mentalhealth

Our Life during the Pandemic : In the Words of a Dad

Hear it from the Mammas!

Hello Raghu, you are the first dad to be featured on the blog & I am so happy to have you share your experiences with us. Tell us a bit about your family.

We’re a relatively small household with just three of us currently residing in Bangalore. My parents are based in Dubai and my brother in London. We’re a bit nomadic in some sense having lived in multiple places across different geographies; though Bangalore is home for us all. Luckily my daughter has had a stable residence over the last two and half years which has definitely helped in providing a certain comfort and sense of belonging to her. 

As we are speaking during the pandemic, can you share how your life as a father was before the pandemic & how it has changed now?

I was an Investment Banker till recently when I decided to take a break. Given the professional demand, my time with my daughter was limited to a few hours in the morning and Sundays when work-life permits. My wife had committed her entire time to our daughter, which allowed me to fulfil my professional obligations without having to worry about my daughter’s development; granted that my peace of mind stemmed from the fact that my wife is a trained Montessori guide. Under these time limitations, we had a decently established routine wherein, the mornings were quality hours where we got to learn, explore, play and of course include some routine hygiene and food related activities. When she started attending a Montessori school, the routine was more streamlined. Weekends were for us to spend quality time and build our own relationship which initially revolved around activities such as building stuff (lego, dominos etc), books, sitting on the swing, going for drives, visiting the mall, restaurants etc. 

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Our routine prior to the lockdown revolved around her school timings. Our approach has been to try and increase her exposure to the world around us, be it from visiting different parks, attending plays/musicals (targeted to her age group), maintaining a healthy social life by interacting with friends and family and getting to explore other parts of the world. 

However, ever since the lockdown, her world has changed and enclosed by the four walls of the house and only us for her to socialize with. It is extremely tough to ask a child, who has gotten used to spending time exploring the world around, to suddenly limit herself to the house. We have tried providing as many opportunities for her to expand her learning by offering activities around development across various facets. Children are very resilient and far more adaptable than adults; they build themselves a new normal within no time. She does miss going to school, the park, meeting people etc. but she understands, in her own way, that life is different now. Establishing a routine is quite difficult when we really aren’t time bound. We’re taking each day as it comes while trying to make sure her developmental needs are not sidelined.

Do you feel you have more quality time with Urvi? How do you both spend your time together?

Given that I am on a break from work, I definitely have a lot more quality time with her which is more paced and not rushed due to any time constraints. My daughter has clearly developed her own sense of what activities she likes to do with each of us separately. With me, it revolves around building stuff, be it lego, blocks (plain ones, bristle based etc.), playdough and even some DIY activities (building a bird feeder or some shelves). She also likes to pretend-play with me (with her kitchen set, dolls or doctor kit). We also spend quality time everyday on the swing. When it comes to books, cooking and dancing, she is equally engaged by my wife and I. The entire creative department from art, needle work, rangoli and nature play is my wife’s domain.  

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Many parents are juggling a lot of responsibilities and find that screen time is giving them some respite. Do you offer Urvi screen time? What are your thoughts?

Prior to the lockdown, screen time was solely limited to video calls with her grandparents and aunts/uncles. We have been a screen-free household until recently. However, as she is also growing up and observing us use our phones/tablets/laptops, she has become more curious about them. We now limit screen time to educational contents, around her interests, which mainly revolves around seeing rangoli designs and animal related content. Our approach has been to use the screen as an educational medium and restricting viewing time to 20-30 mins a day. She does also chat with our parents and occasionally wants to see her baby pictures/videos. We do not use the screen during meal times as we try and encourage her to be aware of her meal activity. She of course likes to play while eating and also likes to eat outdoors. I know it’s difficult for working parents to be able to spend that much time around meals, however, I believe that content curation is very important at this impressionable age. Parents should analyse and decide if the content they are planning to introduce to their child is appropriate for the child’s age and the impacts of exposing them to mature content earlier than necessary. Overall screen viewing time can impact the child’s development both mentally and physiologically. 

