Marriage Counseling Tag

Anxiety and Depression During Pregnancy, ‘Wellness for People Like Me.’

Anxiety and Depression During Pregnancy, ‘Wellness For People Like Me.’

Depression and Anxiety in Pregnancy

Writer, blogger, and art therapy graduate Angela Grace Wilt shares some of her experiences in recovering positive coping and mental health including ways to manage anxiety and depression during pregnancy. This is a part of the ‘People Like Me’ Series of our wellness blog, real people, real stories, real ways to incorporate wellness into stages and experiences of everyday normal life.

Being a woman comes with a lot of ups and downs.  Women are prone to anxiety and it can be very hard to to admit.  For example, women are closely tied to the monthly cycles that their body experiences.  Things such as menstruation cause anxiety, depression, mood swings, and intense bodily urges with cravings.  Men never will get us or grasp what we go through.  We are just that unique. For as long as I could remember, I have felt that as a woman I am special and cursed all at once.

Then of course recently, as I have taken this jump into parenthood with the amazing biological potential of my body, quickly I have learned that while things like premenstrual dysphoria, and the normal anxieties and depression of menstruation are challenging, pregnancy holds a whole long list of unique and larger fears and physical difficulties. In fact, this is true for all women, and according to The American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with some symptoms of anxiety or depression during pregnancy. The shift in mental health have multiple sources, think about it, there is insomnia because our body is changing so fast that some women can be prone to rapid heartbeat, which makes it harder to fall asleep.  There is also the whole list of ‘what ifs.’ Will my baby and I make it to full term?  Will my baby be healthy?  I can no longer drink alcohol, ride adrenaline driven roller coasters, lift heavy weights, or really take any chances of too adventurous tasks.  With each decision I make, I consider the question ‘what will makes my little bump, a healthy or not so healthy baby.’

Physical and emotional changes are also thread within social fears and adjustments, I sometimes wonder, have I planned enough for this pregnancy that has in many ways, just happened. The truth is, I am not some 30 something who has been charting my cycle for 6 months to achieve conception, I didn’t plan to get pregnant just yet.  I thought about it sure, but just like most couples we wanted to walk down the aisle with a white dress of lace and flowers all  the scenery of our closest friends and family shouting us on, it was always my dream of being that princess and marrying my soul mate!  We still will have that for our future, but it will be after we get through the current stresses. In addition to the changes in my timeline, I also care about what our parents think about our having a baby right now. Having a baby out before marriage can be shocking for some religious and cultural values. We were lucky because my family is just fine with it, and with a little time to adjust, my better half’s is now happy about the news.

The list of anxieties and real practical matters which accelerate my concerns are aplenty, even small things have caused me stress, I have had to shop for insurance as a pregnant women, because I am twenty-six, pregnant, and didn’t have any. Finally, babies are expensive, health insurance is also expensive, we have stresses of finding better jobs, I have to go on insurance yet because I am twenty-six and don’t have any.  We are cleaning house and making a baby room. When all of these real life stresses start to mount very high, I can feel my heart beating faster, I try to stop and think of the things that we do have, I try to re-frame my anxieties and depressed thoughts in a positive light, I pause and I say to myself, ‘I have my boyfriend, our love together, and I have a supportive family. I have myself and my strengths, and I am strong and able.’That always seems to calm me down and help me to remember that there is much to be excited about as we move forward together as a young family.

With all of these anxious and depressed thoughts swirling in my mind, I have taken the time to put together a small list of ways that I manage and support my emotional health during my pregnancy. Of course if you are struggling with mental health during or after your pregnancy, talk to you PCP or Mental Health provider, get a screening for Postpartum or Baby Blues, every year women die or don’t bond with their babies due to maternal mental health factors. If you are like me and relatively healthy but feeling a little anxious or blue, then read on because these tips may help you as much as they helped me.

Use positive self talk, be your own biggest fan and encourage yourself like you would a friend

I say nice things to myself, I write little notes and post them through out the house, simple thoughts like,’ Rome was built in a day’ ‘We will get everything done in time.’ We’re already almost half way there at twelve weeks.  It’s just a wild ride.  My body is going through so many beautiful changes. Tune in, all of my emotions are heightened.  Hunger is giving me nourishment now.  Sleep is always appreciated.  Sex is fierce and always wanted.  Sadness and anger are intense.  I have energy that comes out of nowhere.  Its ok if sometimes I can’t stop crying.  I love my baby and baby’s daddy and not want anything more than to be with just them and them alone.  I want the best by our new child.  I want to give it proper nutrition and a good home life.  I want to be a good parent and my baby to grow in a family where love is the answer and anger is dealt with in a healthy supportive manner. I will protect this baby with all that I have.  This child’s needs and wants are now first.  I am ready to teach this baby proper education, morals, respect, and spirituality.

