Note: This article hasn’t been updated since 2014. The basic underlying principles are certainly still valid; however, our current understanding of neuropsychology and neuroscience would provide greater insights into strategies.
Parenting With PTSD:
11/4/2014
[How to Keep our Stress from Affecting our Children: A look at how PTSD, anxiety and depression, or even “just stress” can stand in the way of our attempts to parent our children respectfully, and techniques to minimize the impact of that stress on ourselves and our children]
Originally, this post was intended to be about the specific issues that parents with PTSD face, both in their day to day interactions with their children and society and the self-doubt and negative thoughts that they struggle with internally. In my research and while I was working on the article, however, it became apparent that the strategies which I have found that work, can also be used for parents with any anxiety disorder or just an increased level of stress in general, as well as parents suffering from depression. So while I will address specific symptoms of PTSD and discuss that topic, I hope that will not discourage other mothers and fathers who are dealing with stress or depression to try these solutions and see if they can benefit their lives as well.
With this in mind, the original post of Parenting with PTSD will remain, followed first by some emotion regulation techniques, ways to trick your brain into producing oxytocin [a natural stress reducing chemical], strategies for lowering stress in your life in a general sense, and finally, resources to assist with mental health issues and stress.
Parenting with PTSD:
I am going to be very candid in this post, very candid and very real. It is only in the hope that my honesty might help someone who is struggling to make it through a situation that is similar to the one I have made it through. Mental health problems are not always comfortable topics to discuss, but it is imperative that we do. The stigma is slowly fading, but many people still suffer in silence, needlessly.
The topic of parents with PTSD had come up several times in the past few weeks and it is bittersweet to know that I am not the only mother who has these thoughts and experiences, despite the countless times I have thought that I was alone. But, when I was researching articles on how PTSD in the parent affects the parent-child relationship, I was disheartened to only find information on how the child is negatively affected [including secondary truamatization, effects of emotional abuse, and heightened anxiety]. While this is certainly important, there was no description of issues from the parent’s perspective and no solutions were offered to the parents struggling with these issues, aside from getting counseling. I am a high functioning parent with PTSD; I have been working with a therapist for almost 8 years and have learned many coping strategies, and I was still left feeling hopeless and with the thought that I was traumatizing my children daily. So, I wanted to offer the perspective of the parent with PTSD and some tips that I have picked up over the years for minimizing the impact that my disorder has on my children.
I was diagnosed with PTSD in March of 2006. I spent almost a year, in which I couldn’t leave the house alone at all, and many days I couldn’t leave the house even with a trusted friend. I began therapy [cognitive behavioral therapy] and was started on an anti-depressant and anti-anxiety medication. As a career artist and illustrator, I worked through the underlying traumas with artwork and a book. For me, it really helped to find a way to use these horrible images and feelings to create something “beautiful” and useful. I created a large solo show of these works and it was displayed at a prominent local gallery in December of 2006. The day after we took the show down, I was re-victimized and it seemed as though all the progress I had made had disappeared and I was actually in a worse spot than before. It took me years of suicidal thoughts, flashbacks, alcoholism, therapy, medications, journaling, meditation, searching, different professionals, and finally becoming pregnant and getting sober to get back to a place where I was starting to heal again. My son saved my life. But my children aren’t enough to get me better. Unfortunately, and even cruelly, sometimes, my children trigger the lingering symptoms I have from these traumas and that is a unique horror in itself.
There have been times, as a parent, when my depression became overwhelming. It was hard to function, even harder to keep a smile on when Bambino was around. I really tried, knowing that it hurt him to see his mama like that, but some days it was too much. I can’t take my children places like theme parks, Chuck E Cheese, and would love to be able to veto trick or treating on Halloween. I have had days in which I couldn’t manage a trip to the park because of the fear and anxiety. Days in which I couldn’t manage a trip to the grocery store for milk. Luckily, I had [and still have] a good support system of people who were willing to bring me milk, or potatoes, or coffee when I really needed a helping hand. Bambino has lots of “aunts” and “uncles”. I can’t count the nights where I went to sleep crying softly because I had convinced myself that I was “ruining my child” or that I just didn’t feel I could ever be strong enough to be enough of a mother for him. Sometimes, when the boys are being very noisy, my anxiety rockets from a 1 or a 2 all the way to a 9; no time to pause. And other days that started with a higher anxiety level than normal, in which I am extra prone to impatience and irritability. There are two occasions where I had to be hospitalized to recover from suicidal thoughts. I still get night terrors. And there is the rare occasion that Bambino or Noodles does something completely innocent, completely normal for a child, and that action triggers a flashback for me.
