handy play resource, an avenue for finding help and trusting care to your child.

Your friend is your needs answered.

He is your field which you sow with love

and reap with thanksgiving.

And he is your board and your fireside.

For you come to him with your hunger,

and you seek him for peace.

—Kahlil Gibran, The Prophet

This was first published in the December 2014 issue of Complete Wellbeing.

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That’s my client’s story but it could be yours, too.

I have dealt with ‘Empty Nest Syndrome’ [ENS], as it is referred to by most clinicians, with a lot of my clients. ENS is characterised by feelings of grief and loneliness that parents or guardians feel when their children leave home for the first time to attend college, a job in another city or just to move to their marital home after they get married. While mothers seem to be affected the most, by no means are fathers spared. While ENS is not a psychiatric disorder, it often needs therapy and support just like any other ailment.

Getting through the grief

It seems almost inevitable that parents would go through some feelings of desolation as their last child leaves home. While most parents understand and accept the need of their child to move out for work, education, marriage or to live independently, the emotions evoked by this event are hard to control and manage. The sadness at seeing their child go away, being powerless to have a say in most aspects of their lives, worrying about their safety, being concerned about their ability to manage without parental guidance, and the sudden emptiness in their lives and homes, can be very hard on parents.

Stay-at-home parents, women experiencing menopausal symptoms, parents who have recently retired and single or separated parents may feel the loss much more than others.

Preparation is everything

You can’t prepare for it just a few months before your children are ready to go out in the world. Preparation starts much earlier… in fact, from the time your children are young kids.

• Raise independent and self-assured children: It is important to integrate certain practices in your everyday interactions with your kids. Provide them with acceptable choices, allow them to make decisions on their own, respect their selection, provide support for any [potential] negative fallout. Show your children that you are with them and their preferences. The warmth that you create by doing this stays with them throughout their lives and they will continue to be in touch with you.
• Encourage independent thinking: Listening to your children’s ideas and allowing them to interpret their environment as they see fit can do wonders for their thought process. Follow some rituals that engage your children at the family level. For instance, watching a movie together, sitting down for meals with each other, and having a brief chat before bedtime can a long way in creating strong attachments between you and your child. The combination of independent thought and family rituals will ensure that your child will be able to live independently and but will still reach out to you for guidance and love.
• Keep the channels of communication open: Regular, non-intrusive conversations about their state of mind and their feelings help promote a continuous dialogue between you and your children, even after they have moved out. By doing this, you ensure that your child will keep in touch with you and keep you in the loop about any concerns in his life. This knowledge can help in cutting down your anxiety.
• Accept the facts: Accepting that your children’s need to live their life cannot be based on your personal experiences may sound scary but is actually a freeing experience. Once you are able to accept and trust your children, you can help, support and encourage their endeavours. In this way, they will still need you but in a different way than before.
• Live your life: I cannot stress enough the importance of living your own life. Cultivating a hobby and involving yourself in meaningful work can be a life saver when your child’s departure leaves behind a sense of emptiness. Involve yourself in a home or work project or sign up as a volunteer at the local school or charity. A fellow counsellor, whose kids have left for another country, has learnt to sidestep her anxiety by devoting many hours teaching English at a girl’s orphanage. She says it makes her feel wanted and it keeps her too busy to feel lonely.
• Focus on your partner: Children moving out is also a wonderful opportunity to reach out to your spouse. There was probably no time to devote to each other when both of you were busy bringing up the kids and working towards their future. Plan some activities with each other, go for walks, and watch that movie you never found time for or read together daily. Going on a holiday together will also help you deal with the feelings of loss.
• Change your point of view: Look at the children’s departure from a different perspective. It’s time you patted yourself on the back for all your efforts through the years. Relax, sit back and enjoy the results of your labour. A lot less housework, more time for your hobbies and significantly reduced financial burden can be very liberating.

ENS and the single parent

A single parent can get badly bruised by the empty nest syndrome. In most cases, a single parent has worked overtime to raise his/her children. Working a full time job to meet the financial demands of the family and often doubling up as the cook, housekeeper, tutor and nanny to the children can be physically and mentally demanding. But you are also rewarded by the child’s undivided love and loyalty. Due to the lack of a partner, this relationship often takes the form of a friendship and can be extremely rewarding for both the child and the parent.

