Maternal Mental Health

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By Deidre Rideout, MS, LCMHC

May is Maternal Mental Health Awareness Month, and it is a great month to discuss ways to support a person struggling with a perinatal mental health condition. The perinatal period refers to before, during, or after pregnancy. The Department of Health and Human Services published a report in 2024 on maternal mental health to address the current Maternal Mental Health Crisis in the U.S. The report shares that the U.S. maternal mortality rate far exceeds the maternal mortality rate of other high-income countries, and that in the 36 U.S. states that participated, 84% of the reported pregnancy-related deaths were determined to be preventable. Over half of these deaths were during the postpartum (PP) period of 1 week PP to 1 year PP.  

Anxiety disorders are one of the most reported and common complications associated with pregnancy, and it has been proven that women with a mental health condition are 50% more likely to experience severe maternal morbidity (SMM). Mental health conditions are the leading cause of pregnancy-related deaths in the U.S. 

These statistics are heartbreaking, and maternal mental health is a topic that should be spoken about far more than it currently is. The saying, “it takes a village to raise a child,” no longer applies to most families in the U.S., and many families report feeling like they don’t have connections or support in their parenthood journeys. 

A wonderful local resource we have in NH is The NH Mom Hub, located at Hope on Haven Hill in Rochester, NH, with their primary mission being to connect NH moms to the support they need. The NH Mom Hub offers calls and texts for emotional support, peer support from moms with lived experience, weekly check-ins if needed, and helps navigate resources. The Mom Hub can be contacted at (603) 841–5353 and more information can be found at https://www.hopeonhavenhill.org/momhub/ 

Here are ways you can support a parent you think may be struggling:

1. Active listening without offering any unsolicited advice

2. Validate without making the narrative about you

3. Be present

4. Ask how you can help and follow through (within your own boundaries)

5. Check-in without expectations 

6. If you are concerned about the safety of a parent or a child, do not hesitate to call a medical professional and/or crisis hotline at 988. 

Resources:

https://aspe.hhs.gov/sites/default/files/documents/688063d3176311f3b2ee6c14f02bf4e4/rtc-maternal-health.pdf

https://www.hopeonhavenhill.org/momhub/ 

Diet Culture: Why Trendy Diets Can Be Harmful to Your Health

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By Halsey Redman

In a world saturated with Instagram influencers, TikTok trends, and a constant barrage of “miracle” weight-loss methods, diet culture has become nearly inescapable. Every week, it seems there’s a new food to avoid, a new detox tea to try, or a new “life-changing” meal plan sweeping social media. But while these trendy diets may promise quick results, they often come with hidden costs to both physical and mental health.

What Is Diet Culture?

Diet culture is a set of beliefs that idolize thinness and equate it with health and moral virtue. It often prioritizes appearance over well-being, encouraging restrictive eating patterns in pursuit of an "ideal" body. This culture feeds into the idea that there’s a one-size-fits-all approach to health, when in reality, nutrition is highly individual.

The Problem With Trendy Diets

Most trendy diets share a few red flags:

• They promise rapid weight loss.
  

• They eliminate entire food groups (carbs, fats, etc.).
  

• They rely on unregulated supplements or products.
  

• They’re based on anecdotal evidence rather than science.
  
  

Not only are these diets unsustainable long-term, but they can also lead to nutrient deficiencies, metabolic damage, disordered eating behaviors, and even increased risk of chronic illness. For example, a restrictive low-carb diet may help you lose weight initially, but over time it can lead to low energy, poor digestion, and hormonal imbalances if not properly managed.

Why Professional Guidance Matters

Every body is different. What works for one person might be harmful to another. This is why it’s essential to consult with a licensed medical professional, such as a doctor or registered dietitian, before making any major changes to your diet. These professionals consider your medical history, current health conditions, activity level, and lifestyle to tailor nutritional advice specifically to you.

They can help you:

• Identify nutrient deficiencies
  

• Set realistic and sustainable goals
  

• Manage chronic conditions like diabetes or high cholestero
  

• Build a healthy relationship with food
  
  

Shifting the Focus: From Dieting to Nourishment

Rather than chasing quick fixes, try shifting your focus to how food makes you feel energized, satisfied, and well. Eating for nourishment and health doesn't mean giving up your favorite foods or obsessively counting calories. It means building a balanced approach to eating that supports your body and mind.

Here are a few healthier ways to think about food:

• Add, don’t subtract. Instead of focusing on what to cut out, think about what you can add more veggies, more fiber, more water.
  

