Intrusive Thoughts vs Dysphoric Milk Ejection Reflex (D-MER)

Dysphoric Milk Ejection Reflex (D-MER) and intrusive thoughts can both be distressing experiences during breastfeeding, but they are distinct phenomena with different causes and characteristics. Here’s a breakdown of each, how they overlap, and how they differ:

What Is D-MER?

•Definition: D-MER is a physiological response to milk ejection (letdown) characterized by a sudden wave of negative emotions, such as sadness, anxiety, or anger.

•Cause: Thought to be linked to a sudden drop in dopamine during the letdown reflex, which is necessary to release prolactin for milk production.

•Key Features:

•Emotions are fleeting, lasting 30 seconds to 2 minutes during or just before milk letdown.

•The feelings are tied directly to the act of breastfeeding or pumping, not external triggers.

•Mothers often describe it as a “doom-like” sensation.

•The feelings fade as the breastfeeding session progresses.

What Are Intrusive Thoughts During Breastfeeding?

•Definition: Intrusive thoughts are unwanted, involuntary thoughts or mental images that can be distressing. They often focus on fears of harm to the baby, inadequacy, or catastrophic events.

•Cause: Typically linked to postpartum mental health conditions like anxiety, depression, or obsessive-compulsive disorder.

•Key Features:

•Can occur at any time, not just during breastfeeding.

•Not tied to a physiological reflex but rather psychological or emotional stress.

•The thoughts can feel persistent and overwhelming, even if they are fleeting.

•Often accompanied by feelings of guilt or shame for having the thoughts.

Key Differences Between D-MER and Intrusive Thoughts

Overlap Between D-MER and Intrusive Thoughts

Both can occur during breastfeeding and may contribute to a mother feeling overwhelmed or questioning her ability to cope. However, the underlying mechanisms are different, and the strategies for addressing them vary.

Red Flags to Distinguish Intrusive Thoughts From D-MER

1.When They Occur:

•If the distress arises only during milk letdown and fades quickly, it is likely D-MER.

•If it occurs outside of feeding or is tied to specific scenarios, it is likely intrusive thoughts.

2.Content:

•D-MER involves generalized dysphoria, not specific fears or scenarios.

•Intrusive thoughts often have vivid, specific, and sometimes graphic content.

3.Level of Distress:

•D-MER causes emotional discomfort but usually not panic or deep guilt.

•Intrusive thoughts can be deeply distressing, triggering anxiety or obsessive worry.

4.Impact on Bonding or Functioning:

•D-MER is unlikely to affect overall bonding with the baby.

•Intrusive thoughts may lead to avoidance of certain situations (e.g., not wanting to be alone with the baby).

How to Manage D-MER vs. Intrusive Thoughts

•For D-MER:

•Understanding It: Knowing it is a hormonal reflex can ease guilt or fear.

•Stay Hydrated and Eat Regularly: Stable blood sugar may help.

•Monitor Triggers: Some mothers find stress or caffeine can worsen symptoms.

•Seek Support: Talking to a lactation consultant who is familiar with D-MER can provide reassurance.

•For Intrusive Thoughts:

•Therapy: Cognitive-behavioral therapy (CBT) can help manage anxiety and reframe intrusive thoughts.

•Medication: Antidepressants or anti-anxiety medications may be helpful if symptoms are severe.

•Mindfulness Techniques: Grounding exercises can help reduce the impact of intrusive thoughts.

•Talk About It: Sharing these thoughts with a trusted friend, partner, or therapist can help normalize the experience and reduce shame.

When to Seek Professional Help

•If you are unsure whether you’re experiencing D-MER or intrusive thoughts, consult a lactation consultant or mental health professional.

•Seek immediate help if you feel like you might act on harmful thoughts or if the distress is impacting your ability to care for your baby or yourself.

Remember

Neither D-MER nor intrusive thoughts mean you are a bad parent. Both are challenges that can be managed with the right support, and seeking help is a sign of strength, not weakness. You’re not alone in this.

Intrusive thoughts while breastfeeding

Intrusive thoughts while breastfeeding are more common than many people realize and can be deeply distressing for parents who experience them. These thoughts often come out of nowhere, feel unwanted, and can cause feelings of guilt or fear. Here’s a breakdown of where they come from, what’s normal, and when to seek help:

What Are Intrusive Thoughts?

