Anxiety & Women: Hormones, Sleep & What You Can Do

Anxiety & Women-Hormones, Sleep & What You Can Do; #anxiety #women #hormones #sleepIt’s 3:30 a.m. I was simply rolling over to fall back asleep, when my brain switched on like a 100-watt light bulb, and now I’m flooded with stress, worries, and thoughts of what I “need to get done” or about “my overwhelming life,” when I thought I’d put those thoughts to bed hours ago. I know I won’t fall back asleep. Still, I try. I try belly-breathing, then progressive muscle relaxation, then letting myself think for a while, to tire me out. Then, I pray. I pray for sleep. I pray that this knot of tension inside me will leave, that the fatigue my body is feeling will overpower the thoughts that hold me hostage. Finally, at 5 a.m., I get up and begin to type. It helps to get these thoughts out of me and maybe do some good for others in the process. Finally, I sneak down to the basement and exercise; I know it’s one of the best things I can do to not only distract my mind, but to provide much-needed energy for the day and hopefully later, the ability to finally rest.


This is anxiety, and trust me, it’s miserable. I don’t know why I haven’t written more about it before. That’s one thought that was spinning through my mind while I wasn’t sleeping this morning—Why haven’t I written about anxiety, when it’s the predominant symptom with which I struggle? When it’s one of the most common issues for all women, for all people? (Read “I am the FACE of DEPRESSION (& Anxiety): Overcoming the Stigma”)



Anxiety & Women

It’s not only my predominant symptom: “Anxiety disorders include phobias, social anxiety, panic disorder, generalized anxiety disorder, OCD, PTSD, and separation anxiety disorder, and are considered the most commonly occurring class of mental disorders (CDC 2015)” [2].”


Anxiety is the most common mental health issue in women. Yes, more common than depression. Anxiety will affect one in three women throughout their lifetime [2], and often, depression and anxiety go hand-in-hand. Women are also twice as likely as men to develop an anxiety disorder, and symptoms tend to appear earlier in life for women [1].



What is Anxiety?

So, what, exactly, is anxiety? Clients have described it to me as, “I’m on edge all the time.” “My mind won’t shut off.” “I can’t stop thinking about everything I need to do” or “worrying about everything that could Anxiety & Women: Hormones, Sleep & What you Can Do; www.DrChristinaHibbert.comhappen.” “I can’t relax;” “I’m on edge all the time.” Or, I described it, above, “I can’t sleep even though I’m exhausted: My mind is holding me prisoner.”


Anxiety is, first and foremost, a feeling. We need anxiety to warn us of danger or to make us to take action when something needs to get done. If something is wrong and we feel worried, stressed, or afraid, anxiety helps set off the sympathetic nervous system, raising our heart rate and blood pressure and setting off stress hormones, like cortisol, in the brain, preparing us for action, telling us, “You need to do something about this!” When we take action, or when we are able to relieve the stressor or resolve the situation, our mind is supposed to shut off, our parasympathetic nervous system returning our body to a calmer state, heart rate slowing to normal, stress hormones subsiding.


What is an “Anxiety Disorder?”

Chronic anxiety, like an anxiety disorder, however, comes from an overactive stress response. Instead of resuming a calmer state once the threat has been overcome, the parasympathetic nervous system doesn’t kick in for those with an anxiety disorder. Instead, the mind stays on, keeping the body on high alert, even when there is no actual present threat. This keeps cortisol coursing through the body, blood pressure high, and heart rate working over time. This, understandably, makes it very difficult to relax, for the brain to shut off, to sleep. In turn, poor sleep and little relaxation contribute to anxiety and depression, among other things, and the cycle continues. It’s exhausting just thinking about it!


Types of Anxiety Disorders
There are several forms of anxiety disorder, including: Generalized Anxiety Disorder (intense, pervasive anxiety), Panic Disorder (including panic attacks), Specific Phobias (or extreme fears), Social Phobia (or fear of social situations), Obsessive-Compulsive Disorder (OCD, consisting of obsessive, stress-filled thoughts and compulsions to alleviate the stress), and Posttraumatic Stress Disorder (PTSD, with a traumatic trigger, followed by re-experiencing the event, like in nightmares of flashbacks, numbing/avoidance of things associated with the event, and heightened state of arousal).


Additionally, as mentioned above, anxiety may co-occur with major depression or other mental illnesses.


Anxiety & Hormones

In women, anxiety is also a common component of hormonal shifts, like those in pregnancy, postpartum, with PMS, PMDD, or in perimenopause. In fact, many women experience the most anxiety during the years leading up to menopause; and many of these women have never experienced anxiety before!


In pregnancy and postpartum, anxiety is common, as well, with approximately 6% of pregnant and 10% of postpartum women experiencing a perinatal anxiety disorder. Approximately 10% will experience pregnancy or postpartum panic disorder (with associated panic attacks), 3-5% will experience pregnancy or postpartum OCD, and 9% will experience postpartum PTSD, usually following a traumatic childbirth.


Unfortunately, thanks to society’s “myths of motherhood,” many believe it’s “normal” for moms to feel anxious or worried, so too many mothers live with unnecessary anxiety that can make life miserable. The truth is constant anxiety is not normal, and it’s important for women to recognize their symptoms so they can seek and receive treatment to overcome the anxiety and to heal.



Anxiety, Hormones & Sleep

Anxiety is often associated with insomnia or other sleep issues. Again, this is a vicious cycle, as lack of sleep continues the cortisol and adrenaline in the body that only make anxiety worse, and vice Anxiety & Women: Hormones, Sleep & What You Can Do www.DrChristinaHibbert.comversa.

According to the National Sleep Foundation, women are much more likely report sleep issues than men, one reason being the many hormonal shifts women experience premenstrually, in pregnancy and postpartum, and during perimenopause. A few days or a week before a woman’s period starts, she may find she can’t fall asleep or, more commonly, can’t stay asleep, as I described above. As I’ve studied the link between sleep, anxiety, and hormones it’s become clear: women are much more vulnerable to sleep disturbance during times of shifting hormones, and each month those hormones shift twice! First, there’s a drop in Estrogen around day 14, or around ovulation, and then the bigger drop in Estrogen and Progesterone occurs a few days to a week before her period starts. This can make sleep feel impossible for women who are sensitive to these shifts, with terrible sleep one or more weeks every month. (For more on this, read myWomen’s Emotions blog series, parts 1, 2, and 3.)


What can You Do for Anxiety?

You don’t have to suffer, living with anxiety. Treatments are available and highly successful.


  • The “gold standard” for anxiety treatment is a combination of anti-anxiety medication (including antidepressants, which also reduce anxiety) and psychotherapy. The medication works to correct the overactive brain chemistry while therapy teaches techniques and skills for how to manage daily symptoms. Either one of these treatments on their own will likely be beneficial, as well, research shows. (More on “Antidepressant or Not?” here.)



  • Learning relaxation skills, like mindfulness, deep breathing, and meditation are also beneficial in treating anxiety. Research shows these self-help techniques allow you to train your brain and body to let go and relax. Additionally, anything that helps relieve tension and stress can help–like massage, naps, quiet time, a hot bath, reading, watching a television program (not a scary one!), or time with friends and family.


  • Exercise is another helpful treatmenteither alone or as an addition to these other options. The benefits of exercise are proven and extensive, and for anxiety, exercise can not only work out the tension and give the mind a way to let go; it also helps the body become tired, so you’re more likely to sleep better. Though some who struggle with anxiety find cardiovascular exercise difficult, because it may mimic the feeling of anxiety (heart rate up, shortness of breath), lifting weights, doing yoga or Pilates, or very mild walking have shown incredible benefits in rAnxiety & Women: Hormones, Sleep & What You Can Do www.DrChristinaHibbert.comeducing symptoms of anxiety. (Read more about this, as well as strategies to make exercise work for you, in my new book, “8 Keys to Mental Health Through Exercise!” [See Coupon to save 25%, below!])


  • Realize anxiety is not you! Then, FEEL the anxiety. One of the most helpful things I’ve learned over the years is that I am not the anxiety. It is a feeling in my body, not me. Too often, anxiety takes over like it’s running the show—the show being your life! And too often, we let it run the show. We feel like we are the anxiety. We fight feeling it because it’s so uncomfortable and we don’t know how to handle it. Or, at least, we think we don’t. One thing you can try is to sit and FEEL the anxiety. Notice where it is in your body. Breathe as you feel it and recognize it is not you. I find it helpful to imagine the anxiety is slightly in front of me as I lean my body away from it. It reminds me I am in charge of my life; my emotions are not. As we FEEL powerful emotions, like anxiety, they truly lose their power. (Read How to FEEL Powerful Emotions & watch the related 3-Minute Therapy video, here.)