I don’t think I’ll ever really be “over” it, but I have finally learned to live with myself and work through it all. There are elements of that pain though, the shame, how my identity kind of built itself around those events, and the insecurity that will likely never leave me. But, my depression, anxiety and agoraphobia are now manageable, It has been almost 3 years since I have had a suicidal thought. I have learned that there are other, amazing things that help define me, and in trying to show my boys a level of security, I have built some of my own. But there are many physiological symptoms of PTSD that will never vanish. This disorder causes structural and chemical changes in the brain, my brain will always react this way. So without good coping strategies for stress, my life and my relationship with my children will suffer. Today, I would like to share those coping strategies that have helped to “normalize” my family a bit. There are several issues that seem to be common with mothers [or fathers] with PTSD which I would like to address and offer solutions. I have split them up into anxiety related symptoms and depressive symptoms, as the two are dealt with differently.
Anxiety related:
Anxiety reactions are caused by typically “normal” stimulus triggering the fight, flight, or freeze response in your brain. My favorite explanation of this occurrence is found in an article on debbiebayerblog.com:
"Here’s the problem, the activity of our frontal lobes can be shut down by the other parts of our brain when there is significant stress in our body. This comes from what is called the “fight, flight, freeze, or faint” mechanism. This mechanism in the brain is hard-wired into each of us for survival purposes. It is the part of the brain that puts someone into shock when they have been injured and/or traumatized. It is also the part of the brain that can allow a person to lift a car by themselves if their loved one or someone they care about is in danger.
The brain does not analyze the type of stress it is experiencing, that is, this ‘fight or flight mechanism’ is binary. It functions on a “yes” or “no” basis. “Yes,” there is enough stress to activate the mechanism or “no,” there is not enough stress to activate the mechanism. Human beings have no control over when this mechanism is activated.
This is how PTSD works. Seemingly innocuous sights, sounds, smells or sensations trigger this brain mechanism even when there is no actual threat to the person. The stress in the body is not even consciously recognizable to the person with PTSD. The brain reacts to the trigger and the person is put into the experience of being threatened without choice or control because the frontal lobes cannot get their signals through. When this mechanism is activated free will and choice become impossible. This is true for each and every human being on the planet, whether we like it or not.”
The triggering of this fear response can present as several different events [panic attacks, flashbacks, night terrors] and can lead to other complications of anxiety [social anxiety, irrational fears].
Your child inadvertently triggering a flashback or “fight or flight” response: This symptom, though it is often the least occurring, is the most troublesome issue of parenting with PTSD. When your body is having such a strong, adverse reaction to something that is often normal behavior for a child, it is terrifying and all consuming.
Often, without practice in learning to pause, we have immediate reactions that are often devastating [at least temporarily] to our parent-child relationship. For me, it is as if I am watching myself react. The reasonable part of my brain is almost shouting at me to slow down, but I can’t. I have never gotten physical with my boys in these moments, but I have often yelled or “snapped” at them. And from a typically even-tempered caregiver, that reaction is confusing and shocking to a child.
Social Anxiety: This encompasses everything from the inability to be in places that are too crowded [see: Children’s birthday parties and theme parks] to those days that we can’t handle the other parents at the park or the library. Sometimes we can push through, but other times it is best for us and our children that we remain at home.
Increased Stress Levels causing irritability and impatience: This is still a big one in my life. I am still learning and am slowly becoming more consistent. But when my stress level is high (as often happens when you are a parent or just a human being trying to survive this world), my patience suffers greatly. And patience is crucial in maintaining a close relationship with a child. We have to be calm and consistent when they aren’t able to.