•Definition: Intrusive thoughts are unwanted, involuntary thoughts or images that pop into your mind. They can be bizarre, scary, or even disturbing.

•Common in New Parenthood: They often revolve around fears of harming your baby (accidentally or intentionally), your baby being harmed by others, or catastrophic events (e.g., dropping your baby or suffocating them during sleep).

Where Do Intrusive Thoughts Come From?

1.Hormonal Changes:

•Postpartum hormone shifts (like drops in estrogen and progesterone) can affect mood and thought patterns.

•Oxytocin, the “bonding hormone,” can heighten your emotional sensitivity and awareness, making you hyper-alert to perceived dangers.

2.Sleep Deprivation:

•Lack of sleep impacts mental health and increases anxiety, which can lead to more intrusive thoughts.

3.Heightened Responsibility:

•The intense responsibility of caring for a newborn can trigger fears about your ability to protect and care for them.

4.Postpartum Mental Health Conditions:

•Intrusive thoughts are common in postpartum anxiety (PPA), postpartum depression (PPD), or postpartum obsessive-compulsive disorder (PPOCD).

5.Evolutionary Factors:

•Some researchers believe intrusive thoughts are an evolutionary “alarm system” designed to make parents vigilant about their baby’s safety.

What’s Normal vs. Concerning?

Normal Intrusive Thoughts:

•Brief and fleeting.

•Recognized as irrational or not aligned with your values.

•Do not lead to actions.

Red Flags:

•Thoughts are persistent and distressing, interfering with your ability to function or bond with your baby.

•You feel like you might act on the thoughts or cannot separate yourself from them.

•They are accompanied by other symptoms of postpartum mental health issues, such as:

•Intense anxiety or panic attacks.

•Feeling emotionally disconnected from your baby.

•Hopelessness, worthlessness, or excessive guilt.

•Difficulty eating, sleeping, or concentrating.

When to Seek Help

If intrusive thoughts are causing significant distress or you feel unsafe, reaching out to a healthcare provider is essential. Support options include:

•Therapy: Cognitive-behavioral therapy (CBT) is especially effective for managing intrusive thoughts.

•Medication: Antidepressants or anti-anxiety medications may help in severe cases.

•Support Groups: Postpartum mental health groups can normalize your experience and provide coping strategies.

•Lactation Consultant: If breastfeeding itself feels like a trigger, a lactation consultant can help identify ways to make the experience more comfortable and manageable.

Tips for Managing Intrusive Thoughts

•Acknowledge and Label the Thoughts: Recognize them as intrusive, not reflective of your true feelings.

•Practice Self-Compassion: You are not a bad parent for having these thoughts. They are not your fault.

•Talk to Someone: Confiding in a trusted friend, partner, or therapist can ease the shame and isolation.

•Grounding Techniques: Mindfulness, breathing exercises, or engaging in sensory activities (like holding a warm cup of tea) can redirect your focus.

•Prioritize Sleep and Nutrition: Even small improvements in self-care can make a big difference.

Intrusive thoughts can feel scary, but they don’t define you as a parent. With support and care, they can be managed and often resolved. You’re not alone, and help is available.

High lipase=soapy milk. Oxidation =metallic milk

High lipase in breast milk can affect the taste and smell of expressed milk. Lipase is a natural enzyme found in breast milk that helps break down fats, making them more digestible for infants. When lipase levels are higher than average, the fat breakdown process can accelerate, which may lead to changes in the milk’s flavor and odor. Often, breast milk with high lipase develops a “soapy” or “metallic” taste after being stored, even when properly refrigerated or frozen. While this change does not make the milk unsafe, some babies might refuse it due to the taste.

It’s important to distinguish high lipase from the oxidation of breast milk. Oxidized breast milk tastes rancid or sour/spoiled even when stored per usual guidelines. It’s caused by drinking water that may contain copper or iron ions, and from taking  fish-oil and flaxseed supplements or eating a diet high in polyunsaturated fats.