  • Treat the sleep issues to treat the anxiety. If your sleep is severely affected by anxiety, it may be better to start by treating the sleep. Temporary sleep aids, including melatonin supplements, can help you finally get some rest, and just getting some sleep can help the anxiety begin to decrease. CBT can also help in treat the thoughts associated with sleep disturbances. Sometimes, there may be another sleep disorder, mental illness, or physical illness in play that’s causing your symptoms, so it’s always best to get a full physical evaluation first and talk to your doctor about what’s right for you. (Read Sleep Better, Cope Better: 6 Insomnia Causes & Cures, here.)


  • Hormone Replacement Therapy (HRT) is worth looking into for perimenopausal/ menopausal-related anxiety, and some women benefit from hormone therapies for perinatal anxiety disorders, PMS and PMDD. It can be tricky getting hormone therapies right, however, and many women are sensitive to hormone-based treatments, which may make symptoms worse, at least at first. It is therefore important that you work with a knowledgeable doctor about the best therapies for you. S/he can help monitor your mind and body’s response to hormone treatments as well as your progress. It may take some time to get it right, but when you find a treatment that works, it’s well worth it.


  • Avoid/limit caffeine and other stimulants. If it’s your routine to wake up with a heavy dose of caffeine and/or to keep it pumping throughout the day, you may need to tackle that habit first. Caffeine and other stimulants only exacerbate anxiety. If you want the anxiety to diminish, first the caffeine has to vanish.




You can beat Anxiety!

Bottom line: you don’t have to live with constant anxiety. Yes, it will take work. Yes, it will take time. Yes, it will take patience–with yourself, and with others. But anxiety is not a normal part of life—for women, for moms, for men, for dads, for kids, for anyone.


If you’re suffering from any form of anxiety, please seek help. Talk to your doctor or mental health provider and ask what treatments might be best for you. And if you’re not finding the right answers, keep searching and asking until you do.


Don’t let anxiety get the better of you. Start right now. Breathe. Deeply. In and out. And again–in and out. Then, repeat after me, “This anxiety is not me. If I seek help and let it in, I can, and will overcome this anxiety, one breath, one moment, one step at a time.”



Do you struggle with anxiety? What is most helpful for you in treating symptoms of anxiety? What lessons have you learned that you can share with others experiencing the same thing? Please leave a comment, below, and let us know.

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Anxiety & Women-Hormones, Sleep & What You Can Do #anxiety #women #hormones #sleep


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[1] Anxiety and Depression Association of America. (2016). Anxiety and Women: Facts. 

[2] Hibbert, C. (2016). 8 Keys to Mental Health Through Exercise. W.W. Norton Publishing: New York, NY.

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Depression & Motherhood: Facts, Help, & How to Overcome

Depression & Motherhood-Facts, Help, & How to Overcome, www.DrChristinaHibbert.comDepression affects one in five women throughout their lifetime and is especially prevalent during the childbearing years. Pregnancy, postpartum, hormone shifts, sleep depravation, and the pressure of parenting and raising children while also dealing with life changes and stress, all combine to make depression in motherhood common.


Motherhood & Depression

In fact, motherhood does make us more vulnerable to depression. While the lifetime rate for women and depression is about 20%, the majority of these episodes occur in the childbearing years. 10% of women experience depression in pregnancy, 15% experience postpartum depression, and if untreated, maternal depression can last for months or even years. It makes sense, doesn’t it, considering the extreme stress, lack of sleep, hormonal shifts, and life changes that occur in the mothering years?

There are various types of depression in motherhood, including major depression, which is a clinical disorder and includes symptoms like:

  • sadness, crying

    Singing & rocking my youngest, Sydney. Though I was able to breastfeed her, I introduced a bottle early on. I knew I needed it to help me survive PPD.

    Singing & rocking my youngest, Sydney. Though I was able to breastfeed her, I introduced a bottle early on. I knew I needed it to help me survive PPD.

  • fatigue
  • hopelessness
  • feeling worthless
  • changes in sleep or appetite
  • lack of interest in things you used to enjoy
  • guilt, frustration, and/or anxiety
  • feeling overwhelmed
  • possible suicidal thoughts

Dysthymia is a form of milder depression that persists most of every day for most days, for two years or more. Seasonal depression, or Seasonal Affective Disorder, is also common in women of childbearing years, and is believed to be more common in women who are also vulnerable to PMS. Finally, situational depression may occur because of loss, change, or life stress. This type of depression may go away when the situation clears up, or it may persist, especially if it was never dealt with.


Hormones, Depression, & Motherhood

And then there are hormones. Hormone-related depression can come in the form of postpartum depression, perimenopause, and/or PMS (premenstrual syndrome). It’s estimated 85% of women experience at least one significant symptom of PMS each month, and PMS is most common and at its worst among women in their childbearing years.

Approximately 3-8% of women experience Premenstrual Dysphoric Disorder, or PMDD. PMDD most commonly affects women who have at least one child, are in their late 20’s-early 40’s, and who have a family or personal history of depression or postpartum depression. [1] These facts just speak to the role our shifting hormones and compiling life experiences play in the development of mood changes, and especially in depression. (More on hormones and women’s emotions here.)


How do we know when we’re experiencing depression, versus just having a bad day or week or month or year?

People often say, “I’m depressed,” but what they really mean is that they’re sad, stressed, overwhelmed, exhausted. True depression lasts for two weeks or more, and includes symptoms like those above, like: sad, anxious, or “empty” feelings; feelings of hopelessness, worthlessness, or guilt. It also significantly impacts your daily life, your relationships, and your functioning. Major depression isn’t something you just wake up and “get over.” It’s something you must work to overcome. But, remember that, with help and time and work, it IS something that can be overcome.


The Impact of Depression on Kids, Partners, Family

The hardest part of depression in motherhood is often the fact that we moms can’t afford to be Depression & Motherhood- Facts, Help & How to Overcome www.DrchristinaHibbert.comdepressed. We have to be “on,” 24/7; we don’t want to feel depressed, and we especially don’t want our children to suffer as a result. All this can add up to some pretty hefty guilt, and sometimes, even shame.

The truth is that untreated maternal depression does impact our children. In fact:

  • Untreated maternal depression is the number one predictor of future behavioral and cognitive problems in the child.
  • It is associated with less positive parenting practices, like smiling, reading to, and talking with children.
  • It can affect social development, since children of depressed mothers often take on the low self-esteem their mothers tend to exhibit.
  • And untreated depression can negatively impact marriage and relationships as well, often leading to depression in one’s husband or partner, or too often, to separation or divorce.

Yes, the stakes are too high, moms. We can’t afford to let ourselves remain depressed. We can no longer kid ourselves by saying, “It only affects me.” It doesn’t. And even if it did, is that what we really want? To feel miserable? To feel unworthy? To feel so low all the time?

I don’t say this to add more guilt. Trust me, as a mother who struggles with depression myself, that’s the last thing I would want to do. I say this because it’s true. Motherhood does not mean depression. We can, and will, overcome depression, if we take it seriously and seek help. We can be happy, full of hope, and joyful as we raise our children. But first, we need to be honest with ourselves and seek help. We need to take action, to let go of the guilt that holds us captive. We must trust that we can, and will, be well again.


Help: What can we do about Maternal Depression?

There are many ways we can treat depression, including self-help, social support, and professional help like therapy and medication. In order to know what will work best for you, it’s important to create a game plan.

In this week’s episode of my “Motherhood” radio show, I spoke with Jennifer Peterson, mom of 5, writer, and creator of the blog “The JoyFinders.”  Jen has struggled with depression and is very candid about the lessons she has learned, and I share some of my own struggles and lessons as well. Listen to the episode on demand, on or download it for later. Or, watch it on my YouTube channel. Then, read how to create your game plan, below.

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How to Overcome: Creating Your Game Plan

One thing Jen shared was how important it is for her to have a game plan, and I agree, it’s crucial. How do we create a “game plan” for dealing with depression? Here are a few ideas:

  • Be honest about where you are. Before you can be honest with others, you need to be
    I started the "I am the FACE of Depression" campaign to get people talking. It's okay to admit you struggle with depression. It doesn't define you.

    I started the “I am the FACE of Depression” campaign to get people talking. It’s okay to admit you struggle with depression. It doesn’t define you.

    honest with yourself. It’s okay to say “I’m struggling with depression.” In fact, you may find it freeing. Sort of like an exhale—it can be a relief to just be where you are. Sometimes, your body is screaming at you: “Hey! I’m not doing so well. We need to be depressed for a while and figure some things out!” Are you listening? (Read “Women & Depression” for a new view.)