Recognizing the distinction between rational and irrational fears, so as to not become over-protective of your child: This is a tough one, because the line is a little different for everyone. But, for example, I wish we could fore-go trick or treating because of my fears. My predisposition to worry about everything from poisoned candy to pedophiles combined with the media’s propensity to sensationalize makes me want to keep my boys from situations that could be potentially threatening. But, I don’t want my children to miss out on the excitement and joy of Halloween because of a “could be”. A lot of things “could be” dangerous, but typically they are benign. I won’t be able to protect my boys from everything in this world and I don’t want them to grow up afraid to live. So I have to find a balance, and figure out which of my fears might be causing me to be OVER-protective of my children.
How much “real” emotion to allow your children to see: This is another issue which each parent will have to address to figure out where a comfortable line fits for their family. Visceral emotional reactions can be startling and scary to a child, and are best kept to a minimum and explained when both parties are calm. But emotion in general, when appropriately modeled, dealt with, and communicated about can be very beneficial to a child’s understanding of their own emotions and empathy for others.
Depressive Symptoms:
Low Affect: When we are depressed, our faces, bodies and voices echo that depression to anyone who interacts with us, including our children. Our faces remain fairly expressionless and our voices lack emotional tone and animation. These can be startling, especially to a young child who uses our faces and our voices to connect with us and understand his own emotions and level of safety. It is important to try and be aware of what our voices and body language are communicating to our kids.
Thoughts of inadequacy magnified by children: I thought I felt useless when I was depressed and single…then I had kids. It seems like those feelings of inadequacy grew tenfold. Not only was I useless in my own life, but I was failing my children, whom I was meant to love and take care of. And I really wanted to be a good mother, I really tried to, but I always felt as if I wasn’t enough.
Lethargy and Loss of enjoyment: It’s hard enough trying to keep up the enthusiasm and energy required to raise a toddler or preschooler or infant [or teenager, I’m sure], without suffering from depression. Even minor bouts of depression can severely interfere with the demands of life with a child.
Trying to “explain” to your kids: Again, this is a subject that must be approached differently by each family and child, considering age appropriateness and family relationships. If you are finding it difficult, it might be beneficial to enlist the help of a family counselor to discuss these issues with you and your child, so they can form a healthy understanding of the situation.
Pause When Agitated: Tips to Help Regulate Anxiety or Stress
These strategies have helped me to keep some control over my emotions and anxiety in high-stress situations at home and in the world so I don’t tend to dissociate or become impatient or irritable with my boys. They all work best if I am able to recognize early warning signs of anxiety attacks and utilize the techniques before anxiety builds into a full-blown attack. The earlier the better. But they even help to calm me down after I have lost control and become cross with Bambino. But often, by then, he is already upset [rightly] and sometimes has gone to sleep upset without me having the chance to apologize, so the real goal is to avoid it getting that bad.
The following techniques are NOT meant to replace seeking advice from a counselor, psychologist, psychiatrist, or trusted medical or psychiatric provider. If symptoms of anxiety or depression are interfering with your daily life, please seek counseling and/or consider medication. PTSD, anxiety disorders and depressive disorders are serious illnesses and shouldn’t be shrugged off. These suggestions are meant to complement a support system and therapeutic approach or to assist with occasional episodes of stress or depression.
Smell your kiddo: Seriously…go in for a hug and take a deep breath. Smell their hair or neck.
Why this works: Triggers the release of oxytocin in the brain, Oxytocin is a natural stress relieving chemical produced in the brain to promote good feelings of caregiving. Studies have shown that a child’s scent (specifically newborns) lights up the pleasure center in a woman’s brain. Also, it won’t hurt that, when you are stressed or anxious, you decide to respond with affection rather than react on impulse.
Grounding Techniques: The most simple one is to just remind yourself that “You are safe”. Remind yourself of where you are and what is going on “I am home, I am with my children, I am safe”.
Another of my favorites is 5,4,3,2,1 [this is also great for children if they’re having a meltdown]:
- Name 5 things you can see in the room with you.