What are some things you feel Urvi is missing out on because of the pandemic? Does she ask you about these things? How do you navigate such situations?

I think she misses her school routine and visiting the park the most. She definitely asks about both of these regularly. From our perspective, restricting social interaction, now that she can communicate well, is one of the areas which she will miss out on. The new normal might change the current generation’s concept of social interaction and it is concerning that they will not experience it the way we did. We have to cope with life as it is, until there is a viable vaccine, and trying to maintain relationships digitally, to the best of our abilities, will be our focus. It’s so important for young children to be able to play together, physically, and we hope that we can offer it in a restricted and safe manner soon.

Do you think it’s important to talk to young children under 6 years about the pandemic? 

Yes, but it is important that the messaging is inline with what they can understand. Rather than talking about it in a global perspective, it’s important to try and relate it to their life and their world. For Urvi, we kept it as simple as we could, by talking about a sickness and the need to maintain a certain level of hygiene and distancing. She has taken to it rather well and knows why we cannot go out now and not interact with people. She also knows why people cannot visit her and why airports are closed. I do not think children should be exposed to the pandemic via the media nor in terms of fatalities. Parents should limit their knowledge to safety and in enforcing social distancing. Kids are far more mature than we give them credit.

With so much uncertainty around, how do you take care of your mental & physical health and how do you model this to Urvi?

This is definitely challenging today. From a mental perspective, it’s important that we maintain a healthy, peaceful and happy atmosphere for Urvi. She is already bearing the burden of not being able to live her life as before, and the least we can do is to not disturb her equilibrium by violence (physical or verbal). There are going to be days that will be challenging as parents where limits could be pushed. We should try and limit their exposure to our outbursts or frustrations as much as possible. On the physical side, it is important to maintain one’s health, especially during a pandemic. Involving the children in physical household chores is a great way for them to contribute to the family and also keeps them occupied while spending time with the adult. It also helps develop movement coordination and fine motor skills. Yoga is another great way for children to improve their flexibility. There are a number of yoga poses which are suitable to children and can be introduced once they have developed the ability to balance well. Personally, I can do more to model the need for better physical health by working out and involving her in the routine.

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Lastly, do you have one piece of advice to share as a dad to other parents during this crisis?

In these troubled times, as a dad, maintaining your composure and being patient is very important. It’s also important that we should not be too hard on ourselves as our mental wellbeing will ensure that we provide the best environment for our child. 

Understanding Postpartum Depression – A Professional Perspective : Mamma Love Series

Mamma Love Series

As part of the Mamma Love Series, I approached Dr. Susan Pawlby, a Developmental Clinical Psychologist, and former Lecturer in the Section of Perinatal Psychiatry at the King’s College, London, UK.  She is also a member of the Multi-Disciplinary Team on the Channi Kumar Mother and Baby Unit at the Bethlem Royal Hospital, South London and Maudsley NHS Trust. Dr. Pawlby is now a visiting Senior Research Fellow at King’s College, London.

She shares below about depression in parents, mothers in particular, from her years of experience working in this field. She also shares what kind of support is offered clinically and how we can support the pregnant and postpartum mammas in our lives.

How is antenatal depression different from postnatal depression and how do they affect the baby? 

A major depressive episode is an illness characterized by low mood and/or loss of interest or pleasure in usual activities, lasting at least 2 weeks, with secondary symptoms being appetite or weight changes, sleep difficulties, psychomotor agitation or retardation, fatigue or loss of energy, diminished ability to think or concentrate, feelings of worthlessness or excessive guilt, and suicidality. The difference between antenatal depression and postnatal depression is only in the timing of the depressive episode, one being during pregnancy and the other after the birth. The symptoms are the same. Antenatal depression may affect the foetus by increasing cortisol, norepinephrine and inflammation which affect the fetal environment and have implications for maternal and infant health. Maternal stress has been associated with poor birth outcomes including preterm birth, infant mortality and low birthweight. Postnatal depression may affect the baby if the mother’s symptoms mean that she finds it difficult to respond to her baby’s physical, emotional and social needs.

