Chemical Pregnancies: 8 Facts to Know

If you’ve ever spent time on websites or online forums dedicated to trying to conceive, you may have seen the term “chemical pregnancy.” It’s kind of—OK, definitely—confusing. What exactly is a chemical pregnancy, and how might you know if you’ve had one? We talked to ob/gyns for the top facts you need to know.

1. A chemical pregnancy describes a miscarriage that happens so early on, you may not even know you conceived.

“‘Chemical pregnancy’ is just the name of a very early miscarriage,” Maura Quinlan, M.D., M.P.H., an assistant professor in the department of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine, tells SELF. How early? Well, it’s hard to say.

A miscarriage is the loss of a pregnancy in the first 20 weeks, according to the Centers for Disease Control and Prevention (CDC). After that, it’s known as a stillbirth.

A chemical pregnancy doesn’t happen within a definitive time frame in those 20 weeks. Instead, this term typically describes the experience of getting a positive pregnancy test very soon after a fertilized egg attaches to the uterine lining, but getting confirmation that you’re no longer pregnant soon after that.

2. You might find out about your chemical pregnancy when, after getting a positive pregnancy test result, you get your period or see your ob/gyn.

At-home pregnancy tests look for the presence of human chorionic gonadotropin (hCG), which is a hormone from your placenta (the organ that helps maintain and nourish a pregnancy). With a chemical pregnancy, you have enough hCG to get a positive pregnancy test result, but your levels will start to fall as you miscarry.

If you’re trying to conceive, you’re probably keeping really close tabs on your cycle, so you may take a test the second your period is late. Getting your period soon after you get a positive result can understandably be confusing and devastating. (Although, keep in mind that there are all sorts of non-period reasons why you might bleed a bit early on in pregnancy, like a vaginal tear.)

The other way you might discover a chemical pregnancy is if you go to the doctor. Every practice is different, but your doctor will typically want to see you anywhere between six and 10 weeks after your missed period, Jessica Shepherd, M.D., a minimally invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF.

During that visit, your doctor will want to confirm your pregnancy, which may involve an ultrasound. If you’re what doctors call clinically pregnant, there will be a gestational sac in your uterus or, if you’re further along, an embryo or fetus with a heartbeat, Dr. Quinlan says. If you’ve had a chemical pregnancy, tests won’t detect any of this, she says.

You might also realize you’re miscarrying due to bleeding and cramping as your body passes the tissue, but these symptoms may not be that intense since it’s so early, Dr. Shepherd says.

3. Not every false-positive pregnancy test is due to a chemical pregnancy.

A false-positive pregnancy test (when you get a positive result but aren’t actually expecting) can happen for many reasons, including a chemical pregnancy. But it’s hard for doctors to say how many false positives are due to chemical pregnancies specifically, Dr. Shepherd says, since there are quite a few other reasons why you might see a positive result when you’re not clinically pregnant.

They include using an expired test, having an ectopic pregnancy (when a fertilized egg attaches somewhere outside of the uterus), being on a fertility medication that contains hCG, and having residual hCG in your system after you give birth or have a miscarriage, Dr. Shepherd says. Menopause (or the time right before it, known as perimenopause) can cause your pituitary gland to produce more hCG, which could lead to a false positive. There are even rare cases of people with chronic kidney disease having elevated hCG levels (the kidneys play a role in clearing hCG from your system).

At-home pregnancy tests are most accurate if you wait until a week after your missed period to take them, the Mayo Clinic explains, although that’s mainly about avoiding false negatives, since it allows your hCG to build to solidly detectable levels. But to avoid the (rare) prospect of a false positive, you should make sure the test isn’t expired and follow the instructions precisely. Sometimes people get false positives because they let the test sit too long, then see a faint “second line” that seemingly signals pregnancy when it’s really just a line where pee has started to evaporate.

4. It’s definitely possible to have a chemical pregnancy and not know it.

If you don’t take a pregnancy test, you might chalk any random chemical pregnancy-induced bleeding and cramping up to a late or irregular period and PMS, Dr. Shepherd says. This is why experts say miscarriage occurs in about 10-20 percent of known pregnancies; the true incidence rate may be even higher.