If you’re dealing with high lipase in breast milk and want to reduce the taste changes, here are a few strategies that may help:

Scald the Milk: heating it to around 180°F (82°C) until you see small bubbles around the edges but not a full boil—can inactivate the lipase enzyme, stopping further fat breakdown. This process needs to be done immediately after pumping, before storing the milk in the fridge or freezer

Trial of Different Storage Techniques: Although high lipase is an inherent trait in the milk, storage methods can sometimes influence how quickly the milk’s taste changes. For example, freezing milk immediately after pumping may slow down the enzymatic activity more effectively than refrigeration

Offer Freshly Pumped Milk: For families who don’t need to build a large freezer stash, offering freshly pumped milk can avoid the taste change issue altogether. Since high lipase typically impacts milk stored for longer periods, using milk within a few hours after pumping can maintain the taste and avoid baby’s rejection

Experiment with Mixing Fresh and Stored Milk: If scalding or using only fresh milk is impractical, some parents have success blending fresh milk with previously frozen milk, which can dilute the taste changes enough to be acceptable to their baby

Such training doesn’t work for babies over 3 months

Around the 3- to 4-month mark, babies experience an exciting transition as the suck reflex, which is so vital in the early months, begins to integrate. Sucking is a reflexive skill designed to help babies feed effectively, but as babies develop, they naturally transition to exploring other oral skills, including chewing, which is key for future eating skills when solids are introduced around 6 months. At this stage we no longer focus our energy on “suck training”, because many babies don’t want to practice sucking, they want to chew

Chewing toys and teethers help babies strengthen their jaw and practice moving their tongue and mouth in ways that lay the groundwork for chewing solid foods. This is a learning period without the expectation of swallowing food, which reduces pressure and lets them practice freely

Teethers and chewing toys let babies feel different textures and shapes, building their sensory awareness in a safe, controlled way. These sensations will become familiar, making the transition to solids more comfortable later on. These skills also carry over into sucking skills

Ditching the pacifier at this age can be helpful because it allows babies to focus on this new skill of chewing, which they are naturally ready to explore

Practicing with teethers is all about giving babies the chance to explore their mouths and practice controlling the movements they’ll need for safe and effective food chewing

By shifting from pacifiers to chewing toys, you’re supporting this natural developmental progression and giving your baby plenty of time to practice essential oral skills well before they’re expected to handle food. It’s a low-stress, baby-led way to prepare for solids while giving them the space to practice and play.

Why is lactation advice so confusing?

Lactation advice can be incredibly confusing, and honestly, it’s not surprising why! There’s a lot of conflicting information out there, and not all of it is based on the latest research or tailored to individual needs. Here are a few reasons why lactation advice can feel so overwhelming:

🤱🏽Every Baby (and Breast) is Different: No two breastfeeding journeys are the same. What works for one mom and baby may not work for another, and there isn’t always a one-size-fits-all answer.

📽️Outdated Recommendations: Sometimes advice from well-meaning friends, family, and even healthcare providers might be based on outdated practices. For example, certain ideas about feeding schedules or how to handle milk supply have shifted significantly in recent years.

⚖️Mix of Personal Opinions and Evidence-Based Practices: Online forums, social media, and parenting groups are full of personal stories and tips. While these can be helpful, they sometimes mix opinion with fact, making it hard to know what’s genuinely evidence-based.

🔮Cultural Beliefs and Biases: Different cultures and communities have unique approaches to infant feeding, which can sometimes clash with medical advice or feel like extra pressure to follow a particular path.

📚Medical Professionals Vary in Knowledge: Some healthcare providers don’t have in-depth lactation training, which means that their breastfeeding advice can be more limited. That’s one of the reasons why lactation consultants are so helpful—they’re often more up-to-date on the latest research and trained to support different needs.

❤️‍🔥Emotional Investment: Breastfeeding can be tied to a lot of emotions—self-doubt, hopes, frustrations, and joy—which makes it easy to feel overwhelmed when things aren’t going as planned or when you’re getting conflicting advice.

🚽Unrealistic Expectations on Social Media: Pictures and stories on social media sometimes show breastfeeding as this seamless, beautiful experience. While it can be that way, it’s not always immediate or easy. This portrayal can make it harder for parents to navigate real-life challenges when they crop up.

Finding a trusted source, like a certified lactation consultant, can help cut through the noise, since they’re trained to provide advice that’s both evidence-based and supportive of each family’s unique needs. Having someone in your corner who understands the challenges and can offer personalized support makes all the difference.

Can I freeze breast milk in glass jars ?