  • Find what you need. What do you need to overcome depression? This will look a little bit different for each person, but pay attention and see what things help you feel better. Your list may include things like, “I need to talk with a friend each day, to go for a walk, and to get to bed early.” It may include, “I need to give myself a break, to say “no” more for now, and to go out with my husband at least once a week.” What do YOU need when you’re in the throes of depression? Some common items include: sleep, exercise, activity, social interaction, doing less, alone time, time to rest, serving others, quality time with kids/partner/friends, a support group, therapy, massage, medication, etc.


  • Seek support. We need each other, especially in times of discouragement, grief, heartache, and depression. Yet, depression can make us want to isolate. That’s one of the hardest things about it. But healing comes through seeking and finding support. Search out those people in your life who make you feel comfortable, who “get” you, who understand depression and will be there for you. Sometimes, it helps to have a friend or family member who will check up on you, who will push you out of the house or stop by to make sure you’re taking care of yourself. Professional help is important, too. Therapy is a great place to start—to learn coping strategies and help solidify your game plan. If your depression is moderate to severe or if self-help and therapy don’t work, you may want to talk to your doctor about trying an antidepressant. (Read “Antidepressant? Or not? )


  • Schedule activity. Even one little activity each day that gets you dressed or interacting with people or out in the sunshine or out of the house can make a big difference on your mood. It’s one of the best things you can do to “treat” your depression. And getting in the sunshine is also excellent for lifting depressed mood.


  • Talk about it. Depression isn’t something to be ashamed of. The more we talk about it, the more we see we are not alone. I wrote about my battles with depression in this article. Jen shares her struggles in our Motherhood interview. Be honest with your family, with your partner, with your close friends. No, you don’t have to tell everyone you meet. But, explaining to those who love you most that you’re having a hard time and are working on it is very helpful. I encourage you to talk with your kids about it, too, in words they can understand. Many moms fear that telling their kids will make them afraid or worried. The truth is, they probably already know something isn’t “right,” and talking honestly with them about it can be reassuring, if it’s done right. Same goes for husbands/partners. My close friend struggled to even tell her husband she was suffering from depression and anxiety. She tried to handle it all on her own, and she eventually took her own life. Again, the stakes are too high. We can’t afford to remain silent. Talk about it. It is healing.


  • Write it down. Once you know your game plan, write it down. Post it somewhere you will see it often so it can remind you of what you’re aiming to do.


  • Follow your plan and adjust as needed.  It will take time to figure out what you need to become depression-free, just like it will take time to heal from depression. It’s okay to let yourself be where you are, to take the time you need to do it right. Make changes as you learn new elements of your plan for wellness. For instance, if winter hits and you suddenly realize how much sunshine has to do with your mood, you may make sitting in the sun each morning a part of your routine, or exercising outside a “must do.”



  • Depression isn’t you.Motherhood & Depression-Facts, Help & How to Overcome, #motherhood #depression #mentalhealth
  • It’s doesn’t make you weak, and it’s not a character flaw.
  • Depression isn’t something to feel ashamed of; it’s something to work on.
  • While it’s normal to feel guilt when you’re a mom who’s depressed, it’s also only helpful if you use that guilt to help you grow. Let it guide you toward the help and plan you need. Then, let the rest go.
  • With honesty, openness, and work, your family will not suffer as a result of your suffering. They are resilient, and so are you.
  • You are not alone. Seek support and love. Then, let it in.
  • With help, you will be well.


What is the hardest part of depression in motherhood for you? What helps you overcome? What does your game plan contain? Share your thoughts by leaving a comment, below.




[1] Premenstrual Syndrome Fact Sheet,

[2] More facts on Postpartum Depression:




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8 Keys to Mental Health Through Exercise, #exercise #mentalhealth

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My new book!

Advance Praise for “8 Keys to Mental Health Through Exercise”

“[A] useful and supportive exercise guide . . . . As Hibbert makes clear, she has not written a workout regimen or weight-loss how-to, but a guide to using exercise to become both mentally and physically stronger. . . . [A]n enlightening and empowering instrument for people who have struggled with mental illness.” — Publishers Weekly

“The 8 Keys books series provides clear, concise, empirically supported evidence for anyone from beginners to experts; 8 Keys to Mental Health Through Exercise is certainly no exception to this mantra. . . . Dr. Hibbert works through the process of change with an array of exercises and reflection questions that ease even the most ambivalent reader into the process. . . . [A]n eye-opening read not only for those searching for the motivation to commit to adding exercise to their routine, but for anyone striving towards self-empowerment. Dr. Hibbert synthesizes a large body of research into a captivating argument for how and why exercise serves as an immensely powerful mechanism for improving mental wellbeing.” — Somatic Psychotherapy Today

“Exercise is essential in maintaining good health—both physical and mental. . . . Hibbert’s book should help readers stick with a successful plan.” — Booklist

“As a therapist, I’m a big proponent of exercise for its positive effects on mood. I frequently talk to my clients about the positive effect of exercise on the body and mind. But even when you know all the positives, you don’t always fully utilize exercise as a way to get or stay mentally well. This is why 8 Keys to Mental Health Through Exercise is such a useful tool. . . . [I]t’s full of reflection questions, writing prompts, and action items. . . . [G]reat for those of us who want to experience more of the benefits of exercise, but need a bit of help creating a plan and overcoming the mental blocks to doing so.” —PsychCentral

“These 8 keys hold the potential to change your life! In this wonderful book, Dr. Hibbert provides us with effective and easy-to-implement tools that allow the mind and the body to unite, change, and heal. A must-read for anyone seeking to change their bodies in a holistic way.” — Dr. Shefali Tsabary, clinical psychologist and New York Times bestselling author of The Conscious Parent

“Exercise is a magic pill for mental well-being; it clears your mind, calms your body, and makes you feel good about YOU and what you have accomplished. Dr. Hibbert has captured this mind-body connection, and why we must all move toward improved mental health through exercise.” — Kathy Kaehler, celebrity health, fitness, and nutrition expert and bestselling author

“A delightful synopsis of why exercise is so essential to our mental health. With a narrative that is both a pleasure to read and superbly sensitive to the common barriers that get in our way, Dr. Hibbert shows the reader how to harness the motivation for self-care and well-being. Hibbert’s clinical skills and down-to-earth guidance can make a believer out of the most resistant exerciser!” — Karen Kleiman, Founder and Director of The Postpartum Stress Center, author of Therapy and the Postpartum Woman

“I love this book because it combines solid research with practical, easy-to-follow steps to achieve the motivation and skills to exercise for better mental health. Being at your ‘personal best’ and, for parents, being a great role model to your children, means taking care of yourself first. If you’re serious about getting fit mentally and physically, this book will help you to flourish!” — Dr. Rosina McAlpine, parenting expert and author of Inspired Children;

“An incredible, accessible, and useful tool for ANYONE hoping to get exercising. Dr. Hibbert offers guidance, support, and tangible solutions to assist the reader through physical or mental roadblocks in order to strive to be their best self. I can’t imagine anyone finishing the book without finding themself an improved individual. I’m grateful it has been written so that more people can benefit from exercise and tackle it through these carefully designed steps.” — Dana Pieper, creator of EveryBody Fitness


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8 Keys to Mental Health Through Exercise 

Supplemental Materials



Earthquake Assessment Chart, p. 37

Exercise Motivation Self-Evaluation, p. 94-5

Exercise 4 Mental Health SMART Goal-Setting Worksheet, p. 111-116

Thought Record, Part 1, p. 134

Thought Record, Part 1, Example, p. 137

Thought Record, part 2, p. 139

Thought Record, part 2, Example, p. 141

Exercise 4 Mental Health SMART Goal-Setting Worksheet, p. 111-116

My “Exercise 4 Mental Health Plan” Worksheet, p. 202-7



How to FEEL Powerful Emotions

Change Your Thoughts Using a Thought Record

Using Thought Record, Part 2




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With exercise for mental health, it should be a long, healthy, happy life!





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The Many FACEs of DEPRESSION (& Anxiety): Pregnancy & Postpartum–Caroline’s Story

The Many FACEs of DEPRESSION (& Anxiety): Pregnancy & Postpartum--Caroline's Story; #pregnancy, #postpartum, #ppd, www.DrChristinaHibbert.comWomen are particularly vulnerable to depression and anxiety in pregnancy and postpartum. In fact, 15% of pregnant and up to 20% of postpartum women experience depression, while 6% of pregnant and 10% of postpartum women experience anxiety in the form of extreme worry, panic, PTSD or Obsessive-Compulsive Disorder. And it doesn’t just affect moms. An estimated 14% of dads in the U.S. experience Paternal Postnatal Depression, too!


I have had my share of postpartum depression (PPD) and anxiety, and I know it’s a very hard thing to bear. I also know that I’m not alone in my experiences. Millions of other women (and men) have experienced PPD, too, and we must keep talking about it if we want others to know that they are not alone, if we want others to know help is available, and that, if they seek help and let it in, they will be well.


