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Hormones & Mental Health Across the Lifespan: How Puberty, Pregnancy, Postpartum, Perimenopause, and Menopause Shape Our Emotional Well-Being

5/11/2026

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Larisa King, MSN, PMHNP-BC

Psychiatric Nurse Practitioner

Women are beautifully complex. Throughout our lives, our bodies move through a series of hormonal transitions that influence how we feel, think, rest, and function. Yet many women are never taught how deeply these shifts affect emotional wellbeing. For Women’s Health Week, I want to shine a light on what’s happening beneath the surface. Because if you’ve ever wondered, “Why do I feel this way?” the answer is often that your hormones are speaking—and you deserve to understand their language. 

Puberty marks the first major shift. It’s not just physical development; it’s a neurological remodel. As estrogen and progesterone rise, many girls experience mood swings, increased sensitivity, emotional reactivity, and changes in sleep. This is also when anxiety or depression may first appear—not as a sign of weakness or personal failure, but as the natural result of a brain undergoing rapid growth while hormones surge and settle. Offering young girls empathy, open conversations, and supportive community creates a foundation of emotional safety that stays with them into adulthood. 

Pregnancy brings another profound transition. Hormone levels rise higher than at any other time in life, which can create emotional sensitivity, increased worry, vivid dreams, and shifts in focus. For some women, pregnancy feels grounding; for others, it’s overwhelming or destabilizing. Both experiences are valid. Pregnancy affects every woman differently, and the most important thing is feeling supported, informed, and free to talk about what you’re experiencing—without fear of judgment. 

The postpartum period is one of the most intense hormonal transitions a woman can face. Immediately after birth, estrogen and progesterone drop rapidly, while a mother is also adjusting to profound physical recovery, feeding demands, identity changes, and—perhaps most difficult of all—sleep deprivation. Many mothers experience tearfulness, mood swings, irritability, anxiety, intrusive thoughts, or brain fog. While “baby blues” usually pass within a couple of weeks, ongoing distress may signal postpartum depression, anxiety, or OCD—very real, very treatable conditions that deserve compassion and support, not silence or shame.

Perimenopause, the years leading up to menopause, can feel like puberty in reverse. Hormones don’t simply decline; they fluctuate widely before settling, and those fluctuations can trigger anxiety, irritability, sudden mood shifts, sleep problems, emotional overwhelm, and cognitive fog that leaves many women saying, “I don’t feel like myself.” These experiences are real and often under-recognized. Women deserve validation, information, and supportive care during this season rather than being told it’s “just stress” or something to simply push through. 

Menopause itself marks twelve months without a menstrual cycle and a shift into a new hormonal baseline. Some women feel a sense of calm and clarity as moods stabilize. Others experience emotional changes, anxiety, sleep disruptions, shifts in libido, or a sense of loss. Like every stage of womanhood, menopause is not an ending but an evolution-- one that can bring renewed purpose when women feel informed and supported.  
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One of the most beautiful truths about these transitions is that women were never meant to move through them alone. Historically, women gathered, shared stories, and supported one another through every season of life. Today, in a world that asks so much of us, these circles of connection are more important than ever. When women share their experiences, something powerful happens: we feel seen rather than misunderstood, validated rather than dismissed, and connected rather than isolated. We recognize that our emotional experiences are human, not flaws. We rediscover strength we didn’t realize we had. Community creates healing; hormones may influence how we feel, but sisterhood influences how we heal. 

As we talk openly about these hormonal shifts, it’s also important to acknowledge that for some women, emotional symptoms interfere with daily life in ways that deserve additional support. Psychiatric medication management can be a helpful, compassionate tool—not a last resort or sign of failure. When symptoms such as persistent anxiety, depression, panic, intrusive thoughts, irritability, or significant mood swings begin to affect work, relationships, sleep, or overall quality of life, a medication evaluation can create real relief. Some women benefit from antidepressants or anti-anxiety medications, others from targeted sleep supports or mood stabilizers, and some from a collaborative approach that includes hormonal treatment with their OBGYN. Pregnancy and breastfeeding deserve special consideration, but many medications are safe, and for some women, staying on or beginning treatment may support a healthier pregnancy or postpartum experience. Medication is never the whole story—it’s simply one tool that can help a woman feel more like herself so she can fully participate in her life. 