- Name 4 things you can feel (“chair on my back” or “feet on floor”)
- Name 3 things you can hear right now (“fingers tapping on keyboard” or “tv”)
- Name 2 things you can smell right now (or, 2 things you like the smell of)
- Name 1 good thing about yourself
Why this Works: Grounding techniques refocus your brain’s attention to the current reality. Anxiety relies on [often irrational] fear of the future that is typically based on events of the past. Often, when focused on our immediate surroundings, there is nothing to fear. Building a sense of safety and security in our present lives is a large key to minimizing overwhelming anxiety into something manageable that we can cope with.
Trick your brain out of the amygdala: Find something that your brain can “reason” with. I like math, because it is all fact; emotionless. I also like to use language. I find that just trying to reason with myself about the situation that is causing me stress holds too much emotion and I stay stuck in the anxiety. But if I find another “problem” for the reasoning areas of my brain to focus on, it tricks me out of the stress. If I am repeating a word in my head, like “panic” i try to think of all the synonyms for it that I can, and then i try to remember the word for panic in other languages I have learned. Or I will invent a math problem…you don’t have to solve it, once your brain is distracted and you calm down, you can redirect the focus of the reasoning to the problem at hand. When that is too much, I count in my head.
Why this Works: You are literally getting a different part of your brain to take back control from the amygdala. As long as you’re “stuck” in the anxiety, it is impossible to make a reasoned decision. All of your actions will be reactions to this stress and will only compound the issues.
Now this is a tough one...If your child sets off one of your triggers…try as many of these as you can remember until you have re-grounded yourself in the moment.
1. Pause. Take a few deep breaths. [Seriously, this is the best bit of advice to use every time. If you can learn to just pause in these moments, you can move from reacting to acting]
2. If you are extremely anxious or distressed, try to turn away from your kid or calmly put a hand over your face so the intense emotion on your face doesn’t startle him or her. Take a few deep breaths and tell your little one, “Hold on [child’s name], mama is a little dizzy” (or something similar, but use your child’s name)
3. Tell yourself your child’s full name. Tell yourself your child’s birthdate. Then count out how many months old they are, slowly, and on the fingers of your right hand if you can. Touch each finger purposefully. Count them out, though. If your child is extremely young, do days. If your child is older, you can stop once you have calmed down a bit and your breathing is normal.
4. Count out five things about your child or your parent/child relationship that are happy/joyous/loving. Count them out on one hand. Gently squeeze each finger between the thumb and forefinger of your other hand as you say them. If your little one is still there, say them out loud, something like this, “I love your smile” [squeeze thumb], “You have the sweetest laughter” [squeeze index finger] etc. etc. Then remind yourself where you are, whom you are with, and that you are safe. 5. Touch your child. Hug them. Rub their hair. Do something to physically reconnect with them.
Once you are both calmed down completely, discuss what happened and how whatever action made you feel uncomfortable [age appropriate conversation].
My son used to cover my eyes sometimes. He’ll come up behind me and put his hands over my eyes. Inside I lose it. But I calmly remove his hands. I pause. I do as much of the things above as I need to to re-orient myself and I explain to him that I know he is just playing, but when he does that it really scares mama. I explain that I’m not upset with him, but when he covers my eyes I can’t see and that’s scary for me. He understood after a couple of times and doesn’t do it anymore.
Why this Works: Pausing will keep you from having an immediate emotional reaction. Turning away or covering your face a bit will minimize the impact that your uncomfortable emotions will have on your child. This can help keep your child from becoming anxious as well or having a bad reaction to your anxiety [secondary traumatization].
Using your child’s name will help re-orient you in the present moment. Counting out the months will get a different part of your brain working and so will using your right hand. Positive affirmations help ground you in the present and help re-connect you with your child and your loving relationship. The last three statements are to re-orient yourself in the present moment as well.
Also check out Meridian Tapping techniques. You will have to practice them a bit to remember the sequencing, but they really help if you are having a panic attack or a flashback.
Trudging Through: When Depression is Interfering
Depression is caused, largely, by dysregulated neurocircuitry in the brain. Underperforming noradrenaline and serotonin receptors [likely also other neurotransmitter systems] cause us to feel down, miserable, dissatisfied; steal energy, and mess with emotional regulation.