How does depression of mothers affect the emotional regulation of babies? 

One of our tasks as mothers is to help our babies regulate their own emotions. When a baby is born their brains are not well-developed. Infants have some limited self-directed regulatory behaviours such as thumb sucking, visual avoidance, and withdrawal but these behaviours have limited effectiveness. When babies have uncontrollable cries, it is up to us, the parents, to help them regulate their bodies and emotions, so that they learn to self-regulate. This is more easily accomplished during the sensitive period when the brain is still flexible. In order to do this a mother needs to notice, monitor and recognize her baby’s emotions and adapt her own emotions according to the situation. If the mother is depressed, her own emotional feelings may overwhelm her and she may not notice her baby’s distress or be able to offer appropriate support.

What kind of intervention is offered to mothers experiencing depression? 

In the UK, we have multidisciplinary teams of perinatal health professionals – psychiatrists, psychologists, nurses, nursery nurses, occupational therapists, social workers – who support women suffering from depression during pregnancy and following the birth, both in the community and in special Mother and Baby Units. They offer different interventions including medication, talking therapies, promoting well-being through support with sleep, nutrition, exercise, and specially tailored interventions promoting the relationship between mother and baby, keeping the whole family in mind.

How many women who experience postpartum depression actually seek treatment? Why do you think many do not come forward for help?

One UK study in 2011 showed that only 43% of people suffering from postpartum depression sought help. Among the reasons given for not seeking help were that

  • it was not serious enough to warrant help from a professional
  • they were too scared to tell someone for fear of the consequences, which included fear that their baby would be taken away by social workers
  • they did not realise until later that they were suffering from postpartum depression
  • they felt that the support they were receiving from family and friends was sufficient;
  • they felt that their partner did not support their seeking treatment, they lacked sufficient information about what to do.

How can healthcare providers pay attention to the mental health of pregnant mammas during routine checkup?

In the UK midwives now routinely ask questions about a woman’s mental health at the first antenatal appointment, as recommended in the NICE guidelines (2014)

How common is PPD in fathers? Why might this happen? 

Research suggests that between 8% and 22% of new fathers suffer from postpartum depression. Men may be reluctant to talk about their symptoms and may self-medicate using alcohol. Men whose partners are suffering from postpartum depression may feel that they have to be strong, but once the partner has recovered, their symptoms may become visible. Look at Mark Williams website to learn more about how fathers experiencing postpartum depression can be supported. 

How can new parents be supported to avoid depression during pregnancy and after? 

More discussion in antenatal classes and in the media about the risk factors of becoming depressed and the importance of seeking help. Awareness of keeping stress levels down in pregnancy and encouraging women to take maternity leave from 36 weeks pregnant rather than from the birth. Reaching out to Governments to recognize the importance of supporting mothers-to-be and fathers-to-be in order to avoid mental health problems in this and the next generation. Seeing parenthood as one of the most important tasks that we do.

Are there any ways by which as a society, we can eradicate the stigma around mental health? 

Promote the slogan that mental health is as important as physical health and that Governments should invest as much in one as the other. 

The Importance of Practicing Gratitude with Young Children : Part 1 : WHY?

Articles

The word gratitude brings to mind a feeling of thankfulness; an acceptance of circumstances and an acknowledgement of the gift of life.

But, does gratitude end with just the feeling or is it much more than a fleeting feeling of thankfulness?

When we choose to make a habit of gratefulness by adopting an attitude of gratitude, we are making a long term investment in the mental and physical well being of not just ourselves but of those around us, as well. A grateful disposition is probably the best gift we can give our children to take with them into adulthood. 

“It is gratitude that enables us to receive and it is gratitude that motivates us to repay by returning the goodness that we have been given. In short, it is gratitude that enables us to be fully human.”