5. Although it describes a very real phenomenon, “chemical pregnancy” isn’t technically a medical term.

Calling it a chemical pregnancy (or sometimes a biochemical pregnancy) instead of a miscarriage “is really more semantics,” Whitney You, M.D., a maternal-fetal medicine specialist at Northwestern Medicine Prentice Women’s Hospital and Lake Forest Hospital, tells SELF. “This is very patient-driven terminology,” Dr. Shepherd adds.

In fact, ACOG doesn’t use the term, Jamila Vernon, an ACOG spokesperson, tells SELF. Instead, they (and many doctors) use the phrase “early pregnancy loss” to indicate any miscarriage in the first 13 weeks, including the extremely early ones people might describe as chemical pregnancies.

6. Like all miscarriages, chemical pregnancies typically happen because of chromosomal abnormalities.

Chromosomes are the structures inside cells that contain genes, and most cells have 23 pairs of chromosomes, making 46 total. Normal sperm and eggs should each have 23 chromosomes, but if either has an abnormal number, so will the resulting embryo, ACOG explains—and that can lead to a miscarriage. “The fact that any of us are here really is remarkable given all the things that have to happen for a pregnancy to work,” Dr. You says.

There are a few other potential factors that can raise the risk of miscarriage, such as being over 40, ACOG explains. The jury is still out on whether or not activities like smoking and drinking play a role in miscarriage, but of course it’s still good to avoid these because of the other harms they can cause to a developing fetus and baby.

And don’t worry: Doing things like working, exercising, and having sex do not cause miscarriages, ACOG says.

7. A chemical pregnancy usually doesn’t require any physical treatment.

The only reason why you’ll need physical treatment after a pregnancy loss is if any of the tissue stays in your uterus and needs to be removed. Given that a chemical pregnancy happens so early, it’s highly unlikely that you’ll need any of those treatments, Dr. Shepherd says.

8. If you’ve had a positive pregnancy test, you should talk to your doctor no matter what, especially if you experience bleeding or cramping afterward.

Your doctor will likely want to run a few tests to confirm your pregnancy, including blood tests and an ultrasound. If you did in fact have a chemical pregnancy, the ultrasound will allow your doctor to make sure all the tissue has passed.

If losing a wanted pregnancy has shattered you emotionally, that’s entirely normal. Your ob/gyn should be able to counsel you on getting pregnant again. If necessary, seeing a mental health professional may help you process your emotions surrounding a miscarriage.

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Emotionally stable people spend more during the holidays, according to new study

Christmas holidays offer a time for families to get together, but for retailers, holiday sales can represent up to 20% of annual revenue. How consumers spend money during this time period is of interest for retailers as well as for individuals who are looking to better understand and control their spending habits. New research suggests more emotionally stable people spend more during the holiday season, and people who are nervous and have a lower stress-threshold (higher neuroticism) spend less during the holiday season.

The study, “Who are the Scrooges? Personality Predictors of Holiday Spending,” appears in the journal Social Psychological and Personality Science.

“We’ve known for a while that personality is related to what we call ‘broad outcomes:’ how much money you make or how happy you are or how long you live,” says co-lead author Sara Weston (Northwestern University), “but we know less about why personality is related to those things.”

In their study, Weston, co-lead author Joe Gladstone (University College London), and colleagues show that personality traits are related to more specific spending behaviors, which should in turn impact the broad outcomes, like long term financial goals.

Aggregating more than 2 million individual transactions from 2,133 participants’ bank accounts, the researchers compared the relationship between the Big 5 personality traits (OCEAN — openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) and spending over the Christmas season.

The study showed people who are more emotionally stable spend more over the holidays while those high in neuroticism spend less over the same time period.

In addition, those with more artistic interests and more active imaginations, those higher in openness, spend less during the holiday season while those low in openness spend more.

The study also revealed those who are more conscientiousness spend more, and those who are less conscientious spend less.

The scientists emphasize that personality is only one small part of consumer behavior, especially at the individual level. From household size to income and many other factors, there are numerous influences at the individual shopping level.

This research, however, provides a road map of how combining large scale information with personality can provide a “big picture” view of consumer habits.

“By providing objective measures of both annual and holiday spending, the data allow for a truly ecological study of the relationship between personality traits and consumer behavior,” says Gladstone.