Freezing breast milk in glass mason jars is considered safe, as long as the jars are properly sterilized and you leave enough space at the top to account for expansion when freezing; glass is generally considered a good material for storing breast milk and is a safe option for freezer storage when used correctly. 

Key points to remember:

  • Use freezer-safe jars:
    Ensure your mason jars are labeled as freezer-safe. 
  • Leave space at the top:
    Always leave about an inch of space at the top of the jar to accommodate milk expansion when frozen. 
  • Sterilization is crucial:
    Before first use, sterilize your jars by boiling them in water for at least 20 minutes.
  • Wide-mouth jars preferred:
    Opt for wide-mouth mason jars as they are less likely to crack when freezing. 

The importance of tummy time for babies with a PEG tube

Tummy time is important for every baby, including those with PEG (Percutaneous Endoscopic Gastrostomy) tubes. While the tube can present unique challenges, tummy time is still possible and incredibly beneficial for helping babies develop strength and coordination. Here’s why tummy time matters for babies with PEG tubes, along with some tips to make it a comfortable, safe experience.

Why Tummy Time Matters for Babies with PEG Tubes

Strengthens Core Muscles: Tummy time helps build neck, shoulder, and arm strength, which supports motor skills like reaching, rolling, and crawling.

Promotes Motor Development: It encourages babies to learn new movements and explore their environment, essential for cognitive and motor development.

Helps Prevent Flat Spots: Spending too much time on their back can lead to flat spots on a baby’s head. Tummy time helps relieve this pressure, promoting healthy skull shape.

Aids in Digestion: Gentle tummy time movement can support digestion, which may be especially helpful for babies with feeding tubes who might experience some digestive sensitivity.

Builds Visual and Sensory Skills: When babies lift their head to look around, they’re improving their visual tracking and sensory processing skills, both important for future milestones.

Tips for Tummy Time with a PEG Tube

Create a Comfortable Position: Place a soft, rolled-up blanket under the baby’s chest to ease pressure on the PEG site. This will help them feel comfortable and supported while on their tummy.

Start Slow: Begin with short sessions (just a few minutes at a time) and gradually increase as the baby gets used to the position. There’s no need to rush—each small step is a win.

Choose the Right Time: Aim for tummy time when the baby is alert and not too full after feeding. This reduces the risk of discomfort or reflux.

Use Engaging Toys: Place toys or mirrors at eye level to encourage the baby to lift their head and look around. This will not only make tummy time more enjoyable but also strengthen their neck and shoulder muscles.

Adjust as Needed: If the baby seems uncomfortable, try adjusting their position or using a tummy time pillow to ease pressure on the PEG tube site.

Monitor the PEG Site: Keep an eye on the tube and surrounding skin to ensure there’s no irritation. Some parents find it helpful to place a gentle pad or gauze around the tube area for extra cushioning.

Involve Family Members: Tummy time is a great bonding opportunity! Get down on the floor at eye level and make faces, sing, or play with them to make it feel like family time.

When to Seek Guidance

Always feel free to check with your healthcare provider, especially if you’re uncertain about positioning or if tummy time seems uncomfortable for your baby. Physical or occupational therapists who work with feeding tube babies can also be a wonderful resource for specific positioning and support.

With a few adjustments, tummy time can be safe, comfortable, and enjoyable for babies with PEG tubes. Each tummy time session is another opportunity for growth, helping them gain the strength they need for all the milestones ahead.

Random drop in breast milk supply

Occasionally I’ll hear of moms who had a well established milk supply and all of a sudden their supply drops. What can cause a late onset decreased milk supply?

🤰🏽Pregnancy. Milk supply drops during pregnancy because of hormone shifts to protect and grow the fetus. Domperidone or other milk making herbs/medications and more pumping or feeding will not work to increase supply

💊Hormonal birth control (pill including progestin only pill, IUD, etc)

🤱🏽Breastfeeding on only one side at a feeding or “block feeding” to correct an oversupply if done too long or with a small storage capacity

💊Some medications can decrease the milk supply (antihistamines, decongestants). Certain herbs in excess or as essential oils can, too (too much peppermint or sage)

🛌 Sleep training. Babies are supposed to wake often at night for the first 3 months and continue to wake through the first year. Night nursing keeps milk hormones high for making supply and sleep training can sabotage milk supply for some

😷Blocked ducts/mastitis as well as any illness with a fever may decrease the milk supply

