Depression, Pregnancy, and Psychotherapy

A  study in the journal Human Reproduction recently concluded the following:

Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use.

This is an important study for several reasons:

  • Pregnant moms who are depressed can be at risk for not taking care of themselves or their unborn baby (not eating well, not taking prenatal vitamins, not going to OB visits).
  • Moms whose depression is not well managed during pregnancy are at a greater risk of developing postpartum depression
  • Moms who are depressed risk other physical and mental health problems
  • As most families know, mom’s mental health and mood has an impact on everyone else in the family

So what do the results of this study really tell us?  Antidepressant use during pregnancy needs to be evaluated carefully.  But to me (as a psychologist, of course) the more important conclusion of this study is this statement right here:

There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.

In fact, psychotherapy can be highly effective for many mood disorders, including for depression before, during, after pregnancy.  This is great news because, unlike medication, psychotherapy has few (some would say zero) side effects.  An effective and safe treatment option for moms and their families – now that is an important conclusion.

Fore more information about finding and visiting a psychologist, go here.



Laptop Shooting Dad: No Different Than the Rest of Us?

Have you heard about the dad who recently shot up his teenage daughter’s laptop because of some unflattering things she wrote about her parents on Facebook?  Not only did he fire shots into the computer, he also filmed himself doing it and posted the video online.  As someone who does not see a lot of gunfire in everyday life, I have to admit the footage is a little alarming.  The dad’s rage, anger, and disappointment are clearly visible in his rant before the shooting, but after watching this interview with the dad and his family I’m wondering if he is much different than any other overwhelmed parent?  It’s easy to criticize other people’s parenting styles from afar, but is all the criticism of this dad really justified?  Sure firing a gun at anything can be scary, and his tactic of “you’re criticizing me in public, so now I’m doing the same to you” is a little childish, but really – what parent hasn’t reacted in a childish way when pushed?

Some things to keep in mind when judging the laptop (or any other) dad:

Being a parent is super hard, and we all get pushed further than we’d like sometimes.  This is not to say that all parents are abusive, or do harmful things to their kids (and I’m certainly not ok’ing abusive parenting techniques).  But I know there isn’t a parent around who hasn’t said something or done something they regret in a moment of frustration or anger.  Heck, just last week I told my daughter I didn’t care if she ever completed any of her homework again.  Oops!

Parenting in the age of technology is something we’re all learning on the fly.  None of us parents now can refer back to how our own parents dealt with: at what age to buy kids cellphones, how much texting is too much, how to navigate privacy and safety issues on Facebook, etc.  Yea, there are resources out there, but in essence, we’re all making it up as we go, so it’s not a surprise that we make some (or a lot) of missteps along the way.

Being negative and criticizing others doesn’t do much for our mental health.  I have recently written a couple of posts (here and here) about the damaging effects of negativity in the workplace.  Negativity towards other parents and families is no different.  Resist the urge to badmouth others and use that energy to work on your on family’s challenges.


Addicted to Facebook?

I hear people say this a lot: “I am soooo addicted to Facebook!”  I think they typically mean to say that they like Facebook and spend a lot of time on it.  But as one of my readers recently asked, is it possible to be really and truly addicted to Facebook?   As in, bad things start happening in life because of a user’s Facebook time?  This is a great question and one I have been thinking a lot about since my reader asked.  So, first things first:  What does “addiction” really mean?  According to the DSM-IV, ONE of the following things need to be present in order for one to qualify for a diagnosis of substance abuse (and let’s just assume for a moment that Facebook can be considered a substance):

  1. Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance related absences, suspensions, or expulsions from school; neglect of children or household). This one is definitely possible when talking about Facebook.  Again, this isn’t going to apply to the vast majority of Facebook users, even the die-hards.  But for those who find themselves constantly checking their friends’ statuses, playing games, searching for new friends – to the detriment of their other duties in life – they may indeed meet this criteria.
  2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use). At first I thought this point wouldn’t apply to Facebook use, but then I thought of Facebook-ing while driving.  In very extreme cases, it would be possible for folks to have gotten into legal trouble because of Facebook-ing while driving and yet continuing to engage in the behavior.
  3. Recurrent substance related legal problems (e.g., arrests for substance related disorderly conduct). I don’t know about this one.  Can one get into legal trouble on Facebook?
  4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights). This is one I have actually seen in real life.  Husbands complaining that they never see their wives anymore because they spend so much time on Facebook.  Wives complaining that their husbands won’t stop playing Facebook games long enough to engage with their families.   Perhaps these things can be warning signs of troubled Facebook use, and the possibility of more serious problems down the road.