Its normal to be overwhelmed, life is now changing! 

Anxiety,stress, and fear are the norm when we are overcoming big changes. ways just important to remember that having a baby is a life changing experience. Normalizing the emotions that I am experiencing helps me by making me not feel the guilty, ashamed, or odd for having these dips and emotional shifts.

Reach for your Tribe!

Please remember, you are not alone.  You are a powerhouse and you have many people who will listen and talk. Make a list of 5, if you can not list at least 5 people who will pick up the phone for you, see a therapist and talk about the feelings of isolation and loneliness. Mom, dad, best friends, siblings, make a list and think about who is the best person to talk with through the things that come up. It will likely be a different person for each of situations that one may encounter on the pregnancy journey.

Use your breath

The body and its breathing are powerful, breathing can be used to energize and manage our response to stress. Take some deeps breaths every day.

Make a Wellness Routine

Do calming relaxing type activities like yoga, walking in nature or just walking, stretch, journal, and keep time for yourself  to collect your thought and consider the daily experiences that you are managing.  Essential oils can help ease the mind and emotions and of course be sure to choose blends that are safe to use during pregnancy.

Bond with your baby 

Talk to your baby while its in the womb, there will likely be a time after your baby is born that you are longing to be so closely connected to him or her again, try to cherish these moments and zoom out towards the big picture where you are nurturing a sacred bond right now in your womb. Being a woman is very special, and this connection, with baby snugly centered in my sacral area, right as my mother and my mothers mother have always done, this is something that men can not understand, but I am ok with that.

We are powerful, we are able to make changes that influence the outcomes of our life. Pregnancy like all things, is what you make of it.  Do your best to stay positive by thinking of the new exciting things that can be done all in great fun with your new family together.  Your love of baby and yourself will take you far. Be gentle with yourself when you notice the stress, anxiety, and fear of the 9 months ahead. This is a special time that can be used to get really healthy and in tune with your bodies needs. As always, seek medical help from a PCP, Gynecologist, or Licensed Professional Counselor if you have concerns about your mental health.

Premarital Counseling Questionnaire

Premarital Counseling Questionnaire

Premarital Counseling Questionnaire, prepare your relationship for a long happy marriage.

If you have recently answered ‘yes’ to a marriage proposal, then along with the rush of planning your version of the perfect wedding you also may also be considering whether you should be going to premarital counseling. Premarital counseling is a form of couples therapy that emphasizes wellness, you can learn more about the process here. Our counselors have put together a premarital checklist to look at your relationship and to determine if it makes the wellness grade for relationship health, this will help you and your partner to understand some parts of your relationship in a deeper way. Don’t be afraid to feel a little uncomfortable, these are not the kinds of questions that you normally think about but that also is what makes them especially powerful to assess the strengths and various qualities of your unique partnership. This does not replace premarital counseling but it does help you each to examine your relationship in a mindful and healthy way.

• Why do you want to get married?
• What roles do you see for yourself in your marriage?
• What do you imagine might be your biggest challenge in being married?
• What makes your relationship unique?
• How do your friends and family view your relationship with your partner?
• What is your idea of the perfect wedding?

Are there others who are close to you who have different ideas for how your wedding should go?

How do you each talk about your thoughts and needs on this topic?

• How do you manage conflict?
• What are each of your conflict resolutions styles?
• What has been a challenge for your conflict resolution?
• How you repair conflict?
• When you feel stress how can you partner help you?
• How would you describe your communication style?

Is it generally easy for you to talk about your needs?

Do you find you over communicate your needs?

Do you have an attacking communication style?

Do you become very emotional when you communicate?

• How similar or different are each of your sexual libidos?

Describe the amount of foreplay that you have with your partner on average?

Do you feel able to initiate lovemaking?

Do you feel able to decline sex with your partner?

Are you able to orgasm?

Do you have sex that is non-penetrative?

• What are some of your financial concerns about your future together?
• What is your ritual around managing the finances?
• How do you handle household maintenance like cooking and cleaning?
• Do you plan to have children together?
• What trait do you most admire in your partner?
• What is one mutual goal between the two of you?
• What do you see yourselves doing in 10 years?
• What do you see yourselves doing in 20 years?

With the help of questions like these, you and your partner can begin the lifelong process of deepening your understanding of yourselves and each other, keeping in mind, your answers to these questions will likely change over time. That is normal and to keep your marriage healthy, you should continually check in with each other and have hard conversations about things that matter to you. Wellness means that we manage and care for ourselves and our relationships in a way that keeps them strong and happy and that we strategically plan for success by growing our relationship to be stronger. Great marriages are created intentionally by addressing individual and relationship needs, prioritizing connection, listening and compromising.  None of which are easy, but all of which are well worth it to live happily, in love, for the rest of your life.