Caroline’s story is another example of the many faces of depression and anxiety. Hers is another face to add to this movement, and another voice to help raise awareness, reduce the stigma, and let all who suffer from (and overcome) depression and anxiety know: “You truly are not alone.”


Caroline’s Story…

“I am the face of anxiety and depression.

In November 2006, when I had my first child, a son, I had heard of Postnatal depression and was determined never to be struck by it, I was naive then, thinking I could control such a thing as PND.

‘Overall, my experience postpartum with my son was very positive. I made sure I kept busy and built up a good social network through going to mums and bubs sessions at the local library and joining the local breastfeeding support group and going to meetings. However, there were times when anxiety would kick in, I’d feel shaky and thoughts would rush through my head. I’d worry about dropping my precious baby down the stairs or stress about driving in the car with him. I thought about what I could do to help me feel calmer, I bought lavender and used the drops on tissues under my pillow and in my handbag and in an oil burner. I also started listening to guided meditations both before going to sleep and during the day"The Many FACEs of DEPRESSION"- #Pregnancy & #Postpartum Caroline and taking daily exercise – walking and swimming mainly. While these strategies helped, I really felt I needed to work with a counsellor, so I contacted the doctor (Dr Cate Howell) who narrated the mediation CD I was using and formed an ongoing therapeutic relationship with her and saw her as needed over the next three years.

‘When anxiety kicked in BIG time after the birth of my daughter in December 2009, I was so grateful that I already had a great doctor in Cate, I also knew that Cate didn’t reach for her prescription pad straight away as I had never taken medication for my anxiety before. My second episode of post-natal anxiety was much more intense than the first. I was having trouble sleeping (it’s torture when your baby and toddler are asleep and you can’t sleep!), I was pacing, felt shaky, had racing thoughts and couldn’t make simple decisions or complete simple tasks like packing a baby bag, something I had done hundreds of times before. I didn’t trust myself to be a safe driver as I was so shaky and sleep deprived so I gave my car keys to my husband.

‘I went to see Dr Cate as soon as I could and she was the most supportive doctor I could have wished for. Initially I was shocked, because I was much worse than last time. She said I would need to look at going on medication and she referred me to a psychiatrist. The psychiatrist did prescribe medication and also referred me to an in-patient mother-baby clinic. This experience was very scary as even though ultimately it was part of my recovery, it took me on a “medication roller coaster,” as I was determined to keep breastfeeding so could only try “breastfeeding friendly” medications first, some of which caused awful side effects. In the end, I gave up breastfeeding to go onto a medication which I have been on for nearly 5 years, except for a one year break.’


Depression, Anxiety, & Medication

‘I tried going off my medication at one point, because I figured I was no longer “postnatal,” so couldn’t experience severe anxiety or depression. I was wrong! My psychiatrist knew that I had reduced my medication, but not that I’d gone off it completely. I was fine for a year without medication, then became unwell again in 2013, very shaky, racy thoughts mainly around being not good enough, like a big bully in my brain was how I described it later to my son. I knew I’d need to go on medication again and didn’t want to risk the “medication rollercoaster” of side effects while being home caring for kids, so I checked myself into a private clinic for treatment both medication and group therapy.



Health & Healing

‘This most recent episode, while upsetting and disruptive, was also amazingly healing, as I was able to recognise the signs of what was happening to me and seek treatment first as an in-patient and then go on to do some courses as an outpatient. Of particular interest and use was an ACT (acceptance and commitment therapy)/mindfulness course. It also helped me to realise that medication is an essential part of my treatment plan.

‘Even though we don’t choose all of what makes up the rich tapestries of our lives, we can embrace all of life with gratitude and love and be open to the lessons that it holds. For example, I carry a lot of grief over the fact that, because of how severe my post-natal anxiety was and the medication I’m on, I probably won’t have a third, fourth, fifth or sixth child. I feel anger and frustration that I can’t raise the big family that I wanted to.

‘At the same time, however, I realise that the family I do have is such a gift! I have a healthy 8 year boy and a 5 year old girl who light up my life each day, and I have my health and a lifelong commitment to and passion for growth and healing.”




Help the Movement!

Read & Share Stories from ‘The Many FACEs of DEPRESSION” series:

Overcoming the Stigma of Depression & Anxiety: “I am the FACE of DEPRESSION (& Anxiety)”–My Story

Men, Illness, & Mental Health : Pernell’s Story

Motherhood, Postpartum, & Spirituality: Jami’s Story



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Postpartum Support International’s 2015

Third Maternal Mental Health Awareness Month

Blog Hop!

2015 PSI Blog Hop: You are not alone!

2015 Theme:
You Are Not Alone: Focus on Support Groups and Resources

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PPD & Motherhood Mental Health: Self-Care & Letting Help In–The 2 Most Important Things (PSI Blog Hop 2014)

PPD & Motherhood Mental Health: Self-Care & Letting Help In--The 2 Most Important Things (PSI Blog Hop 2014); #PPD #postpartum #PSIBlog #motherhoodIt wasn’t until I first became a mother–with a beautiful baby boy I dearly loved, yet still struggling through postpartum depression–that I realized how hard it was to practice self-care and let others help me. I thought I could—and should—do it all on my own. It was my downfall, making my depression worse. I didn’t realize how much sleep deprivation messed with my emotions. I didn’t yet understand how asking for and receiving help would be one of the most important components of self-care for me. I didn’t yet know it is one of the most important components of self-care for everyone.

My fourth postpartum depression (PPD) episode was unlike the first three. So much more intense. So much more complex. My sister and brother-in-law had recently died and we had inherited our two nephews only 4 weeks to the day that our fourth baby was born. We had three kids, and then we had six.

But, I had grown over the years as a mother. I had become a clinical psychologist specializing in maternal mental health and perinatal mood disorders. I had founded The Arizona Postpartum Wellness Coalition to help other mothers and families. I had taught courses and given speeches and written articles on PPD and the Baby Blues, and I knew, 100%, how badly I needed to take care of myself and let help in.

Because this fourth postpartum experience was such a complex and challenging time, I immediately set up all my resources. I scheduled counseling sessions—for me and my husband, for our nephews, then 6 and 10, and for our two other sons, then 8 and 11. I let people do laundry for me, take my 4 year-old daughter for play dates, bring in meals, and even help me paint the nursery and prepare my home for my two new sons.

PSI Blog Hop 2014--#PPD & #Motherhood #MentalHealth Recovery: Self-Care & Letting Help In, The 2 Most Important Things; #postpartum #PSIBlog

My children, first meeting their new little sister. 2007

After a few months though, when grief hit hard, I started to feel like I didn’t want to burden others. I didn’t want them to have to be around me because I felt so negative inside. I didn’t want to complain or whine or be crying all the time. And, if I’m being honest, I really felt like no one could understand what I was going through. How could they? It was so messy and raw and painful on so many levels. I felt weaker than ever before and isolated myself. I got quiet.

As I wrote, in my memoir, This is How We Grow, of that time, “I…know I haven’t invited anyone in. I take responsibility for that. I let myself seem ‘fine’ when I’m in public. I am ‘fine’ when I’m in public. That doesn’t mean I don’t have my hard times at home, or even that ‘fine’ is good enough. I wish others would notice the redness of my eyes, the dark circles around them, my sighing, the energy it takes to smile.” (p. 161)

Since my memoir came out last November, several close friends have said, after reading it, “I feel so badly, I never knew how much you were suffering.”

“I didn’t let people in,” I’ve replied. “There was no way you could have known.”

Luckily, I let my husband in. And I let my psychologist in. And I let my inner psychologist weigh in and remind me of the coping skills I’d already developed. Luckily, I at least did that much, and it was enough to get me out of the darkest days and into other help, like an antidepressant, friends, family, and writing my story.


We Mustn’t Get Quiet
But, one week ago yesterday, my dear friend lost her life as a result of mental illness. Her three children have been best friends with my children for ten years. She was their “second mom,” like I have been to her kids. It is an incomprehensible loss for her husband and children. It is a devastating loss for my children, for me, and for our entire community.

She had been trying to work on self-care, though I knew, like so many other mothers, it didn’t come naturally to her. She had been setting up and trying to utilize her support network. Outwardly, she had been doing those things that seemed right and good and helpful. But I can see now, despite all her efforts with self-care, she didn’t know how to do the one most important thing: let all that help in.


Self-Care is Crucial
How many other mothers, and children, and fathers, and families have to suffer, or even die, before we get it—that self-care isn’t about excess and dawdling and bon-bons on the couch watching soap operas. Self-care is a necessity. It’s about life, and health, and joy; it’s also about preventing despair, isolation, and death. At its core, self-care is about letting help in.