Your body is wise. Your emotions are valid. And your journey through hormonal change is part of what makes you resilient and deeply human. Whether you’re guiding a teenager through puberty, navigating pregnancy or postpartum, wrestling with perimenopause, or stepping into the transition of menopause, you deserve care, community, and compassion. If you ever wonder whether therapy, medication, or evaluation might help, reach out. You are not alone—and you never have to walk these changes by yourself.

When women support each other, we don’t just survive these transitions.
We thrive.

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Larisa King
Author, Larisa King is a board-certified Psychiatric Nurse Practitioner with over 20 years of healthcare experience. She is deeply committed to providing compassionate, person-centered psychiatric care that helps patients feel heard, respected, and supported.

Before becoming a PMHNP-BC in 2019, Larisa spent more than 15 years as a psychiatric nurse, giving her an extensive background in caring for patients across all ages and life stages. Her dedication to mental health led her back to school to earn her advanced degree, driven by her passion to deliver care that is both clinically excellent and deeply human.
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From Conflict to Connection: What Really Happens in Couples Therapy

5/4/2026

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Yubi Aranda Sandoval, MS, LCMHCA, NCC

Psychotherapist

Couples therapy is one of my favorite types of therapy sessions. Some therapists choose not to do couples therapy due to the complexity of working simultaneously with two individuals who are navigating distress in their relationship. I have to admit—it isn’t easy. However, when we take a moment to slow the session down, we often begin to uncover something important.

Many times, the couple is caught in a cycle that has been gradually developing over time. At first, the disagreements may seem small—misunderstandings about communication, differences in expectations, or moments when one partner feels unheard. But over time, these small moments can accumulate. Before long, small disagreements grow into larger arguments, resentment begins to build, patience wears thin, and one partner’s defensiveness can start to sound like an attempt to “win” rather than understand the other.

What is fascinating about couples therapy is that the conflict we see in the room is often just the surface of something deeper. Beneath the frustration, anger, or distance, there are usually unmet needs, fears, and vulnerabilities. One partner may be longing to feel appreciated or prioritized. The other may be feeling criticized or inadequate. When these emotions go unspoken or misunderstood, couples often fall into patterns of blame, withdrawal, or defensiveness.

These patterns are what therapists often refer to as cycles. One partner might pursue conversation while the other shuts down. The more one pushes, the more the other retreats. Over time, both partners begin to feel alone in the relationship, even though they may deeply care about one another. In these moments, the goal of couples therapy is not to determine who is right or wrong. Instead, the work focuses on helping the couple recognize the pattern they are caught in and understand how both partners are affected by it.
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Slowing the conversation down is one of the most powerful tools in couples therapy. When couples are arguing at home, discussions can escalate quickly. Voices get louder, assumptions are made, and the original concern becomes buried beneath layers of hurt feelings. In therapy, we intentionally slow things down so that each partner has space to speak and, just as importantly, to be heard. Often, when one partner finally feels understood, the intensity of the conflict begins to soften.

Another important part of couples therapy is helping partners shift from defending themselves to becoming curious about each other. Instead of reacting with “You always…” or “You never…,” couples can begin asking questions like, “What did that moment feel like for you?” or “What were you hoping for from me in that situation?” These small shifts in communication can open the door to empathy and reconnection.

One of the most hopeful aspects of couples therapy is witnessing how quickly change can happen when partners begin to understand each other differently. When couples start to see the cycle they are caught in, they often realize that the problem is not necessarily each other—it is the pattern they have both been pulled into. This realization can create a sense of teamwork rather than opposition.

Couples therapy is not about creating a “perfect” relationship. Every relationship will experience conflict, stress, and moments of disconnection. The goal is to help couples develop healthier ways of navigating those moments so that conflict becomes an opportunity for growth rather than a source of ongoing pain.
 
Despite the challenges, couples therapy remains one of the most meaningful types of work I do. There is something powerful about watching two people move from frustration and misunderstanding toward empathy, clarity, and renewed connection. When couples begin to feel seen and heard again, the relationship often starts to feel like a place of safety rather than struggle.

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Yubi Aranda Sandoval
Author Yubi Aranda Sandoval is a Licensed Clinical Mental Health Counselor Associate. She is of Mexican heritage and speaks Spanish fluently. Yubi is trained to work with couples and families facing challenges and seeks to improve their communication and connection. Yubi has worked with individuals who have experienced anxiety, depression, trauma, loss, difficulties with life transitions, and women’s health. She is excited and looks forward to building a strong therapeutic relationship with her future clients.
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Healing Happens in Pieces: Why Slowing Down Is Essential to Emotional Processing

4/29/2026

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Gail Herbert, MS, LPC, LCMHCA

Psychotherapist

When my boys were little, if one was crying, and I met them with “Stop crying, it wasn’t that bad,” they would sniffle and the painful feeling would be extended. If I instead met them with, “It hurts doesn’t it?” and rubbing their back, they would finish crying and return to playing. If I slowed and took my time with gentleness and comfort, the feeling moved along. If not, it seemed to get stuck. Moments like these have shaped how I understand what it really means to heal.

