In the last decade, more and more people have figured out how to make this transition easier.

It matters to some extent if you have a partner and if the relationship is a viable one. Not having to worry about a child at home can be very liberating and can take you and your partner to a time you had together before you had kids. Do you remember a time in your relationship when you were about to have kids and were worried about losing your freedom? When you were free and could just focus on each other and do whatever you wanted to.  

Even though you had more freedom in years before the kids leave home then when they were young, still there was a lot of energy spent on them. 

Now there is space to just focus on you and your partner and think about doing stuff you did not do for a long time, such as:

• It is time to reconnect with your partner
• Think about new personal and professional goals
• Resist the Urge to Check-In too much with your child
• Reach out to family and friends, especially those who have been through this.
• To the extent that it is possible, plan for this ahead of time. Line up experiences that would be fun.

Things can feel even more lonely and upsetting if you are single. You may feel abandoned, useless and alone. It is important to realize that your kids can no longer be the only meaning in your life.  They will always need you and be very important, but you need to figure out a life for yourself. There simply is no choice about this. 

During this time consider the following:

1. It is a great time to reach out to others who are in your life and extend yourself in ways you did not have to before.
2. It is also an ideal time to do soul searching about what you care about and what interests you have. It may be time to devote to your career.
3. Consider ways you could volunteer your time and energy to help others in need.

The main thing to remember is that your kids cannot be your life when they are adults. Trying for that will be disappointing to you and not fair to them.

The post Tips for Dealing With Empty Nest Syndrome first appeared on Irina Firstein, LCSW.

We all know that our goal as parents is to make our children independent, autonomous adults, the experience of letting go can be very painful.

It is hard not to have children in your home who need care and attention. Sometimes, there is a sense of having no purpose in life.

There are also worries about their safety, well being, their ability to actually take care of themselves.

Parents dealing with empty nest syndrome often have a profound sense of loss which can make them vulnerable to depression, alcoholism, identity, and marital crisis. 

There is often a deep void, it is hard to adjust.

These feelings are normal and usually ease with time. In the beginning stages of this, it is critical to reach out to family and friends and talk about these feelings. Some will need professional help as this can trigger old feelings of abandonment and loss.

It is important to see this as a life passage both for you and your children. You need to trust that you are not losing them and will have a relationship going forward albeit somewhat different, but not worse than before. You will still be a parent, always.

Just like childbirth, many people have gone through this and have survived. You will too.

The post What Is Empty Nest Syndrome? first appeared on Irina Firstein, LCSW.

Situational depression occurs when there is a triggering event which is distressing and creating a downward spiral. This can be a loss of a loved one, illness, rejection, abandonment, blow to one’s self esteem, a sense of failure in an important endeavor or trigger from past traumatic experience or event. All of us react to such events with deep sadness, but sometimes, it turns into feelings of depression which are associated with hopelessness, feelings of aloneness, lack of energy, sometimes guilt and shame.

Sometimes the depth of these feelings indicates a possible biological component as well. Situational depression can be treated and resolved with psychotherapy alone. Insight oriented therapy combined with a good therapeutic relationship can be enough. EMDR can also be very helpful as most causes of a situational depression have origins in past traumatic events. If the depression does not respond to therapeutic interventions, it may be a good idea to have a consultation from an experienced psychopharmacologist.

When a patient comes in with a depression that is more or less chronic with various degrees of severity and with no apparent trigger or precipitating event, there may be a biological cause. While psychotherapy is helpful, in these cases it is useful to consult a psychopharmacologist to explore options for antidepressant medication. A good psychiatrist is usually able to figure out the right medication which will alleviate the distressing feelings and lift the depression.

The post Different Types of Depression first appeared on Irina Firstein, LCSW.

There are many reasons for this phenomenon. The most common are hormonal shifts and for some the trauma of a difficult birth. Both wreak havoc on the brain and the nervous system. There is also a sense that this long anticipated event is done and there can be a possible sense of a letdown. Often times the moment of baby’s arrival and subsequent days and hours are challenging, especially to a new mother. Some women may experience a sense of inadequacy in not knowing exactly how to care for the infant. Another reason for many is the pain experienced after childbirth, whether it is due to severe trauma to the pelvic area and stitching or due to C-Section. For many mothers there is also a weight issue, which can take time to resolve, but can effect self-esteem and make a new mom feel unattractive.