How can we help moms in need?
After a friend of mine heard of our tragic loss last week, she said to me, tears streaming down her face, “There have to be so many others out there who are suffering alone and won’t—or don’t know how—to let people in. What can we do?”

This question has been on my mind all week. What can we do? The following four things are, to me, the most important. If we can do these four things, we can stop the suffering, be there for each other, and keep our mothers safe, healthy, and strong so they can do what they do best—love and nurture their children.


1) Learn about and practice self-care. Learn to let help in. We must all learn how to take better care of ourselves. We must talk about, and teach, and encourage letting others help us, too. PSI Blog Hop 2014: PPD & Motherhood Mental Health Recovery--Self-Care & Letting Help In, The 2 Most Important Things;“In our darkest times it is easy to feel better off alone and isolate. Our suffering is personal, and no one shares it in the same way, so why even bother? But, I can tell you–we do need others, whether we feel like it or not…Making islands of ourselves only causes more pain.” (This Is How We Grow, p. 153)

This is especially important for pregnant and postpartum mothers, and for mothers going through stressful circumstances or dealing with mental health concerns. But it’s equally as important for all mothers and women—because we are the nurturers of families and communities. It’s also important that we educate our children and teens and young adults about self-care, that we model it for them so they may learn to see self-care as an essential part of a healthy life.


2) See others’ needs. It’s hard to see others’ needs if they don’t let you in, but one thing I know for sure is we must use our gut, not just our natural eyes. If you feel something’s not quite right, please say something or do something. Yes, it’s okay to ask a mother if she is struggling. Yes, it’s okay to tell her she seems sad and ask what you can do. We must ask and talk about it, for it sends the message that none of us is alone. It reminds us we have a friend, a hand held out in the dark. I often say, “I’d rather say something and be wrong than not say something and wish I would have.” (Read “3 Messages Every Mom Needs to Hear.”)


3) Offer support now. If you have the impression to send a text or post a quote on her Facebook page, do it. If you’re driving by and feel you should stop, please do. You might talk yourself out of it: “She’s busy.” “I don’t want to intrude.” But you’re not intruding, and even if she’s busy, she’ll at least know you care. As I write in This is How We Grow, “How do we connect? We listen. We hear. We respond. We feel. We reach out and ask, ‘How are you?’ and wait for the honest answer. Then, we reach out again. And again. We say, ‘I’m so sorry. My heart is breaking with you.’ We look past our discomfort, or we say it out loud, ‘I don’t know what to say or do. I just want to be here for you.’ We are willing to be in that space of our own discomfort or pain, because we know it’s not about us. It’s about loving the one we love…Strength and healing are in connection.” (p. 287)


4) Stick with her for the long haul. Pregnancy and postpartum depression/anxiety, and maternal mental illness, are not over in a week or a month. Neither are most of the great stresses of motherhood. Continue to ask how she’s doing. Check in regularly. Listen with your heart and not just your head. Keep doing it for as long as it takes to help her be well again.


Bottom line…

“We need connection to survive. As poet Mark Nepo writes, ‘The question to put to our daily lives, then, is this: In love, in friendship, in seeking to learn and grow, in trying to understand ourselves…When pressed by life, do I bridge or isolate? Do I reconnect the web of life and listen to its wisdom? Or do I make an island of every confusion as I try to solve its pain?'” (This is How We Grow, p. 153)

May we form a great, strong web–a net of connection and support, so when one of our sisters, friends, mothers, tribe falls, we may catch her. One voice. One hug. One love-filled, supportive, mom-to-mom moment at a time. Together, we are strong.

~Written in loving memory of Jody McDaniel.

My family, today. 2014

My family, today. 2014


Join the PSI Blog Hop Here

Read this post for guidelines, then link up, below.

(Note: Posts that do not follow the guidelines will be removed by the editors)

If you need immediate help, please call the National Suicide Hotline at 1-800-273-TALK (8255)

If you are looking for local pregnancy or postpartum support and resources in your area, please call or email us:

Postpartum Support International Warmline (English & Spanish)

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PSI Maternal Mental Health Awareness Month Blog Hop


Please share your thoughts by leaving a comment, below. What have you found crucial to postpartum and maternal mental health recovery? What suggestions do you have for how we can better help moms in need? Are you willing and ready to join together and form this net of support and love?

#1 Amazon Bestseller, This Is How We Grow, by Dr. Christina Hibbert, Available now on!
Be sure to check out Dr. Hibbert’s Amazon Bestseller, This is How We Grow
available now on



**This is How We Grow Charity Fundraiser**

All proceeds from sales of This is How We Grow during the month of May 2014 will be donated to The McDaniel Family Fund, in honor of Maternal Mental Health Awareness Month and in memory of my dear friend, Jody, who lost her life last week.

Read the fundraiser post here.


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Dr. Christina Hibbert

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“Perfect?” or “Fake?”: 8 Myths about Perfectionism & 8 Truths to Cure It

"Perfect?" or "Fake?': 8 Myths about Perfectionism, & 8 Truths to Cure It; www.DrChristinaHibbert.comAre you a perfectionist? Not sure? Well, do you…

  • Set unrealistically high goals/standards for yourself and/or others?
  • Judge yourself based on what you do/don’t accomplish?
  • Have a hard time stopping a project until it’s exactly how you want it?
  • Have trouble relaxing in even a small mess at home?
  • Feel like a “failure” if you can’t do things just right?

If you answered “yes” to one or more of these, you probably struggle with perfectionism.


“Perfect?” or “Fake?”: The Problem of Perfectionism

As a women’s mental health expert, I’ve helped my fair share of perfectionists. They don’t usually come in for help with perfectionism, though—more like help with underlying depression, anxiety, relationship issues, or overwhelming stress. Yes, these are all consequences of perfectionism, along with other things like poorer health, mental well-being, and overall life satisfaction.

That’s the problem with perfectionism–it isn’t what it appears to be at all. Perfectionism is a false exterior that covers up other, deeper issues. It’s a mask.


8 Myths about Perfectionism & 8 Truths to Cure It

Only once we identify perfectionistic behaviors and personality traits can we begin to do something about it. Let’s look at some of the myths of perfectionism, therefore, and some of the truths. Hopefully, these will open our eyes, educate us, and begin the perfectionism recovery process:


1) Myth: “Perfect” means “without faults;” with hard work and dedication, it’s possible to achieve this state of being.

Truth: “The Greek translation of the word ‘perfect’ actually means, ‘complete,’ ‘so good that nothing of the kind could be better,’ and ‘that which has attained its purpose.’” (This is How We Grow, p. 270) This is a much different ideal than striving to be “without faults.” Perfection isn’t possible; it isn’t real, and this makes perfectionism a real problem for many people, especially women. None of us is or ever will be “perfect,” or “without faults.” “Seeking to do right, to be complete, to live authentically, is the opposite of perfection.” (Ibid, p. 271) And doesn’t that sound so much better, anyway?


2) Myth: Perfectionists simply strive to be their very best."Perfect?" or "Fake?": 8 Myths of Perfectionism, & 8 Truths to Cure It;

Truth: Perfectionism is actually the opposite of healthy striving. We tell ourselves it’s good to be a perfectionist; “I just like things to be the best they can be,” we say. But this isn’t true. In fact, research shows there’s a distinct difference between perfectionism and healthy striving:

  • Perfectionism is trying to reach an unrealistically high goal or standard—one that can never be reached.
  • Healthy striving is setting high but achievable goals/standards.
  • Perfectionism is seeing mistakes as evidence of unworthiness.
  • Healthy striving is understanding mistakes are part of the process, and being able to more easily get back up after setbacks/mistakes.


3) Myth: Perfectionism leads to success.

Truth: Research tells us perfectionism actually “hampers success. In fact, it’s often the path to depression, anxiety, addiction, and life-paralysis.”[1]


4) Myth: It’s good to desire positive outcomes, and that’s what perfectionists do.

Truth: Perfectionism focuses only on the outcome, and it leaves no room to feel “positive” about it. Life isn’t about achieving a perfect outcome—whether it’s a dinner you’re making, keeping your house spotless, or the vision you have for how your life will turn out. It won’t turn out perfectly. Trust me. Life is about curves and twists and surprises. If we want to be healthy and happy, we must learn to recognize the beauty in the process of life, not the outcome.


5) Myth: Perfectionists are just natural leaders, and that’s why they like to be in “control” of things and people.

Truth: Perfectionists actually feel out of control. That’s why they so desperately need to control everything around them. Deep down, perfectionists are terrified of being seen as they really are—as a real individual with strengths and weaknesses. Unfortunately, much of life is out of our control, and no matter how hard you try to control life, it’s never going to work. That’s why perfectionism leads to stress and unhealthy habits/conditions: it’s a never-ending pursuit of a false ideal.