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Heart Attack: First Aid

Someone having a heart attack may experience any or all of the following:

  • Uncomfortable pressure, fullness, or squeezing pain in the center of the chest
  • Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms, or occasionally upper abdomen
  • Shortness of breath
  • Lightheadedness, dizziness, fainting
  • Sweating
  • Nausea

A heart attack generally causes chest pain for more than 15 minutes, but it can also have no symptoms at all. It’s important to be aware that symptoms other than chest pain may occur, such as indigestion or neck or jaw pain that is persisting despite the use of medications.

What to do if you or someone else may be having a heart attack

  • Call 911 or your local medical emergency number. Don’t ignore or attempt to tough out the symptoms of a heart attack for more than five minutes. If you don’t have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, and realize that it places you and others at risk when you drive under these circumstances.
  • Chew and swallow an aspirin, unless you are allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.
  • Take nitroglycerin, if prescribed. If you think you’re having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else’s nitroglycerin, because that could put you in more danger.
  • Begin CPR if the person is unconscious. If you’re with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven’t received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions (about 100 per minute). The dispatcher can instruct you in the proper procedures until help arrives.
  • If an automated external defibrillator (AED) is available and the person is unconscious, begin CPR while the device is retrieved and set up. Attach the device and follow instructions that will be provided by the AED after it has evaluated the person’s condition.

Updated: 2017-07-28

Publication Date: 2017-07-28

11 Makeup Tips I Learned From My Cosmetologist Mom

Anyone who knows me knows the significance that makeup carries in my life. Makeup helps me investigate my constantly-shifting identity; it offers me confidence when I find it lacking; it allows me to unapologetically embrace my womanhood and exalt my beauty.

I was raised by a master of the trade—my mother, a professional makeup artist, conducted her cosmetic wizardry in my home for years. When I was little, I watched her work with awe: her meticulousness when she prepared her supplies on folded tissues; her focus when she primed a face for application; and that perfection she somehow always—and I mean always—achieved, outlining lips or shadowing eyelids. It was mesmerizing, and I studied it like a hawk.

Throughout the years, she’s taught me a number of valuable lessons about makeup, not just practical makeup tips about application, but about what makeup does, and what beauty is. My mother is one of the deepest, most compassionate, most humble women I know and somehow, her philosophies around makeup work in tandem with her character. Through her lessons, I’ve come to understand why she’s based her life around cosmetology. Here are some of the lessons I’ve learned from her, and exercise pretty much every day of my life.

1. Makeup should enhance, not cover up.

Probably one of the most salient lessons my mom taught me about makeup is that it should complement your features, not create new ones. For example, I’ve always been self-conscious about my nose bump: that distinctive anthill on the bridge of my nose that I’ve always thought made me look slightly bird-like. When I reached out to my mother with this insecurity, she taught me how to work with this characteristic feature of mine: to “lower” the bump with darker shades, and highlight the more elevated parts of my face with lighter tones. But this trick didn’t obscure my bump. Instead, it allowed me to play with it: enhance the features that I loved, and work with the features I loved a little less.

2. Anchor your elbow to achieve a straighter cat-eye.

Anyone who knows me knows that my “go-to” aesthetic is the bold cat-eye. My mom’s famous trick to achieve that clean wing? Lean your elbow against a straight surface, and lightly rest your cheek against your palm. In that way, your hand doesn’t shake when drawing that line. Remember to use a light hand with your liner; too much pressure will make it easier to smudge!

3. You can be head-over-heels in love with makeup and still embrace a bare face.

My mother is a stunning woman. One thing I absolutely adore about my mom is that despite her romance with cosmetics, she can still rock makeup-less Mondays. She’s taught me that I don’t need makeup to be beautiful: I’m gorgeous with my characteristic cat-eye, and I’m just as gorgeous without.

Talia Green

4. ALWAYS remember to blend at the chin.

You know that really prominent line you see at your chin when you forget to blend your foundation? Yeah, me too. Remembering to blend has always been one of my biggest problems—and luckily, my mom is always quick to remind me about it. A useful tip is to not only smudge the foundation at the chin, but blend down your neck, too. Also, by applying your blush across your chin and down the sides of your neck, you’ll help smooth the appearance of your foundation.