What is healing? I believe it is integration of the parts of a person. Dr. Dan Siegel says: “harmony [unfolds] with the five features of FACES flow: Flexible, adaptive, coherent (holding together dynamically over time), energized, and stable.” To be able to be flexible and adaptive to circumstances, to be coherent in thought, and to feel energized and stable in emotion, is to be able to flow with the ups and downs of life.

When healing is a goal–if you feel like something has shattered within–then slowing down is important, even if you want it to happen quickly. This can be frustrating, I know! But remember that healing happens continuously on a path. It is not a final destination that happens suddenly. And if you feel as though you have shattered, those pieces can be put together any way you want them to be. You can rebuild yourself into who you want to be.
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So how does a person “slow down” emotionally? It means spending time with emotion. This does not mean sinking down into a pit of sadness. Rather, it means noticing feelings with curiosity and without judgment. A person may do this in meditation, while being creative, while walking or showering, any way that helps you feel emotion. It is critical to meet the emotion with curiosity and not judgment. For example, if I feel sad, I feel uncomfortable. I might close my eyes to tune into my body. Then I might notice I feel a little bit of fear in my stomach. Rather than trying to push it away with thoughts such as “You should not be feeling this way” or “Just get over it!” instead I might notice those thoughts and think “I wonder what is making me feel afraid?” Or I might picture myself as a child or friend. I might imagine giving that person a hug or being nurturing.

If I can learn to treat myself as I treated my boys, with slowness and nurturing kindness, healing will move along more quickly than with harsh criticism of myself. Give it a try. Let yourself feel emotion. This is where healing begins.

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Gail Herbert
Author Gail Herbert is licensed in the states of North Carolina and Missouri and has over 20 years of experience in mental health, social services, and educational settings.

Trained in Emotionally Focused Therapy for couples and individuals, EMDR, and sand tray therapy, Gail has experience with those who have had painful or overwhelming circumstances, trauma, teens, adults, and couples.
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Why We Love Arbor Day!

4/24/2026

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Sharon A. Findlay, MS

​Director of Human Resources & Administration

"Love is like a tree, it grows of its own accord, it puts down deep roots into our whole being."
― Victor Hugo

If you’re thinking, Wait—trees? Isn’t this blog usually about mental health? The answer is yes… and also, we really love trees. Before I go any further, a quick history lesson:

The year is 1872, and journalist J. Sterling Morton is struck by how barren the plains of his home state of Nebraska appear. As a nature-lover, he proposes a mass tree-planting event and the seeds for what we now know as Arbor Day are planted (multiple puns intended)!

This brief peek into the past reveals more than you might expect. Why was it so important to cover the plains with trees? What else was happening at the time?

Pioneers were still settling the area, and without trees on the Great Plains, the soil was at the mercy of the wind. The land couldn’t be worked effectively for farming, limiting settlers’ ability to survive and thrive. Trees and their stabilizing root systems weren’t just a want they were a necessity. 

And that’s what roots are: a necessity. They hold things together. They provide nourishment. They protect stability. They are life-giving and life-sustaining. Banyan trees, in particular, are known for their impressive root systems. They grow “prop roots” that begin high in the branches and extend downward toward the ground. Once these roots take hold, they form new trunks and root systems of their own. This unusual process allows banyan trees to grow outward in a nearly indefinite fashion, making them exceptionally strong and resilient.

It’s hard not to see how this mirrors our inner lives. So let’s take this metaphor inward for a moment: What are your “roots”? Not necessarily where you came from, but what grounds you, protects you, and gives you life. And what happens when those roots become ungrounded? Imagine a banyan tree with multiple trunk and root systems. If one of those systems is damaged or removed, the tree can become unbalanced—more vulnerable to wind, water, or other forces that might uproot it.
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Humans are much the same. Often, it isn’t just one thing that leads someone toward healing and inner work. Sometimes it is—but more often, it’s a collection of experiences, stressors, or losses that gradually create a sense that something is out of balance.

That’s where the beauty of therapy comes into play. You don’t have to do this alone. Therapy can offer extra roots, extra shade, and extra support during a season when you need it most. It’s part of why our founder named the practice Banyan Tree Counseling.