The Counseling and Wellness Center of Pittsburgh

830 Western Avenue Pittsburgh PA 15233

4108 Monroeville PA 15146.

Relationship Wellness Checklist, A Mindful Marriage Moment

                                  Relationship Wellness Checklist, A Mindful Marriage Moment

Mindful Marriage Counseling

Our marriage, relationship, couple-dom, is something that works based upon often unstated rules, we peacefully and automatically operate with a lifetime of typical exchanges peppered with glimmers of joy, one part emotional support, heaps of memories made, dutifully maintaining our promises for commitment. Maintaining contented connections with our loved ones isn’t usually a goal that we think about.  We know that to keep our minds, bodies, and spirits healthy, mindfulness holds the keys to happiness and longevity. The wellness model has useful applications to marriage counseling and couples therapy, we have compiled a 5-part relationship wellness checklist – lets take a moment to see how well your relationship makes the grade.

• Do you disagree and air grievances with your partner? By disagreeing, we mean constructively having a discussion about things that are bothering you within the relationship. One very ominous behavior pattern is when a couple comes in and tells the therapist or counselor that they never argue. We know that this is not usually a sign of relationship health. In this situation, it is likely that one or both partners are withholding vital information and may even be passive aggressive and building resentment by not discussing their true feelings. This communication fallacy is a product of imagining that by not being open about annoyances that they are preserving their bond. Withholding feelings and missing chances to constructively manage disagreements is a relationship destroyer and leads to emotional disengagement in the long term.
• Does your relationship have intimacy? The concept and behaviors associated with intimacy are multifaceted. Intimacy is a dynamic synergy of emotional trust, physical connection, and having shared meaning within the relationship. Intimacy is built over time and is facilitated through travailing joys and difficulties together for example, by exhibiting the ability to offer emotional support through a crisis.
• Do you check in with each other through the day? Many of us have demanding jobs and schedules, even having to endure travel to maintain our work responsibilities. Yet, our cell phones and Skype provide us with a chance to tighten the chasm of disconnection by having some face-time, texting, or calls through the day. It is important to turn toward our partner to share highlights and check in, and this characteristic is something that healthy relationships do have in common. Alternately, this doesn’t mean to call every hour and lapse into conflict if our relationship is not experiencing as much face-time as we would like. We should highlight that checking in, is a natural response to feeling connected and participating in the intimacy of our friendship with our partner.
• Is there sexual and non-sexual touching between you and your partner? Both forms of touch are very important in our relationships, while many couples go through periods of lower sexual frequency, they stay connected by touching, hand holding and having other forms of non-sexual touch. Both forms, sexual and non-sexual touch are equally vital for our sense of well-being and bonding. Keeping in mind, consensual intimate touch provides a cascade of hormonal responses, releasing Oxytocin which is dubbed the cuddle hormone and facilitates bonding.
• Who do you turn to for support? Can you name 5 people? Is your partner one of those people? If your partner is not one of the top 5 people who you turn to for support, your relationship may be headed for trouble and this is an indication signaling that your relationship may be prey to a deeper issue worth exploring with a marriage counselor or couples therapist.

Warmly brought to you by the licensed Therapists and Professional Counselors at

The Counseling and Wellness Center of Pittsburgh and Monroeville

830 Western Avenue Pittsburgh, Pa 15233

4108 Monroeville Blvd Monroeville, Pa 15146

The aftermath of an affair, 4 ways to tell, ‘Should I Stay or Go?’

Repair or Run the Other Way? My partner had an affair, Should I Stay or Go?

If you or your partner has recently discovered an affair has been happening in your relationship, in this moment you are likely trembling, a blurry fury of agonizing hurt, the entire relationship now may feel foreign to you. As a couples counselor affairs and their tempestuous aftermath are ironed our my office couch. Both parts of the couple struggle to make sense of the betrayal and its costs, couples seek aid and asylum to find the answers to questions such as; should we stay together or separate, will our relationship ever regain a sense of normalcy, ‘am I weak or foolish for thinking of staying?’ ‘how can we fix this?”

A relationship is founded and grows upon a platform of trust, without the reinforcement that trust provides, the person who was victimized by the affair will be thrust into a state of panic, questioning every action and motive of their life and partner. An affair is a trauma to the relationship, often people who have learned of, or been told about an affair from their partner, suffer from symptoms similar to PTSD or Acute Stress Disorder. Sleeplessness, anxious and intrusive thoughts and images, fear of it happening again. Within the wake of this mountain of emotional upheaval they create their next course of action, remain together or disassemble their lives. Use this guideline to weigh the options, keeping in mind the decision is one that must be made by ones self, as it is personal, intimate, and an infinitely complex choice to make.