5. Your lifestyle can affect the health of your skin.

My mother taught me that your skin is the largest organ of your body, so it makes sense that your habits will influence its health. She reminds me to take care of myself—body, mind, and soul—and my complexion will thank me for it.

6. Remember to remove your makeup before bed.

Coming home after a long day at work (or a crazy evening at the bar), sometimes all you want to do is plop into bed and worry about everything else in the morning. But my mom has taught me the importance of always removing makeup before hitting the hay. Sleeping in foundation can mess with your skin; all of the dirt and dead cells that have accumulated throughout the day clog up your pores, leading to inflammation and breakouts. That’s why I always follow her advice to use a makeup remover, cleanse thoroughly, and remember to moisturize afterwards.

Related: Sorry, Makeup Remover Wipes Are Not as Good as Washing Your Face

7. Swap out your eye makeup regularly.

Remember how I said my favorite look is the bold cat-eye? That means I use a lot of eyeliner. My mom always reminds me to renew my eye makeup often—theoretically, every two to three weeks. Eye makeup can be like a petri-dish for bacteria, and using old eyeliner (or mascara can cause irritation and infection. Pro-tip: If it’s dried out, or starts to smell funky, it’s probably time to swap.

Talia Green

My mom and dad

8. For a daytime look, accentuate either your lips or your eyes (not both).

It’s no secret I love my bold cat-eye and my burgundy matte lipstick. But, when shooting for a casual daytime look, my mom suggests opting for either one or the other. Both “bolds” are beautiful (and if that’s your look, go for it!), but to achieve a more subtle aesthetic, focus on one feature to accentuate. That way, you celebrate that feature, not the makeup you used to adorn it. My mom’s rule of thumb: “Bold eyes, light lips, or vice versa.”

9. Brushes are wonderful, but you can use your fingers and still get great results.

When on the run, my mom doesn’t always carry all her brushes and sponges—and she still applies her makeup perfectly. So, yes, you can achieve a smooth eyeshadow, sans the supplies. The trick is to use dry fingers, and a light hand. Dab your middle finger gently in your shadow, and dab just as gently at the crease of your eyelid. Use a clean finger to blend across the lid.

10. Keep sample-size supplies for touch-ups in your purse.

My mama’s a busy woman, but she never fails to touch up her makeup on the run. She always keeps a little makeup baggie in her purse filled with sample-sizes of the essentials: her lipstick, her eyeliner, her mascara, and her blush. It’s compact, it’s portable, and it’s always with her. And the world wonders how she looks so stunning all the time.

11. Your makeup should be for YOU.

Even if that means unorthodox. Even if that means “out of your color palette.” Even if that means gaudy, rainbow-gradient eyeshadow (which I owned for pretty much all of sophomore year in highschool). And yes, even if that means no makeup at all. One of the most invaluable makeup lessons that I learned from my mom, one always at the forefront of my mind, is that my style is for me and me alone. I wear what makes me feel beautiful, what makes me shine, what helps me emphasize the beauty that’s already there. Because that’s what makeup does, really, and that’s why my mom has based her profession around its practice: It excavates inner beauty. It reveals your beauty to you, and helps teach you that you were always beautiful, even before you ever wore makeup. And I’ll always be grateful to my mother for imparting that lesson to me.

What if needle pokes didn’t hurt?

A major US children’s hospital introduced a first-of-its-kind project to eliminate or reduce pain from elective needle procedures in all infants and children, reports a study in PAIN Reports®, part of a special issue on research innovations in pediatric pain. The official open-access journal of the International Association for the Study of Pain (IASP), PAIN Reports is published in the Lippincott portfolio by Wolters Kluwer.

“This is the first report of a successful system-wide protocol implementation to reduce or eliminate needle pain, including pain from vaccinations, in a children’s hospital world-wide,” write Stefan J. Friedrichsdorf, MD, FAAP, Donna Eull, RN, and their colleagues of Children’s Hospitals and Clinics of Minnesota, Minneapolis.

Four Proven Strategies to Reduce Needle Pain in Children

“Pain remains common, under-recognized, and under-treated in children’s hospitals and pediatric clinics,” the researchers write. At their hospital, over 200,000 patients experienced unrelieved needle pain annually due to vaccinations, blood tests, injections, and other procedures. While patient surveys found that needle procedures were “the single greatest source of pain and anxiety for our patients and families,” staff surveys surprisingly gave a low priority to reducing needle pain.