This Arbor Day, I hope you’ll think of lots of things, including trees. I hope you’ll notice the beauty around you, thank the roots that sustain you, honor the roots that need more support—and maybe even smile at a tree.

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Sharon Findlay
Author Sharon Findlay brings nearly 20 years of experience in mental health, education, and organizational leadership to her work. Raised in a military family across the U.S. and abroad, she developed an early understanding of resilience and adaptability.

With a Master of Science in Organization Development focused on resilience in individuals and groups, Sharon takes a systemic, consultative approach that integrates human connection with organizational health. Her background in residential and therapeutic settings shaped her belief in the power of intentional, compassionate care. She is currently pursuing a Master of Arts in Counseling to further support individuals in their healing journeys.
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Art For All: Where Creativity and Wellbeing Intersect

4/15/2026

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Emily Ortiz Badalamente, MA, LCMHC, ATR-BC

Psychotherapist

As an art therapist, I often get the pleasure of hearing about people’s relationship with the word “art.” Some people talk to me about their favorite kind of art or craft. Others tell me about their favorite art projects from school. I hear about favorite museums, wine and paint nights with friends, or experiences like knitting that feel therapeutic and peaceful. It’s one of my favorite topics to discuss with others.

Often, I also hear people say “I’m not good at art.” I hear about how much people loved art class in childhood, but felt discouraged by grades. Or how they try to be creative, but perfectionism gets in the way. For all those who have a positive relationship with art, I meet just as many people who feel that art and creativity are out of reach.

This saddens me, because art and creativity can make us happier and healthier - no matter how “good” we are! A 2016 study showed that short artmaking experiences led to lowered cortisol levels, suggesting lowered stress. This was true regardless of type of artmaking, or if the person had any previous art experience (Kamail et al., 2016). Other studies suggest that enjoying art is linked to higher levels of wellbeing and happiness, as well as potential for lowered hypertension and inflammation (Lee et al., 2024).

This is obviously great for those who enjoy artmaking, or like being around art. But what about those who feel intimidated or bored by art? Because I am an art therapist, you can probably predict what I’m going to say…

Art is for everyone! Creativity is for everyone, and everyone is creative in their own way. I know that the “classic” ways of being creative, like drawing or painting, can often feel intimidating.

Because of this, I like to encourage people to pay attention to creativity that already exists in our everyday lives. Some examples of this are:
  • Choosing a new outfit combination, or dressing to evoke a certain feeling (like dressing “happy” or choosing colors that make you feel confident)
  • Redecorating, or hanging up new art on the walls of your room or home, and noticing how the art you own makes you feel or think
  • Stopping to enjoy a mural, or a creative display in a store window
  • Trying a new recipe, or a new flavor combination when making a meal
  • Decorating your planner pages with stickers or color combinations
  • Arranging your bookshelves in a way that pleases you

When we start to notice where creativity already exists in our lives, we can start to nurture it, and take it even further! If you’re interested in art and creativity, but are maybe unsure of where to start, here are a few ideas:
  • Make a scrapbook or album of photos that are meaningful to you. Choose colors, stickers, and words that connect to the emotions the photo evokes in you.
  • Go on a photo walk, and give yourself a photography theme. Using your camera or phone camera, take pictures of only red items, or only snap photos of leaves. Look up a photography scavenger hunt online to complete while you’re on a walk.
  • Think of art or craft styles that interest you, and look up some tutorials. YouTube and social media can be great resources, but don’t stop there. Make a plan to experiment and find some supplies. Some ideas to look up are tie dying, polymer clay crafts, stampmaking, origami, or paper mache. For some added creativity, try to use materials you might already have on hand!
  • Go see some art! Check out a museum, or look up local galleries to visit. Find murals or public art in your area, and take yourself on a field trip. Ask yourself, what inspires you? What styles, colors, and subjects do you like or dislike?
  • Take a beginning art or craft class. Some great local options in Winston-Salem are Sawtooth School for Visual Arts, Forsyth Tech’s Personal Enrichment Classes, Dabble Art Bar, Art Shac, and Village Fabric Shop.

Whether you are interested in making art, or just appreciating it, I encourage you to nurture your own connection with creativity. It can be a great way to better know yourself, learn new skills, or challenge your worldview. And you might just find ways to feel happier and healthier along the way!
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If you’re interested in going further, and would like to explore how creativity can help you work on your mental health and wellbeing goals, consider working with an art therapist or creative arts therapist. For more information about art therapy, please visit The American Art Therapy Association. To learn more about the creative art therapies, like music therapy, drama therapy, and dance/movement therapy, please visit the National Coalition for the Creative Arts Therapies Associations.