Some of the new mothers I have seen in my practice developed obsessive thoughts about hurting the baby which were tormenting and quite severe. Other mothers were extremely afraid that somehow their actions will hurt or kill the baby.

I have also seen cases when a new mother is not willing to let anyone near the baby or hold the new baby. It still feels like the baby is part of them and not a separate person. They may also have fears that another person, including the father will somehow hurt the baby.

Another potential area of depression is when a mother has difficulties with breast feeding or has inability to get the baby to latch on to the breast. This is often associated with feelings of guilt and failure as a new mother.

Depression at times can also occur when bonding with the newborn does not occur immediately and takes time. This leads to feelings of being a bad mother and a terrible person. This almost always this resolves itself.

Finally there is lack of sleep which can cause depression due to exhaustion and irritability with those around, which may lead to conflict with spouse and family.

Some or most of these feelings and issues should resolve fairly quickly. If months and months go by, and the depression or obsessive thinking and behavior does not get better, it is a good idea to seek professional help. Talking this out with a therapist familiar with these issues can be immensely helpful. Normalizing the feelings and or uncovering possible underlying causes of these symptoms can speed up the recovery, and sometimes, an antidepressant is in order as well in particularly extreme cases.

The post New Moms And Postpartum Depression first appeared on Irina Firstein, LCSW.

Sadness is a normal and healthy human emotion, in response to variety of experiences. It often is connected to disappointment which is mild to moderate, feeling hurt by someone or something, feelings of occasional loneliness, work related stress or mishap of some kind or another. It is an opposite of feeling “happy” or joyful. This is usually a feeling that passes relatively soon, it can be days or hours and the person will return to a “normal” emotional state. Usually when one is sad there is no disturbance in sleep or appetite, no issues with functioning at the workplace or school or generally in any major area of life. Feelings of sadness usually resolve spontaneously.

Depression on the other hand is a more profound state. It is deeper than sadness, or is a sadness that does not lift over time. In fact, it usually gets worse. It is also, unless, biologically driven, connected to disappointment, failure, rejection, sense of aloneness, low self esteem and generally a profound sense of loss. Depression is characterized by low energy, lack of desire for anything, inability to experience any pleasure, social withdrawal, disruption in sleep and eating, a general sense of hopelessness and futility. It is a much deeper, darker and more profound state. Whereas a sad person can sometimes be cheered up, a depressed person, generally can not get out of their state and attention and intervention by loved ones do not help or if they do, it is not lasting. Depression can last a long time, and, over time can get worse and needs professional attention.

There is usually no treatment needed for sadness, it is part of natural ebb and flow of human emotions, and is as normal as joy. In case of depression, usually psychotherapy and often times medication as well, are in order. This combination is usually sufficient to resolve depression over time.

The post Am I Sad or Depressed? first appeared on Irina Firstein, LCSW.

Grieving a loss of a parent is normal. However, when it is extremely prolonged with not much significant ease, this can become what we call, complicated grief.  In a way what this means is that this is not only pain of a loss of a loved one, but, that there are complications in the relationship with a deceased parent that have not been worked through or resolved and it is difficult to move through the stages of grief and loss which leads to a “stuckness” of  unresolved feelings – most often guilt, anger and sometimes, shame. Sometimes, complicated grief reaction occurs when there is not sufficient separation that usually is a part of an adult relationship with a parent or if the death took place under sudden or tragic circumstances with no preparation for facing the loss.

In dealing with a loss of a parent, usually, emotional support from friends and family as well as time, can eventually provide some relief. As time passes and other things occur, there is a natural sense that “life goes on”, so to speak.