To find yourself suddenly alone after the kids have flown the nest can bring on feelings of isolation, exclusion, melancholy and agonising concern for the children. These are some of the things single parents can do:

Reach out to friends: Especially other single parents, irrespective of the stage of life they are in. They can empathise far better with your state than others.

Become part of a support group: Ask a therapist to guide you to one. Online communities can also be an effective support structure. This will tell you that you are not alone and provide you with someone to talk to when you are going through a tough time.

Rediscover your hobbies: Pursue them diligently. You now have the time to focus on yourself. Take advantage of it.

Volunteer your skills at an orphanage, old age home, centre for the blind or at a school: This gives a symbiotic opportunity to someone in need and provides you with a feeling of being needed.

Start an exercise programme: The endorphins released during a workout help in keeping negativity at bay. There is also the added advantage of keeping yourself healthy and in good shape

Watch for signs of depression

Allow yourself to mourn the loss of the relationship you enjoyed with your child. But if you find yourself indulging too much in nostalgic rumination and weeping about it for more than a couple of weeks, a visit to a therapist might be a good idea. Depending on the severity of your condition, your therapist may put you on medications ranging from the innocent Bachflower remedies to stronger anti-depressants.

Not all’s doom and gloom

Empty nest syndrome is definitely difficult to cope with, though some studies have shown that parents whose children leave home do not necessarily experience the level of grief normally associated with this syndrome. A study done on British, Chinese, Southern European, and East Indian families living in Vancouver found that although parents felt some sadness at their children moving out, a majority experienced increased marital happiness and joy from extra leisure time. The study found that the anticipation of children leaving home was more frightening than the actual departure.

And, just to put things in perspective—empty nest syndrome means that your children are independent and capable of taking care of themselves without your daily support. It means you have done a great job of raising them. Rather an Empty Nest Syndrome than “Boomerang Kids” who come back to live with you!

This was first published in the August 2013 issue of Complete Wellbeing.

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Communicate: Talk to your children about the new person in your life. Based on their [favourable] response, give them the details about where you met, why you like him/her, etc. Give your children the space and time to evaluate their feelings. Also, give them the freedom to express their feelings and opinions. If they seem upset, allow them to vent their feelings and wait for them to get used to this new development.

Be honest: Being honest about your relationship and where it is heading is important. It takes away the surprise element from the picture, allowing your children the time to mentally prepare themselves to accept the new parent. Try to respond to all queries calmly to allay any fears. Remember, it is normal for a child to have reservations. Do not react with anger and counter his/her response with over justification in defense of your relationship.

Have an informal introduction and casual meetings: Provide multiple opportunities to your child and your partner to interact with each other in low pressure situations. Busy workdays and large family gatherings are not the right choices. Weekends or holidays, half day picnics or quiet dinners at home are a great start to getting to know each other. As they get comfortable with each other, progress to having your children spend the entire day with your partner, sometimes in your absence.
Spend time with your child: This is especially important after your children have met with your partner. Answer their questions in the best possible way. Allay their fears of abandonment by stressing on the fact that you will always be their parent, no matter what. You will be there with them every step of the way and now they will have another parent to share their thoughts and feelings with.

Talk about the logistics of the decision: Here is a list of some of the things that you should go over with your child [after a discussion with your to-be-spouse]:

• Where will you stay?
• If you move into a new house, will your child be able to take his/her belongings along?
• Will he go to the same school?
• Who will drop and pick him from the school/ bus stop?
• Will he have new rules and a new structure with this change?

Once you and your partner are married, continue to communicate with your child. I cannot stress enough the importance of having a continuing dialogue through this transition and thereafter. Remember, your child is an individual with his own mind. Respect his needs and he will respect you. Listen to what he says and keep the channel of communication open.

In your enthusiasm to ensure everything is going well, remember to take a back seat once in a while. Take a hiatus from some of the daily activities that you did with your child. Let your partner take over. Setting new daily rituals such as a game of scrabble before dinner, a walk in the evening or reading bedtime stories go a long way in creating a bond.