References
Kaimal, G., Ray, K., & Muniz, J. (2016). Reduction of Cortisol Levels and Participants & Responses Following Art Making. Art therapy: Journal of the American Art Therapy Association, 33(2), 74-80. https://doi.org/10.1080/07421656.2016.1166832
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Lee, S. S., Lee, S. H., & Choi, I. (2024). Do art lovers lead happier and even healthier lives? Investigating the psychological and physical benefits of savoring art. Psychology of Aesthetics, Creativity, and the Arts, 18(3), 279–286. https://doi.org/10.1037/aca0000441

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Emily Ortiz Badalamente
​Author Emily Ortiz Badalamente is a Board Certified Registered Art Therapist (ATR-BC) and Licensed Clinical Mental Health Counselor who works with teens (age 16+) and adults experiencing ADHD, life transitions, grief and loss, trauma, anxiety, and self-esteem issues. Emily's warm and empathic style lends to a trusting and respectful therapeutic relationship with her clients. Her strengths based approach allows clients to gain insight, attain achievable goals, and create a fulfilling, joyful, and authentic life. Emily’s approach to therapy is integrative; she believes in addressing the spiritual, emotional, and physical needs of her clients so they may attain self acceptance and healing.  
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Saying Goodbye

3/20/2026

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Leslie "Les" Gura, LCMHC, NCC, CCTP

Psychotherapist

The spring equinox represents the passing of season, from the harshness of winter’s cold and early darkness to the brightness of warmer temperatures and longer days. Many people welcome this time of year with joy in their eyes and a spring (so to speak) in their step.

But it’s rarely that simple, is it? Some people are sad to say goodbye to winter. I’m one of them.

It’s not that I love the cold or snow – although the storm that dumped 6 inches on us the last day of January was the most beautiful in my 23 years in North Carolina. It’s just that this time of year reminds me of two difficult dates in my life. My dog, Nilla, the most gentle, perfect canine ever, died on March 17, 2023. Thanks to social media, I am reminded of that day constantly this time of year. And April 2 will mark what would have been my father’s 106th birthday. My best friend and most important influence has been gone for nearly 44 years.

In other words, when I think about the onset of spring, my mind goes to those two huge losses. My throat is tightening as I write this blog.

The thing is, treating grief is an essential part of counseling. And my lived experience informs and strengthens my work with clients who are grieving. Some don’t even know it because grief, though centered on loss, is not always about death. Often, I will gently point out to clients that their anxiety or depression over losing a job or breaking up with a partner is actually the way they are experiencing grief.

Regardless of the type of grief, how do you recognize it? Here are a handful of ways:
  • Not wanting to get out of bed.
  • Lashing out at others (especially loved ones) over minor issues.
  • Overeating.
  • Using substances.
  • Feeling a constant ball of anxiety in the pit of your stomach.
  • Struggling to fall asleep because of racing thoughts.

And how do we learn to manage grief’s symptoms? It starts with recognizing a loss, because once we accept we have suffered one, we can begin to grieve it more openly.

My father’s death in 1982 was shattering because it came out of the blue; he had appeared at age 62 in the best shape of his life. I was just 22 and didn’t know how to shed tears, much less grieve. It took seven years, when the 1989 movie Field of Dreams was released, before I grieved my dad’s death. At the end of the movie, Kevin Costner’s Ray Kinsella turns around in the twilight to see his father emerge from the cornfield and they get to play catch. In the darkened theater, my throat caught. I could barely breathe. And, oh, I felt hot tears rolling down my cheeks more quickly than I could wipe them away. My wife noticed. And for the first time, I was able to share the pain of my dad’s death with another person.

Flash forward 34 years and grieving came easily, but no less painfully, when I recognized my dog, Nilla, was in decline. In October 2022, I chose to get ahead of the grief to come by through a series of daily social media posts honoring Nilla, sharing fun, nostalgic and poignant pics of my 14-year-old dog. Then, after she died, I let the immediate pain subside and eventually blogged about knowing when and how to make that awful, merciful decision about a beloved pet.
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There are many ways to manage grief. Here are a few ideas:
  • Have a trusted friend or loved one (or therapist) listen without judgment. Beware of those who attempt to problem-solve, make it about themselves, or become defensive.
  • Journaling can allow you to write out feelings and emotions that would otherwise be bottled up inside.
  • A gratitude list allows you to gently smile and recall kindness and love in your life.
  • Role play enables people who are grieving to act out emotions they are feeling, presumably with an empathetic partner or coach in the endeavor.

