No matter how brilliant the person may be, I have never met anyone with depressive illness who could acknowledge and accept their brilliance. Mental illness is an equal opportunity disorder that crosses all races and socioeconomic classes and affects the self esteem of those with the disorder. The ability of the disease to manipulate self doubt leaves many insecure in their talents and abilities. Worries and doubts about being a good parent can limit instinctual maternal abilities. Insecurities about parenting capabilities can be magnified by active symptoms of depressive illness which may also limit the ability to remain consistently emotionally available.

In my opinion, adults who have had the experience of limited and conditional love and attention as children have less self confidence and more insecurity. My message, therefore, is to make it your personal goal to achieve your best emotional stability. If you cannot be emotionally available when ill, plan to find a warm, loving and emotionally available person to help you co-parent. It may be your partner, a grandmother, a neighbor or your best friend. Just find someone who can be readily supportive of your child when your symptoms of illness make you become emotionally unavailable. In this way, you can limit the potential impact of your poor self esteem and avoid repeating the legacy of emotional distance from your child.

I have frequently been accused of making my patients obese. Reports of patients eating almost no calories yet gaining or maintaining weight while on my medications is a daily event. In my defense, clinical practice has required keeping my knowledge of nutrition current since my college days at Cornell. So what has been my observation about weight loss? It appears that emotional eating is alive and well in my practice.

When quizzed, my patients often reveal that they have quirky diets or they eat too much and do not exercise. Consider my favorite question, “What did you have for breakfast yesterday?” Most often I am told that my patient does not believe in eating breakfast or had consumed coffee and a carbohydrate such as a bagel or toasted bread with butter. The bread selection was white, which has minimal nutritional value. Meanwhile, that same patient will complain of a lack of energy. Many of my patients are befuddled by the knowledge that the brain needs nutrition in order to function in the morning. Caffeine alone will not provide the carbohydrates, fats, and proteins required for optimum performance.

So what is the latest information in the weight loss world? The answer seems simple but may be very hard to do: write down the calories you consume during the day. A Kaiser Permanente study published in the American Journal of Preventive Medicine reports that participants who wrote down their daily food intake lost the most weight. Weight Watchers has been aware of this simple well known fact since their inception, requiring members to write down their intake for optimal results.

The Kaiser study included an ethnically diverse racial population of 1,685 people who were designated as obese or overweight at age 25 or older. It discovered that the most powerful predictor of weight loss was how many days per week diary entries were recorded. The author, Stevens, concluded that visualization of food intake allows for accountability and awareness of said intake.

What does this mean for you? Writing down everything you eat in a disciplined fashion requires determination as well as identification of a method that works for you. I have heard that some patients use colorful index cards placed in their pockets. Others have identified online sites for recording on the internet. Still others use pocket composition notebooks found at local office supply stores. Whatever method you use, just use it consistently in order to have the best weight loss success story.


http://www.mypyramidtracer.gov/

Differences in parenting styles can be a major problem. Two individuals with different backgrounds come together to raise a child. The ability to parent gets very complicated when a parent has emotional issues and can't be consistent with their message to their children. In my opinion, that can be a recipe for disaster. Children are smart, period. They quickly figure out how to get their needs and desires met. Problems in parenting occur when both parents can't agree on the messages about the rules for their child.

Limit setting is an area that can be very tricky. One parent may be unable to set limits for a variety of reasons. In my world of psychiatry, if you are depressed, it is very hard to stay consistent with the parenting message. The other parent should agree and not be erratic in supporting the depressed parent in their established kid rules. So when one parent says no but is too overwhelmed to stay consistent, the kid often seeks out the parent who will grant them permission. For example, the kid gets to play on the computer although one parent said no. Later the parent with depressive illness feels better, but the kid learned a lesson about parental differences. Ask parent X for permission when parent Y says no. The child learns from the parenting differences not to listen to the "mean" parent who sets limits.

This Mindsupport message is to settle your parental differences in adult privacy. Kids learn life lessons when both parents agree on the issues.

Motherhood often provides numerous lessons in flexibility, starting with the breast feeding choice. A few years ago, Jennifer Lopez made the cover of People Magazine after the birth of her twins. I appreciated her frankness concerning her decision to opt out of breast feeding. It appears she has bonded with her babies but decided it would be okay not to breast feed. She was quoted in the article as saying, "My mom didn't breast feed and I think that was the thing for me. You read and figure out what is the best for them."

Many of my patients feel that they must breast feed their babies. I have witnessed many patients struggling with their illness, attempting to breast feed, staying up all night, working the next day and not accepting treatment for their illness out of fear of an adverse effect on their baby. These women have great responsibilities as they balance newborns, families, and careers, often without extended families to help them. Yet they feel in order to be a good mother, breast feeding is their only option.

If you want to breast feed and it works for you, great! If not, and bottle feeding your baby is the best option, that's fine too. We have made mothers feel guilty about the bottle feeding choice. I have met many moms as they struggle with both severe emotional illness and trying to breast feed. Their inability to obtain restorative sleep and appropriate treatment magnifies their illness and inability to enjoy the early days of mothehood.

Hearing the message from Jennifer Lopez is gentle reminder that females have the ability to choose whether or not to breast feed.

Love should not hurt. Domestic violence is a real problem. It is not acceptable under any circumstances for your child to witness someone beating you or cursing at you. Kids deserve better childhood memories. If untreated, those children are then at increased risk of repeating the cycle themselves. Their real family dramas can last a lifetime in their child's mind. Kids who experience this negative, violent world can believe they are worthless adults and repeat the same cycle of negative life experiences. In my job as a psychiatrist, I often see patients who are locked in their past with painfully horrible childhood memories. This daily pain can be magnified by untreated emotional illness which allows them to develop a higher tolerance for painful life situations. My favorite example to tell patients is that it takes them longer to tell someone to stop when their bare feet are being stepped on.

So if you are planning to get pregnant and you have painful issues that impact your daily life, get treatment first. Children thrive in loving and nurturing emotional environment.