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Hello, friends! I have a Q&A episode for you today. This is an extra special episode for a couple reasons. First off, I’m starting a new weekly tradition. If you share your favorite quote from the episode on social media and tag me, you might be selected to win a free copy of one of my books! Second, my nearly one-year-old kiddo, Leo was very present in this episode. I had to squeeze in the recording between other appointments, so you hear some babbling and such in the background.

Hi, Duff, I have a tough situation I’m going through. I was raised with an extreme fundamentalist Christian upbringing. We were taught that makeup, jewelry, trimming hair, dancing, going to movies, watching most TV shows, etc. were wrong. From youth I was given the messages that I was sinful and going to Hell. I was the black sheep of the family. I was told that I was rebellious from the beginning as evidenced by my having said “no” to my mother while covering her mouth and at age three when I put my fingers in my ears, wiggled them and made a face at my mom. Through the years, I’ve tried to let go of the resentment and pain of a lifetime of messages that I’m evil and going to Hell, but I just can’t. I’m having to cut off the relationship with my mother due to abusive statements. Now I feel like I need to limit my contact with the others, too. It hurts like Hell as it feels almost like my mother has died and that I’m losing the others as well. How do I deal with any lingering guilt? How do I heal and go on? Thank you.

First off, it’s important to consider the fact that I am not religious and I personally have negative associations with a lot of fundamentalist religious practices. Regardless of the faith that we are talking about, it’s clear that the message that you have received from a young age is that you are bad, that you are weird, and that you don’t deserve good things.

If anyone was treated this way over years and years, they would develop some difficulties because of it. Especially since these messages came to you during periods where you were still very much establishing your sense of self. When your entire experience is painted with these negative interpretations, it’s easy to internalize the messages that you are getting and make the voice your own.

One thing that I think could really help you out would be to make sure that you have some support from people that can actually understand and empathize with what you’re going through. The internet will likely be a great tool for you. A friend of mine escaped from a religious cult and began writing a blog about her experiences. Without any sort of promotion, her blog gets a great deal of traffic because there are so many others out there with the same questions. Is this right? Is this legal? How can I get out?

I would start by doing some google searching of key terms like fundamentalist recovery, ex-christian support groups, etc. Living After Faith is a blog that seems to have some good resources, but I can’t personally verify them.

Basically you need other people to tell you that you aren’t crazy. That you have been mistreated and that they truly do understand what you are going through.

I’m really proud of you for standing up for yourself and establishing some boundaries with your mother and other family members. Your family called you a rebel, and maybe you are. I think that’s a good thing. That rebellious spirit might be the only reason that you were able to see the truth of the matter and begin to stand up for yourself.

You mentioned that it feels like your mother has died. That is a great point and it’s totally normal. While your mother is still alive, the relationship that you have had with her for a long time has died. You’re allowed to have mixed feelings about that. Take someone who has a physically abusive parent or a parent with severe substance abuse issues. This person may not like their parent. They may even hate them. But when that parent dies, it is totally normal to still have a grieving process. This may be similar. Even if you hated the way you were treated and the relationship you had, it’s still something that you are used to having in your life and there will be a period of adjustment to get used to the fact that that relationship has to die.

It will take some time and there very well may be different stages of grief that you go through. That’s okay. You need to be your own advocate and make sure that you are taking good care of yourself while you adjust.

If you’re not in therapy, I think that would be a very good idea. I imagine that you feel guilty even talking about these issues since they run so deep. A therapist is someone who can be professional, maintain confidentiality and will never judge you for saying things that you family would get mad at you for.

Setting boundaries as you are beginning to do is a great first step. Finding a way to have support and empathy will be massively important as well. From there, you will need to learn how to live life without considering what your family would think or how your religion would judge you. That can take some time and it will definitely take practice. Learning some skills to challenge your negative and self-defeating thoughts through therapy or self-help resources would serve you well as you practice this new way of being.