​Remember, if you find your throat tightening or eyes welling this season, let the tears flow. More than anything, grief is a process that, like the seasons, can be hard to predict.

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Les Gura
Author Leslie "Les" Gura, LCMHC, NCC, CCTP brings a unique, narrative-informed perspective shaped by nearly 30 years as a journalist focused on storytelling and social justice.

​Les specializes in trauma work, including EMDR, and is particularly drawn to helping clients process difficult experiences and reshape the narratives they carry. Les integrates multiple counseling approaches, grounded in presence, empathy, and deep listening.
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Growing Into the Woman I Wanted to Be

3/10/2026

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Brittany Proxmire, MA, LCMHC

Psychotherapist & Community Outreach Coordinator

March has always felt like a special month to me. Not only do I celebrate another year around the sun this month, but I also love the shift from winter to spring. The longer days, the warmer air, the sunlight. It feels like the world is waking up again. The sun brings out all the serotonin and somehow wakes up my soul, too.

More recently, I realized that March holds another important day, International Women’s Day,  which feels especially meaningful at this point in my life. I’ve been surrounded by strong, intelligent, and impactful women for as long as I can remember. I grew up in a female-dominated home, and now I work for businesses that are also largely female-led. When I really stop and think about it, the influence of these women has shaped so much of who I am today. There’s something deeply empowering about that kind of environment. A sisterhood where each person’s strengths, weaknesses, and individuality are welcomed and embraced.

When I applied to work at Banyan years ago, the fact that it was a woman-owned business really resonated with me. At the time, I was still shedding parts of my younger self. The timid, people-pleasing version of me that often stayed quiet or followed the lead of others. But deep down, I knew I wanted to grow into someone stronger. I wanted to be someone who could be unapologetically themselves. Someone who stands up for others, empathizes with people’s struggles, and leads with confidence rather than feeling the pull to simply follow. At 30 years old now, I can look back at who I was in the first few decades of my life and smile, because I know little Brittany would be so proud of me and would truly see me as an inspiration. I’m still growing and evolving, and am proud of it.
Looking at where I am now, I know that so many women before me helped make that possible. Women like Ruth Bader Ginsburg, Maya Angelou, Dolly Parton, and Rosa Parks, just to name a few. Their courage, creativity, and determination created space for others to find their voice.

If you ever visit our offices, you might notice that many of our therapy rooms are named after influential women throughout history. It’s a small but meaningful reminder of the legacy they’ve left behind and the paths they helped create for the rest of us.
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Who are the women who shaped you? The ones who modeled courage, compassion, resilience, or strength in ways big or small. For me, the most influential figures were the ones sitting beside me at the dinner table, cheering me on from the sidelines, or quietly reminding me that I am capable of more than I realized. Maybe they were the same for you.

And maybe that’s what International Women’s Day is really about. Not just celebrating the icons we read about in history books, but also recognizing the everyday women who inspire growth, encourage authenticity, and remind us to keep becoming who we are meant to be. I can confidently say that I’m surrounded by many incredible everyday women: my sisters, my friends, and my colleagues, who continue to inspire me in ways big and small.

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Brittany Proxmire
Author Brittany Proxmire, MA, LCMHC is a Licensed Clinical Mental Health Counselor specializing in pediatric therapy. With a warm and playful approach, she engages children and adolescents, providing evidence-based techniques like play therapy, art therapy, talk therapy, Exposure & Response Prevention (ERP), and other modalities. Brittany collaborates with families, offering insight and support, while empowering clients to make positive changes and discover their authentic selves. In Brittany's work with teens and young adults she utilizes cognitive-behavioral therapy and humanistic approaches to foster behavioral change and self-awareness. Brittany's ultimate passion is helping children, teens, young adults, parents and families find happiness, peace, and harmony.
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5 Tips for the Anxious Athlete

3/3/2026

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Sarah Vanderpool, LCMHC, NCC, LPSC

Psychotherapist

In addition to being a licensed psychotherapy, I am also a former competitive athlete and current coach. With the latter role, helping my athletes prepare for competition, both mentally and physically, is my job. But as parents, as coaches, and as athletes, what do we do when our brain becomes unmanageable and negatively affects athletic performance? While there is certainly no “one size fits all,” I’ve used my knowledge as a coach, parent, and mental health professional to compile what I think is a helpful list of things to consider for athletes who have pre-competition anxiety.

