Postpartum Depression

Postpartum Depression what are my treatment options?

Postpartum depression: more than just the baby blues

“This is an illness that takes away a women’s ability to access joy right at the time she needs it most.”      – Dr. Katherine Wisner

Baby blues

The baby blues include mood swings and feelings of anxiety and sadness that typically emerge 3-5 days after giving birth and dissipate on their own within a few weeks. 70% of new moms experience this temporary change in mood. The baby blues differ from postpartum depression in the length of time in which the symptoms peak as well as the severity of the symptoms.

“There’s societal pressure to feel happy and blissful, so women don’t talk about [the baby blues]. There’s enormous guilt and shame.” –Dr. Samantha Meltzer-Brody

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temper tantrums

Temper Tantrums

Temper Tantrums: What they are, what they mean and how to manage them

“The presence of tantrums does not mean that my kid is a brat, it just means that he is still learning. And I’m definitely okay with learning.” –Paula Rollo

You’ve been there. You’ve seen that toddler lying on his back in the middle of the store, screaming at the top of his little lungs and pounding his fists when he didn’t get the Snickers bar in the candy aisle. You’ve heard that child screeching and crying hysterically a few rows back on the plane as you’re already struggling to mentally prepare yourself for Thanksgiving with the in-laws. You’ve seen it; you’ve heard it and for a few moments, maybe even pitied the humiliated parent who was desperately trying to calm their child mid-meltdown. You might even have been that parent. How confident did you feel in your ability to handle that situation?

First, here’s the good news, temper tantrums are NORMAL for children between the ages of 18 months and four years old. Temper tantrums are unpleasant and disruptive behaviors that are frequently demonstrated by crying, hitting, kicking, throwing things, stomping and breath holding that occur in any situation involving change. Though tantrums often occur at home, especially during bedtime, mealtime and bath time, tantrums are unfortunately more common in public settings such as the grocery store, the playground or during church. In the midst of a tantrum, it may feel as though eternity has passed, but the average length of a tantrum is three minutes and typically occurs once per day. Studies show the likelihood of a tantrum occurring is 87% between the ages of 18-24 months, 91% between 30-36 months and 59% between 42-48 months.

How to deal with temper tantrums in two-year-olds

Tantrums begin to increase in frequency at this age as your child struggles to communicate their emotions and express their physical needs. Your child is growing as an individual and is beginning to discover their likes and dislikes. Teaching them sign language for words such as “I want,” “more,” “tired,” and “drink” can be very helpful as their language skills continue to develop as being tired, hungry or sick can result in worse and more frequent tantrums.

How to deal with temper tantrums at age three

At this age, your child might be throwing his tantrum to test your power and see how you respond to conflict. Don’t worry, this isn’t an indication of future chaos, but rather a curiosity of how you make decisions is a normal part of his development.  Teaching your child to handle their frustration (“use your words instead of screaming”) and to be able to ask for help is crucial at this age.

How to manage the tantrums of four-year-olds

Tantrum frequency often dissipates at this age as your child has continued to develop communication skills. If the tantrums have continued steadily around the age of four and a half, as a parent you probably feel exhausted and defeated. Seeking the opinion and assessment from a medical provider at this age is recommended to rule out any physical or psychological issues contributing to the tantrums.

How to stop kids from throwing temper tantrums

There is no magic solution or foolproof way to prevent temper tantrums, but remember the three C’s: it is important to be CALM, CONSISTENT and COMPASSIONATE when your child has an outburst. Keeping your own temper in check is important. Take a few deep breaths and try to see the situation from your child’s perspective. It is imperative to avoid arguing or trying to reason with him and remember that demonstrating physical or verbal aggression in response to your child’s tantrum will only teach him to be aggressive. Always praise your child for getting it right.

Ignoring your child’s negative behavior sounds easier said than done, but it is vital to avoid giving in to your child’s demands. Choose your battles, however. Would five more minutes at the playground really disrupt the entire day? Studies show that switching to an activity your child enjoys or making a funny face as a distraction has been proven effective. A brief time-out is also a recommended strategy. Designate a specific location for time-outs, explain to your child why she is in time-out (“you hit your brother”) and follow the general rule of one minute per age of the child. For older children, this technique is continued in taking away privileges such as time on the Ipad or watching Scooby Doo.

Your child thrives on routine and having a relatively stable schedule is important so your child has an idea of what to expect next during the day. The lack of routine can cause anxiety in your child. Providing your child with five minute and two-minute warnings of an upcoming transition is highly effective (“Five more minutes of watching Moana and then it’s time for a bath”).  Another suggestion is to offer your child the opportunity to make simple choices (apple juice vs. grape juice with lunch) so that your child feels her opinion is valued.

Michael Potegal, Ph.D. recommends asking, “What function does this inappropriate behavior serve?” Potegal also has explained the Anger Trap and the Sadness Trap that parents often find themselves in. He states of the Anger Trap: “If you get just as mad and irrational as your child, it’s like throwing gas on a fire,” and of the Sadness Trap: “When you comfort your child in the middle of the tantrum, you reinforce the behavior; instead say ‘I’m sorry you’re upset. When you calm down, I’ll give you a hug and we can talk about what happened.”

You might be wondering if you are causing your child’s temper tantrums, and sometimes you might be. But it’s important to remember that your child needs to learn to control herself. Unrealistic expectations and rigid rules can be confusing to your child and the response to this pressure is often a tantrum.