Overall, I think you are absolutely on the right track. Have some patience. The issues that you are talking about have been brewing for a very long time. They aren’t going to go away over night, but I just want to encourage you to keep taking care of yourself and doing what you need to do.

So, I’m a single mom to an 18 month old boy, and I’ve been struggling with severe clinical depression, severe anxiety and bipolar 2 disorder since I was 14 years old. I used to be on medications, but had to stop when I get pregnant with my son. For the past two years, I’ve had a really hard time coping with parenthood while trying to maintain my mental health. What are your suggestions for young parents struggling with bipolar disorder and depression?

First off, you’re amazing. Being a woman isn’t easy. Being a mom isn’t easy. Being a single mom isn’t easy. Being a single mom with severe psychiatric issues is tough as shit. The fact that you’re alive and that you’re hear asking this question is already an accomplishment.

I don’t know a lot about your situation just from this question, so it’s unclear to me whether you went off of your medication at the advice of your doctor or what. I wanted to just let people know that you don’t always have to come off of all your medications when you are pregnant and breast feeding. There is a lot of fearmongering out there that will tell you that you need to drop everything in your life and become this perfect immaculate vessel for your child.

Of course you want to try to give your kid the best shot, but there are many medications that actually carry very little risk to the child. And you also need to consider your own mental health. Are you going to survive the pregnancy without the medication, are you going to be able to successfully parent a child without your medication etc.

To be absolutely clear, this is something that you need to discuss with your doctor. There are so many different medications out there and every individual person’s situation is different. If you feel like you are not being heard, get a second opinion. My wife stayed on medication throughout the pregnancy for both of our boys and throughout breastfeeding.

Anyways. back to the question. If you aren’t on medications again, this is always something to consider, especially if your meds really did the trick for you in the past. It sounds like these are not just light life adjustment difficulties that you are talking about here. You have had significant mental health challenges for years now and you described severe clinical symptoms. This is usually the type of thing that requires treatment.

Please be gentle on yourself for needing help at this stage. There is so much pressure to be a perfect parent, whatever the hell that means, and it’s easy to beat yourself up when you feel like your mental health difficulties are impacting your ability to parent. It’s not selfish to care for yourself. It’s essential.

The postpartum period can be really tough when it comes to mental health. There are hormonal changes, your body is totally different than it was before you had a kid, if you’re breast feeding, sometimes that can be a challenge, and babies can just be assholes sometimes which makes things difficult to cope with.

A lot of the advice that I would have for you is typical – make sure you have a good support network, that you are getting some time to yourself to invest in your own self-care, if you have access to therapy and medication management, please take advantage of that, and take in as much content related to the issues that you are having as you can.

In terms of the parenting and mood disorder interaction, I would encourage you to focus a lot on routines and consistency. This will be helpful for both you and your kiddo. Depression and mania are destabilizing forces. Establishing consistency and routines can help to combat that.

Basically when you are feeling down and unmotivated or you are just having racing thoughts and agitation, you want sort of a playbook or rule book. What am I supposed to be doing right now? That’s where the routines come in. It’s not easy to stick to them, but it does help you understand what your next steps should be in a given day.

You may not have a lot of time on your hands to read or take online classes about self-help skills such as breathing exercises for your anxiety or cognitive tricks that can help you pull out of some of your problematic thinking patterns, so one thing you may want to try out is audiobooks.

Obviously you are a fan of audio content since you listen to this podcast. Listening to audiobooks and podcasts about depression, bipolar, anxiety, etc. is a great way to maximize your time. You can play it while you are cleaning up the house or while you are driving in the car. Fill those in between spaces with helpful content. At some point you will find a gem that makes a lot of sense to you and then you can try to apply it to your life.

Overall, it’s no wonder that you have had a hard time lately. I don’t think anyone can blame you for that. I’m glad you’re thinking about yourself again and wondering what you can do to get back on track. In addition to the tips that I gave you here, you could also go to my website and use the search bar to find other episodes that cover topics like anxiety, bipolar, and parenting with mental illness.