Feeling anxious before a big game or competition is completely normal, but when nerves start to interfere with your performance or enjoyment, it’s time to take action. Many athletes struggle with pre-game jitters, overthinking, or fear of failure, but with the right mindset and strategies, anxiety can actually become a powerful source of focus and motivation.
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​1. Fuel Your Body
Put good in, get good out. Athletes must properly fuel their body for optimal competition results. This includes proper nutrition throughout practices, days/hours leading up to, and after the main event. A well-fueled body performs better and recovers faster. See what Abby Olmstead, Registered Dietitian Nutritionist, has to say about fueling your body properly for competition: Fueling your Body for Game Day.


2. Be a Goldfish
Goldfish have a short memory — and that’s a good thing. Finding the mental toughness to shake off mistakes and stay focused on what is happening in the moment can be challenging, but practice makes permanent. Keep moving forward and focus on what’s next – you got this!

3. Visualization
Mentally rehearse success. Picture yourself performing confidently and skillfully. See it from a 3rd-person perspective (like you’re watching yourself from the stands) and from your own eyes. This is what people mean when they say “eat, sleep, and breathe your sport”. Utilize positive visualization any time you have a free moment and make it part of your pre-game routine.

4. Pre-Game Routine
Routine builds confidence and reduces nerves. Everybody’s pre-game routine might look a little different, but the goal is the same – train your muscle memory well before game time. Include sleep, nutrition, breathing, and visualization. Add music, positive self-talk, or a specific warm-up — whatever helps you lock in. If you’re not sure what to do, ask your coach and/or teammates for help. Or your trusty mental health therapist 🙂

5. Breathe
Slow breathing = calm body and clear mind. When anxiety rears its unwanted head, you’ll want to have some coping skills in your back pocket to help mitigate the frustrating effects anxiety can have on your body and your performance. When you can control your breathing, it helps regulate heart rate, which is directly impacted by anxiety. Slow your breathing, and make your exhale longer than your inhale. Try 4-7-8 breathing:
  • Inhale for 4 seconds
  • Hold for 7 seconds
  • Exhale slowly for 8 seconds
Pro tip: Struggle to exhale slowly? Hiss like a snake to control the airflow.

You have more power over your mind than you realize. So go, right now, and practice your breathing and visualization, and make a few notes on what a pre-game/competition routine might look like for you. In part two, I’ll talk more about managing adrenaline, and practicing for permanence, not perfection.

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Sarah Vanderpool
Author Sarah Vanderpool, LCMHC, NCC, LPSC is a Licensed Professional School Counselor and Licensed Clinical Mental Health Counselor. She specializes in working with children, adolescents, and college-aged adults. As a former competitive athlete, Sarah has a niche in sports psychology and enjoys supporting youth and adults who participate in both competitive and recreational athletics alike to overcome psychological obstacles such as stress, anxiety, concentration, confidence, anger, and depression.
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Fueling Your Body for Game Day

3/3/2026

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Abby Olmstead, MS, RDN

Registered Dietitian Nutritionist

Nutrition plays a crucial role in sport performance, but it doesn’t have to be complicated! Fueling for competition can be possible anywhere with any budget, amount of prep time, or level of cooking skill. As a registered dietitian nutritionist, I help people meet their nutrition goals in a way that is accessible and manageable with their lifestyle. This includes working with athletes on increasing nutrition quality and making sure they are getting the proper diet to maximize sport performance. Here are my top recommendations to help feel your best before and after the big game. 
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Every Day
Preparation for game day starts with your everyday food choices. Ensure you are taking care of yourself during practice and training sessions by eating enough food, and making sure you are getting a good balance of different food groups. Aim for about 55-60% carbs, 15-20% protein, and 20-30% fat in your diet. MyPlate is a good guide! Protein is getting a lot of hype these days, but don't go crazy on protein. To make sure you're getting enough for muscle building and repair, aim for around 1.2-1.5 grams per kilogram of body weight (remember, 1 kg = 2.2 lbs). Try to cap it at around 30 grams per meal. Variety in micronutrients is important, try to eat a rainbow! Different fruits and veggies have different vitamins and minerals which show in their color.

Hydration is key! Drink up, around 60-80 ounces of fluid daily. Remember hydration can be more than just water. Electrolytes, coconut water, milk, or juice all count!