• Is the partner who committed the affair being accountable? There must be a high level of accountability if the relationship will be repaired. This means that the cheating spouse accepts responsibility for his or her actions. If instead your partner is blame shifting or gaslighting, by saying that the affair is your fault or someone else’s fault, or if he or she is trying to minimize the impact or the hurt this will not work. The relationship must have truth to begin the healing process. It can be very frightening to own up, and some personality types that are antisocial, psychopathic, or narcissistic will likely use more defensiveness when met with the truth and or will struggle with empathy for their betrayed partners hurt. Under these circumstances it won’t be possible to work thought what happened in a healthy way.
• Has communication been cut off with the paramour? If communication is on going with the alternate partner there is no chance that the relationship can heal from the betrayal. There are people who will try to stick it out and court their partner while he or she tries to figure out which partner to choose. This is not a recipe for healthy connection, jumping around doing the “pick me dance” will likely lead to a major impact on self esteem and an internal sense of anxiety and profound sadness. Many couple’s therapists will not treat a relationship when there is an active affair happening.
• Is your partner willing to have greater transparency with you? This means giving you the codes to his or her phone, email, and social media accounts. Even with the codes and access to your partners interactions, it will take a herculean effort to restore any sense of safety or trust. This is a good first step in letting ones partner in and pushing the affair partner out.
• Do you want to do the work or forgiveness? While it is true that the affair is often symptomatic of deeper issues, the aftermath puts a tremendous strain on both parties. Deciding to work through and forge forgiveness is a toll which most heavily gets heaped upon the person who has experienced the betrayal. If you have learned that an affair has happened in your relationship and that you want to work on repairing it, you will simultaneously actively be committing to forgiving, this will be exquisitely difficult. After enough time has passed, you will be required to work through the process of handling anger, hurt, sadness, resentment, jealously, insecurity, all in the name of staying with your partner. Keep this in mind as it may not be for everyone which is ok!

All of these grim facts in mind, there is hope, if the above questions can be answered with certainty then there is a path to be forged toward forgiveness. Not an easy one but it is possible to have a connection which is stronger after an affair. Trust is a formula of consistency over a time, trust can be rebuilt if the formula is followed. With understanding, truth, and commitment, love is a robust and golden vessel which proudly contains the tender blossoms of our lives. A vessel that is able to withstand complete annihilation and be recreated to become gleaming and full again, or sometimes it is best to pluck our precious contents and replant somewhere anew…

In love and care,

Counseling and Wellness Center of Pittsburgh and Monroeville

Stephanie Wijkstrom MS, LPC, NBCC

Jackie Mandock, LPC, NCC

Jackie Mandock, LPC, NCC, LBSC, MH is a counselor at Counseling and Wellness Centers of Pittsburgh- Monroeville. She provides therapy to children, adolescents, families, couples, and adults. Jackie approaches therapy from a holistic perspective, always staying mindful of how the body, mind, and spirit are interconnected. Jackie is certified in trauma focused cognitive behavioral therapy and is trained in parent-child interaction therapy.  She has worked with many different concerns in these specialized populations ranging from attention-deficit hyperactivity disorder to trauma, as well as anxiety and depression. Jackie is also a licensed behavioral specialist with a strong background in autism.  Jackie was a school-based therapist and is familiar with school concerns and supporting educational issues. She is a graduate of University of Pittsburgh with a Bachelors in Psychology and Neuroscience and  from Chatham University with a Masters in Counseling Psychology. Jackie also has a Master Herbalist diploma from American College of Health Sciences.

Counseling Pittsburgh

Our licensed professional counselors are here for the community offering evidence-based therapy, marriage counseling, family counseling,  child therapy, art therapy, premarital counseling, all by top rated clinicians. Our team of therapists has over 150 years of experience between us, we offer therapy to heal from Depression, Anxiety, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, and our Couples Therapists can treat a full range of relationship issues from conflict communication, to intimacy enhancement, and parenting concerns. In all of our centers, we also provide a menu of comprehensive wellness services. We offer wellness support including health treatment options from our certified nutritionist, kinesiologist, clinical herbalist who specialize in offering the people of The Greater Pittsburgh and Western Pennsylvania communities providing wellness solutions for mind, body, and spirit. Be well with us!

Contact us at our Pittsburgh location 830 Western Avenue Pittsburgh Pa, 15233 Our Pittsburgh center is located in the northshore of the downtown Pittsburgh. Therapy near Northside, Southside, Brighton heights, Lawrenceville, Shadyside, Bloomfield, Strip District, and Mt. Washington. Our hours are from 7-am-8 pm  Monday through Sunday. We accept UPMC, Highmark, Blue Cross Blue Shield, United, Magellan, Aetna, and Comp Psych as well as Out of Network, Self Pay, and Sliding Scale options.

For a therapist near you – Call us at 412-322-2129