🍼Giving bottles can very much decrease the milk supply if you’re not pumping to replace those feeds. When at all possible, pump whenever baby is getting a bottle, regardless of if it is formula or breast milk being given

🎡”Overdoing it”. Anything that interrupts feeding baby on demand, including too many visitors, too many errands, or making baby wait to feed by the clock

📌Periods. Supply can temporarily dip during periods

🚿An “abundant milk supply” associated with a less than “ideal” latch. The milk flows into baby’s mouth with little participation of baby. Baby may often choke while breastfeeding, especially during let down. Tongue tie is a common cause of baby having a shallow latch and can be a significant cause of decreased milk supply even if there were no problems early on. Baby was riding an abundant supply instead of stimulating milk supply

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#milksupply #milksupplybooster #breastmilkbooster #breastmilksupply #breastmilkmagic

What they don’t tell you about your baby’s sleep

The sleep industry has become a significant player in the parenting world, offering products and services that often frame infant sleep as a problem to be solved rather than a biological process to be supported. This framing has led to a growing market of sleep training programs, specialized swaddles, bassinets, and apps designed to “fix” perceived sleep challenges. However, this approach frequently disregards the normal biological patterns of infant sleep, rooted in evolution and human physiology.

Biological Infant Sleep Patterns

Newborns and infants have sleep-wake cycles that are drastically different from adults, characterized by:

• Short sleep cycles of 40–60 minutes, with frequent awakenings.

• A strong biological need for nighttime feeding, particularly in the first 6–12 months, to support rapid growth and brain development.

• A preference for proximity to caregivers, which has evolutionary roots in ensuring safety and promoting bonding

Studies show:

Night wakings are normal: Research indicates that 50–70% of infants wake at least once per night to feed at 6 months of age, and about 30% still wake regularly at 12 months.  Night feeding is linked to maintaining milk supply in breastfeeding mothers and reducing the risk of Sudden Infant Death Syndrome (SIDS) due to lighter sleep patterns in babies

The sleep industry often capitalizes on parental exhaustion, societal pressures for “independent” babies, and a lack of understanding about normal infant sleep. By marketing solutions that promise longer stretches of sleep or earlier “self-soothing,” the industry shifts the narrative toward sleep as a problem requiring intervention.

Key issues include:

Creating unrealistic expectations: Sleep training programs often promise that infants can sleep through the night by 3–6 months, despite evidence that this is biologically uncommon.

Commercializing fear: Products like high-tech bassinets and sleep monitors frequently market themselves as essential for safety or parental peace of mind, exploiting fears about SIDS or sleep deprivation.

Undermining parental confidence: The focus on external solutions can make parents feel inadequate or dependent on products rather than trusting their instincts and understanding their baby’s needs.

Economic Impact

The baby sleep industry is lucrative, with estimates suggesting it generates billions of dollars annually. Sleep training programs alone can cost hundreds to thousands of dollars, while specialized products like bassinets (e.g., the SNOO) or sleep consultants command premium prices.

Supporting Biological Sleep

Supporting biological infant sleep involves educating parents about what’s normal and providing realistic, evidence-based guidance:

Co-sleeping or room-sharing: Studies show that close proximity helps regulate infant sleep and feeding, aligning with natural patterns【16†source onsive parenting:** Responding to a baby’s nighttime needs fosters secure attachment and helps them feel safe, which can improve long-term sleep habits.

Adjusting expectations: Understanding that night wakings decrease gradually as babies grow can reduce stress and the perceived need for intervention.

Why This Matters

By acknowledging infant sleep as a normal, adaptive process, we can shift the focus from “fixing” babies to supporting families holistically. This involves recognizing the pressures placed on parents by the sleep industry and offering empathetic, science-based support that validates their experiences. Ultimately, the goal should be to empower parents to trust their instincts and navigate the realities of infant sleep without unnecessary commercial pressures.

Knuplez, E., & Marsche, G. (2020). An updated review of pro- and anti-inflammatory properties of plasma lysophosphatidylcholines in the vascular system. International Journal of Molecular Sciences, 21(12), 4501. https://doi.org/10.3390/ijms21124501

• Mindell, J. A., & Owens, J. A. (2015). A clinical guide to pediatric sleep: Diagnosis and management of sleep problems (3rd ed.). Wolters Kluwer.