So, what’s the conclusion; can we become addicted to Facebook?  I think the answer is yes.  While Facebook is not a mood or mind-altering substance (like alcohol or drugs), its overuse can cause “clinically significant impairment or distress.”  Concerned about your own Facebook habit?  Try curtailing your use – or totally abstaining – for the next week or two.  Set specific “Facebook time” in which you can enjoy checking up on your friends, but declare Facebook off limits during other times of the day.




Psychology and Space: Is Your House Affecting Your Mental Health?

I love houses. I love talking about them, thinking about them, working on them, decorating them…they provide endless amounts of entertainment and challenge.  Usually I indulge my loves of houses in my free time.  But recently I have found myself doing more talking and thinking about houses and space in my work hours as well.  Specifically, can our homes affect our mental health?  Yes.  There are many, many ways your home can affect your mental health.  Think of these situations:

People who are home-less

People who live in un-safe areas

People who live in un-clean, cluttered, and/or un-sanitary homes (think: Hoarders)

People who live in homes they cannot afford

Today I am going to talk about another group of people whose mental health is being affected by their homes: People whose homes are too darn big.  How can this be a problem?  Aren’t all of us pining to get into a house with more square footage, more rooms, more SPACE!?!?  Maybe, but I am beginning to see that too much space can be a problem as well.

Think of a how a “typical” suburban family might spend their evening: Dad in the basement watching basketball, teenager in his/her room playing video games, tween in the living room watching the Disney Channel, and mom in her bedroom reading stories on-line about Robert Pattinson.  Am I the only one who sees a problem here?

I’m afraid our homes have gotten so big (and so wired) that we often miss out on time that could be spent as a family.  Remember the old days when there was only one TV in the house and we had to take turns choosing what we wanted to watch?  Remember when we actually watched shows as a family (think: Cosby Show) and then talked about the funny parts all week?  While having our own spaces is neat and cool, I wonder if it is the best thing for our mental health, and for the health of our families?  Will we one day wake up and realize we barely know the other people living under our roof?  I hope not.

So before you buy a bigger home, or spread out to all corners of your existing house, think about what you are doing.  Share a TV, a couch, a bowl of popcorn.  Play Monopoly, or spend time just talking.  Enjoy your large spaces, but remember to spend time in close quarters with the ones you love, too.

photo by:


Ex-Boyfriends & Facebook

Oh, Facebook.  Who knew I had so much to say about you?  Maybe it’s because you are involved in a large percentage of the conversations I have (inside and outside of my office).  Maybe it’s because I have some deep-seated psychological issues with you stemming from childhood?  I’m not sure.  Regardless, here goes another post…

Perhaps there are a few folks out there who have re-connected with old lovers, boyfriends, and crushes on Facebook and it has turned out great.  But more often, it doesn’t.  What do we really hope to accomplish when we “Friend Request” our old prom date?  Do we want to re-kindle the flame?  Re-hash old times?  Peer into their current life?  Are any of these worth the risk?

And believe me, the risks are many.  Chatting on-line with an old lover can be a slippery slope to other types of, huh-hum, communications.  Whether or not we are currently in a relationship, it is important to be aware of the temptations these on-line interludes pose.  Posting on each others walls, to IM’ing each other during work, to meeting for coffee, to meeting for other “things” can happen more quickly than you might imagine.  The lure of romance and the memory of youth can be difficult things to turn down, particularly if your current relationship has grown predictable and less than steamy.