Hey! Do you have any advice or tips for someone (like me) who finds it very hard to allow anxiety attacks to wash over them? I find that, when I feel that panic, I begin to panic about the panic and it’s all one big nasty circle with me in the middle of it close to tears. This usually hits me at work, and I feel as if I have reverted back to being a helpless little child. I’m struggling daily, and if I’m being honest I just wish it wasn’t even an issue for me. Thanks for letting me get in touch!

This is called panic disorder. Obviously I can’t diagnose you from this single question, but it does sound quite a bit like it.

According to the DSM, panic disorder is when you have frequent unexpected panic attacks and at least one panic attack is followed a month or more of the person fearing future attacks.

The way I like to think of it is that you get almost a phobia of panic attack. The fear of getting an attack can be so bad that it starts a panic attack on its own. It’s really tough to deal with. It can be inconvenient and embarrassing, so it’s super easy for it to build up into a legitimate fear.

The good news is that panic disorder is treatable. The research shows that with the right tools and work you can stop having such frequent panic attacks and lessen the severity of them when they occur. Fundamentally, the anxiety symptoms are not the issue here, it’s your reaction and interpretation of them.

As you might already know, one of the most essential components of most successful anxiety interventions is exposure. You need to build a better tolerance for the feelings of anxiety and the fears that come along with panicking. Right now you are preoccupied with worries about the potential of panicking, which makes you more sensitized.

This is predictable, but therapy is going to be one of the best ways to do this. There are certainly things that you can do on your own as well, but if you have CBT therapists in your area that specialize in anxiety disorders, you could probably make some big improvements rather quickly.

When we talk about exposure, there are different elements to it. One of the most effective things to get exposure to are the internal sensations that come along with panic. Right now, it sounds like when your body starts to feel a little off, whether that is dizziness, muscle tension, lightheadedness, etc. you brain goes “Holy shit, it’s time to panic!” Do stop your brain from overinterpreting like that, you could get some practice at coping with those feelings. At home, you could simulate the experience of panic, or even start a panic attack, by running in place, breathing through a straw, spinning in an office chair etc. Obviously talk to your doctor before engaging in these activities to make sure it would be safe for your to do so.

When you invite in the sensations that you usually avoid, it helps to take away their sting. It also helps you to teach your body that you don’t actually have anything to fear when you start to have some of these sensations. There is a whole protocol for going through an exposure hierarchy step by step. My online course is one great resource for walking you through that. You could also pick up some workbooks like the cognitive behavioral workbook for anxiety.

Obviously medication may also be an option. You could meet with a psychiatrist for an evaluation and they could talk about whether it might make sense to start some medication to lower your overall baseline level of anxiety, or if sedating medication like xanax would be appropriate for those really intense moments.

There may also be a catastrophic thought element to the whole situation. It’s very common to overestimate the possibility of threats with anxiety and underestimate your ability to cope with them. When you are at home and more level headed, you might make some little note cards with your common reaction to stress and your logical reinterpretation that you can bring with you.

For example, when I immediately get to work, I feel flushed and like I need to run to my desk before I start panicking. On the back of that card you can write your rational response to that, which might be “Nobody has ever told me that I looked red. I’ve had very few panic attacks that were so bad that I needed to stop what I was doing” etc. You could also write some options for coping. You could show up 15 minutes early and let yourself calm down in the car before walking in for instance.

Overall, you want to hone in on what aspects are the ones causing you to panic. Is it a person, something about the work environment, a certain physical sensation, a certain thought etc. A journal would be very helpful in tracking this. From there you can further narrow and focus your approach for professional and/or self-help.

Thanks for listening!

Interested in having Duff answer a question on the podcast? Email Duff at robert@duffthepsych.com and maybe you’ll hear it on a future episode!

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