In response, pain medicine specialists and hospital leadership designed and implemented a quality improvement project to eliminate or reduce needle pain. Developed using the “Lean” improvement methodology, the “Children’s Comfort Promise” project vowed “to do everything possible to prevent and treat pain.” Frontline staff were trained to always, without exception, offer four research-proven strategies:

  • Numbing the skin with topical anesthetic (4% lidocaine cream, available over-the-counter)
  • Giving sucrose (sugar water) or allowing breastfeeding in infants younger than 12 months
  • Using age-appropriate methods of “comfort positioning” (for example, sitting upright on the parent’s lap for preschoolers, swaddling for infants), and never holding down or restraining children
  • Age-appropriate distraction (toys, books, games, smartphones, virtual reality)

Between 2014 and 2016, the project was implemented in staggered fashion across the hospital and clinics. As use of the four strategies increased, patient satisfaction with pain management significantly improved. In surveys, families who felt their child’s pain was “always well-controlled” rose from 60 to 72 percent. As the project was rolled out, staff concerns about implementation were allayed. Follow-up suggested that pain reduction strategies in infants actually saved time, compared to time spent comforting infants after painful needle procedures, and reduced staff turnover.

“The Children’s Comfort Promise has become our institution’s new standard of care for needle procedures,” Dr. Friedrichsdorf and coauthors write. They note that progress is still needed in some areas — for example, increasing the appropriate use of lidocaine. The strategies are now being introduced and refined at four other North American children’s hospitals (Montreal, Toronto, Kansas City and Atlanta), thanks to a grant by the MAYDAY Fund.

The study represents a “real-world” application of research to improve pediatric pain care, according to an introductory editorial by Guest Editor Christine T. Chambers, PhD, RPsych. The special issue presents nine original papers highlighting innovations in pediatric pain research and care. Topics include factors associated with the development of pain in children; new research methods in pediatric pain, including culturally sensitive approaches; new theories that point the way toward future advances in controlling pain in children; and abstracts from a recent state-of-the-art conference on pediatric pain management.

Pediatric pain care has made “tremendous progress” since the 1970s and 1980s, when it was widely believed that babies couldn’t feel pain and shouldn’t receive anesthetics. However, Dr. Chambers writes, “Inadequate pain management continues to be reported for children experiencing painful procedures, after surgery, and in the context of chronic pain.”

Groups such as the IASP’s Special Interest Group on Pain in Childhood actively promote education, research, and advocacy about pain in children. Dr. Chambers concludes, “We all must work hard to push ourselves…to address the problem of poorly managed pediatric pain and ensure that all children and their families receive the pain care they deserve.”

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What We Can Learn About Self-Care From Olympian and Advocate Aly Raisman

As an Olympic gold medalist, gymnast Aly Raisman was the picture of strength and poise. In the past year, she has shown that strength and poise time and time again, speaking openly and loudly about the sexual abuse she suffered at the hands of former USA Gymnastics doctor Larry Nassar, as an outspoken advocate for victims of abuse, and in her work for prevention and awareness. In the days before an appearance in a makeup-free New York Fashion Week show as part of Olay’s #FaceAnything campaign featuring fearless women, Raisman tells SELF what fearlessness means to her.

“Being fearless really doesn’t mean that you’re not afraid,” she says. “It just means you do it anyway because it’s something that you believe in. But I think in order to take on something that is hard, you have to take care of yourself.”

Prioritizing self-care is crucial to her efforts to fight for other survivors and to educate adults in the sports world to prevent child sexual abuse. “If I want to be able to advocate for change, I also have to have balance in my life,” Raisman tells SELF.

She says that a daily routine has been an important part of maintaining that balance and calls it therapeutic. “I recently read somewhere that how you start your day is typically how you feel for the rest of the day, and I really agree with that.” She keeps her mornings unhurried, getting up at least an hour before she has to leave, so she can have breakfast, sip some hot water with lemon, and take some time for herself.

Being an effective advocate and role model means being prepared for “work” at anytime.

“Sometimes people will come up to me in the market or at the mall, and they’re sharing their stories about being a survivor for the first time,” Raisman says. “I want to do everything that I can to make sure they feel heard, and make sure they are believed—I really want them to feel that.”