The Night Before/Morning Of
Focus on keeping  it balanced! Evenly distribute your meal into thirds: ⅓ carbs, ⅓ protein , ⅓ fruits/veggies, with around a golf-ball-sized amount of fat. The night before an away game can be especially challenging with limited options. During travel games, packing snacks can be a game changer to fill nutrition gaps. Remember fast food can be balanced too!

The last thing anyone needs before a big game is an upset stomach. Stick with familiar foods to avoid any potential negative symptoms.

Before the Game
When you are 30-60 minutes before the main event, load up on easily digestible, simple carbs for quick energy. Think crackers, pretzels, granola bars, or low-fiber fruits like bananas, grapes, or applesauce. Also, remember that bananas are also an awesome source of potassium, which helps prevent muscle cramps!

Recovery Time
You might realize it, but after the game is nearly as important as before! Help your body recover with what you eat. Refuel with a mix of carbs and protein. Carbs refill your energy, and protein helps repair muscles, reduce soreness, and build strength. Also, fun fact: chocolate milk is a superstar recovery drink!

​By consistently utilizing these food and hydration strategies, athletes can not only perform at their best, but recover quickly and support overall well-being. Always keep in mind good nutrition isn’t just something that happens on game day, but every day in between!

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Abby Olmstead
Author Abby Olmstead, MS, RDN is a Registered Dietitian Nutritionist focusing on developing healthy relationships with food, improving overall wellness through nutrition, management of food intolerances and allergies, eating disorder treatment, gut health, and more. She works with adults, children (age 5+), and families to help create the best possible health outcomes for each individual person. 

Abby is a Health at Every Size (HAES) advocate, utilizing Intuitive Eating and positive nutrition models to improve nutritional health without fear, shame, or judgement. She is a believer that “all foods fit”, and passionate about helping people increase confidence with food choices, improve body image, and reestablish a connection with food as a part of culture and social interrelation.
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Through a Child’s Eyes: What If They’re Not Acting Out But Learning?

2/27/2026

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Gregoria Arreola-Meza, MS, LCMHCA, LPSC, NCC

Psychotherapist

Recall a time when you were expected to know how to do something without any prior knowledge. How did you feel? You may have felt confused, frustrated, or even hurt by the implication that you should have known something you didn’t. In my work with children in therapy,  I continually challenge myself to understand that a child's approach to a situation is shaped by the skills they possess at that time. As adults, we may unconsciously label children's behaviors that do not align with our expectations as attention-seeking, mischievous, or overreacting to situations.

We might think to ourselves, "Why would you think that was a good idea?" To challenge this perspective, I’d like to share an anonymous quote I once stumbled upon: "The sooner we let go of the expectation that children are capable of adult-like behavior, the easier it will be to tolerate their mistakes." I recognize how difficult it can be to understand why children do not always consider consequences before acting on their emotions. I invite you to reflect on the times when we, as adults, have struggled with this ourselves. It can indeed be challenging.
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By removing the adult lens, we may realize that children are not seeking attention, but rather connection. They may not intend to be mischievous; instead, they might simply be struggling to use conflict-resolution skills they have never been taught. Additionally, what we perceive as overreactions may simply reflect a child’s current level of understanding. It would be unfair to expect someone to know something they are not familiar with. 

Through my work, I have learned that when a child shares their experiences with me, it is their way of expressing "I promise I am trying my best… with what I know.” By approaching their stories with curiosity, non-judgment, and empathy, I am able to create a space where trust and learning can begin. This may involve helping children identify positive versus negative choices, distinguish a positive consequence from a negative one, and express which emotions may arise when deciding one over the other. By striving to view a child's story through their eyes, I come to understand behavior as a cue for growing and learning rather than as attention-seeking, mischief, or an overreaction. 

How would you navigate a world that expects you to know it all if you never had a chance to learn it?

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Gregoria Arreola-Meza
​Author Gregoria Arreola-Meza, MS, LCMHCA, LPSC, NCC is a bilingual (English and Spanish) Licensed Clinical Mental Health Counselor Associate and Licensed Professional School Counselor in North Carolina who works with children, adolescents, and adults, providing empathetic support that helps clients build healthy coping skills and expressive outlets while honoring each person’s story, identities, cultural background, values, and lived experiences.
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    Banyan Tree Counseling & Wellness

    We are a team of licensed clinicians with a holistic, strengths-based, and evidence-based approach. We offer counseling for people of all ages, life coaching, group therapy, educational consulting and advocacy, assessments, and dietary nutrition services.
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