Do not shield your child unnecessarily from your partner. Have faith in your spouse and allow him/her to discipline ‘your’ child. You are now a family and you need to give your spouse the freedom to have a one-on-one relationship with your child. Beside, it sends out a consistent message. Only then, will you function as a cohesive unit.

This was first published in the October 2012 issue of Complete Wellbeing.

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However, that is not the only factor that defines marriage readiness. Financial stability and independence are an important variable in the decision process but not the only one. Mental readiness is also, if not, ‘the most important’ factor.

So how does one know that one is ready to make a commitment? Does one get married due to loneliness and for want of a companion? Should one commit for financial stability, emotional intimacy or sexual gratification? Or should one take the plunge because one is growing older?

Technically, one can get all of the above needs met in a series of temporary relationships or a committed live-in relationship.

Readiness to commit is a culmination of a complex matrix of variables.

In my practice, I meet many couples with idealistic or over-the-top romantic notions of a relationship. Most of these ideas fall apart within the first few months of the relationship. Marriage is not about unending sacrifices and compromises but neither is it only about red roses and candle-lit dinners. The notion of a marriage lies somewhere in the middle. Any committed relationship needs some basic ingredients: respect, trust, acceptance and love. A healthy respect for each other’s attributes, implicit faith in the partner’s actions and motivations, acceptance of each other’s differing needs and expectations and of course, love is what makes a relationship work.

Marriages and committed relationships bring about significant changes in our lives. So it’s important to assess your readiness.

Assess your readiness

• You will become answerable to and accountable for someone else. Once you get married, many of your actions will not only reflect on you but on your partner as well. This is an added responsibility. Are you game to take this on?
• Your time is not just your own anymore. You will have to put some time aside for your partner and his/her needs—many times at your personal cost. Are you ready to let go of a substantial chunk of your ‘me time’?
• You will have some shared responsibilities towards each other’s families. Your duties towards your own parents will not necessarily decrease, though they could change. How do you feel about this added obligatory duty?
• Success of a long-term commitment necessitates little sacrifices and many compromises. From big decisions like career choices to seemingly small compromises like sharing your personal space and belongings with another person—there is a whole spectrum of changes that one needs to make. You can take them in your stride or look upon them as impediments to a happy life. How equipped are you to handle this change?
• If you stay in different cities, career sacrifices could be a part of your marriage. How willing are you to let go of your current job or potential promotion to support your partner’s career decisions?
• Having and raising children is a significant part of marriage. It involves time, effort and another round of adjustments to your life. What is your outlook on having kids?

When you answer these questions, remember, that there is no right or wrong answer to them. It’s your view and you are entitled to it. However, if you find yourself mulling over these questions and responding to most of them in the affirmative, then you are probably ready to take the plunge!

The most significant sign of marital readiness is when you brood about: Do I know myself?

Are you aware of your attributes, weaknesses, values? Most of us are ignorant about our own beliefs. They live in our subconscious. Unless faced with a situation that demands a conscious response, majority of us aren’t even aware about our own opinion about different issues that
we could face.

A self-exploratory journey is the foundation for marital readiness. It becomes easier to choose a partner because the knowledge of self will bring a lot of clarity to the process. You know who you are and what you expect. As a corollary to that thought, you will also know if you want to be in a committed relationship.

Finally, mental readiness is a frame of mind and only the person herself can know if she is up for the commitment. It is important to assess the readiness before starting off on the process of finding a marriage partner or committing to an existing one. Nothing could be worse than getting married and finding you would rather be alone.

This was first published in the June 2012 issue of Complete Wellbeing.

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7 marriage myths

1. Marriage will make me happy

People enter marriage with this belief and keep waiting for the happiness to happen. If it doesn’t, they feel that marriage is a sham. No marriage can make you happy—it’s you who can make you happy. The unhappiness that you probably feel now is a function of your mental perceptions and conclusions that you draw in a given scenario. Unless you change your point of view, the sadness/frustration/disappointment will remain. The happiness in marriage is for you to find and create. But for that you have to change your glasses, look anew at the source of your feeling and happiness will be right at your door.