Although she’s open to helping others navigate their feelings, Raisman wants people to know that she’s just a person dealing with her own trauma, too. “It’s a big responsibility, and I take it very seriously, but I try my best to let people know that I am human, I’m not perfect. If I give someone advice, I’m speaking as a survivor as well. I’m not an expert, I’m not a therapist, I’m just speaking from my own experience and speaking from the heart. Hopefully people can understand that I’m still dealing and figuring all this stuff out, too.”

Raisman is a believer in the power of therapy to help survivors of abuse develop ways of coping with stress, anxiety, and triggers in everyday life. She says many people have told her they’re afraid to talk to a therapist about their abuse, but she emphasizes that “you’re in control of what you talk about” in therapy. It’s been a part of how she takes care of her mental health.

To other survivors she says, “My best advice would be, if you’re sharing your story and someone isn’t taking you seriously, is to take care of yourself. Abuse should never, ever happen, but if someone is telling you on top of that that they don’t believe you, it’s just horrific. So take care of yourself—meditate, focus on things that make you happy—I know it’s easier said than done.” She adds, “There are people out there that will believe you, and will listen to you, so don’t stop until you get the answers that you want.”

Raisman acknowledges that not all stories get told, and that few have the voice and the platform that she has. She knows the responsibility that comes with it. “I recognize the fact that I am being heard, and I feel very grateful for that,” she says. “I also recognize the fact that a lot of people report their abuse, or share their stories with someone and they are not believed or listened to. That is unacceptable.”

Jessie James Decker Defends Picture of Herself Drinking While Breastfeeding: ‘I Know What I’m Doing’

Country singer Jessie James Decker incurred the wrath of the internet’s relentless mommy shamers this summer when she posted an Instagram of herself breastfeeding her baby while holding a glass of what appeared to be wine (a rosé, possibly sparkling, to this trained eye). A month after the uproar, Decker’s attitude hasn’t changed.

“Cheers bitches,” the mom-of-three cheekily captioned the original shot.

“It was bananas. A lot of people had a problem with it,” Decker, who gave birth to her son Forrest in March, told Us Weekly at a NYFW show for her brand Kittenish on Monday.

“I have three children. I know what I’m doing now. And it’s totally OK to toast to a celebration and have a drink while you’re breast-feeding,” Decker, who also has a 4-year-old name Vivianne and a 3-year-old named Eric, Jr., continued. “After three children I’ve learned about what things to worry about and what things not to worry about and a sip of wine isn’t one of them!”

Experts generally agree that having an occasional drink while nursing is probably NBD—just keep it to one or two and wait a couple hours.

“It is acceptable to have the occasional alcoholic beverage while breastfeeding,” Diane L. Spatz, Ph.D., a professor of perinatal nursing at the University of Pennsylvania and nurse researcher at The Children’s Hospital of Philadelphia, previously told SELF.

When you drink, the alcohol enters your bloodstream and then diffuses into your breast milk, Maija Bruun Haastrup, M.D., a researcher in the Department of Clinical Biochemistry and Pharmacology at Denmark’s Odense University Hospital, previously told SELF. And the concentration of alcohol in your breast milk is about the same as your blood alcohol concentration (BAC), Brendan H. Grubbs, M.D., assistant professor of clinical obstetrics and gynecology at the Keck School of Medicine at the University of Southern California, previously told SELF.

“The highest concentration occurs approximately 30 to 60 minutes after consumption, and declines at the same rate as seen in maternal blood,” he says. “When there is no more alcohol in the blood stream, there is no more alcohol in the milk,” Dr. Haastrup explains.

This means that pumping and dumping usually isn’t necessary. “There is no need to pump and dump after drinking alcohol, because this will not speed up the clearance of alcohol from breast milk,” Amy Schutt, M.D., an assistant professor of obstetrics and gynecology at Baylor College of Medicine, previously told SELF. “Instead, when a mother feels sober enough to drive, she is sober enough to nurse.”

If, however, you are feeling intoxicated and your breasts feel uncomfortably full, then go ahead and pump and dump to relieve the pressure, international board-certified lactation consultant Joan Younger Meek, M.D., R.D., chairwoman of the American Academy of Pediatrics Section on Breastfeeding and associate dean for Graduate Medical Education at Florida State University College of Medicine, previously told SELF.