6) Myth: Perfectionists are confident and secure, that’s why they work so hard and always look and act “perfectly.”"Perfect?" or "Fake?": 8 Myths about Perfectionism & 8 Truths to Cure It;

Truth: Perfectionism, at its core, is all about insecurity. When working with perfectionists, I always end up working on self-esteem and self-worth. That’s the true cure for perfectionism—discovering your true, innate worth, getting in touch with and learning to love the real you.


7) Myth: Perfectionism is a strength.

Truth: Perfectionism is a weakness, and at its worst, an illness. That’s why I used the word, ‘cure,’ above. Though there are certainly some benefits to perfectionism–like the motivation and drive to, say, stick with an exercise plan or achieve a big goal–perfectionism is all about working to achieve an unrealistic standard. It usually involves holding others to that same standard, driving everyone crazy (yourself included) in the process. Perfectionism is a mask for the underlying problem—not feeling like “enough.” Those who struggle with perfectionism feel unworthy of love and attention, so they seek it through what they do. But this is a recipe for overwhelm, stress, poor health, and yes, failure. Thus, in the end, perfectionism acts more as a weakness than a strength.


8) Myth: If you’re a “perfectionist,” you’ll always be that way.

Truth: Perfectionism is a choice, and with education, hard work, and dedication, you can choose to cure your perfectionistic side. You can choose to let things go. You can choose to see beauty in the process. You can choose love—love of your life, your family, and yourself.


The Good News About Perfectionism

If you see yourself in any of these myths, please take heart in the truths. Let them open your eyes to another way of living–let them inspire you to begin today to kick the perfectionism habit. Take a searching look at how perfectionism treats you. Like a bad boyfriend, it tells you you’re never good enough, makes you work to receive love, and never lets you quit. “He’s no good for you,” I say. No darn good. Time to let him (or rather, it–perfectionism) go.


Check out my series on “How to Feel Self-Worth.” It’s a great place to begin to dump perfectionism and learn to love the real, beautiful, imperfect you.

Are you a perfectionist? Do you see yourself in any of these myths or facts? What stands out for you after reading this? Leave a question/comment, below, and let us know what you think!

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Be sure to check out Dr. Hibbert’s Amazon Bestseller, This is How We Grow
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"Perfect?" or "Fake?': 8 Myths about Perfectionism, & 8 Truths to Cure It;

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Brown, B. (2010) The Gifts of Imperfection, p.56.

Beyond Depression: Diagnosing Postpartum OCD–Part 2 (& video)


Beyond Depression: Diagnosing Postpartum OCD (Part 2);  #PPD #Postpartum #Pregnancy #OCDIn Part 1, we explained the symptoms of Pregnancy/Postpartum Obsessive-Compulsive Disorder (PPOCD) and what makes this disorder the most misunderstood of all the Perinatal Mood/Anxiety Disorders. (If you have not yet read Part 1, I suggest doing so before moving on.)


In Part 2 we discuss the diagnosis of PPOCD, what makes it so tricky, and tips for families and providers to help mothers get the best possible diagnosis and care.


Postpartum OCD: The Most Misdiagnosed Disorder

Postpartum Obsessive-Compulsive Disorder is not only considered the most misunderstood disorder; it’s also considered the most misdiagnosed. Many people—even well-established medical and mental health professionals—confuse Postpartum OCD with Postpartum Depression (PPD), thinking these mothers are “just depressed,” and failing to recognize the extreme anxiety and duress these mothers and families are experiencing. Though treatment for PPD might help with the depressive symptoms, the misdiagnosed PPOCD mother often fails to get the treatment she needs to address the intrusive thoughts and reduce her anxiety.

Even more harmful, PPOCD is too often misdiagnosed as the more rare and potentially life-threatening Postpartum Psychosis (which affects 1 in 1000 mothers). In my 13 years as a psychologist and expert on pregnancy/postpartum mental health, I have witnessed the unfortunate hospitalization of several mothers experiencing postpartum OCD. Misdiagnosed with Postpartum Psychosis, these mothers were seen as a threat to their infants and subsequently hospitalized in behavioral health units, placed on antipsychotic medication, and separated from their infants—many for up to a month or more. Most were also told they must stop breastfeeding, and some were reported to Child Protective Services.

The damage done to these mothers–and their husbands, infants, and families–is, understandably, heartbreaking. Only once they were released and began to research their symptoms did they learn about Postpartum OCD. They were eventually able to find me, or another expert on Perinatal Mental Health, and receive the proper diagnosis and treatment, including a referral for the right kind of medication, and psychotherapy.

This is why I am writing this article—because medical and mental health providers, and families, need education on perinatal mental health if we are to prevent the unnecessary suffering of so many mothers, babies, and families.


Why is PPOCD so often Misdiagnosed?

Having trained hundreds of providers over the past nine years as Founder of the Arizona Postpartum Wellness Coalition, I’ve learned a few things about why PPOCD is so misdiagnosed:

1)   These are usually well-meaning providers who are trying to do the right thing. They simply lack important information, education, and/or clinical experience to make the right diagnosis. Unfortunately, some have never even heard of Postpartum OCD.

2)   Providers want to protect the baby, and rightly so. Keeping babies safe is obviously a top priority, as it should be. Unfortunately, providers hear “thoughts/images about harm coming to the baby,” and they panic. They immediately fear the mother may be a threat to her child, so they act in order to protect the baby without taking the time to research, assess thoroughly, and consult.

3) However, protecting the mother is part of protecting the baby (I think most providers would agree). Babies need healthy, strong mothers who are receiving the best treatment to help them get well soon. With proper training, education, and diagnosis, we can protect both babies and their mothers. We can heal families and not cause more harm.


Diagnosis: Postpartum OCD vs. Psychosis

 Watch this 3-Minute Therapy video, “Beyond PPD: Diagnosing Postpartum OCD,” on my YouTube Channel, and watch Part 1 video, “Beyond PPD: Understanding Postpartum OCD” here. Then, please continue reading, below.

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Following is a list of the distinct differences between Postpartum OCD and Psychosis. Understanding these differences can help families and providers distinguish PPOCD from Postpartum Psychosis to help make the correct diagnosis. Please note: This is article is merely for educational purposes, however, and should never replace true medical/mental health assessment and care.

Postpartum OCD:

  • Thoughts are in the mind–they are non-psychotic, intrusive thoughts. This means the woman is still “in reality,” and the thoughts come from her mind and not her outside environment. She does not want the thoughts to come. They intrude upon her.
  • Women recognize thoughts/images are unhealthy. They are highly aware these thoughts are not “okay,” and they may work very hard to try and stop the thoughts from coming (hence the compulsive behaviors).
  • Extreme anxiety related to thoughts/images. These mothers are worried, stressed, and fearful of the thoughts. They experience great distress because of them.
  • More gradual onset and brief duration. Sometimes OCD starts in pregnancy, then continues and perhaps intensifies postpartum. Other times it starts days, weeks, or even months after the baby is born. Episodes tend to last for seconds or minutes, though the aftereffects (like anxiety) can last much longer.
  • Overly concerned about “becoming crazy.” They will research and ask loved ones/providers, over and over, “Are you sure I’m not going crazy?” This only proves they are well-aware of what they are experiencing, and not at all out of touch with reality.


Postpartum Psychosis:

  • Thoughts are psychotic in nature—including delusions (false beliefs) and/or hallucinations (hearing/seeing things). This means the mother is experiencing a break with reality.
  • Women do not recognize actions/thoughts are unhealthy. Psychotic people do not know that what they are saying/doing are wrong, scary, or in anyway abnormal.
  • May seem to have less anxiety when indulging in thoughts/behavior. Psychotic people typically seem to feel less anxious the more they indulge in their psychotic thoughts/behaviors. Their affect is usually very flat, with a detached, spaced out sense about them.
  • Acute onset—a sudden noticeable change from normal functioning. Postpartum Psychosis usually occurs quickly, often in the first seven days postpartum. Symptoms come suddenly, and family members often describe a sudden, distinct difference in behavior and personality.
  • Thoughts are longer in duration and more all-encompassing. Psychotic episodes may last for hours or days, and it’s as if they take over the person, as if she is not herself.
  • Thoughts come from the environment. She may have thoughts in response to people/situations around her, wheras PPOCD mothers’ thoughts intrude into their minds and are not a result of their outside world.


Final Important Things To Know about Diagnosing Postpartum OCD

My intention with this article is to open the door to greater awareness and education about PPOCD, so we can help mothers, babies, fathers, and families get the diagnosis and care they need and deserve. Again, this article is in no way intended to replace medical/mental health care, though I hope it might enhance it.