When we’re significantly depressed it makes it difficult to connect with our children and lowers our affectual responsiveness [the expressions on our faces and tone of voice that communicate that we are happy and love our children]. They pick up on these changes in us and perceive them as either their parents withdrawing their love and approval for some reason, or a significant threat to our well-being or theirs. This can be confusing or cause anxiety.
Be a Robot.
Do all of the things that you need to do, even if you don’t want to do them. Do them mechanically. Push through.
It will keep you from sinking further into depression. If you can…imagine how mechanically you are doing things. Exaggerate it. Actually pretend to be a robot.
What this does for you: It gets you moving. It keeps you participating in life.
What this does for your kiddos: If shows that you are still active in life. If you are able to mimic a robot, they may perceive this as “make-believe” as a kind of game, in which your depressed mood will seem appropriate and not as shocking.
Have a Staring Contest with your child.
What it does for you: The eye contact and closeness should help to produce dopamine and oxytocin production in your brain and may kickstart an improvement in your mood. It also may get you laughing which would be an added bonus.
Laughter provides a significant oxytocin boost.
What it does for your kiddo: It provides a “re-connection” opportunity on days or at times when it is hard for us to connect as we normally do. It shows our interest and focus is with them. And as it will be hard to not smile at your child or attempt to touch them, it will lighten the mood and ease the tension for both of you.
Make a list of things in your life that represent your Worth, your Love, and your Happiness.
Make this list when you aren’t depressed. But refer to it when you are feeling low. It is even better if you can find visual representations of these things as well…photographs, your child’s stuffed bear, an art or craft project that you made together on a good day…It is BEST if you can find a way to involve all of your senses.
Make a box. Fill it with your favorite small candy or snack, a scented candle that either makes you feel comforted or energized, something soft of your kiddos, photographs of happy times, and a mixed cd of your favorite upbeat songs.
What it does for you: This physically invites your brain back into happier times.
What it does for your kiddo: A happier mama is beneficial to everyone.
What you can do Day to Day to lower anxiety and improve mood:
Healthy Self-Care: Eating a good, healthy diet, getting as much sleep as possible, showering/bathing regularly, getting [even just a bit] of regular exercise, staying hydrated…All these basics of self-care are the appropriate foundation on which to build a healthy mind and healthy attitude. When you can do nothing else, do these, even when you don’t feel like it.
Magnesium: Insufficient intake of magnesium can raise anxiety. So it is possible that at least some of your day to day stress could be caused by that. In addition to a magnesium deficiency contributing to your stress problem, raised intake of magnesium can lower stress levels overall. Try adding a magnesium supplement to your daily vitamin intake.
Make [and stick to] a schedule: Make sure that you are taking care of yourself and your family’s daily needs. Sign up for a weekly activity or two to look forward to, to get around friendly people, and provide consistency for your kiddos.
There is also ample evidence that meditation can lower overall stress and anxiety levels in sufferers of PTSD, anxiety disorders, and psychologically healthy individuals. Take some times each day, even if it is just 5-10 minutes to meditate. If you are just starting out…pick an appropriate positive affirmation [“I am enough”], pay attention to your breath and your chest rising and falling, and with every exhale, repeat your phrase in your head. Enjoy the calm. You can also find a lot of good meditation techniques online.
Positive self-talk: This can be included in a daily meditation or independent of it. When I start to feel down, I like to just repeat something positive about myself, or an example of growth over in my head a few times. When I can’t think of anything I fall back on “I am enough” or “My children need ME”
Re-focusing your attention on the positive. Make a gratitude list each night with a few things for which you are grateful. Try not to dwell on the negative things; don’t give them your attention. Try to minimize complaints and criticisms, instead try to find something positive about every interaction. These things will take practice and patience, but learning to recognize on what you are placing your focus will help to start the process.
Support: A good support system is crucial to coping well. Seek out friends, family, a therapist, a support group to have a good support system locally. Commit to an activity in your community to get out around like-minded people. And if you ever are considering suicide please contact a support person or call the suicide hotline.