Instead, Spatz suggests simply nursing or pumping before having a drink so that your body has time to clear the alcohol from your system within the next nursing cycle. “If you are only having one, by the time you are due to breastfeed your baby again, the alcohol will be out of your system,” she says.

The biggest risk of drinking while breastfeeding is what may happen if you go overboard.

Of course, regularly consuming more than the recommended amount while nursing is ill-advised due to potential long term effects on your baby’s health. According to the CDC, “exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns.”

And in the short-term, the fact is that if you feel tipsy, woozy, drunk, whatever, you probably shouldn’t be breastfeeding or caring for your baby. “Alcohol consumption above moderate levels may also impair a mother’s judgment and ability to safely care for her child,” as the CDC puts it. So if you do plan on getting a little boozy on Mom’s Big Night Out, just leave the care to your partner or a babysitter and enjoy yourself.

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Anxiety Attack and Panic Attack: Is There a Difference?

Imagine experiencing an all-encompassing surge of fear combined with chest tightness, shortness of breath, or a slew of other frightening symptoms. How would you label this episode?

If you would call this an anxiety attack, you’re not alone. But, according to experts, that’s not the most accurate description for this kind of terrifying occurrence. If you spoke to a mental health professional, they would likely tell you that this constellation of symptoms signals a panic attack.

“In my experience, a patient will say, ‘I had an anxiety attack,’ but what they mean is that they had a panic attack,” Neda Gould, Ph.D., a clinical psychologist and associate director of the Johns Hopkins Bayview Anxiety Disorders Clinic, tells SELF. “‘Anxiety attack’ is more of a layperson’s term.”

To that point, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which professionals rely on to identify various mental health conditions, only outlines panic attacks, not “anxiety attacks.”

The DSM-5 defines a panic attack as the rapid onset of intense fear plus at least four additional anxiety-provoking physical or psychological symptoms.

Those other symptoms include:

  • Heart palpitations, a pounding heart, or an accelerated heart rate. “It can feel like your heart is going to jump out of your chest,” Mona Potter, M.D., medical director at the McLean Anxiety Mastery Program in Boston, Massachusetts, tells SELF.
  • Sweating
  • Trembling or shaking
  • Feeling short of breath or smothered
  • Feeling as though you’re choking
  • Chest pain or discomfort
  • Nausea or abdominal distress. “You can feel sick to your stomach: It can tighten, have sharp pains, or feel like butterflies,” says Dr. Potter.
  • Feeling dizzy, unsteady, light-headed, or faint. “You might experience tunnel vision, like the world is closing in,” says Dr. Potter.
  • Experiencing chills or, alternately, stifling heat
  • Numbness or tingling sensations
  • Derealization (feeling like reality is confusing or no longer exists) or depersonalization (feeling detached from your thoughts, feelings, and body). “You know you’re there, but don’t feel like you are truly present, and you don’t feel like yourself,” says Dr. Potter.
  • Fear of losing control or that you’re “going crazy”
  • Fear of dying. “Often times, a panic attack will land someone in the ER because it feels like they are having a heart attack or asthma attack that requires immediate attention,” says Dr. Potter.

Although panic attacks can feel neverending, they will eventually hit a peak and dissipate, Dr. Potter says. Episodes typically crest within 10 minutes, but the length can vary.

Some—but not all—people who experience panic attacks do so in the context of an anxiety condition called panic disorder.

About 4.7 percent of U.S. adults experience panic disorder at some time in their lives, according to the National Institute of Mental Health (NIMH). The number of people who experience panic attacks is higher because of a key distinction: “Not all people who have panic attacks get to a point of panic disorder,” Dr. Potter says.

Panic disorder means you have repeated panic attacks with no clear trigger. For instance, some people experience panic attacks in the context of drug and alcohol use or due to medical conditions such as hyperthyroidism (an overactive thyroid, which can lead to heightened anxiety), Dr. Potter explains. People who have post-traumatic stress disorder and are confronted by a trigger can have panic attacks, as can someone with social anxiety who’s in a situation that stokes their fear. Since the panic attacks in these scenarios have underlying sources, rather than coming on randomly for no reason, they don’t qualify as panic disorder.