However if the loss, heartbreak and grief start turning into a feeling of depression, it may mean that the reaction to the death is “complicated” grief and it is time to seek professional help. With a help of an experienced therapist, it is important to identify the “unresolved” issues or any other elements of the relationship with a parent or other self  related feelings and issues that are in the way of integrating this major event into one’s life and continuing to experience life in its fullest capacity.

The post Depression After The Death of a Parent first appeared on Irina Firstein, LCSW.

Its a  kind of Post – Holiday Blues, I don’t want to call it depression, but for many its a slump. For many of us the social calendar is empty and the work one is full. The credit card bills will soon be arriving, reminding you of all the money you spent on gifts, etc.

You can try to change this “blah” perspective to a positive and productive one. Its time to think about doing all things you have been putting off because you are not preoccupied with all the year end stuff, such as gifts, travel, family obligations.

If you worry about feeling lonely and isolated during this time, have a dinner party, make plans to see people. Many of your friends, family and colleagues feel the way you do. reach out to friends and family and organize stuff, everyone will appreciate this, go see films, plays and concerts you had no time to indulge yourself with during December. Many, knowing about this slump actually plan trips in January and February.

You know you have been here before and it passes. As the months go forward and you weather the cold weather and snow storms, you know spring is coming and with it rebirth and new inspirations and good feelings.

Hang in there!

The post How to Deal with Post-Holiday Blues first appeared on Irina Firstein, LCSW.

I would like to present some reasons for holiday blues as well as some ideas on how to cope or minimized stress and depression  during  holidays.

Holidays are stressful for many reasons: there are demands such as parties, shopping, entertaining, endless gifts, not to mention pressure to be happy. Many of us have unrealistic expectations of ourselves and others, some are not able to be with our family or friends for financial or other reasons, there is financial stress that comes from over-commercialization and feelings of duty and expectations. Many suffer from a mild depression in winter anyway due to limited light (seasonal affective disorder). Finally, for some of us, holidays are sad because of a recent loss due to death or a breakup. Even past losses become more intense during the holiday season as we think of being with those who are no longer here during this time. Holidays are a time when feelings of loneliness if they are there, become more intense. Loneliness and loss are often at the root of all sadness and depression.

Here are some tips to help deal with holiday stress and depression:

– Don’t deny your feelings, feel them and acknowledge them. If you are going through a loss, or if there are reasons to feel sad, its OK. No one can force themselves to feel happy if they are not. Don’t put more pressure on yourself then you already feel.

– If you can, reach out. Think of everyone you may be able to connect with, go on a spiritual retreat or volunteer your time to help those who are in a much worse situation, this puts things in perspective quickly and makes you feel good that you were able to make someone else’s life better.

– Remember, holidays don’t have to be perfect every year. Every holiday season is different and its not helpful to compare. Life changes, families change, try not to hold on to past, but embrace what is now. If you are married or in a serious relationship, you may have to compromise this year and suck it up, go to your partner’s family and miss seeing yours. May be your best friend is not around this holiday, accept life as it is, do the best you can. If you are a couple with older married children, they may not be with you this holiday season, find a way to accept this and celebrate with those who ARE  around. Try to enjoy who you have around you, rather then dwell on who can not be with you now. This too may change next year.

– Many of us have financial stress during holiday time. Stick to a realistic budget. Don’t compare yourself with what others can spend.

– It’s a good idea to plan ahead in terms of shopping and entertaining. Last minute scrambling creates a lot of stress and takes whatever joy there is out of holiday season.

– Don’t abandon good self care habits like exercise, healthy eating, don’t use holidays as a reason to drink excessively,  get plenty of sleep. Say NO when its too much! Emotionally healthy living is a balance between caring for self and caring for others.

– Make sure you get some old sure proven activities in that make you feel good, whatever they may be. It can be as simple as watching a favorite movie, listening to music or curling up on a couch with a good book.

– Finally, if the sadness, blues or depression persist way after the holidays are over, may be its a good idea to seek professional help. This may be a full blown depression and it needs to be dealt with.

Let me know if you have other good tips or ideas so I can share them.

The post Why Holiday Blues and How To Beat It. first appeared on Irina Firstein, LCSW.