Robert .A. Emmons,Thanks! How the New Science of Gratitude can make you Happier

Gratitude & Children

With children under the age of six, gratitude begins as a subtle and indirect ritual which gradually becomes a more active and involved process. This can be as simple as a conversation at the end of the day between a parent and child or a teacher and a small group of children. The adult in the picture brings to focus some of the events of the day and helps the children pin emotions around them that focus on gratitude.

Young children understand a lot more than they can speak and by giving words to emotions that they feel, we give them the opportunity to narrow down these emotions to specific words. “Were you relieved when Mudra brought you a tissue when you fell at the park today?” or “You seemed delighted to set the table for dinner.” The words that surround gratitude such as joy, thankful, relief and happiness are simply highlighted in this practice with children.

Why?

  • Learning to Unwind with Gratitude 

Studies have shown that adults who spend a few moments each day journaling at least three things that they are grateful for have better mental & physical health, sleep & exercise better and tend to avoid depression. Although young children may seem inherently more joyful, practicing gratitude is a habit that will stay with them through life. It can be a simple bedtime ritual just like brushing their teeth.

In its own way, gratitude is a kind of prayer; instead of asking, we show our children to give thanks. Gratitude is a dynamic and open prayer where we recollect events of the day and be thankful for how those events have enriched and shaped us.

  • Acknowledging Collective Effort 

Gratitude helps children acknowledge that so many people and circumstances come together to sustain us.  Let us take a family, for example. Different members of the family support each other in different ways. Every member of the family is a contributor – tangible or intangible and every presence makes a difference. Many of us often take our closest family and friends, the ones who always love and support us, for granted. When we help our children acknowledge such presence in their lives, and when we ourselves acknowledge the same with our children, they begin to understand that life is made beautiful by the collective effort of so many.

  • Gratitude in the face of Adversities 

When a child has had a painful experience – falling down, an argument with a friend or sibling or losing something, we often try to either suppress or dismiss the experience. “Do not talk about the park or he will remember he fell down and start crying again” or “Stop crying! It is not such a big deal.” 

Instead if we talk about the experience, for example, “Today, what happened at the park?” (pause) “You fell down and cried. It must have been painful. Do you remember what happened after that?” (pause) “Yes, Mudra came running with a tissue and helped you. I am so grateful you have a friend like Mudra.” (pause) “Do you remember what we did after that? (pause) “We went to the doctor and he gave you an injection. You were scared. I held your hands and stayed close by. Did that make you feel better?” (pause) “Now, you are back at home and resting. Once you feel better, we can go back to playing in the park.” 

When we talk about trying experiences and help our children find hope even in those circumstances, it shows them perspective. It helps them always try and look at things to be grateful for even in adverse circumstances.

  • Spontaneous Thank You’s! 

How often we ask, rather nudge and even force children to say Thank You! As aware as we of the power of these words, we seem content with the words more than the feeling. With children, we expect instant responses.  While our children might say the words out of fear or compulsion, do we stop to think if they really are thankful? Instead, by talking to children through simple conversations such as, “I am so thankful for grandpa. He came all the way just to play with you”, we help them become aware that a certain person has done an act of kindness for another. It helps our children gradually build a habit of reflecting on the act of the other person. “Why did grandpa come? Does he really love and care for me?” 

When we think of it this way, we help our children build a web of emotions around benevolent acts. These will eventually lead to spontaneous thank you’s. Such thank you’s will stem from a deep sense of gratitude and give the words their true value.

“Childhood maybe the optimal time to promote healthy attitudes and the prevention of problems, and gratitude training could play an important role in any program designed to foster well-being. As in adults, gratitude may be a very valuable tool that children can use to negotiate both the ups and the downs in their lives.”

Robert .A. Emmons,Thanks! How the New Science of Gratitude can make you Happier

As indirect as the practice of gratitude is with young children under the age of six, it is like a seed that we plant in childhood and nurture with love and care. This seed of happiness will eventually instil a genuine sense of gratefulness and is possibly one of the most invaluable gifts we can offer our children.

Stay tuned for Part 2 of the same article on the different ways in which we can practice Gratitude with Children under 6 at home and in communities.