If your child has learned that temper tantrums are an effective way to have their needs met, they may remain a problem and set the stage for future behavioral issues. Some teenagers even engage in tantrums that include screaming, name-calling and slamming doors and unfortunately can escalate into behavior that is destructive or hazardous.  If your child poses potential harm to himself or others, seek professional help.

Remember, tantrums are NORMAL. You are not a bad parent and your son/daughter is not a bad child.

 Keep yourself in mind

If you have found yourself getting angry or frightened by your child’s behaviors, seeking professional help is recommended. In these situations, you will often start feeling anxious about your own feelings, especially about parenting. Children who throw frequent tantrums are more likely to be abused and it is common for parents to begin feeling guilty about their feelings of wanting to stop their child’s tantrums using physical means. The therapists at Cristina Panaccione and Associates would love to help you navigate through these struggles. Call us today to schedule an appointment: 412-439-1416 or contact us for more information.

“Kids this age think magically, not logically. Events that are ordinary to us are confusing and scary to them. They don’t understand that the bathtub drain won’t swallow them or that their uncle can’t really snatch their nose.” –Gina Mireault, Ph.D.


“Temper Tantrums: Guidelines for Parents and Teachers” (National Association of School Psychologists)

“Temper Tantrums in Young Children…” (Developmental and Behavioral Pediatrics Journal),,

Image Credit – Adobe Stock

emotional abuse

Emotional Abuse in relationships

Emotional Abuse

“The scars from mental cruelty can be as deep and long-lasting as wounds from punches or slaps but are often not as obvious. In fact, even among women who have experienced violence from a partner, half or more report that the man’s emotional abuse is what is causing them the greatest harm.” ― Lundy Bancroft

Abuse in the dating world is defined as “a pattern of coercive behavior in which one person attempts to control another through threats or actual use of physical violence, sexual assault, and verbal or psychological abuse. These acts may include physical, sexual, verbal, mental or emotional abuse.” (Source: Safe Voices)

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life transitions, transition

Life Transitions – what the heck are they?

Life Transitions – planned and unplanned

What do job change, loss of a loved one, moving, losing valuables in a flood, retirement, pregnancy, and graduating high school all have in common? Drum roll please…they are all LIFE TRANSITIONS! Sounds like a fancy name given to something that is not actually fancy at all? You’re correct! “Life transitions” is a blanket term “we therapy people” give to the personal experience of coming to terms with any change throughout life that causes us to re-invent ourselves in some way. We go through change and transition all the time; some are easy and some are not. A life transition can be expected, like turning 30, or unexpected, like losing your home in a fire.

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controlling husband

Controlling Husband – five signs to look for

Five signs your might be married to a controlling husband

Are you concerned that your husband may be controlling? Perhaps you’ve felt this way for a long time, but have found yourself creating excuses for such behavior. Maybe you feel that it’s your fault, or that it’s just the way he is. In fact, you love him. The first step towards finding hope for a better relationship is simply recognizing and becoming aware of some of the signs. Listed below are 5 common indicators of an overbearing spouse who may be attempting to control you:
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Gottman Method

Couples Counseling using the Gottman Method

What is the Gottman Method?

Developed over the course of multiple decades, Dr. John Gottman and his wife Dr. Julie Schwartz Gottman created Gottman Method Couples Therapy to help couples achieve a better sense of understanding, awareness, empathy, and connectedness within their relationships – ultimately assisting them in achieving heightened intimacy and interpersonal growth. Through extensively studying empirical research using real, actual couples, along with years of expertise in clinical practice, this approach to couples counseling is considered both practical and scientific. By combining therapeutic interventions with couples exercises, the Gottman method assists couples in identifying and addressing their personal hindrances to effective communication and bonding.

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opiates in pregnancy

Opiates in pregnancy – what are the effects?

Is your baby being affected by Opiates in your pregnancy?

Opiates in pregnancy – with the current overprescribing of opiates in the Pittsburgh are and the us in general, it is becoming more of an issue for moms to be.  Clearly if you are using or addicted to opiates either in legally or illegally, you need to act to avoid hurting your baby.

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Chronic pain

Chronic pain – what can you do to lessen it’s impact on your life?

Chronic pain definition and symptons

Chronic pain is defined as any pain that lasts longer than six months that is the result from either a physical health condition/injury or mental health condition. Studies show that chronic pain can also be a sign of untreated depression, anxiety, grief, unexpressed anger or being emotionally overwhelmed.

According to the Betty Ford Center, a clinic that focuses on addiction treatment, the markers for identification of those suffering from chronic pain include: symptoms of depression, history of abuse (physical/emotional/sexual), high levels of current stress, anxiety and the tendency to catastrophize ones thoughts. Studies completed by this facility show that trauma that takes place early in life trains the brain to be more receptive to future chronic pain that is typically not treated easily.

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Codependency when soulmates become relationship addicts

Codependency or Relationship Addiction

“If you live your life to please everyone else, you will continue to feel frustrated and powerless. This is because what others want may not be good for you. You are not being mean when you say NO to unreasonable demands or when you express your ideas, feelings, and opinions, even if they differ from those of others.” -Beverly Engel, The Nice Girl Syndrome

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Falling out of love

Falling out of love – what do you do about it

Falling Out of Love?

The realization that our feelings towards our partner have changed can be confusing. Is it for the best? Was it him or I that changed? Was I actually in love or was it all fantasy? This can be one of the most painful processes to undergo. In order to understand where the love went, self-reflection is necessary. The recognition of our own behaviors in relationships that result in distance between us and our partner can allow us to understand ourselves and our interpersonal patterns on a deeper level. Carolyn Joyce states that “we must know ourselves in order to truly fall in love with someone else.”

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