And what about our emotional health?  How will re-living the glory days serve us?  For some it can be fun and nostalgic.  For others it can be a sad reminder that life didn’t turn out the way we expected.  Even if we are content in our current situations, there is nothing like seeing an old boyfriend on Facebook who lives in a mansion, travels the world, and has a supermodel for a wife to make us feel as if we don’t measure up.  Do any of us really need that?  I sure don’t.

photo by: jfiddler



Stress, Self Esteem and Facebook

I’ll be honest, I have never been a huge fan of Facebook.  It’s not that I am anti-social media – I love Twitter and read lots of blogs on a daily basis.  But I’ve never quite figured out how to use Facebook, maintain healthy levels of stress and keep up my self esteem at the same time.

Facebook-induced stress

It has taken me several years to realize the sneaky ways that Facebook can cause stress in my life if I give it a chance.  Am I logging on enough?  What am I going to miss if I don’t catch up on my “friends” today? Am I logging on too much?  Am I neglecting my duties (as a mom, wife, psychologist, friend) because I am spending too much time on Facebook?  Should I accept her friend request?  Un-friend him? Ahhh! Just writing about these things is increasing my blood pressure.

Facebook is a time-sucking machine that can take us away from our families and friends and replace them with long-lost high school crushes and distant relatives we’ve never met.  Do we really want to add to our already stress-filled lives in this way?

Facebook and self esteem

In just the last few days I have read about “friends” who:

  • still fit into their wedding dress from 10 years ago
  • had a great time at a party (that I was not invited to)
  • “Puked [their] guts out 10 times”
  • Just finished “another” triathlon
  • Gotten a “huge” raise
  • Named Girl Scout leader of the year

Now, these things are all wonderful (except maybe the puking one), but when I read them I don’t feel great.  Instead I feel lazy, or unpopular, or inadequate, or like a bad mom/wife/friend.  And here I thought connecting with all our pals was supposed to make us feel loved and energized about our social lives.  I know I’m not alone in feeling the opposite.

Perhaps it’s because the people I really care about don’t frequently post on Facebook?  Or perhaps it’s because when great, sad, funny things happen to the people I love they typically tell me in person – or at least via email – about the event?  Either way, reading about the lives of “friends” (read: not people I would consider a true friend) is typically not an experience that I would describe as pleasant or fulfilling. Instead it feels like snooping or eavesdropping on someone with a perfect life: Not fun.

So, instead of browsing around the profiles, pictures, and posts of our old flames and the neighbor down the street, maybe we can turn the computer off and interact with the real people in our lives.  I can feel my stress and self-esteem levels go back to normal just thinking about it.


Adios Amigo: The Importance of Unfriending

One of my Facebook “friends” started out the new year by announcing that as part of his New Year’s resolutions he was going to be cleansing his Facebook account of all unwanted friends*.  At the end of his post he announced that his unwanted “friends” would know they didn’t make the cut when they no longer saw his (frequent) posts.  At first I thought: “How rude!” Why would he proclaim such a thing for all the world to see?  But as I thought about it more, it occurred to me how important this act really is.

Do any of us really have 647 friends?  Do we really want to know what some of those old high school classmates are doing?  Do we really want to hear about the neighbors’ kids’ little league stats after every game?  Do we really want to know that our old college friend can still fit into her wedding dress 15 years later?  Um…no.

So perhaps as we start a new year, in addition to organizing our closets, and coming up with creative resolutions, we can also try to remember the definition of a true friend:  Someone we really care for, and want the best for – and someone who wants the same for us.  Someone we would rather pick up the phone and talk to, or drive across town for – and not someone whose life we watch from a computer screen miles away.

And perhaps by clearing out the non-friends from our “friends” list, we can remember who – and what – is important in our lives.  What makes us happy and what relieves our stress?  If we are honest with ourselves, reading about far away people from our distant past only makes us out of touch with the people and things we truly care about in the here and now.

*I didn’t make the cut

Study Participants Wanted

I am posting the following notice from my colleague Dr Keely Kolmes who is conducting a study on therapy, social media, and clients.  Please read on for more information:

Are you a person 18 years old or over, who has been in psychotherapy,
and has sought or found information about your therapist on the
Internet? If so, we would appreciate your taking the time to complete a survey.