• Gettler, L. T., & McKenna, J. J. (2011). Evolutionary perspectives on mother-infant sleep proximity and breastfeeding in a laboratory setting. American Journal of Physical Anthropology, 144(3), 454–462. https://doi.org/10.1002/ajpa.21430

Mom, you’re not angry, you’re overstimulated

When Overstimulation Feels Like Anger: Understanding, Triggers, and Coping as a Mom

Being a mom is beautiful, messy, and—let’s be honest—utterly overwhelming at times. There are moments when the noise, the demands, and the constant everything of parenting hit a limit you didn’t know you had. For many moms, that feeling of overstimulation doesn’t just feel like being overwhelmed—it feels like anger.

What Does Overstimulation Look Like?

Overstimulation happens when our senses or emotions are bombarded past our ability to process them. For moms, it often manifests as:

•Irritability: Snapping at your partner, kids, or even yourself.

•Need to Escape: That urge to shut yourself in a quiet room or leave the house—alone.

•Overreaction: Yelling or having a strong emotional reaction to something small.

•Physical Symptoms: Racing heart, headache, or even feeling nauseous.

•Emotional Overload: Crying or shutting down entirely.

It’s important to remember that feeling overstimulated doesn’t make you a bad mom—it makes you human.

Common Triggers for Overstimulation

Every mom is different, but here are a few triggers that tend to set off that cascade of overwhelm:

•Sensory Overload: Loud noises (crying, toys, TV), clutter, or constant touching can push your senses to their limit.

•Emotional Demands: Meeting everyone’s needs (sometimes at the expense of your own) can feel suffocating.

•Sleep Deprivation: Lack of sleep makes your brain less able to handle sensory or emotional input.

•Feeling “On” All the Time: If you don’t get a break, your nervous system never gets to reset.

•Personal Stress: Financial worries, relationship tension, or work stress add fuel to the fire.

Why Overstimulation Feels Like Anger

Anger is often a secondary emotion—it rises up when we feel unsafe, frustrated, or powerless. When overstimulation hits, your brain may interpret it as a threat, and your fight-or-flight response kicks in. That flood of adrenaline can make you feel irritable or outright furious, even if your baby is simply crying or your toddler is climbing on you for the tenth time.

Coping Strategies for Maternal Overstimulation

The key to managing overstimulation is recognizing it early and giving yourself the care you need. Here’s how to start:

1. Pause and Breathe

•When you feel the anger rising, take a moment. Breathe deeply—inhale for 4 counts, hold for 4, and exhale for 6. This slows your heart rate and calms your nervous system.

2. Lower the Sensory Input

•Dim the lights, turn off the TV, or lower the volume on toys.

•Step into a quiet room, even for just a minute or two.

3. Set Boundaries Around Touch

•If constant touching is triggering, create moments where your body is your own. This might look like wearing your baby in a carrier instead of holding them, or encouraging independent play while you sit nearby.

4. Communicate Your Needs

•Tell your partner or support system what’s happening. Say, “I’m feeling really overwhelmed. I need 10 minutes to reset.”

5. Create Small Breaks

•Build micro-moments of peace into your day. Drink your coffee on the porch, listen to a favorite song, or close your eyes for 30 seconds and visualize a calming scene.

6. Release the Pressure to Be Perfect

•Give yourself grace. You don’t need to be a supermom. A calm mom is more valuable than a “perfect” one.

7. Seek Support

•Connect with other moms who understand how hard it can be. Sharing your struggles with someone who “gets it” can be incredibly validating.

•If anger or overstimulation feels constant, talking to a therapist or counselor can provide tools to cope.

What to Tell Yourself in the Moment

When overstimulation flares, it’s easy to spiral into guilt or shame. Instead, remind yourself:

•“This is temporary. I am safe, and I will get through this.”

•“Feeling overwhelmed doesn’t make me a bad mom.”

•“It’s okay to take care of myself right now.”

The Bigger Picture

Motherhood is full of joy and love, but it’s also relentless. Overstimulation is not a sign of weakness or failure—it’s your brain and body asking for a reset. By understanding your triggers and learning how to cope, you’re not only taking care of yourself—you’re modeling for your kids how to manage emotions and prioritize well-being.

You’re not alone in this. And you’re doing better than you think.