For Mothers & Families:

  • Postpartum OCD is highly treatable, and there are some excellent providers out there who can help you with what Beyond Depression: Diagnosing Postpartum OCD (Part 2) (& video); #PPD #postpartum #pregnancy #OCDyou need.
  • Postpartum Support International (PSI) is the best resource to help you find the proper provider for you. They also provide phone support and advocacy, so please contact them for help. I have been a member, volunteer, state coordinator, and board member with PSI over the past 15 years, and I can attest that they are the best postpartum resource around.
  • Remember to keep trying until you find the provider that is right for you. It’s not only okay to seek a second (or even third) opinion, it is recommended if you feel you’re not receiving the proper care.
  • Involve your partner/husband/mother/family in your care, too. This will help you feel like you have a team supporting you and will help you keep at it until you get the right care. (More on treatment of OCD to come in Part 3, so Subscribe, below, or check back soon. Also, check out my Postpartum Depression Treatment series for more on overall treatment options.) 


For Medical/Mental Health Provders:

  • Connect with others in this field, and consider joining PSI. Attend their annual conference and others like it, for more in-depth education on perinatal mental health. I’ve been attending for 14 years, and they are incredibly informative every time.
  • Most importantly: If you feel uncomfortable diagnosing PPOCD on your own, seek consultation or supervision. If you can find a perinatal mental health expert in your area, consult with them, or refer your client to them, if that feels like the best option. Call and explain your concerns, discussing them together. This is the best way to ensure you are keeping both baby and mom—and the whole family—safe and well.
  • Another important factor in making the right diagnosis is involving the mother’s husband/partner and family in the assessment. Ask them how she has been and how they feel about her. Involve them in helping you monitor her symptoms and getting her to other providers for treatment, as needed.


This is such an important topic, and one I fear gets far too little attention. So, join me–let’s start this discussion, and keep it going. Let’s get talking, so our mothers, fathers, families, and healthcare providers will understand Postpartum OCD. Let’s get educating so our postpartum families will no longer have to suffer in silence–so they will receive the concern, help, and care they so rightly deserve.


Read Part 3 of this “Beyond Depression” series, on Postpartum OCD & Treatment.

Read Part 1:  “Beyond Depression, Part 1: Understanding Pregnancy/Postpartum OCD


I’ve received more feedback, messages, emails, and discussion on this topic than any other, ever, on my site. If you have something to say about this, I would like to hear it. Please leave a comment, below, with your thoughts/questions/concerns. Let’s get and keep this important dialogue going.

#1 Amazon Bestseller, This Is How We Grow, by Dr. Christina Hibbert, Available now on!
Be sure to check out Dr. Hibbert’s Amazon Bestseller, This is How We Grow
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Beyond Depression: Diagnosing Postpartum OCD (Part 2);  #PPD #Postpartum #Pregnancy #OCD

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Related Articles/Posts:

Beyond Depression: Understanding Pregnancy/Postpartum OCD (Part 1) (& video)

Beyond Depression: Postpartum OCD Treatment (part 3) (& video)

Pregnancy & Postpartum Emotional Health

Postpartum Depression Treatment

Postpartum Depression Treatment: For Dads & Partners

Postpartum Depression Treatment: For Couples

Postpartum Depression Treatment: Complementary Alternative Modalities

Postpartum Depression Treatment: Psychotherapy

Postpartum Depression Treatment: Medication

Postpartum Depression Treatment: Self-Help

Postpartum Depression Treatment: Sleep

Postpartum Depression & Men: The Facts on Paternal Postnatal Depression

The Baby Blues & You

Postpartum Survival Mode

16 Things I’d Like My Postpartum Self to Know, 16 Years & 6 Kids Later (PSI Blog Hop)

Moving Beyond Shame: The Ultimate Power of Support & Time (PSI Blog Hop) 

Pregnancy & Postpartum Mood & Anxiety Disorders: Are Women of Advanced Maternal Age at Higher Risk?

In Praise of Fathers: 10 Research-Based Ways Dads Impact Kids for the Better

5 Reasons Self-Esteem is a Myth

How to Feel Self-Worth: “The Pyramid of Self-Worth”

Thought Management, Part 1: The Relationship between Thoughts, Feelings, the Body, & Behavior

Womens’ Emotions & Hormones– Series

Achieving Balance–Why You’ve Got it Wrong, & How to Get it Right

Pregnancy & Postpartum Loss, Grief, & Family Healing (Part 1)

How to Cope with and Treat Perinatal Loss & Grief (Part 2)



Pregnancy/Postpartum Resources & Help:

Postpartum Support International Website (Worldwide help and support for new mothers and families, including a bilingual hotline and state/country coordinators to help you find the right treatment provider or support in your area.)

Postpartum Progress Blog (Excellent source of education and support for mothers and families)

Pregnancy & Postpartum Resources

Arizona Postpartum Wellness Coalition (AZ Support Groups, Events, Education)

Postpartum Stress Center (Education for Providers and Families)

Postpartum Couples Website



Facts for this article were taken from The Arizona Postpartum Wellness Coalition‘s 2-Day, research-based course, Perinatal Mood/Anxiety Disorders: Assessment & Treatment, and my 1-Day, research based course, Perinatal Mood/Anxiety Disorders: Advanced Clinical Skills. For more on these programs, please visit or, or email me. For more on PPOCD and links to research, please visit


**This article is not intended to replace proper medical/mental health care. If you think you may be suffering from Postpartum OCD, please contact your medical or mental health provider, or PSI, for referrals/help/support.**

“The Pyramid of Self-Worth” Step 1–Practice Self-Awareness (& video)

"The Pyramid of Self-Worth": Step 1--Practice Self-Awareness; www.DrChristinaHibbert.comIn my last post, we discussed how to feel self-worth, using what I call, “The Pyramid of Self-Worth.” Today, we get to start working through the steps of the pyramid, toward our ultimate goal of increasing our sense of self-worth.

Before we start, let me say, I realize this is just a blog, and we certainly won’t be able to cover every aspect of discovering self-worth for every person, but I believe in these principles, and I’ve seen them work before. Following The Pyramid of Self-Worth, we can discover, or rather uncover, who we really are. We can feel our true potential. We can grow in self-worth.

Understanding Self-Awareness

What is self-awareness?

Before we can practice self-awareness, we first must understand what self-awareness is and what gets in our way of being more self-aware. For our purposes, self-awareness means “the ability to allow yourself to see all of you—including the good, the not-so-good, and yes, even the ugly.”

What blocks self-awareness?

For many, self-awareness is difficult. Some simply have no interest in self-awareness, but most start out aware but then block self-awareness. Why is this so? Bottom line…I think it all boils down to fear:

1)    Fear of seeing something really ugly if we dig too deep.

2)    Fear of feeling worse about ourselves because of what we see.

3)    Fear that, once we see, we’ll have to make change, and changing can be scary.


Watch this “3-Minute Therapy” YouTube video on “Feeling Self-Worth: Step 1–Practice Self-Awareness.”

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Self-awareness requires courage.

It certainly can be challenging to become self-aware. Self-awareness requires courage. You may be saying, “But I’m not courageous.” Yes, you are. It takes courage to read this article. It takes courage to get honest with yourself and how you are, and who you are. It takes courage to desire to change, to work on that desire. Yes, you are courageous, and that is great news, because self-awareness requires courage.


Self-Awareness dispels the fear and brings peace.

Sure, it might be tough to see what we see at first, but eventually, as we see all of who we are, we become free of it. As we courageously take a deep breath, open up our heart, and step inside, we find the truth, and as the bible says, “the truth shall set you free”—free of fear. It’s easy to fear the monsters hiding in the closet, but seeing them in the light takes the fear away. The more of us we expose to the light, the less there is to fear, because the more we know.

Self-awareness opens us up to the truth, and that gives us the opportunity we need to accept that truth, as we will discuss in the next post. This is the ultimate gift of self-awareness—peace. No longer do we fight against the dark parts of who we are; instead, as we see and name the darkness, we bring it to light. And who’s afraid of the light?


Self-Awareness can be exciting.

Hard as it might be to practice self-awareness, it can also be exhilarating. We not only see the “negatives;” we also get to discover our strengths. We get to understand who we really are, and not just who others, or the world, tell us we are. We get to grow toward our true potential. That’s why self-awareness is such an exciting endeavor: It opens the door for lifelong progress.


 The Pyramid of Self-Worth: Step 1–Practice Self-Awareness

So, how do we begin the process of self-awareness? Here are a few strategies to get you off and on your way:~Dr. Christina Hibbert, from "The Pyramid of Self-Worth": Step 1, Practice Self-Awareness;

1) First and foremost–Leave the judgment out of it. Self-awareness is not self-judgment. It’s looking, and seeing, and discovering who you really are. So, check your judgment at the door. Let yourself open up and freely see it all. 