Another essential diagnostic criterion for panic disorder: The episodes are so terrible and distressing that, for at least one month after having a panic attack, you have persistent concern about having another one. If you have panic disorder, you may also start avoiding certain places or activities in an attempt to ward off subsequent attacks. This is called agoraphobia. “Your world starts shrinking because you are constantly afraid of having another panic attack,” says Dr. Potter.

Maybe, after reading this far, you’ve realized what you were calling anxiety attacks don’t qualify as panic attacks. That doesn’t mean you’re not struggling enough to deserve help.

Other mental health conditions can have overlapping symptoms with panic attacks. For example (and unsurprisingly), generalized anxiety disorder (GAD), a mental health condition categorized by extreme, unnecessary worry that impedes your life, can cause issues such as fear about everyday things, trembling, sweating, feeling out of breath, and stomach aches, according to the NIMH.

Don’t subject yourself to the lie that if you “just” have moments of extreme anxiety, not full-blown panic attacks, you should be able to deal. If you feel like your anxiety is affecting your life, it’s worth seeking help, period. In fact, similar treatment methods can help both anxiety and panic attacks.

While panic attacks are absolutely frightening, thanks to treatment like therapy and medication, they’re not invincible.

Here’s what may help if you think you’re suffering from panic attacks or some other form of anxiety:

Therapy

Cognitive behavioral therapy, often considered the gold standard for anxiety conditions, works to retrain your thoughts and actions in situations that make you anxious.

CBT can be particularly effective in treating panic attacks and, specifically, agoraphobia that stems from panic. As part of CBT, you may engage in a technique called exposure therapy, where a mental health professional might intentionally bring on symptoms of a panic attack to habituate you to them. For instance, if the dizziness really agitates you, a therapist might have you spin you around. If a racing heart is what worries you most, they might ask you to jog in place. Then you’ll work together to change your reaction to these triggering sensations, including with methods like deep breathing.

“One of the biggest pieces of treatment for panic is actually being able to say, ‘This is a panic attack, these are physical symptoms,’ and not doing anything [extreme] to make it go away,” says Dr. Potter. “It seems kind of counterintuitive, but that basically removes the fear aspect and kind of settles things down.”

This obviously might be scary, but under the supervision of a professional, exposure therapy really can be a helpful way of gaining control over your panic. “Often, when you break that connection—‘these symptoms are bad, I need to get rid of them’—and look at them more as ‘OK, this is bad, but I can tolerate it,’ they begin to dissipate over time,” says Gould.

Medications

There’s nothing wrong with using medication to treat panic attacks or anxiety. It’s an option for a reason.

Docs often turn to antidepressants called selective serotonin reuptake inhibitors (SSRIs) to target anxiety and panic symptoms, says Dr. Potter. These work by obstructing how easily your brain reabsorbs serotonin, a neurotransmitter that can affect your mood, the Mayo Clinic explains. Tricyclic antidepressants, which hinder reabsorption of the neurotransmitters serotonin and norepinephrine (this is implicated in your fight-or-flight response, are another common option for both panic attacks and anxiety, according to the DSM-5.

Then there’s a group of medicines called benzodiazepines that can rapidly decrease panicky feelings by working as a sedative, the Mayo Clinic explains. The biggest issue with them is that, if used frequently, you can build up a tolerance as well as a dependence. “If every time a person has a panic attack, they think they need to have that medication, it can become a band-aid treatment,” says Gould. That’s why she often likes to think about benzos as a better option for once-in-a-blue-moon situations, like if heights petrify you and you’re about to take a trip to the top of the Empire State Building.

Beyond that, your doctor might recommend lifestyle changes to combat your panic, the Mayo Clinic explains. If, say, having too much caffeine gets your heart racing in a way that can lead to a panic attack, cutting back might do wonders for your mental health.

Clearly, there’s no one-size-fits-all treatment for panic attacks. But, as Dr. Potter emphasizes, they are treatable.

It might take some trial and error to figure out how to deal with your panic attacks (especially when it comes to your meds since every drug can come with side effects). The best strategy will likely be a multifaceted blend of lifestyle changes, therapy, and medication that get you closer to living life with less fear.

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