• Practice mindful eating. Slow down, listen to your hunger cues, and enjoy your meals.
  

• Ditch the guilt. Food is not a moral issue. There are no “good” or “bad” foods, only balance.
  
  

In conclusion

Diet culture thrives on insecurities and false promises. But your health is far too important to gamble on the latest trend. If you're looking to make meaningful changes to your diet or lifestyle, the best place to start is with a qualified professional who has your full picture in mind—not just your waistline.

Let’s ditch the fads, respect our bodies, and focus on nourishment over numbers.

Helping Someone with a Substance Use Disorder—When They Don’t Think They Have One

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By Dr. Scott Schinaman, Psy.D., MBA, CEDS-C

Working in the mental health field, we often encounter one of the most challenging clinical situations: supporting someone with a substance-use disorder (SUD) who doesn’t believe they have a problem. It’s a delicate balance—offering compassion without enabling, addressing concerns without pushing someone away. As mental health providers, it’s crucial that we navigate this space with empathy, patience, and evidence-based strategies.

Understanding Denial: It’s Not Just Stubbornness

Denial in substance use isn't always a conscious choice. Often, it's a psychological defense mechanism—protecting someone from the shame, guilt, or fear that might come with acknowledging a substance problem. The brain’s reward system also plays a crucial role. Substances hijack the dopamine system, leading individuals to prioritize the use of drugs or/and alcohol over negative consequences, relationships, or health.

Recognizing this helps shift our approach from confrontation to curiosity and compassion.

Lead with Empathy, Not Ultimatums

One of the most effective tools we have in the talk therapy world is the therapeutic alliance. When a client doesn't see their substance use as problematic, our first job isn’t to convince them otherwise—it’s to build trust.

• Use motivational interviewing (MI) techniques to explore ambivalence. Ask open-ended questions like, “What do you like about using [substance]?” followed by, “Are there things you don’t like?”

• Reflect back on their own words, helping them identify discrepancies between their values and their using behaviors.

• Avoid labeling. Terms like “addict” or even “substance-use disorder” can trigger defensiveness, shame, and/or guilt, especially early in the process.

Focus on Function, Not Diagnosis

Sometimes it helps to shift the conversation from “Do you have a problem?” to “Is this working for you?” Frame substance use in terms of its impact on the person’s goals, relationships, and health. For example:

• “How is your alcohol use affecting your energy or motivation lately?”

• “Have you noticed any changes in your mood or anxiety since you started using “X” more frequently?”

This client-centered focus promotes self-reflection and increases the chances of genuine engagement and connection.

Involve Natural Support Systems—Carefully

Families and friends often notice the problem before the individual does. If they’re involved, we as clinicians can guide them in setting boundaries while maintaining a supportive stance. Community-based approaches like CRAFT (Community Reinforcement and Family Training) help loved ones learn how to reinforce sober behavior and avoid enabling, as does other community-based group support like Alanon.

It’s important to coach support systems to resist the urge to “fix” or force insight. Instead, encourage them to highlight natural consequences in a non-judgmental way…which is difficult.

Offer Harm Reduction and Entry Points

While abstinence may be the long-term goal, meeting someone where they are is often more effective. Harm reduction strategies—like discussing safer use practices or helping the person consider cutting back—can open the door to deeper change later.

Even if someone isn’t ready to engage in treatment for their SUD, they may be willing to work on related issues like anxiety, depression, or relationship conflicts. These entry points allow us to plant seeds and slowly build insight.

Know When to Wait—and When to Act

We must accept that some people won’t be ready to change right away. That’s not failure—it’s part of the process. Our role is to hold space, offer tools, and stay consistent. But if an individual is in immediate danger—such as experiencing suicidal thoughts, repeated overdoses, or severe withdrawal—we must act swiftly, involving crisis intervention, medical treatment or a higher level of care.

Final Thoughts

Helping someone who doesn’t see their substance use as a problem requires patience, clinical skill, and a deep well of compassion. It’s not about forcing change—it’s about planting the seeds, cultivating readiness, and being there when the soil is ready for growth…growing roots if you will.

The journey from denial to awareness to recovery is rarely linear. But with the right approach, we can walk alongside our clients, patients, and loved ones—without judgment—and help them take the first step toward healing and recovery.

References:

1. Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.

2. Meyers, R. J., & Wolfe, B. L. (2004). Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening. Hazelden.

3. SAMHSA (Substance Abuse and Mental Health Services Administration). (2023). TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment.

4. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.

5. National Institute on Drug Abuse (NIDA). (2022). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).