2) Take a searching look at who you are. Ask yourself, “Who am I?” Then, listen. You will likely hear all kinds of answers–from the outward descriptions, like “I am a teacher, friend, and runner”–to the inward, “I am hopeful, happy, hard-working”–to the very deep, “I am God’s child. I am a spirit, an eternal soul. I am love. I am filled with divine potential.” Whatever you hear, take note. You are beginning an important process, one that will last a lifetime. Take your time and listen to what your heart is continually whispering about you.


3) Take a closer look at how you are. Ask, “How am I?” I’m not talking about how you feel; I’m talking about how you are in the world–with other people, in your daily life, in your relationships. How do other people see you? What strengths or weaknesses have you seen through other people’s eyes? What have other people said about you from which you might learn something? We’re not interested in judgments of who you are as much as opening your eyes to see all of who and how you are. So, be willing to open yourself up. Be willing to see how you are in the world. Gather the evidence like a detective. Lay all judgment aside. Simply open your eyes and take a courageous look.


4) See your weaknesses. We all have them, you know–weaknesses. Some of us can easily identify twenty, while others might struggle to see even one or two. Whichever end of the spectrum you’re on, it’s time to get realistic. See the things with which you struggle. See the areas that need more work. You might have a quick temper, be extremely shy, have debilitating fears, suffer from depression, or be extremely sensitive to hormone changes or sleep loss. Whatever weaknesses you discover, remember this: Weaknesses do not make you a weak person. They make you human. With time and work, your weaknesses can become your greatest strengths. 


5) See your strengths. Some of us struggle more to see our strengths than our weaknesses. Some reject compliments or any words of kindness or praise. But we have strengths, too–all of us. You might be a great listener, an excellent cook, a talented musician, gardener, or computer genius. You might be great with kids, a natural leader, extremely compassionate, or responsible. Search out your strengths. They are your best assets–the ones you’ll eventually want to develop and share with the world. Seeing your strengths is an important part of self-awareness, for they are an important part of who you are and who you are destined to become. (More on strengths & weaknesses, read this.)


Be sure to check out all of this 5-part series:

(Part 1) How to Feel Self-Worth: “The Pyramid of Self-Worth (& video)

(Part 3) “The Pyramid of Self-Worth”: Step 2, Practice Self-Acceptance (& video)

Build Your Sense of Self-Worth–

Self-Awareness Tools

Try one or more of these “tools” to help you begin your practice of self-awareness.

1) Practice self-awareness. As you go throughout your day today, open your heart and your eyes. Notice how you interact with others. Notice how you feel inside. Notice the things that come easy to you and those with which you struggle. Work on leaving the judgment out–simply see. When it gets hard to see these things, stop and take 10 deep breaths. Remind yourself that self-awareness is a courageous act, one that will lead you to a stronger sense of self-worth and purpose. At the end of the day, write down what you have discovered.

2) Create your “I Am” List. Imagine you’re a detective, out to explore and gather the facts about who you are. Start with two lists: “I am,” and “I am not.” The more you uncover, the more you keep adding to your lists.

3) Start a list of “strengths” and “weaknesses.” Again, no judgment. Your job is merely to uncover the truth–to see all parts of you. Add to your lists as you learn more and more about yourself. Read this article for more on Strengths & Weaknesses.


Leave a comment below with your thoughts on self-awareness, and be sure to join us next time as we work on “Self-Acceptance.”


#1 Amazon Bestseller, This Is How We Grow, by Dr. Christina Hibbert, Available now on!
Be sure to check out Dr. Hibbert’s Amazon Bestseller, This is How We Grow
available now on!



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Discovering Self-Worth: Why is it so hard to Love Ourselves?

Discovering Self-Worth- Why is it so hard to love ourselves? www.DrChristinaHibbert.comWhy is it so hard? I’ve given a lot of thought to this question over the years, because the number one issue I see in my psychology practice is a struggle with self-worth. People may come in for help with depression, anxiety, relationships, or parenting, but underlying these challenges is almost always “low self-esteem,” a struggle to love oneself.


I’ve read, studied, and watched my clients, friends, family–and yes, myself–struggle to feel self-worth–to truly embrace, believe, and feel it, deep in our bones. I’ve written about how self-esteem is a myth and how we must instead dig down and discover our true, inherent worth. I’ve even developed a model for discovering self-worth, and I’m currently writing a book on self-esteem after a breakup, with more books to come on this important topic.


But it still makes me cringe each time I hear someone say, “I don’t know how to love myself,” or “I try to believe it, but deep down, I don’t feel my self-worth.” I cringe a lot.


Why is it so hard to Love Ourselves?

So, why is it so hard to love ourselves? Why can’t we just believe the books, experts, and centuries-old wisdom that tells us we are so much more than we feel we are? Why can’t we accept our strengths and our weaknesses? Why can’t we simply love ourselves and let love in? I don’t have all the answers for why discovering self-worth and practicing self-love are so hard, but I do have some ideas:


1) Our experiences don’t match what we’re told or shown in the world. We hear, “You are of worth,” “Each soul has infinite value,” “We are all beautiful, talented, amazing, in our own way,” and we may even believe it–for a while. Then, we go out into the harsh world where our beauty and talent are compared to others, where we are judged, and where we learn to judge ourselves. Suddenly, our self-worthy thoughts have vanished. Our own parents or family are often part of this self-doubt system. They may, knowingly or unknowingly, instill in us a struggle with self-worth, through years of criticism, mixed messages, or withheld love. Unfortunately, some live a whole life never hearing a kind word, never feeling the power of true, unconditional love. How can we believe we are worthy of love if we never experience love in its purest form? Even if our parents were loving and taught us self-worth, teachers, friends, and others around us can tarnish our sense of self-worth, if we buy into their lies. Media also contributes, for sure. Images of those who are slimmer, smarter, richer, faster, more creative, more successful, or more beautiful plaster the world outside, create doubt in our world within.


2) We tend to pay more attention to negative experiences than positive ones. In psychology this is called “The Negativity Bias,” and it means that we humans are much more likely to remember and hold to the negatives of life than the positives. We’re also more likely to let the negatives influence our future behavior. They stick to us like glue. We’ll never forget the time our teacher said we were stupid or that cute high school boy said we were ugly, yet we ignore the dozens of things the people who know and love us see and say about how beautiful and intelligent we are. We ignore all the positive evidence of our beauty and worth, opting instead to cling to the negatives.


3) We don’t trust ourselves. Bottom line. We might feel an inkling, or wonder, “Could it be I really AM amazing?” but we don’t believe ourselves. We discount what is already whispering of our worth within, in favor of the loud messages of doubt without. We then go looking for ways to build our “esteem” in the world–to feel better about ourselves by being better than someone else, or finding the right person to build us up, or becoming a perfectionist so we feel worthy of love. But all of these paths to “self-esteem” will ultimately fail, for they are each built on a system of self-doubt. Instead, we must learn to trust ourselves, to listen for and hear and trust the whispers within that show us our true value and worth, to let go of the opinion and voices of others and trust a greater Source.


This is my new favorite picture I took on our family trip to Mexico. Love the beauty and solitude. I was loving myself in this moment.

This is my new favorite picture I took on our family trip to Mexico. Love the beauty and solitude. I was loving myself in this moment.

Discovering Self-Worth

To me, this is the answer for self-esteem problems: learn to tap into the truth within, to hear and feel it. Learning to create experiences outside that match those truths, learning to see the positive evidence around us and believe it–learning to trust, accept, and love ourselves. It can sound very easy, I know. Yet, I also know it’s not–otherwise we would all feel so much self-worth I wouldn’t be writing this. It’s simple, yes. But it’s not easy.


We’re going to work on it.



Help me get this discussion started, by commenting, below! I really am interested in understanding why self-worth is such a challenge for us, and specifically, for you. Why do you think it’s so hard to love ourselves? What stands in your way? Do any of my thoughts ring true for you, or is it something else? Let’s  begin the self-worth revolution! Together, perhaps we can crush the myth of self-esteem and create a world full of self-worth. Wouldn’t that be lovely?



#1 Amazon Bestseller, This Is How We Grow, by Dr. Christina Hibbert, Available now on!

For more on discovering self-worth, be sure to check out my bestselling book,

This is How We Grow:

A psychologist’s memoir of loss, motherhood, and discovering self-worth and joy, one season at a time.

Available now on!





Discovering Self-Worth- Why is it so hard to love ourselves? www.DrChristinaHibbert.comFor support and insight to help you discover your own self-worth,

join my “This is How We Grow” Personal Growth Group!

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Related Posts/Articles:

Join my This is How We Grow Personal Growth Group!

Self-Esteem & Self-Worth

Personal Growth & Self-Actualization

Goal-Setting: 5 Steps for Personal Growth Success

What I’ve Learned about Personal Growth from a Decade of New Year’s Themes

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