Our names are Keely Kolmes and Dan Taube and we are licensed
psychologists who would like to request your participation in our
research on the effects of encountering your past or current
therapist’s information on the Internet. This study has been approved
by the Institutional Review Board of Alliant International University.

As a participant, you will be asked to complete an online survey
covering your basic demographic information and your experiences
regarding seeking or accidentally discovering information about your
therapist on the Internet. We expect the survey to take about 20 to 35
minutes to complete.

Your input may help therapists to better understand if and how this
information affects clients.

No names or personal information will be linked to the study and your
participation will be completely anonymous so long as you do not put
your name in your responses. If you should wish to contact the
researchers directly, your participation may become confidential
rather than anonymous, although your name will not be linked to any of
the data you submit.

To be eligible for the study, you must be 18 or older, currently in
psychotherapy, or have been in psychotherapy in the past, and have
encountered or sought information about your therapist on the Internet.

If you meet the above criteria and are interested in participating in
the study, you can access the survey at:

If you do not qualify for the study but you know others who might be
interested in participating, feel free to forward this notice or URL.

Thank you for your interest and participation.


Keely Kolmes, Psy.D.

Daniel Taube, Ph.D., J.D.

Are You Ready to Have a Child on Facebook?

Previously I have written about how to determine whether your child is ready for Facebook.  But what about us parents? How do we know when we are ready to parent a “Facebooker”?  Determining if you are ready, as a parent, to shoulder the responsibility of having a child with a Facebook account is perhaps even more important than determining if your child is ready.  After all, it is up to us to set the rules, set the boundaries, and – most importantly – set a good example for our children.

How do you know if you are ready?

  • Be an expert yourself. It is absolutely imperative that before you allow your child to set up a Facebook (or any other social networking) account, you must understand the technology yourself.  In fact, I recommend that all parents with children on Facebook maintain their own page – and check it often.  Not sure how to begin, start here.
  • Don’t break the rules. Check out the rules for using Facebook including the minimum age requirement – it’s 13.  If your child is under 13 and wants a Facebook page of their own, don’t do it (see above point about setting a good example).  Instead, set up a page for your family that you all can maintain together.  Think of it as on-the-job-training.
  • Set some guidelines. What are your family rules regarding Facebook use?  How often can your child be on the site?  Who can they be-friend (my advice: only people that they know relatively well), what sorts of things can they post (“I love my soccer team” is a great post, “My family and I will be out of state all weekend and we couldn’t find anyone to housesit” is not so good), What sorts of pictures are acceptable? What constitutes cyber-bullying and what will happen if they are bullied (or bully themselves)?  What are the grounds for loss of privileges (i.e., grades fall below a certain level)?  Are they allowed to access their account from a mobile device (i.e., smart phone, ipad) or can they only be on the site at home when you are around? Whatever guidelines you set, make sure you are consistent in enforcing them – and don’t forget to follow them yourself.
  • Move some furniture. I think one of the most important things we can do to make sure our kids are safe online is placing the computer where we can see it.  Perhaps that means it is in the kitchen or near the couch.  You should be able to glance at their screen often and easily.  If the computer is in their room, this might be tough.  Little fingers can move quickly when it comes to minimizing an inappropriate screen.
  • Be a good friend. If you decide to allow your child to set up their own account, insist that the two of you become friends.  Better yet, encourage them to become friends with other family members.  As noted above, part of having a child participate in the social networking world requires that you as a parent monitor their use of the technology.  Check out their posts, their “likes,” their pictures, where they’re tagged, and who they’re friending.
  • Turn it off. One of the things I notice frequently in my practice is that both adults and kids have a hard time turning off the technology around them.  Texting at dinner, making phone calls in the car, checking email at the dinner table – is it really necessary?  Talk to your kids about the importance of taking time off Facebook (and all technology) and set a “bedtime” for all devices.  And don’t forget to do it yourself, you might be surprised what happens to your stress level if you unplug on a regular basis.