2. Together, we are whole

A lot of people believe this, even many years into the marriage. But they keep feeling incomplete and are sort of dependent in their relationship and this feeling underscores what they get out of their marriage. If you do not perceive yourself as a whole self sufficient stable entity, you will constantly look towards the other to make you feel whole. Isn’t that too big a burden for your partner to carry? If s/he is busy making you feel whole, then how is s/he to feel fulfilled in your company and this is bound to leave its impact on the relationship. What are you adding to the alliance as his/her partner? Find yourself first and you could be two wholes in one relationship. Now, that is a good marriage.

3. Taking my partner for granted isn’t good

I admit I am guilty of believing this one myself and would take offence if my partner takes me for granted. But, it is still a myth. If I cannot take my I-will-love-you-even-with-your-morning-breath soul mate for granted, then who am I supposed to count on in my hour of need? With overly individualistic family members, unreliable maids and vacillating body mass, he is the only enduring truth in my life. A marriage where there’s no security that your partner will be there for you, feels shaky. I say, you should take the middle path and lean on your partner when you need to, without allowing it to become an every day occurrence.

4. My partner should be perfect

All of us have our imperfections…small blemishes and big flaws. That is what makes us human, and unique as well. How would you feel if your partner expects you to behave like a demi-god? It would require you to be mature and right all the time. How many of you will survive this label—will you act out against it or meekly accept a role that is not you/can never be you? And, more importantly, will the marriage survive it? See your partner for who he/she is and love the human quirks and idiosyncrasies that are uniquely his/her.

5. Ours should be a fairy tale marriage

The fairy tale stories are just that—fairy tales. In real life, there are chores at home, traffic jams, office and family politics, bills and EMIs and cranky kids, most of which you must be aware of right now. But that does not mean it’s not a good marriage. Any marriage based on the precept of Cinderella and her Prince will bite the dust. A more realistic way of looking at a marriage is that, you have a partner to share that load with and find solutions to build something together even though there are fights and disagreements along the way. You will have happy times and there will be challenges too. If you are pragmatic about it, you will have a better shot at a good marriage.

6. Sex isn’t a big deal

This especially happens in marriages that have weathered a few years. We live in an age when sex is discussed more easily, is depicted often in movies and is talked about openly. But I have often seen it dismissed as just sex. In the marriage, sex or its lack therein can mean disappointment, stress at work, physical and mental fatigue, anxiety, hurt and so on. Don’t just repress it or brush it off as if it’s nothing. Examine any change in the sexual rhythm and communicate with your partner about it. Just that dialogue could set it right. Sex is important in a marriage; it is what keeps the spark and keeps you together. Never forget that.

7. Kids will bring us closer

On some levels, they do but on many levels they don’t. Raising kids can be tiring and tedious and catch your marriage by the coat tails. The diaper duty, the homework, house chores can keep you too busy to even notice your partner…forget feeling close to him/her. Most couples I know and see in my clinic, call those days a roller coaster of emotions interspersed with thunderous arguments and vociferous accusations. But if you keep thinking that kids are only supposed to bring you closer, then these disagreements will lead to feelings of resentment towards your kids.

Kids change the dynamics of the relationship, which now functions on a different plane. As is the case with every new job, you will have to find ways to settle in and make it work.

There are many floating around, supposedly based on empirical evidence. Every marriage is unique and so are the two people involved in it. Empirical evidence in this scenario is bound to be flawed. You have found someone special to share your life with. Don’t downgrade your relationship by subjecting it to the generalities and fables at hand. If you do so, you have everything to lose.

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It’s like someone said, “All relationships are happy. It’s trying to keep them together that causes all the problems.” While every relationship is unique, there are certain common issues that ignite the fire and fuel fights. I list them here so that you can watch out for them and throw them out of your relationship.

Fights are good for a relationship. They help clear the air and pave way for a calmer and smoother journey ahead. In fact, a lack of disagreement should alert you to something amiss in your relationship. But take care to avoid unnecessary and potentially dangerous friction.

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